When Insurance Companies Pay For Medicine, They Also Choose What Medicine To Not Pay For

A common strategy used by those who oppose government programs is to highlight any deleterious points while ignoring the alternatives, as if everything would be perfect if the government wasn’t involved. Peter Suderman has a post at Reason entitled When Governments Choose To Pay For Medicine, They Also Choose What Medicine To Not Pay For. The post is based upon this report in The Wall Street Journal on European countries trying to cut back on drug prices.

Yes the title is true but Suderman ignores two important facts:

When Insurance Companies Pay For Medicine, They Also Choose What Medicine To Not Pay For. Insurance companies routinely restrict which medications are covered, and for-profit insurance companies are often more restrictive than government programs as to what they will pay for. Their decisions are much more likely to be based upon maximizing their profits as opposed to trying to rationally allocate limited resources in a fair manner. Another trick often used by insurance companies is to officially cover a medication but make the patient’s co-pay so high that they cannot afford them.

When Governments Do Not Choose To Pay for Medicine, many go without any medications. In an ideal world everyone would be able to get any medication, regardless of cost.  In the real world most people have limitations on the medications they can have, with many people having no coverage other than for government programs. This beats not being able to afford medications at all.

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3 Comments

  1. 1
    Captin Sarcastic says:

    I have had this debate with some folks, and their argument is that private insurers can choose not cover some medications, but if they do, their customers will flock to insurers that DO cover those medications, and the “free market” will balance everything. The problem if course is that most Americans do not have competitive alternatives to their insurer, and the conservative answer to this, is of course, that is is only because of Librul interference in the market that these choices are not available. I then have to try and explain about regulator capture (coporate socialism) to try and make them understand that it is neither liberal, nor conservative policies that create the environment where insurers have no competition, but in fact the result of insurers (or the industry) paying to buy legislation that favors them. Which inevitably leads to a discussion of who are elected representatives really work for, and oddly, we generally agree it is not us. But getting them to consider taking private money out of the election process is a non-starter, so in the end, even conservatives who can grasp the real underlying problem, will still fight to insure that problem is not solved.

    Ugh!

  2. 2
    Ron Chusid says:

    This gets back to the usual defense mechanism from the right to deny any evidence which shows that their policies do not work. We never have pure laissez-faire capitalism since it doesn’t work and often attempts at moving in that direction create serious problems. However whenever a problem is found where the market does not work correctly, as in health care, they can always blame it on government interference, regardless of whether this really makes any sense. There will always be some government interference in the market somewhere, giving them something to claim is the cause of the problem.

  3. 3
    Lori Guffey says:

    RT @RonChusid: Governments restrict medication coverage but so do insurance companies (which libertarians ignore). http://is.gd/cBkGs #p2

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