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.