How “the Grim Reaper effect” stops our government from saving lives

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.

Hep C is a nasty viral infection whose effects are, for a virus, unusually long-lasting. Untreated, it causes serious liver damage over the course of decades, leading to much higher rates of cirrhosis and liver cancer, all of which is very expensive to treat.

But in the 2010s, a number of extremely effective antivirals, which randomi