Reply #12: At work (yes I work for an HMO) we are told that

[ikojo]

co-pays are increased to make the patient "part of the decision making team" when it comes to health care. To make "consumers" aware of medical costs.

I am of the opinion that high co-pays act as a DISINCENTIVE to seek care. Some people simply cannot afford a $25 copay to see a specialist (I pay $20 to see a specialist) or $100 for an ER visit. I know I think twice about going to the ER if I have a really bad migraine (the most common reason for me to go to an ER). I try to sleep it off rather than incur a bill for $100. I know it's cheaper than the actual bill but a hundred bucks is a hundred bucks.

Insurance companies will be pushing HRAs and HSAs more and more. Of course they will be sold to the public as means to get the "consumer" involved in health care costs.