I liken it to drug addiction....in this country the smart folks up in the ivory towers in the world of health insurance knew 2 things...we would LOVE the copay, which we all do now, and that we were going to have a disaster on our hands in 20 yrs...that was back in the early 1990s and voila, here we are....
The copay is both the enemy and the problem, because it hides the cost of everything...if my doctor bills 1200 dollars for a 15 minute visit, but I pay a $25 copay what do I care? However, on the other hand, when my employer moves to a consumer-directed health plan with a high deductible (where I get billed the negotiated physician rates between him/her and my insurance carrier) now I get to see this full $1200 and the allowable amount.
As both an expert in this field, a business owner/entrepreneur and also a consumer, when we move to this model many years ago here at my company, I started BLOWING up my Pediatrician, PCP and also specialists...I remember the first time with my youngest daughter when the Pediatrician wrote 4 prescriptions for her...off to CVS we went and again VOILA, we were told the BRAND NAMES were a total of like 800-900 for the 4 meds, 30 day supplies....I started laughing....immediately called the Pediatrician and said "re-write those bad-boys with all generics"....my bill was like 60-70 for ALL 4 FOR 30 DAYS!!!
That sums it up folks....going to deductibles, negotiated pricing, NO COPAYS for anything, FREE PREVENTIVE MEDICINE, great tools for employers and communcation forums for employees, and we can get out of this mess....also I DO NOT NEED A MEDICAL DOCTOR, to see me to re-order my allergy medicine for another year, which has both been working, and that I have been taking effectively for over 10 yrs...welcome the NURSE PRACTITIONER, OR PHYSICIAN ASSISTANT (btw, tell your kids it is going to be the field to get in to in the next 5-50 yrs...essential to our healthcare success).
This topic, I could ramble for thousands of words right from my hip because I study it, practice it, live in it, believe in it, and have hundreds of clients with whom we have implemented it, and the phone calls on premium increases VANISH!
I hope this helps, and I love writing about this stuff. I would imagine health insurance carriers hate seeing this stuff, however they also know it works...Cigna, Aetna, United Healthcare, they have all had their own employees in these models for 10 or more years....the folks who really hate this are HOSPITALS and DOCTORS because to the scamming ones out there (billing on quantity not quality) they know their offices with Monet artwork are also going to need to become more efficient.
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