Skip to main content

Hypocrisy Exposed by Mindless Bureaucracy in COVID-19 Responses and the Quality Adjusted Life Years Methodology


Life or death circumstances can bring out the best in people or the worst in people. They definitely expose the hypocrisy in people. The COVID-19 crisis has done this in spades. And we have an example playing out in Oklahoma right now with a bill that has gone to Governor Stitt for signature.

That bill, HB 2587, would require implementation of safeguards against state health agencies that would use purely economic calculations to justify withholding life-sustaining or quality-of-life-improving care from the old and profoundly disabled. It’s a response to a methodology called Quality Adjusted Life Years in which the cost of medication is compared to supposed benefit for patients. Since older people have fewer years to live, and might not even be apparently productive, this methodology would deny such individuals at least some medications.

Quality Adjusted Life Years is the sort of methodology described in the Obamacare Act that gave rise to the claim of some opponents that Obamacare created “death panels.” It is a fact that we spend a lot of money in this country, much of it through Medicare, using extraordinary measures to keep people near life’s end alive for a few more months. It’s the sort of thing family members insist on when they do not have to bear the cost of their decision to “save the life” of someone in their 90s (as one old, retired doctor says, “Ain’t nobody gettin’ out of this mess alive”). Some would argue such a methodology is necessary in order to counteract the incentives inherent in “free” health care, and they’re not entirely wrong to do so.

But this is where the hypocrisy comes in. COVID-19 mostly targets old people. In fact, recently it was reported that 28,000 people have died from the virus who lived and worked just in New York nursing homes alone. At the time the number was reported, it represented a third of all deaths in the United States. Meanwhile, just a few days ago, worldwide, no children (right, none) aged 0-9 had died from COVID-19. Only nine aged 0-17 (presumably, really 10-17) had died in New York.

When you consider the death rate, even among the aged, it is truly amazing that we have shut down WHOLE economies in an effort to save the lives of a tiny proportion of our population, most of them aged, unhealthy, and near the end of their lives. Those who argue for the shutdowns, and keeping them going for months, regardless of the economic cost, tend to be left-of-center in their political beliefs. It’s the left-of-center who also seem to be all for withholding medications to people near the end of their lives. On the one hand, they’re willing to trade lots of children’s lives (lost due to economic decline) to mostly save the lives of relatively few old people; on the other hand, they’re willing to do nothing to save the lives of old people when they’re told not to by a bureaucratic, mathematical calculation.

Meanwhile, right-of-center individuals like us have been rather upset that so little has been done to inform the public of who was truly at risk from COVID-19. Governor Cuomo forced nursing homes to take COVID-positive patients, almost intentionally seeding the most vulnerable with the virus. Many of our nation’s leaders have been acting as if everyone is equally at risk, blinding the general public to prudent actions to protect the truly COVID-19 vulnerable, and taking actions (shutting economies) that are truly deadly to the economically vulnerable. It’s as if lefty-leaning politicians have done all they can to kill as many people as possible while simultaneously claiming to save lives.

This is the truly scary thing about this Quality Adjusted Life Years methodology. It sounds like it’s putting cold, dispassionate, objective, and economically-derived mathematics in charge of decisions whether to administer expensive life-saving or life-enhancing drugs, but it’s really putting bureaucrats with who-knows-what sort of agendas in charge of life decisions.

Maybe we just have to live with the ridiculously expensive consequences of free health care for the sickest demographic group in our population in order to maintain our humanity and morality. Maybe instead of trying to counteract the incentives inherent in free health care with mathematical edicts from on high, we should enact different policies and stop giving away health care almost entirely for free in the first place. After all, it’s not really free. And after all, that’s the only way to put people – family and loved ones – who can best weigh the costs against the benefits and the right versus the wrong in charge of end-of-life decisions.

So as strange as it may sound coming from someone who is all about being responsible with taxpayers’ money, it might just be that leaders who hope to stand before God someday with anything like a clear conscience have little choice but to support bills like HB 2587.

Byron Schlomach is 1889 Institute Director and can be contacted at bschlomach@1889institute.org. 

 The opinions expressed in this blog are those of the author, and do not necessarily reflect the official position of 1889 Institute.

Popular posts from this blog

About Those Roads in Texas

A s Sooner fans head south for the OU-Texas game next week, they will encounter a phenomenon most of us are familiar with: as you cruise across the Red River suddenly the road gets noticeably smoother. The painted lane stripes get a little brighter and the roadside “Welcome to Texas” visitors’ center gleams in the sunlight, a modern and well-maintained reminder of how much more money the Lonestar State spends on public infrastructure than little old Oklahoma. Or does it? Why are the roads so much, well… better in Texas? Turns out, it isn’t the amount of money spent, at least not when compared to the overall size of the state’s economy and personal income of its inhabitants. Research conducted by 1889 Institute’s Byron Schlomach reveals that Oklahoma actually spends significantly more on roads than Texas as a percentage of both state GDP and personal income . And that was data from 2016, before Oklahoma’s tax and spending increases of recent years. The gap is likely gr...
Read more

What if Legislators Were Licensed? Well, Just to Make a Point...

1889 Institute, as a general matter, objects to occupational licensing. We have written about it more than any other subject. The scant benefits simply do not outweigh the enormous costs to consumers and entrepreneurs, and  the  burdens that disproportionately impact the poor.   It must be noted that the remainder of this post is a work of satire. This should be obvious to anyone who has read even one of our papers, but each of the proposals below has an analogous provision in Oklahoma licensing laws. To those supportive of government-created cartels, these proposals might sound almost reasonable.  A material threat to the public safety and welfare has for too long gone entirely unregulated, unrestrained and unchecked. This menace has the power to corrode not only mere industries, but to corrupt the entire state economy. It’s no overstatement to say that the practitioners of this perilous profession hold the power to destroy democracy as we know it. After a...
Read more

Intellectual Corruption in Public Schools Exposed by COVID-19

Oklahoma is opening up in stages at last, thank goodness. While we have thought, from the beginning, that shutdowns have been a bad idea, what’s done is done. Now is the time to start recovering, and the faster we get fully re-opened (with prudent precautions for the vulnerable, of course), the better off we will be. Luckily, we are in the United States; the economic damage done here by shutdowns will be far less deadly than in poorer nations as global poverty is expected to increase for the first time since 1998 due to imprudent shutdown orders. And speaking of imprudent shutdown orders, none have been more imprudent than closing Oklahoma’s schools for the last 9 weeks (practically a full quarter) of the year. Action on the part of state leaders was so precipitous that, while we could be talking about re-opening schools to salvage at least part of the lost educational time, it is not now possible . And of course, we now know children were at low risk from the virus and that ...
Read more

OG&E and the Corporation Commission Aren’t Doing Their Jobs

At the time of this writing, it’s been a full week since there was power at my home. I live within OG&E’s electrical grid, so when it comes to being without power this past week, I’m nothing special. Many of OG&E’s customers had no power for days, and some will have no power for well over a week. By the time power is restored to everyone in their service area, OG&E’s own estimate is that it will have taken ten full days to repair all the damage from Oklahoma’s latest ice storm. Ice storms are bears, no doubt about it. They are very hard on trees, and if the roads ice over, they are very hard on cars. But roads, for the most part, were not an issue during Oklahoma’s “Icemageddon” of 2020. The problem was the extra weight of the ice on trees, wires and poles. And what we discovered was that Oklahoma’s electric power grid, once again, was not up to the challenge. Fact is, Oklahoma’s power grid isn’t up to much of Oklahoma’s weather. Every time the electricity goes out, which ...
Read more