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How the Drug Czars Are Squishing the Poor People

By Patrick

While other bay area bloggers are busy screwing up this country's future, something that actually matters is passing unnoticed by all but the very unfortunate.

You may or may not have seen the recent NY Times article about changes health insurers are making to prescription copay policies. Private insurers, taking a cue from Medicaid, are switching from flat-rate copay schemes to percentage based schemes. Essentially, the more a drug costs, the bigger the copay. According to the Times:

No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.

Sophistry, bullshit and befuddlement!

First, Aetna knows exactly how many patients will be affected. Trust me, this is not a shot in the dark. Second, the thread that runs though all of these conditions isn't that they are "fairly common" among Americans. It's that these patients (1) cost more than they pay into insurance, and (2) tend to consume more medical services across the board. The truth is this country spends FAR more money on hypertension, allergies, or high cholesterol, all of which are sometimes treated with expensive drugs. But the new pricing scheme doesn't touch them. Why? Because taken as a whole, cholesterol treatment is profitable (it usually doesn't exceed the cost of a premium) and common (the few patients who consume expensive cholesterol drugs are healthy and vocal enough to scream bloody murder if their copays change).

The treatment of MS, hemophilia and hep C, on the other hand, is not profitable. And those paints aren't vocal. They're sick.

Does anyone really think it is a coincidence that patients with conditions like MS, Hemophilia and Hepatitis C also tend to be the patients who *gasp* require more medical services in general? The new pricing scheme is not a way to "curb rising drug costs." It is a way to discriminate against people with chronic disease, who are not fortunate enough to be in a position to self-advocate.

The immediate effect of the change will be that patients with unprofitable disease will either go bankrupt trying to pay, or stop taking the medication. The ultimate effect will be that patients with chronic AND unprofitable disease leave the health system (a euphemism for dying) more quickly, and cease to be a profit-suck.

There. I said it.

Full post as published by Nuts & Boalts on April 15, 2008 (boomark / email).