Letters: Co-Payments and Beyond

To the Editor:

In his Economic View column, “When a Co-Pay Gets in the Way” (Aug. 11), Sendhil Mullainathan argued for the elimination of co-payments for drugs with proven benefits for the recipients. I agree, but even more can be done to improve the odds that patients will always take their medications over the long term.

In addition to the co-pay barrier, other factors can reduce adherence to medication. Receiving just one- or three-month supplies of chronic or maintenance mediations can cause such lapses. And the cost and inconvenience of an office visit, simply to arrange for a new annual prescription, can be burdensome as well. A patient may have to miss work just to have such an appointment.

Perhaps a longer supply of medication, along with the availability of a nurse for consultation by phone, could further drive long-term adherence to proven drugs.

JAMES P. REICHMANN

Marietta, Ga., Aug. 11

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To the Editor:

Co-payments for medications are only part of the problem. Last year, my health plan started charging $40 for any specialist and $200 for an emergency room visit, even with a premium of close to $800 a month. That adds to the stress of deciding when to go to specialists or the emergency room, even when it’s medically necessary.

If a basic level of free health care were funded by all taxpayers, we could solve many problems and change the economic landscape of this country. We wouldn’t have the stress of worrying about how to afford to stay alive — and the nation’s job creators would no longer have to subsidize employees’ health care costs.

SUSAN A. MCGREGOR

North Kingstown, R.I., Aug. 11

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