This bill was amended to limit the use of evidence by the Health Evidence Review Commission and use of econometric model, the Quality Adjusted Life Year (QALY), which has been shown to discriminate against people with different health conditions. Additionally, the HERC may be presented with a meta-analysis, which is a study to systematically assess previous research, further complicating efforts to avoid considering conclusions that rely on QALYs or other quality of life in general measures.
QALY is a flawed scoring system economists use to determine cost-effectiveness of proposed medical treatments. Healthcare payers use the scores to determine who is eligible for healthcare resources. Based on clinical and practical analyses, QALY calculations measure how much a proposed treatment may improve someone’s quality of life by arbitrarily weighing how long that person has spent in different states of health.
» Per the formula, a year of “perfect health” is worth 1, while a year of “less than perfect” health—such
as living with a disability or chronic illness—is worth less than 1. Death equals zero. The final QALY score equals the number of years a treatment may extend a patient’s life multiplied by determined quality of life.
These types of scores have no place influencing what conditions and treatments the Oregon Health Plan will cover. Oregon has used a Quality-Adjusted Life-Year formula over the last 30 years to determine what would and would not be covered by the Oregon Health Plan.
Senator Linthicum writes:
SB 1508 passed the Senate Floor, and will move to the House. It is a prime example of government intervention with unintended consequences. This bill started as my attempt to curb run-away Insulin prices. However, I voted “NO” because the bill had grown less attractive after each edit.
Essentially, this is a legislative mandate limiting charges for insulin to just $35 a vial, from insurance providers operating within the state. Insulin prices are not driven by extravagant insurance co-pay fees. Insulin prices actually get generated at the manufacturing level, by supply and demand for source materials, research, development, technology, manufacturing and regulatory requirements. Unlike ice cream which experiences greater demand during the summer, insulin has a fairly constant demand curve.
Yet, a major price factor is law-fare – practices that protect big manufacturing dominance through endless trade secret and patent protections. Patent protection are are limited and expire for various insulin formulations but manufacturing techniques are typically protected by trade secret law without limit.
Demanding insurance providers squeeze other plan participants meet the difference directly helps patients but doesn’t solve the problem. In other words, we only moved the problem from one spot on the map to another, as manufacturers enjoy continued market protection.
With each socialist step, the legislature tears integrity away from the free-market system by twisting some segment of our economy. Like minimum-wage laws, paid-leave laws, laws restricting housing, land-use or drug-use there is always a problem that government created which will fester until really hurts. Meanwhile, the politicians, bureaucrats, political donors and cronies get to skate happily along and everything looks good until the next catastrophe.
Read Senator Linthicum’s article
On one side it limits a bad practice, and then it creates another bad practice.