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Wednesday, June 24, 2009


For more information:
Robert Powell Center for Medical Ethics(202) 378-8860, Or Communications Department(202) 626-8825,


WASHINGTON- The Senate Health, Education, Labor and Pensions Committee today defeated on a party-line vote an amendment offered by Senator Michael Enzi of Wyoming, the ranking Republican member to the pending health care restructuring bill that would have prevented the use of “comparative effectiveness” research methodologies as a basis for denial of benefits to patients against their will based on their age, expected length of life, or of the patient’s present or predicted disability or quality of life. Senators Enzi, Gregg, Coburn and Burr spoke in favor of the amendment.

In one example in the medical literature, an attempt was made to assess different “quality adjusted life year” scores for each of the following: “no physical disability, limp, walk with crutches, and need a wheelchair.” [i] In another, the authors wrote, “[I]t may be judged that one year of life with a moderate disability is equivalent to 0.75 years of life at optimal health.”[ii]

Senator Barbara Mikulski (D-Md) lead the opposition to the amendment, claiming it was unnecessary. However, while the existing bill language says that comparative effectiveness research such as this “shall not be construed as mandates FOR payment, coverage, or treatment,” nothing in the current bill prevents it being used to DENY treatment.

“The current sources of funds being considered to pay for health care restructuring are so inadequate in the long term that rationing will be compelled,” charged Burke Balch, director of the National Right to Life Committee’s Powell Center for Medical Ethics. “By rejecting the Enzi amendment, the Senate HELP Committee today cleared the way for that rationing to be based on discrimination against people with disabilities, older people, and anyone considered to have a poor ‘quality of life.’”
[i]. Duru, G, Auray, J P, Beresniak, A, Lamure, M, Paine, A, & Nicoloyannis, N (2002). Limitations of the methods used for calculating quality-adjusted-life-year values. Pharmacoeconomics, 20, 463-73.
[ii]. A. Atherly, S.D. Cutler, E.R. Becker. “The Role of Cost Effectiveness Analysis in Health Care Evaluation,” The Quarterly Journal of Nuclear Medicine 2000 June; 44 (2): 112-120.

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