The basic idea of health insurance is spreading the burden - this is why everyone (healthy and sick) pays into a pool of money when they are well and able to work so that when they are sidelined by an illness or caring for an ill loved one, they can have the resources they need to get better. According to my grandfather, it's a lot like in the old days, you'd pass a hat amongst all the Italian workmen to pay for the hospital (or funeral) expenses for someone who needed them - and by giving your contribution, you're also assuring that if you needed it, the hat would be passed for you.
A NYT article this morning reports that in a new system, called Tier 4, health insurance companies have decided that system could be EVEN MORE profitable for them - and have decided that for some drugs, mostly the ones for life-threatening and chronic diseases, including cancer - people should have to be really sick (hence the "life threatening or CANCER" part) AND pay more for medication. Under this system, people are charged for a percentage of the total actual cost of the medication. This is extremely expensive (eg. $13,500 for a 90-day supply of a medication to treat a type of cancer called CML) and because most of these meds are for long-term illnesses, people have to pay for a continuous supply.
Apparently this isn't a totally new idea, as this 2005 article from the WSJ discusses new ideas for plans using "reference pricing" and "coinsurance" that would charge the user a percentage based on the actual price of the medication. In the WSJ Health Blog, they quote Dan Mendelson of Avalere Health saying “This is an erosion of the traditional concept of insurance...those beneficiaries who bear the burden of illness are also bearing the burden of cost.”
It makes me wonder how all these companies who aren't concerned with health are running our healthcare system...yikes. Maybe it would be better to go back to passing a hat?
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