By Grace-Marie Turner
While Democrats wrestle with internal battles over their multitrillion-dollar social welfare bill, House Speaker Nancy Pelosi is determined to push it forward with her drug pricing plan tucked inside.
A big pay-for comes from “savings” earned by imposing price controls on prescription drugs in Medicare. Democrats want to extract about $600 billion from the pharmaceutical industry over the next 10 years to help pay for their entitlement spending blowout.
The House bill would peg Medicare drug prices to lower prices in other developed nations and then extend them to the entire U.S. drug market. The Senate is considering a different rationing scheme based on price-controlled domestic programs.
What they don’t explain is that these programs mean government, not doctors, would decide which drugs seniors could or couldn’t get. Experience in other countries proves that access to the newest and best drugs would plummet as agency bureaucrats exclude some drugs and limit access to others, prioritizing dollars over lives.
In the United Kingdom, for example, the government starts by setting the monetary value of a year of perfect health at somewhere between $28,000 and $42,000. To decide whether to cover a new drug — and if so, who gets it — government analysts estimate a treatment’s value in how many quality life years a patient would get by taking the medicine.
The mechanism is called “QALY” for Quality Adjusted Life Year.
My organization helped organize a series of focus groups this summer to assess what Americans think of this approach. Our research shows they find it chilling and even abhorrent.
One of their first concerns was the potential for discrimination. The QALY mechanism ascribes a lower value to those living with disabilities or chronic diseases. Unprompted, focus group participants brought up the late physicist Stephen Hawking as an example of how diminishing the worth of a person’s life based on disability is not just morally wrong, but it also fails to account for the contributions that person might make to society.
Similarly, QALYs put less value on those who are older. This means seniors might be denied treatments offered to younger or nondisabled people. One patient said: “It’s definitely wrong. They’re playing God, and it’s not their place to determine who gets to live and who gets to die.”
Supporters of the measures currently before Congress do not explain to voters that the QALY mechanism is a component of their proposal, which they advertise as allowing the government to “negotiate” prescription drug prices for Medicare. They don’t explain they would be importing prices from countries that use this QALY scheme — a hidden but essential feature of their government-determined drug rationing systems.
Senate Democratic leaders, sensing this could be a problem, have said they will create new mechanisms to control prices and not rely on other countries’ models. Some suggest copying the Veterans Health Administration’s complex web of price controls. But that would mean seniors would have access to only half of newer drugs compared to 74% in private Medicare prescription drug plans today.
Deploying QALYs or any similar rationing scheme is antithetical to our values. And it is likely illegal. The Rehabilitation Act prohibits discrimination based on disability in all programs or activities conducted by the Department of Health and Human Services, including Medicare.
The drug component of the Democrats’ spending bill endeavors to circumvent that law by stealthily importing foreign drug prices, thus importing foreign governments’ pseudo-scientific, discriminatory rationing schemes.
We shouldn’t stand for it.