Monday, March 11, 2013

Age-Based Rationing in Sweden?

Reader J.W. alerted me to this story in the Swedish news about apparent age-based considerations in drug subsidies.

Using Google translate, the article is entitled: "Age weighed in medicine bill" (March 10, 2013).

From the translated version:
Niklas Hedberg, head of the new drugs on the TLV, believes that there is an unfortunate wording, but that the work complies with legislation stipulating that they must weigh each consequence of a drug subsidy. 
-For us it is a very complex issue, the starting point is that society's resources for drugs is limited and we are commissioned to be those that prioritize the allocation between different patient groups. Since the legislation has made clear that we must weigh up different principles, and we will take account of drugs in a society holistically, says Niklas Hedberg. 
Would you expect that retirees actually costs if they survive? 
-What is unfortunate is that you can get the picture that it just is a matter of age, it only concerns pensioners. But I think your question is good and it is also very complex. Should we take into account that a patient can start working or not? It is then output effect comes into play.Consumption effect is always when you extend the life of a treat. 
Are pensioners lives worth less? 
-Everyone's health is valued as much, but the calculation model allows perched on top gives the socio-economic perspective, an added benefit of the treatments that allow the patient group can start working again.
In effect, those who are deemed more productive to society will be given higher priority in the national health system than those who are considered a net drain.

This is a nearly-inevitable outcome when medical care (and the system of payments) is considered a collective good that must be allocated accordingly.

The US isn't at this point yet.  But there are intellectuals and policy writers laying the groundwork for similar rationing here.

(One example is this article, "Principles for allocation of scarce medical interventions", co-authored by former Obama administration health policy advisor Zeke Emanuel, brother to former Obama chief of staff Rahm Emanuel.)