Let’s discuss euthanasia…

The proposed bill contains nothing about it. You can search the text of the bill and not find it.

But the bill’s provisions are similar to those in Canada and Europe about relying on scoring different treatments and disallowing ones that don’t meet certain cost/benefit metrics.

QALY (Quality Adjusted Life Years) / QARY (Quality Adjusted Remaining Years) are terms that deal directly with this concept. They deal with measuring how much additional lifetime a particular person would gain from a particular procedure or drug, and also take into account some measurement of the “quality” of that life. It puts into dollars and cents what is essentially what it is worth to society to treat someone with a serious illness.

Example: You have cancer, and need a certain drug to combat it. The drug is very, very expensive, and for a small percentage of the people who take it, their cancer goes into remission, but it’s maybe 2% of the people. Nobody knows if this particular person will be helped or not by the drug, but the QARY analysis says the cost per average year of gained life (the average over the whole 100%, not the 2% who gain a long time) says the cost of treatment is $5000 per QARY. The cutoff for treatment is $4000 per QARY.

So this person doesn’t get the drug that might give them many more years, or might not give them anything more. But they don’t get it and can’t get it. Basically this person has no further options and will certainly die shortly.

No, it is not euthanasia, which would be actively taking steps to end the person’s life. But it is a death sentence for that person, who MIGHT have been able to have many years left.

QARY / QALY analysis is very much in line with what is promoted for cost reduction by the House plan. Something like that is probably what would come out of this plan.

If it’s not exactly that, then it would be something close, because the plan relies on some type of determination of cost / benefit. I don’t think that is in dispute.

So when this man who’s son has cerebral palsey and cancer wants to know what the House plan will do to his son - one of these angry people at a Michigan town hall meeting - it’s a legitimate question. When an elderly person with heart disease wants to know what this plan will do regarding their treatment - it’s a legitimate question.

The people who characterize this as “euthanasia” are wrong, by definition of the word. But the people who imply that such type of decisions won’t be made - that people won’t be told that their option is just to give up and let go - are just as wrong, too, and they avoid being honest about it.

It would be nice if everyone would just be honest about what this stuff all means, so that the debate would be about that.