Quality Adjusted Life Years and the Devaluation of Life with Disability

From The National Council on Disability: For More Info, Go Here…

ngd- This is not a simple policy issue to understand, but it increasingly short-changes everyone with a disability in terms of support and treament, as well as other societal opportunities…

On behalf of the National Council on Disability (NCD), I am pleased to submit Quality-Adjusted Life Y ears and the Devaluation of Life with Disability, part of a five-report series on the intersection of disability and bioethics. This report, and the others in the series, focuses on how the historical and continued devaluation of the lives of people with disabilities by the medical community, legislators, researchers, and even health economists, perpetuates unequal access to medical care, including life-saving care.

When health insurance will not cover medically necessary medications and treatments, individuals experience poorer health and a lower life expectancy. Nonetheless, in an effort to lower their healthcare costs, public and private health insurance providers have utilized the Quality Adjusted Life Y ear (QAL Y) to determine the cost-effectiveness of medications and treatment. QAL Ys place a lower value on treatments which extend the lives of people with chronic illnesses and disabilities.

In this report, NCD found sufficient evidence of the discriminatory effects of QAL Ys to warrant concern, including concerns raised by bioethicists, patient rights groups, and disability rights advocates about the limited access to lifesaving medications for chronic illnesses in countries where QAL Ys are frequently used. In addition, QAL Y -based programs have been found to violate the Americans with Disabilities Act.

The US government does not have a single comprehensive policy on QAL Ys. Some federal agencies are banned from utilizing measurement tools like QAL Ys, while some state and federal partnership programs, such as state Medicaid programs, may. NCD is troubled that health insurance providers, government agencies, and health economists are showing increasing interest in using QAL Ys to contain healthcare costs despite QAL Ys’ discriminatory effect.

The lives of people with disabilities are equally valuable to those without disabilities, and healthcare decisions based on devaluing the lives of people with disabilities are discriminatory. Quality-Adjusted Life Years and the Devaluation of Life with Disability explains QALYs and their effect on the availability of medical care for people with disabilities and chronic illnesses. It makes recommendations to Congress, federal agencies, and public and private insurers directed at rejecting QALYs as a method of measuring cost-effectiveness for medical care and offers alternatives.

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