Here is a story demonstrating how health care costs get distorted. Things to note:
- First, note how much patients can influence what they are prescribed, despite nominal physician control.
- Then look at the cost benefit analysis (or absence of it). Were doctors previously prescribing the wrong treatment, or are they now wasting money? One or the other is true.
- Third, notice how this defrays the pricing distinctions copays create. If a 20% copay incurs the same cost as no copay, expect them to be priced the same. That eliminates an option for cheaper insurance, making insurance more unaffordable.
The story is specifically about drugs, but I suspect the problems exist for a broad range of treatments. More evidence that insurance reforms alone will not improve health care access, the key problem is at the provider level.