Health system of USA is odd. For example, Oregon uses a lottery based system to allocate health care coverage – a scarce resource – to its citizens.
From
New enrollment in the program was closed from mid-2004 until early 2008, when a lottery-based system was introduced. Tens of thousands of Oregonians signed up, competing for 3,000 new spots in the plan.
It is basically saying that the policy makers have given up on trying to design and implement a system to allocate the resource based on any meaningful and measurable metrics.