Let’s revisit an earlier example to get started.
Remember
, the girl with cystic fibrosis whose story we opened this course with? Zoey is taking Trikafta, which has a “list price” of around $300,000 per year in the US, before discounts (we’ll get into discounts in a bit). How can most people afford that?The answer, of course, is health insurance.
In Chapter 4 we talked about how drugs like Trikafta and Zolgensma are very expensive — way more expensive than any one person or family can typically afford — but that those temporarily high prices are what incentivizes investors and companies to take risks to develop breakthrough medicines. According to Vertex, the company that developed and sells Trikafta, more than 99% of people with cystic fibrosis (CF) who are eligible for Trikafta have access to it through their insurance plans (and Vertex provides assistance on top of that).
So who pays for insurance to make all that possible? You do.
Whether it’s through your tax dollars financing government programs like Medicare, and/or with a premium payment taken out of your biweekly paycheck, the vast majority of us pay into insurance so that when any one of us happens to get sick and need it, insurance is there. This is how insurance is supposed to work.