While the study documents changes between the years 1997 and 2000, evidence shows there has been a huge rise in co-payments workers have to make for such drugs in the last three years. From 2000 to 2003, the average co-payment for a preferred prescription drug rose 46 percent to $19, while the average for a nonpreferred drug climbed 71 percent to $29, according to a 2003 survey of employers by the Kaiser Family Foundation.

In their drive to reverse declining profit rates, companies across the United States are forcing working people to choose between paying for medicine and covering the rising costs of rent, food, and other necessities.

“Pharmacy Benefits and the Use of Drugs by the Chronically Ill” was published in the May 19 issue of the Journal of the American Medical Association (JAMA). The facts presented in this report show that as a result of the employers’ drive to incrementally gut health-care plans workers are trying to get by on as little as half of their prescribed medication. The report states that in addition to raising co-payments, companies have adopted policies for “cost sharing” that include requiring use of generic drugs and mail-order services.

Health-care concessions demanded by the bosses have been central to recent union contract fights. Company demands to double workers’ monthly health benefit payment is one reason why 100,000 members of the Communications Workers of America walked off the job in 13 states May 21 against SBC Communications (see article on page 4). Health coverage was also a key issue in 138-day grocery workers’ strike in southern California earlier this year.

The report, prepared by researchers at Rand Corporation, charts the projected impact of a doubling of co-payment charges for privately insured workers among 30 employers, using information from the years 1997 to 2000. The study shows that workers reduced their purchase of eight categories of prescription medicine by more than 25 percent.

The use of anti-inflammatory drugs and antihistamines dropped by 45 percent, meaning that workers actually were able to obtain only about seven months’ worth of the medicine that was prescribed for an entire year.

Some one-third less than the prescribed amount of antihyperlipidemics, antiulcerants, and antiasthmatics were purchased by workers than their doctors’ had recommended, because the bosses jacked up co-payments. About 25 percent of the recommended dosage was not obtained by workers suffering from hypertension, depression, and diabetes.

“Patients with diagnosed high blood pressure reduced use of other drugs by 27 percent when co-payments doubled,” the report says. “These estimates imply that a doubling of co-payments would reduce days [of medical treatment] supplied by more than 1 month” annually for patients with high blood pressure.

For diabetics the picture is as bleak as those using drugs for short-term illnesses. Diabetics purchased 25 percent less drugs than those doctors prescribed to treat their illness in all cases, as a result of the rise of co-payments.

“Our findings raise concern that co-payment increases could lead to adverse health consequences,” said the authors of the study, in an understatement. The figures show that when workers are charged more for health care, they are unable to afford the necessary medicine and so risk more serious health problems later on. As a result, the report states, there is an “increased use of emergency department visits and hospital days for the sentinel conditions of diabetes, asthma, and gastric acid disorder.”

While raising some concerns about the impact of rising co-payments on workers’ health, the Rand researchers approve of measures that penalize working people who opt for brand name drugs to fill prescriptions.

On average workers in the United States pay 27 percent of the premium for health coverage, according to Paul Fronstin of the Employee Benefit Research Institute in Washington, D.C. Demands by employers like SBC for pushing higher premiums on workers will grow even more insistent, Fronstin told the San Francisco Chronicle. “We haven’t begun to see what’s possible in terms of cost sharing.”

In fact, health-care premium charges for workers are rising faster than companies’ costs. A study of 864 California companies showed that between 2000 and 2003 employer costs rose 42 percent for providing family coverage, while payments demanded of their employees’ grew by 70 percent. Gary Claxton of the Kaiser Family Foundation summarized the bosses’ strategy: “It’s hard to ask employees to take a wage cut, so if you want to (cut costs), health care is a way to do it.”

The Rand Corp. study targeted those who are privately insured. Meanwhile, some 70 million people in the United States had no insurance at some point in 2002, and nearly 45 million had no insurance throughout the entire year.

Reflecting the conditions under which undocumented immigrants have to live and work, Latinos had the lowest rate of health insurance of any group in 2002. Only 40 percent of Latinos had health insurance for the entire year, compared to 80 percent of whites and 65 percent of Blacks, according Center for Economic Policy Research. Just over half of young adults, between 18 and 24 years old, had medical coverage year-round.  
 
 
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