After consulting a citizens group, the institute decided that the nation should spend the same amount saving or improving the life of a 75-year-old smoker as it would a 5-year-old.
The article is about what is happening in England, and how their lead is being followed by other countries. Basically, it is triage of what is available from the state system (all started by a panic over the price of Viagra) and how it means limits on things such as dialysis and expensive cancer treatments.
There are two current issues:
First, total expense.
Second, "highly expensive life-saving drugs for terminal illnesses."
But, the question tends to spread to two other areas (as it has in some countries):
First, not allowing people to pay for things themselves; and,
Second, adding in quality of life and similar factors.
Admittedly, they have good points, for example the article talks about a niche drug that started at less than a dollar a dose and quickly had its price raised to $260 a dose as it became more popular (but no more effective or any more expensive to produce). In the United States, such niche drugs account for almost a quarter of the nation's drug bill (24%) -- the foundation of the unfunded entitlement drug benefit that many have called the worst threat to America's security in our generation.
http://www.nytimes.com/2008/12/03/health/03nice.html?pagewanted=1&_r=1&th&emc=th for the entire article.