Should Congress prohibit the use of Quality-Adjusted Life Year in federal healthcare programs?

Health
Protecting Health Care for all Patients Act (H.R. 485)
This bill has Passed the House of Representatives
Bill Summary

The bill seeks to bar the usage of Quality-Adjusted Life Year (QALY) to determine coverage in federal healthcare programs. Quality Adjusted Life Year is a measure that determines the value of a drug based both on the quantitative life expectancy increase and potential qualitative side effects and detriments to quality of life. The bill seeks to eliminate this measure as a determinant of a patient’s coverage of certain drugs. The bill would only apply to federal healthcare programs, in keeping with existing Medicare standards. Sponsor: Rep. Cathy McMorris Rodgers (Republican, Washington, District 5)
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Opponents say

•      "Federal Law already prohibits Medicare from using QALYs in its cover determination, and state Medicaid programs are required by law to cover all drugs. So, I just don’t think this legislation accomplishes anything from a cost analysis, it’s just basically a solution in search of a problem that doesn’t exist because these QALYs are already prohibited. [...] H.R. 485 goes further than current law and I think could bar the use of any value measures by the federal government. " Source: Rep. Frank Pallone (Democrat, New Jersey, District 6)


•      "I'm very concerned about over a billion in funding cuts for our state and local community-based healthcare systems. The major county in the district that I represent, we fought for years to get a county health department and it just came online 3 years ago now. It’s already made a difference in the things it's supposed to, whether its lead poisoning, infectious diseases, tobacco-related diseases, all these things that this fund, which would receive drastic partisan cuts, would be impacted by." Source: Rep. Mary Gay Scanlon (Democrat, Pennsylvania, District 5)

Proponents say

•      "All lives are worth living. It’s unconscionable that a health care bureaucracy would so callously determine that someone’s life is worth less. They deserve every chance to have hope and reach their full potential. The ‘quality-adjusted life years’ measurement is used to discriminate against people with chronic illnesses and disabilities, like cystic fibrosis, ALS, or Down syndrome, putting them at the back of the line for treatment. Moving this legislation will be a priority for our committee" Source: Rep. Cathy McMorris (Republican, Washington, District 5)


•      "I practiced as an Ob/Gyn for nearly 30 years. During that time, I treated each patient as a human being, not just a diagnosis. Quality-Adjusted Life Year (QALY) measurements are cruel and inhibit physicians' ability to care for and treat all patients with dignity. The government should never have the ability to decide the value of a life to approve or deny care. All human life has inherent value and should be treated as such" Source: Rep. Michael Burgess (Republican, Arizona, District 2)

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