I find it refreshing when a government agency says no to spending more money.

Last month, in an editorial titled “Sandbagging an Alzheimer’s Treatment,” the Wall Street Journal editors criticized the Centers for Medicare and Medicaid Services for refusing to pay for Biogen’s new Alzheimer’s drug, Aduhelm.

In their editorial, the WSJ editors rightly criticize various scientists who had insisted on further trials before the drug was approved. As readers of this blog know, I favor the lightest regulation we can get from the FDA. Let the drug companies try their drugs and let us learn what works and what doesn’t.

But approving a drug is different from having a government agency spend tax money on providing that drug. The Journal editors do state one major argument against having taxpayers pay:

Their [the progressives] biggest beef seems to be that Aduhelm costs too much ($28,200 per year) and could balloon Medicare spending.

They seem to think it’s a bad argument but they don’t really say why.

For some years, the Journal editors have had a contradictory view on Medicare spending. They want to rein in entitlement spending generally but they want to have the CMS pay for pretty much any drug for the elderly on Medicare if the FDA approves it. They have never, as far as I know, resolved this tension.

I think the Journal‘s view comes from their late, and brilliant, health care editorial writer Joe Rago. When he visited Hoover some years ago, I tried to get him to see the problem. His argument was that now that the government has Medicare, people on Medicare should be able to get whatever drug might help them, independent of cost. My argument was that Medicare is not all or nothing. I would like to see it ended. That’s extremely unlikely, as the most powerful voting group in the country is not about to give it up. But at least, we should applaud the CMS when it’s even somewhat careful with tax money.

A letter writer to the Journal, S. Paul Posner, put it well in an April 20 (electronic version) letter. Addressing the point that progressives had pushed for the CMS to say no, Posner stated that the CMS:

should spend money where it will do the most good. That means cost-benefit analysis, which progressives are not known to embrace. They shouldn’t be criticized for doing so now.