The Copayment Canard

There is no institution that symbolizes unnecessary rent extraction (taking a cut for no reason) than the health insurance sector (it’s not an industry as it doesn’t actually produce anything useful). The most ridiculous part of our health insurance system (calling our healthcare system a system is like calling organized crime organized) is the institution of copayments (‘copays’). I’ve discussed this before and concluded:

Which brings us back to the rationale for copayments. No one takes too much insulin because they feel like it (that actually could lead to brain damage if not dealt with). There’s no potential for waste involved here. Quite simply, a juvenile diabetic must have the insulin he or she needs to treat this chronic condition. If he or she takes too little, [he or she] get[s] sick and eventually [has] to be hospitalized (which is expensive).

Yet, in the case of insulin, the copayment is large, and for people of modest means who are not poor, it is too much. It’s safe to assume that this is an attempt to gouge people who have no alternative.

Some long-time readers might be aware that I had some kidney stone problems that led to a few surgical procedures and an ER visit. As a result, after seeing a nephrologist and having urinalysis done, I was told to take some cheap medication (it’s offpatent and generic). Starting January 1st, my copay increased by roughly $100 per year. Fortunately, I’m in an economic situation where that’s not a problem (though why these parasitical motherfuckers should get $100 more of my money?). But there have been times in my life where $100 was a lot, and, for many people, that’s a real hardship*.

I have no idea what a copay is supposed to accomplish here. This isn’t ‘elective’ or something like chronic pain management where consumption would be partially under my control. I went to a specialist–whom the insurance company approved, who ran insurance-company approved tests, after which I was given an insurance company approved prescription to prevent more kidney stones–the preventative medicine that policy wonks pee their shorts about.

This is not optional unless they want to increase the likelihood that I will need thousands of dollars of additional medical care. I’m not cutting back on the medication, nor, according to both the medical professional and the insurance company itself, should I. Increasing the copayment does nothing except increase the health insurer’s profit margins.

Remind me again why a real public option, accountable to citizens, not shareholders, was taken off the table?

*And let’s not forget that the poorer you are, the less coverage you have to begin with.

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6 Responses to The Copayment Canard

  1. Sean says:

    To prevent people like me from quitting my job. Long and short of it.

    While I’m generally healthy, I have some mild chronic issues that require continuous medical coverage, else I’m potentially screwed (isn’t this fixed by the ACA, or is this swept under the rug thanks to the mandate?). While Romneycare isn’t too horrible, there’s the issue that you keep bringing up about giant deductibles and the like that can’t simply be hand-waved away, and, thus, is ignored by the pols. C’est la vie.

    Where we in, oh, Canada, I would have left my job months ago, but, because of the aformentioned chronic conditions, I have not. Since I’m quite risk adverse, I haven’t considered going freelance and doing contract work for just that reason, almost exclusively due to a need for decent, affordable health insurance.

  2. Rich S. says:

    Yes, what Sean say is one reason the public option was abandoned. The other is that Obama is a spineless fucking pussy who just wanted something passed for the sake of his legacy.
    Allow me to list some other major items of Obama’s legacy:
    1. HSBC laundering $9B for the Mexican drug cartels, and dealing with Iran in violation of the sanctions. No indictments.
    2. Wall St. banks crashing the world economy due to their mortgage fraud. No indictments, and piles of money to bail them out.
    3. The arguably counterproductive drone strikes with their high non-combatant deaths. When not-so-friendly governments start doing the same, they will point to Obama.
    4. The Keystone pipe, and all the CO2 from the tar sands we will get from it. Our grandchildren will hate us. They will wake up, eat their 3 squares of soylent green, and scream “damn you all to hell!.” The legacy of our generation, and Obama, is that we were the ones who recognised the problem of global warming, recognised that it was us causing it, and then chose to do nothing about it while there was still time.
    5. The death of the rule of law. (See HSBC, and Wall St banks, above). Additionally, throwing a former CIA agent in prison for 30 months for doing the same thing that the guys responsible for the release of Valerie Plame’s name and were never held to account.

  3. Because there was never enough support from Democratic Congresscritters to actually pass a public option in the first place, and anyone who thinks otherwise is delusional.

    • Rich S. says:

      That’s also true. But, he still could have fought for it. There are so many examples where Obama just didn’t seem to have the stomach for a fight. I remember reading about the Brown-Kaufman amendment during the financial reform debate. This would have limited the size of the banks to 3 or 4% of GDP. It failed in the Senate. James Kwak over at Baseline Scenario thought that it would have passed if Obama supported it.

  4. Silent Bob says:

    Your first paragraph (despite containing valid points) is effectively unreadable due to (hey look, it’s snowing outside) too many parenthetical remarks (remarks that occur between parentheses [‘parens’]).

  5. joemac53 says:

    My fixed income just got hit with increased co-pays and 750 bucks of deductible lab work. Wife gets blood looked at for arthritis. I get blood looked at for cancer. Goodbye 500 bucks. If my remaining kid at home needs anything done, another $250. No input from me about the deal. Not a happy guy.
    Maybe some Obamacare will come my way.

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