"We can't cover everything for everyone," said Dr. Walter Shaffer, medical director of the state Division of Medical Assistance Programs, which administers the Oregon Health Plan.

"Taxpayer dollars are limited for publicly funded programs. We try to come up with polices that provide the most good for the most people."

As of now any treatment that doesn't provide at least a 5 percent chance of survival after 5 years won't be approved.

Last fall the [Oregon Health Services Commission] said coverage of palliative care for patients with advanced cancer would not include chemotherapy or surgical intervention intended primarily to prolong life or alter disease progression.

"The letter said doctor-assisted suicide would be covered. To say to someone, 'we'll pay for you to die, but not pay for you to live,' it's cruel," she said. "I get angry. Who do they think they are?"

Dr. John Sattenspiel, senior medical director for LIPA, said that at some level doctor-assisted suicide could be considered as a palliative or comfort care measure. "We had no intent to upset her, but we do need to point out the options available to her under the Oregon Health Plan," he said.