Rationing Health Care: Fair or Not Fair?

In his editorial “Why We Must Ration Health Care”, Peter Singer has argued that US health care should be reformed by Medicare to all citizens. Decisions about what treatments should be covered under expanded Medicare, he believes, should be guided by a measure called the Quality Adjusted Life Year, or QALY. While I agree with Singer on expanding Medicare to all with some private insurance, I disagree with his method of rationing care: the QALY, as it is an unfair system. QALYs are a measure that quantifies a person’s health benefit. The UK’s National Institute of Health and Care Excellence says a “QALY gives an idea of how many extra months or years of life of a reasonable quality a person might gain as a result of treatment” and includes factors such as “the level of pain the person is in, their mobility and their general mood.”(NICE, 2010). In other words, QALY take all factors of a patient that could affect the outcome of a treatment and boils it down to a number that can be compared to other patients. According to Singer, “The QALY tells us to do what brings about the greatest health benefit, irrespective of where that benefit falls”(Singer 7). In Singer’s argument, he believes a policy of QALY maximization should be used to allocate Health Care resources. QALY maximization is a the theory that one should look to fund treatments that have low cost to QALY ratios, which, in other words, means getting the most of bang for your buck in a QALY sense.

On a micro scale, the Organ Procurement and Transplantation Network in the United States already has an already implemented policy of using QALYs to compare health benefit of a receiving an organ. But this process has been proven to be unfair to African Americans. The African Americ...

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... it proves to be an unfair process that discriminates against race as well as the sickest among us. There does have to be some type of rationing in order to cut down on cost but the QALY is not the right way to do allocate health resources.

Works Cited

Foster, Clarence E., III, Benjamin Philosophe, Eugene J. Schweitzer, John O. Colonna, Alan C. Farney, Bruce Jarrell, Leslie Anderson, and Stephen T. Bartlett. "A Decade of Experience With Renal Transplantation in African-Americans." Annals of Surgery 236.6 (2002): 794-805. Print.
Hughes, Jonathan. "Palliative Care and the QALY Problem." Health Care Analysis 13.4 (2005): 289-301. Print.
NICE. "Measuring Effectiveness and Cost Effectiveness the QALY." NICE. NICE, 20 Apr. 2010. Web. 30 Apr. 2014.
Singer, Peter. "Why We Must Ration Health Care." New York Times. New York Times, 15 July 2009. Web. 29 Apr. 2014.