Levka'Last summer, the Congressional Budget Office released a report under the unassuming name “Budgetary Effects of Policies That Would Increase Hepatitis C Treatment.' I read it because I am the type of person who is interested in the budgetary effects of policies that would increase hepatitis C treatment.
Embedded in the report, though, was a point that will be important for just about anything the federal government tries to do to save the lives of Americans.
(. . .)
But the most interesting part of the report to me comes at the end. 'An increase in hepatitis C treatment could also affect the federal budget in other ways—for example, by leading to improved longevity and lower rates of disability,' the authors note. The latter point is pretty straightforward: If hepatitis C leads to disabilities that make people eligible for disability insurance and subsidized health coverage, then reduced hep C means lower spending on those programs. But (and this is me speculating, so blame me and not the CBO if I’m wrong) that effect is probably swamped by that of 'improved longevity.'
Simply put: curing hep C means people live longer, which means they spend more years collecting Social Security, Medicare, and other benefits. That could mean that whatever cost savings the actual hep C treatment produces might be wiped out by the fact that the people whose lives are being saved will be cashing retirement checks for longer.
I like to call it the Grim Reaper effect. The US runs a large budget deficit. It also provides far more generous benefits to seniors than to children or working-age adults. Per the Urban Institute’s regular report on government spending for children, the ratio of per capita spending on senior citizens to per capita spending on children is over 5 to 1. Put together, the deficit and the elder-biased composition of federal spending implies something that is equally important and macabre: helping people live longer lives will, all else being equal, be bad for the federal budget.
In an increasingly aging country, hep C is not the first place where the Grim Reaper effect has been felt, and it won’t be the last. I don’t have an easy fix for the situation, but it feels important to at least understand."
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