Your hypothetical poor person isn't just poor, they're suffering in extreme poverty, and the system could be designed to accommodate them.

Tolls on a congested bridge are "regressive" but are practical and make sense. We shouldn't structure society around what makes things less convenient for the rich, there just isn't very many of them by definition. We should structure society around what improves the lives of most people, within the current realities that exists. This is the classic sin of envy where we'd actually rather be worse off if the person we envied was also worse off.

Now maybe there are other reasons to avoid co-pays, such as higher death rates in areas with co-pays. I'd be interested to see a study that demonstrated the tradeoffs of co-pays.

I don't feel comparing healthcare to tolls is that useful. Systems to accomodate people based on economic need have a tendency to introduce more costs and overhead which will reduce the efficiency that the system was attempting to solve in the first place! This cannot be said for tolls.

I was comparing copays to tolls, not healthcare costs in general. Copays should generally be small, bearable even for a minimum wage worker, perhaps pegged to an hour of the local minimum wage.

You could have income-dependent copayments to mitigate the regressive nature of this, but you are still stuck with the fact that you are incentivizing delaying care without urgency, which is mostly routine and preventive care, which does save money (IIRC, in total as well as just on that care) but also has an adverse impact on health outcomes.

> copayments

What's a copayment?

A required payment by a recipient of insurance-covered service of part of the cost of service, like the fixed £20 per doctor visit suggested upthread.

Thanks

This actually happens in the US...