On health care, don’t abandon our most vulnerable

by | Dec 27, 2020


Sal Nuzzo 

When it comes to health care policy, I am reminded of a line from E.B. White, the author famous for books like Charlotte’s Web and Stuart Little. He proclaimed that “there’s no limit to how complicated things can get, on account of one thing always leading to another.”

It’s a thought we would all be wise to keep in mind as we navigate the commencement of the Biden/Harris administration. It will be particularly useful as they seek to impose their vision of health care on 330 million Americans, including almost 22 million Floridians. Most by now have heard terms like “universal health care” and “Medicare Public Option” bantered about, but few fully understand what specific policy ideas would look like in reality to everyday Floridians.

Throughout the presidential campaign, conservatives called a substantial amount of attention to the possibility of a $32 trillion socialized approach to health care if Joe Biden were elected. With a closely divided Senate, the prospect of that policy reform appears exceedingly slim. Nevertheless, with health care, one thing always leads to another, and Floridians should be paying attention.

As we have come to learn throughout history, faceless bureaucracies can send us in wrong directions before we ever realize it. Back in August, the Trump administration issued a surprising (and troubling) executive order that could ultimately enable states to examine strategies for prescription drug rationing. A new study from the Goldwater Institute, Deciding What a Life is Worth, exposes how this scheme could affect Florida’s elderly and disabled populations. The report uses the term “rationing by stealth,” and it is the stuff of nightmares.

Under this plan, an unelected group called the Institute for Clinical Economic Review (ICER) would be tasked with determining whether your life is worth the cost of a medication you need. By using a mathematical formula called Quality Adjusted Life Years (QALY), ICER would compare the utility and value of your life against the cost of a medication, and could make the ultimate determination on whether you get it.

A little too old? Well, you may be out of luck on that new cancer treatment. Do you have a disability and contract COVID-19? Well, the treatment may be unavailable if ICER has their way.

It’s saddening that, 30 years after the passage of the Americans with Disabilities Act – a law designed to protect the vulnerable among us – we would be contemplating the idea of denying lifesaving drugs to individuals simply because an algorithm controlled by someone you’ll never meet decides that a person’s life isn’t worth the cost of the drug. Yet here we are.

Florida lawmakers have made great strides in the past several years in advancing the types of patient-centered reforms that work, and the Goldwater report is a tremendous complement to those reforms. By resisting any efforts to utilize QALYs in state-administered programs and establishing affirmative protections for patients, we can cement our role as a market-oriented health care policy leader.

We won’t wake up one day and find ourselves with a socialized health care system overnight. But the sad reality is that, like Obamacare a decade before, policy “reforms” like QALYs and the rationing of health care they would bring are steps in that direction. A society based on free-market principles must chart a different course.

Health care is not, and never has been, a fundamental right that government must ensure. It is the antithesis of a right. It is a series of goods and services, performed by individuals and utilized by consumers – subject to the economic laws of supply and demand. Government edicts, faceless bureaucrats, and groups pushing equations that assign a value to a human life should never get in the way of the relationship between doctors and the patients they treat.

Sal Nuzzo is the Vice President of Policy at The James Madison Institute.


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