Some days the little IHT banner in my Gmail makes me want to dance with rage. Most days, in fact. Thanks to headlines like “Patients in U.S. to foot more of the bill for vital drugs”. What fresh hell is this? I wonder. Before I even click through to read the story I feel the foul ripples of some new Social Darwinist experiment poisoning the collective consciousness.
Apparently American health insurance companies, in their infinite wisdom and compassion, have started adjusting their co-payment system (whereby the insured person pays for part of the cost of their prescription drugs) from flat fees – say $20 or $50 a prescription to percentages. Like, 25% or 30%, or more. Not, of course, for cheap, bog standard antibiotics (there’s no money to be made there, they’re in the public domain) but for exorbitantly expensive new drugs “used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia [sic], hepatitis C and some cancers.” Diseases, in other words, that are chronic, devastating and require indefinite treatment.
Usually with drugs which, as the IHT blandly reports for which“[there are] no cheaper equivalents… so patients are forced to pay the price or do without.” Think about that for a minute. This isn’t your usual, boring petty larceny on the part of the insurance companies. This is blackmail on a ferociously ambitious scale. It’s conspiracy to commit grievous bodily harm. It’s attempted manslaughter (if you, the jury, are feeling generous).
They’re not just randomly jacking up the prices for everyone. The insurance companies, surely in collusion with the pharmaceutical companies, are methodically working out what drugs people literally cannot live without and which – because the pharmaceutical companies have cowed the government into ridiculously favourable intellectual property laws – there is no alterative supply for, and unapologetically telling them: your money or your life.
It would be more honest, and probably kinder, if they went round a cancer patient’s house and held a gun to their head. At least then if they couldn’t afford to pay out the end would be quick and painless.
The insurance companies are trying to use the paper-thin justification that by making the sickest people pay the most they are “holding down premiums” for people who aren’t sick – in itself, a breathtaking display of doublethink. People who aren’t sick aren’t going to be paying for prescription drugs anyway, so whether they pay a fixed fee out of zero dollars or 30% out of zero dollars it makes no odds.
Effectively, this new system benefits no-one (except the insurance companies) and flattens already struggling, vulnerable people with the financial equivalent of a cartoon anvil. Only there’s nothing funny about this. There’s nothing funny about having to choose between paying your rent or taking the drugs that will stop you bleeding to death from a bad cut, or having your muscles waste away.
The best bit? Private health insurance companies can “legally change their coverage to one in which some drugs are Tier 4 [the new, percentage co-payment] with no advance notice.” If Kafka were writing today he’d be a reporter, not a novelist.