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NEW SURVEY: Majority of Americans Don’t Know Healthcare Rationing Takes Place in Their Own Backyard

Published May 21, 2020

Pencil laying on survey response sheet.

A new survey from the Alliance for Aging Research finds more than half of Americans don’t realize healthcare rationing takes place in the U.S., 70 percent don’t agree with it.

WASHINGTON, May 21, 2020 — Today, the Alliance for Aging Research released new survey findings regarding the public perception of healthcare rationing in the United States. Amid the coronavirus, healthcare rationing has become a serious concern, especially surrounding ventilator access and hospital admissions. But as results of the nationwide survey show, many Americans do not realize this type of rationing has been encouraged and orchestrated by one particular organization, the Institute for Clinical and Economic Review, or ICER, for some time.

ICER produces reports known as “cost-effectiveness analyses” on how much it thinks new drugs should cost. To do this, ICER uses a metric known quality-adjusted life-year (QALY). QALYs assign a financial value to the patients for whom a given treatment is intended. They originated in the 1960s when the British government sought to ration healthcare for its National Health Service and then other European countries followed suit. Rationing in European countries has not only resulted in access issues but also translates into higher mortality.

The ICER methodology values treating young people in good health over treating older adults (65 and older) and people with disabilities. This greatly limits access to potentially life-saving treatments for the nation’s most vulnerable patients. How? Insurance companies and some government health systems use ICER recommendations as reasoning to deny access to care for patients.

In this survey, the Alliance asked participants if they were aware of an organization that promotes this type of healthcare rationing. The majority — 58 percent — said they were not aware. Of those who are 55 years or older, 72 percent were unaware.

The survey also asked if respondents believed health insurance companies should be able to deny coverage for medical treatment based on the age, illness, or disability of a patient. An overwhelming 70 percent strongly disagreed.

Survey respondents were also asked if they believed the U.S. should follow the lead of European countries that use a similar methodology to ICER for limiting access to healthcare. Fifty-seven percent of overall respondents said “no,” as did 73 percent of respondents over age 55.

In addition to ICER, there is another proposal being considered that threatens to limit access to important healthcare. The U.S. House of Representatives’ drug pricing proposal creates an international pricing index (IPI) that allows the federal government to negotiate the cost of 250 prescription medicines that aren’t facing market competition. This approach would have a negative effect on newer and more innovative medical products and would require the U.S. to effectively adopt the discriminatory cost-effectiveness standard used by foreign governments. The implementation of an IPI policy can mean that some patients and people with disabilities have diseases that are too expensive to receive care and will likely result in healthcare rationing as it has in other countries.

“The coronavirus crisis has shed a necessary light on the realities of healthcare rationing in the U.S.,” said Sue Peschin, president and CEO of the Alliance for Aging Research. “We must better inform Americans about organizations like ICER that have systemized harmful healthcare rationing which can prevent many from receiving life-saving treatments and medications. Discrimination should never be tolerated, especially when it comes to our health.”

This Alliance for Aging Research survey was conducted by Engine Group between April and May 2020 and surveyed 1,000 people across the nation. For more information about the Alliance, visit

About the Alliance for Aging Research

The Alliance for Aging Research is the leading nonprofit organization dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health. The Alliance believes advances in research help people live longer, happier, more productive lives and reduce healthcare costs over the long term. For more than 30 years, the Alliance has guided efforts to substantially increase funding and focus for aging at the National Institutes of Health and Food and Drug Administration; built influential coalitions to guide groundbreaking regulatory improvements for age-related diseases; and created award-winning, high-impact educational materials to improve the health and well-being of older adults and their family caregivers. For more information, visit

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