What is copay in health insurance? Copay is coverage of the difference between set rates and the actual cost of medical care. It exists in all countries of the world. If the role of copay is to curb the frenzied demand for health care, the co-pay balances the government’s ability and the real cost of health care. Economically advanced countries cannot refuse to let their citizens participate in financing health care through private out-of-pocket or private insurance. I wonder what the economically unsupported social guarantees are called? Probably populism. To be fair, the issues of copayments and co-payments have already begun to be discussed by people involved in health care reform.
The benefits of co-payments
- The most important possible achievement is an increase in the availability of health care to patients. And this accessibility will be the greater the more the rate corresponds to the real cost of the medical service. The question of the real cost of a medical service is a long-standing debate that I do not understand. Direct costs are calculated, profitability is added, and the end result is adjusted by competitors’ prices. That’s it! If it is necessary to put the price below production costs, given the competitors’ prices, then this service must be abandoned. The introduction of surcharges does not change anything cardinally, only adds more availability depending on the proposed tariff.
- The competition becomes more transparent and will undoubtedly intensify. The patient wins again.
- Some part of the guaranteed proceeds to the private medical business makes investing in it more attractive. Attracting investment in medicine is a separate global topic. The impression is that this direction is not a priority for the state. Although it is a tremendous reserve for improving the entire healthcare system. And the possibility of additional payments is a powerful lever for the inflow of investments in medicine. After all, it is advantageous for the state to turn from mega-investor into mega-customer of medical services and concentrate its efforts on control of the medical care quality.
- The system of co-payments can positively influence the development of the voluntary health insurance market, which is extremely scarce and has not yet had any noticeable influence on the development of medical care in various countries of the world.
- The system of co-payments influences the creation in the private sector of new directions, which are extremely necessary for the state, for example, screening of newborns for metabolic diseases, screening of pregnant women, early cancer diagnostics, etc.
So the surcharge can have a serious impact on the development of medicine in the country where it is introduced. It has a number of benefits for patients and for the whole field of medicine.