Tier 4 Insurance Plans Are a Pretext for What Will Follow

According to a recent New York Times article by Gina Kolata health insurance companies are cleverly adopting a new pricing plan for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save lives or slow the process of serious diseases.

Now rather than paying a fixed co-pay charge for your prescription medications, patients will now be charged a percentage of the actual cost of certain high priced drugs up to as much as 33 percent. This new drug pricing scheme is called Tier 4 plans and is being touted by industry economists as a cost saving mechanism for health care consumers.

While the US government’s Medicare plan first conceived the 4-tier plan idea as a way of distinguishing between certain considered non-essential life-style or enhancement medications such impotence reducing products, the private sector, however, is now using such 4-tier pricing schemes to separate out the most seriously ill people whose illness or pain requires the most expensive bills.

Rather than spreading the insurance plan’s total cost out over the entire population served, this new pricing plan separates the most seriously ill consumers, often with the most pain, from the healthier who require less expensive medicines. If this is not health care inequity what is?

Some of the more common diseases that have now been moved into this category include multiple sclerosis and rheumatoid arthritis. Under these plans even the insured and more affluent people may not be able to afford the treatments they require.

What disturbs this writer is the industry’s audacity to inflict this costly and inhumane pricing system on you and me in spite of the fact that both pharmaceutical and insurance companies are already charging exorbitant prices and making such huge profits. This is occurring when over one-third of Wisconsin citizens have no health care insurance and many remain ill or are dying yearly because they cannot afford the high costs of medications.

Why would the industry want to provoke health care consumers more than they already are? The reason is because they want to be in a position when the stem cell medicine revolution era arrives to be able to serve both the average insured person and the very rich and powerful with even far more costly miracle cures and enhancements. The Tier 4 option will pave the way to allow such health inequities to co-exist while still allowing the existing very profitable system to continue.

If consumers allow such an inequitable drug pricing system to continue the far more costly future cell based miracle drugs both for diseases and increased longevity enhancement will be accessible and affordable only for the rich and powerful.

Many readers who read this article will wonder how it is possible for the government’s Federal Drug Administration and the federal insurance commission would allow licensed drug manufacturers and insurance companies the right to perpetuate such a pricing plan on the American public? There are two main reasons. One, of course is that it is the very pharmaceutical and insurances company officials that sit on the policy-making and governing sub-committees that write these rules. The second reason is that these two industries pay by far more for your representative’s re-election than either you or I.

Readers should contact their congressional representatives now and ask them to call an emergency session to stop such unjust drug and insurance pricing practices NOW.

Respectfully, William R. Benedict, Madison