Despite what you believe, I really am trying to highlight why your advocacy will likely go nowhere. I thank you for pointing out QALYs. I had not heard of it.

Despite what you believe, I really am trying to highlight why your advocacy will likely go nowhere. I thank you for pointing out QALYs. I had not heard of it. I have read now a few journal articles, and none of them say that QALYs stand alone. For example, https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4733.2009.00515.x https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4733.2009... says: > Aggregate health gains, measured by conventional QALYs, are one of many inputs to the processes of individual clinical decision-making, societal or programmatic audit, or resource allocation. The other considerations, including equity and fairness, need to be considered separately in the conventional QALY approach. Or https://www.valueinhealthjournal.com/article/S1098-3015(24)02355-6/fulltext https://www.valueinhealthjournal.com/article/S1098-3015(24)0... is more recent article, from earlier this year, titled "Quality-Adjusted Life Years, Quality-Adjusted Life-Year-Like Measures, or Neither? The Debate Continues" > The assessment of effectiveness is not and can never merely be a technical exercise. Whatever measure of effectiveness is chosen—even one that has the seeming appeal of being “objective,” such as a clinical endpoint—implies a value judgement about the importance of the various aspects of treatment outcomes. > It is also important to remember that QALYs and their use to estimate incremental cost-effectiveness ratios inform, rather than dictate, decisions. Limitations of QALYs—or, indeed, any chosen alternative to them—can in principle be handled via careful deliberative processes or addressed by the consideration of other kinds of evidence and decision rules, as is typically the case in the HTA processes of many jurisdictions. My gallop gave specific examples which require value judgements, and therefore cannot be made with "relatively simple algorithms". "Same for any other example." You don't seem to understand that no matter what system is used, it's fundamentally driven by political decisions of what is appropriate. We know that politics means some healthcare systems will prohibit gender affirmation therapy. Can the person go elsewhere, where that is allowed, and pay for said therapy, or does the other system have to accept anyone who shows up, on a first-come-first-served basis? Your proposal seems to say that there can be no healthcare outside the government system, so those who want chiropractic treatment, those who want acupuncture, etc. are forbidden by law from even using their own money. (I picked these two because while the science doesn't support their efficacy, often require licensed practitioners because doing it wrong can kill people.) There are not simple solutions, and the longer you insist it's true the more cold shoulders you'll receive.