Sicker patients socked with higher copays

April 15, 2008

Healthcare analysts said U.S. health insurers are rapidly adopting a new pricing system that is boosting copays for expensive prescription drugs.

The New York Times said the new pricing system, which often charges patients 20 percent to 30 percent of the cost of the drugs, can add up to thousands of dollars each month for some people. The Tier 4 system is incorporated into 86 percent of Medicare drug plans and is included in 10 percent of private insurance plans, the newspaper said.

Private insurance companies said they began offering the Tier 4 plans at the request of employers. Critics say the program is poor social policy.

"This is an erosion of the traditional concept of insurance," Dan Mendelson of the research group Avalere Health told The Times. "Those beneficiaries who bear the burden of illness are also bearing the burden of cost."

Copyright 2008 by United Press International

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not rated yet Apr 16, 2008
The best medical care will always involve more expensive techniques. It is not financially possible to give the "best" medical care to every single person in the United States. The insurance companies have developed a method to determine who is proportionately costing the health system more, and is charging them more. Whether or not the insurance companies chose correctly, or whether they are charging appropriately does not amount to "poor social policy", but rather is an experiment, among whose ultimate goals is to give the greatest good to the greatest number of people.

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