>>Should the insurers costs be a factor in patient care? No. This is a very odd view to take. I live in a single-payer system (Canada), although we don't have

>>Should the insurers costs be a factor in patient care? No. This is a very odd view to take. I live in a single-payer system (Canada), although we don't have a similar system for prescriptions (yet). I have supplementary medical insurance through my work. Of course I want my insurer to keep costs low; that means more money to pay for important things, and lower costs for my employer (and by extension, me). I take two regular prescriptions, and I happily accept generics, because they're cheaper and they work. If they didn't, and the name-brand would for some reason, then yes, I'd expect my insurer to pay for that. But to default to the lower-cost one is not a bad thing for patient care. If you think the insurance companies are taking too much money from this relationship (I do) or if the whole idea of barely restrained medical capitalism is immoral (I do) or if insurance companies should have much less control over medical decisions (I do), I can understand that, but especially in the current system this is one of the few good ways to keep costs slightly lower.