Under the Democrats’ proposed health care reform legislation, we know that the government will have to determine some sort of rationing system in order to control costs. We are aware that part of the rationing will be absorbed in the discrimination that the bill inflicts upon the elderly; we know that it cuts $500 billion from Medicare. What has remained puzzling is how exactly this rationing will be determined for the rest of us. Similarly elusive is how the new Health Benefits Advisory Committee will decide whether or not you get certain medical treatments, regardless of the opinion of your doctor. After all, how do you put a dollar value on a human life?
If you think there is no answer to that question, you are way behind the progressives. In fact, most countries with socialized medicine, including Britain, are already using a mathematical formula that expresses the numerical value of one year of a human life in a measurement called the QALY, or “quality-adjusted life year.” In terms of determining medical care, the mathematical formula of the QALY is based on both how much a treatment may lengthen your lifespan and the quality of the life you will be living.
Basically, if you are in optimal health, the QALY of one year of your life is 1.0. But if you have any underlying conditions, like asthma or muscular dystrophy, your QALY is much lower. Under the QALY system, the blind are worth less than those with sight, as those who can walk are worth more than those in wheelchairs. Sound like discrimination against persons with disabilities? It gets worse.
In a paper entitled “Cost-Effectiveness and Disability Discrimination,” the director of the Division of Medical Ethics at the Harvard Medical School, Dan Brock, argues “prioritizing health care resources by their relative cost-effectiveness can result in lower priority for the treatment of disabled persons than otherwise similar non-disabled persons.” He says that type of system not only “implies that disabled persons’ lives are of lesser value than those of non-disabled persons,” but it also “conflicts with equality of opportunity; it conflicts with fairness, which requires ignoring (some/most) differential impacts of treatment; it wrongly gives lower priority to disabled persons for equally effective treatment; it conflicts with giving all persons an equal chance to reach their full potential; and, it is in conflict with giving priority to the worse off.”
The “double jeopardy” scenario that describes how the disabled are not only already suffering with an illness or disability, but are also given a lower priority of health care treatments to preserve or improve the quality of their lives, has been widely debated in countries with universal health care. It does little good to pass health care reform that restricts denying insurance to those with underlying conditions when treatment is still withheld from these individuals as an inherent flaw within the system.
As if that’s not bad enough, the health advisor to the president, Ezekiel Emanuel, is proposing a system even more deleterious. His system, similar to the QALY, is “the complete lives system,” which not only allows for discrimination against the elderly and disabled, but also targets the very young, i.e., our children.
Emanuel says of his system: “When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.”
Leave it to American progressives to take the QALY one step further by defining quality of life as how useful you are to society — that is, how likely you are to increase the government’s tax revenue, hence the emphasis on those between ages 15 and 40. Health care gets a lot cheaper by rationing care to all non-taxpayers.
According to Emanuel, “The death of a 20-year-old woman is intuitively worse than that of a two-month-old girl.” I doubt the parents of the two-month-old agree.
And, if you are a child with disabilities, the government has already completely given up on you. Emanuel believes “services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.” What’s worse, since he does not believe in “guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason,” once the public option puts the private sector out of business, these types of life-changing services for children will no longer exist.
Years of research in treating children with autism, cerebral palsy, epilepsy, and dyslexia are in jeopardy of being rendered null and void. Years of progress in passing anti-discrimination laws may be undone in one single bill.