askyermom

I’m not even going to research, but I will assert with conviction that co-pay is a term intended to make you feel cozy about sharing your money with a large corporation. “We’re all in this payment together!” I would venture that you will not encounter a co-pay requirement outside the U.S. [apparently, I am wrong about this, but I won’t let that stop me.]

What co-pay actually means–you are getting a bill for health care services. It’s supposed to feel like a small thing, as if you are just buying a ticket with a number on it to be seen by a medical person eventually, or paying for parking because you are going somewhere very much in demand by people with cars.

Your co-pay can be $10 or $100 depending on the rules you agreed to that you likely do not remember.

What is the point? Cynically, I would say that it was originally intended to keep people who do not have spare cash from seeing doctors too much. Even more cynically, I would say that it allows clinics to get a payment card on file for the unwary and inexperienced patient. A very young adult told me an urgent care facility wiped out her account to satisfy a bill for services she didn’t even know she owed.

The thing to remember about health insurance is if it’s not government-run, it is a business. Business is not about making you well as much as it is about making money for someone else. When profit is primary, numbers are king. I’m not saying that business is bad, but it’s important to remember the goal of players in the game of your healthcare.

If the insurance company offers you a deal on low premiums (the monthly fee you pay to be in their game) then they will also expect you to pay more in co-pays when you go to a medical appointment (get on the field in the game). See the common factors here? They get paid. Also games.

Because they are a business that is getting paid, they also try to keep their costs low and this is done by not paying for the full cost of expensive procedures. If they can negotiate a lower price for things, they can keep more of the money they have already collected. Do these negotiations ever result in a refund to the players like us? No! I don’t know why, because I don’t know everything, but I think this might be two things: they don’t have to and they may be suffering from the illness of greed.

Here’s a different sort of example, just because. If I sell you an egg for $1, you will likely buy it if a dozen eggs cost $12, assuming you like the occasional egg. If I buy a chicken for $2 and eventually get my henhouse cranking out eggs, I can sell eggs for 50 cents each to the whole neighborhood. Even if I take perfect care of my hens, I am profiting by the time I have 12 hens. $6 per day can pay for all their basic needs and then some. I have some choices at this point. Do I invest in more chickens? Do I send a little rebate to my loyal customers? Do I feather my own nest and find ways to make money with that money? Do I build a better henhouse and ensure the perfect health and potential happiness of my hens? Give them a bigger yard and security with fabulous feed?

What’s the greediest answer? That’s sadly the way that this story often goes. We are very skilled at persuading ourselves that we deserve to keep the profit. After all, we worked hard and took risks. These things are true, but we are conveniently ignoring the fact that the chickens are also very committed to our enterprise. It’s easy to tell ourselves that the chickens don’t mind a bit of cramped space or a little less cleanliness or a bit of lax supervision.

We are far off copays, but I hope this detour explains why chickens don’t get pay raises without a lot of vocal support.

Paying a copay of $10 to visit a medical office is no big deal, right? But what if it was a big deal? What if you were a threadbare college student who had to decide between the medical visit or a couple of burritos? Or imagine you were a mom on the run from a bad situation and $10 was the difference between that visit and paying for used shoes for a job interview?

I’m sure somebody will point out that there is a nopay option for the copay, buried right there in all the fine print in a way that no one who needs it will find it. These little footnotes on footnotes are tucked away for a rainy day in court, not to actually help anyone get care.

Enjoy your freebies, by all means if you can afford them, but always remember the chickens and the people who are in the chicken positions and the people who can only hope to be in the chicken positions.

Love,
yermom

This is the place where I link to book info (4.3 stars! better than good!) and book status info which needs an update of its own. Don’t Eat Your Children might cross the finish line in 2023, but Harlot’s Last Laugh definitely will not.

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