The notion of a "quality adjusted life year" (QALY) begins to show up as the focus of multiple legislation and organizing attempts by medical providers.

QALY is a generic model for assessing "disease burden," which is a way of determining who has access to what kind of medical interventions based on the adjusted "quality" of their life. Similar to how life insurance works, QALY assesses the relative worth of a year of life with a particular medical condition, disability, or functional impairment as compared to the worth of a “healthy” year. The term has been widely critiqued for assigning value to life and then assessing disability as something that decreases the value of that life.