New Co-Pay System Gouges Even Insured Patients

Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.

With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug's actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.

The system means that the burden of expensive health care can now affect insured people, too.

Read the whole story here.

Comments

[JonGee]

I happen to suffer from sarcoidosis, specifically neurosarcoidosis. This is a disease with no known cure. Left untreated, it could leave me paralyzed or dead.
I tried a wide variety of drugs, from Prednisone to Hydrocloroquine to Methotrexate. None of them worked. I was finally given Remicade and the results were instant and dramatic. Because of Remicade, I can walk, drive, work, even hit a few tennis balls.
I get infusions of Remicade once every five weeks. Each infusion runs over $11,000. Do the math. At over $132,000 a year, if I am forced to pay 25%, that"s $33,000.
When I get my infusions, I am in a room full of other patients. Most of them are getting cancer drugs. Over the past two years, I have seen those drugs work miracles. People who seemed to be on death"s door had their cancers driven into remission, many permanently.
Many of them could never have afforded to pay even a small fraction of the cost of their treatment. Many of the patients I saw hugging their nurses and doctors as they got up from their final sessions of chemotherapy, the ones given a clean bill of health, would be dead today.

[falco]

I guess the pharmaceudical companies aren't making enough profit yet. Next thing you know, drugs will be mandatory. They just keep gaffing us left and right don't they? Food goes up, drugs go up, gas goes up, the economy is crashing, Great forward thinking. Oh, I forgot. The plan is to eliminate the middle class (won't be complete until the guns are gone) and they are doing a great job so far. Housing, food, drugs, transportation, jobs. Stock up on the survival gear folks, there is not much else left they can take and it's only a matter of time before America crumbles. Let's hope we're not dodging bombs as we escape the cities.

[maggiemae656]

Did anyone notice that this plan was first utilized in the Social Security program? The government, the pharmaceuticals, and the insurance companies are one and the same. Do you really want nationalized healthcare? I don't the Federal government involved in my health at any level.

The better answer would be to remove the monopoly status held by health insurance and pharmaceutical corporations. Their lobbies need to be disbanded. Pharmaceutical companies need to leave doctors alone and let them take care of their patients. People need to become more involved with their health care and masters of their own destiny. Educational opportunites for accomplishing this would go a long way.

In my opinion, we have many opportunities for pulling in the reins on our current system--I think we will all be very, very sorry at such time as the government starts dictating our medical care. They are already involved to a larger extent than you realize...their lack of oversight has caused us to land where we are, and it's not because they aren't aware--it's because they don't care.

[joebaggadonuts]

How can this possibly be called civilized?

[swift_goat_pet_for_truth]

There is ONLY ONE nation in the ENTIRE WORLD that pays FULL MANUFACTURER's retail for prescription drugs.

Guess which one.

[speakingtruth2power]

Several years ago, I figured that the co-pay came

close to a rational cost for the entire procedure.

Now it sounds like these insurance companies

want to improve their generous profit margins.

Single payer, universal health care is the only

good answer here, as has been realized by

almost every advanced nation but America.

[swift_goat_pet_for_truth]

NOT "almost every advanced nation".
"EVERY advanced nation".

[joebaggadonuts]

Just don't think of America as an advanced nation any more. Problem solved.

Seriously, if we simply lower our expectations to third world status nation, the poor and formerly middle class have nothing to complain about in America. Relative to hmmm, better not name any, we (99.5%) are doing just fine. No reason to be bitter, nor to cling to religion to be saved. No reason to have anger at getting a small slice of "health care" instead of real medical help, or angry about outsourcing or other facets of compassionate corporatism. We have the best health care in the world if you can afford to pay more for it than anyone anywhere else in the world pays for the same thing over there. No, we're paying for it here so multinational drug companies can sell it cheaper over there where they are stuck with single payer systems that actually help their citizens get medical attention and needed drugs. And now, the insurance companies are simply getting their slice of the American drug pie. Or something like that, right? No need to cling to our guns, because we have BlackWater to protect our cities while our National Guard fights for freedom in Iraq. It's all working out just great. No reason to be bitter.

[Vyvjala]

You've never been as sick as just before you stop breathing....................

[GalaxieGal]

Don't you just know that the percentage the customer will pay will be calculated from the list price of the drug, rather than the significantly discounted price the insurance company pays for it. Gee I wonder if the difference means that the insurance company will make a profit on your drug purchase.

[LivingStardust]

You'll know Big Business Fascism has won when McBush or the Liar push for the overturning of EMTALA.

[BlackLeatherRain]

Follow the Money ~~

Health insurers profit when:
1. A healthy person stays healthy and still pays their deductible.
2. An unhealthy person dies sooner rather than later. If a patient is disencouraged from seeking treatment due to cost or from taking part in ongoing medication necessary to live, the HMO comes out ahead if it costs the patient their life.

Our company's PPO rep spoke with us last fall. He opened by introducing a new plan and told us to get used to the idea, because "all companies will be moving here eventually." For the young and healthy, it's a great deal. It's about 30% the cost of the regular plan, the Rx has a minimum copay with the aforementioned % of the drug cost. You pay your deductible up to about $2000/year, you get about $500 in a savings account to put towards that and everything over the $2000 is paid at 80%. A woman in the back of the room raised her hand and asked how that would impact her, considering she takes a unique medication that would cost $5K monthly. His answer? She'd pay the first $2000 deductible, and then 20% of the rest... for the rest of the year.

That's thousands of dollars a year just to breathe. It's insanity. She was recommended to keep her traditional plan and not move to the new wellness plan -- yet, if this is where all companies are going eventually, where can we turn?

[desthmoneses]

We can leave, my dad and my brothers are seriously considering moving and applying for citizenship in another country not encumbered with these types of problems.

[ErnestineBass]

America needs Universal Health Care.

[Tom95134]

I a patient's copay is 30% then the patient is paying 100% of the negotiated cost of the drugs. What the hell kind of insurance is that? It's like going to an urgent care office without insurance. They only charge you about 50% of what would be billed to the insurance company.

[vandegrasse]

I just spent 50 dollars co-pay for 8 Imitrex tablets. I guess it suit the insurance companies if I were to have a migraine badd enough to blow my brains out. I hate those sons of bitches!

[nomoredead]

I am seriously looking for a little retirement house in another country presently. You are going to die in this country unless you are one of the wealthy that can afford this crap. Buh Bye corporate greed.

[desthmoneses]

Funny you should mention that, I have three panamanian cousins who run a real estate company in Panama and have told me on more than one occasion that they have so many clients from the U.S. seeking to buy property for reitrement that they have to turn them away. Take note baby boomers panama is universal health care, when I got sick there I stayed at the hospital over night with a potassium drip and left in the morning without so much as paying a dime.

[nomoredead]

Exactly dest, while in Puerto Vallarta in Feburary, the doctor I called sent a driver to the hotel to pick me up ! drove me to the clinic then gave me loads of free samples. By the by....Panama is very attractive.

[speakingtruth2power]

Canada is not far away enough since it'll soon

be part of the Norte Ameircan Fascist Union!!!

[nomoredead]

....and toooooo cold.

[LivingStardust]

Expect even worse under McBush or the Liar. Especially the Liar since she is in Big Pharma's pocket and sucking at the Insurance Industry teat as well.

[swift_goat_pet_for_truth]

Maybe. But Hillary's medical plan is more progressive than Obama's.