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The US health insurance co-pays transforms doctors into salespeople


Yesterday I went to a chiropractor for the second time. First time around was a diagnostic appointment, I did some X-Rays in the meantime, and it was time to start the actual treatment. However, before we get into it, I had to sit through a visibly prepared speech about how effective chiropractic is (backed up by a WebMD survey), how it requires multiple appointments, even after the pain has vanished, to stabilize the musculo-skeletal structure and to prevent further similar injuries.

I was no stranger to chiropractic, I walked in the practice by myself without being sent by a general practitioner, and yet I felt like I was being advertised something expensive, as if I could walk away from medical care at any point. And then I remembered that my health insurance makes me pay $35 for each chiropractic appointment that last 10-15 minutes.

This is called the "co-pay" in the US and is touted as a way to "responsibilize the patient" who could get too much medical care otherwise? It's baloney, of course, but it puts doctors whose care isn't directly pain relief in the awkward position of having to prop their care up as if they were selling a used car.

In my case for example, a simple two-months 14-appointments chiropractic care plan will indeed cost me almost $500 out-of-pocket, no matter how much the doctor charges my insurance company. And while I can pretty easily afford this cost, this isn't necessarily the case for more than half the American people.

Co-pays aren't specific to the US healthcare system of course, but I know from experience that they aren't that expensive in other countries who have a single payer system. I can dream, of course, but I feel like having doctors on board would help push a reform that's significantly gained in popularity in the US in the past few years.