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The argument that it’s acceptable to exclude prescription drugs because some people will buy a plan without drugs is like allowing plans to exclude coverage for mental health services — if you don’t need it today and think you probably won’t need it tomorrow, why make you pay for it. You could do just that, and some people would buy a plan without mental health coverage — but we don’t allow it because it puts vulnerable people at risk and because it is contrary to the whole concept of insurance. Everybody pays a little more so that everyone is protected when and if they need help. We can try to keep costs down by requiring the use of generics; by excluding some “me-too” expensive drugs; by adjusting co-pays to encourage desirable utilization patterns, but we should not be encouraging people to be underinsured or, more importantly, to put themselves or their families in harm’s way by not taking the drugs necessary for prevention of serious health outcomes, for delaying treatment of current ailments, or by buying at full retail cost, the undiscounted drugs they absolutely must take. Remember what serious consequences can follow even an untreated strep throat in a child. That’s when being penny-wise can lead to life-long medical harm — that’s pound foolishness.Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to over 285,000 State employees, retirees and their dependents.
This program aired on October 17, 2007. The audio for this program is not available.
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