Medication is Expensive. Health Insurance is Expensive. You get to pay for Both

            Based on recent experiences, I noticed two things that seem to make sense until you think about them both together. Let me explain. In the United States we have health insurance, money we pay to a company, so that in the event of an illness, that company will cover our health expenses, which in today’s market can be almost comically excessive. Given these massive expenses, and that fact that the U.S. economy profit driven, companies implement different tactics to minimize their costs. Larger companies are able to negotiate reduced rates on the premise that they will encourage (read: refuse to pay for otherwise) their insurees to use a particular product, service, or provider. While perhaps not morally sound, you have to admit it makes sense from a business stand point. As does a company implementing a copay system, in which insurees must pay at least some portion of their health expense. This seems a bit unfair, as the whole point of insurance is to cover one’s medical costs, but again makes sense economically. People will take just about anything for free, but put at least a small price tag on it, and they’ll weigh their options. Of course, this begins to create problems when the “small” price tag becomes anything but. In summary, people pay for insurance, which then allows them to pay less for healthcare, but they still have to pay something.

            Now, let’s follow some humans down on their luck. One was recently laid off of her job due to budget cuts. She expects to be working again soon, but the next few months will be tight. Another is a single parent of a young child, below school age, and she can only work part time as she cannot afford daycare. Another is a young man of twenty-three, currently working on a master’s degree in laboratory sciences. He is hard working but puts in fifty hours a week toward his degree. These people are all incapable of affording health insurance despite being deserving of it. How do we address this? We have government sponsored healthcare for individuals meeting certain eligibility criteria. Additionally, such plans usually have either no copay, or a very minimal copay, as these individuals clearly have financial barriers. Again, this makes perfect sense. People who deserve healthcare but cannot afford it for a variety of reasons should not be penalized.

            Now here is the part that does not make sense. Let us say that a particular state offers free healthcare coverage for individuals making an annual salary of X dollars or less. Individuals making more than this are expected to obtain their own healthcare, as they can theoretically afford it. Now, imagine a man making $1000 less than that cutoff, and who does not qualify for insurance through his employer. He has free healthcare through the government, and no copay on his medical services and prescriptions. Next year receives a raise putting him at $500 above the cutoff, but still does not qualify for insurance through his employer. He now gets to pay about $300 a month, a copay of about $20 per office visit, about $10 per month for each medication he takes, as well as a variable deductible that could be a couple thousand dollars a year. That’s a hell of a raise he got.

            -AMS