Morris Johnson mfj.eav at gmail.com
Tue Jun 23 15:28:36 UTC 2009

From: "Fred C. Moulton" <moulton at moulton.com>
To: ExI chat list <extropy-chat at lists.extropy.org>
Subject: Re: [ExI] H+ Healthcare

> I bring this up because if we have a universal healthcare, how will
> elderly people be handled? Will they be considered too old to repair?

"A few days ago I was watching a Congressional hearing about the current
health bill and there was brief discussion (basically a lot of unknowns)
about quality-adjusted life year (QALY) which is a metric in some
systems of dispensing or withholding care.  So it is likely that
something will get put in to whatever the final bill turns out to be."

QALY is a universally used metric.  The value is based upon determining how
much of the difference between death and perfect health a procedure
contributes and then dividing that into 100% and multiplying the dollar cost
of the procedure to the system.  I have had some differences with small
costs being given large QALY costs (some vaccines for example) .  Generally
if a QALY costing number exceeds $50,000 nobody will cover it....except in
exceptional circumstances.

One thing that never seems to happen is for manufacturers of high retail
cost drugs to do the QALY math and determine how many customers will be
covered at what QALY value and price their product to maximize usage not
simply on how many high cost customers the market will bear.

The intent is good and it does create a standard for measuring cost/benefit
but I am thinking that the multiplier is subject to some interpretation and
that in the case of regenerative medicine I don't believe there is an
allowance for >100% health(adjusted for age).
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