By the Editorial Board
St. Louis Post-Dispatch, February 24, 2019
Soaring insulin prices are a genuine emergency in America. Many diabetics, suddenly unable to afford their prescribed doses, are self-rationing or using expired supplies. In the world’s most advanced nation, some are dying because they can’t afford a simple injection.
Critics allege artificial price inflation by the insulin industry. Congress finally is conducting hearings to rein it in.
But on this medical topic and so many others, the underlying problem is a health care system obsessed with profit, even if it means suffering or death for patients who can’t pay the asking price. The insulin crisis is one symptom of a wider emergency that won’t end until America fundamentally changes its health care delivery system.
Type 1 diabetes develops when a person’s pancreas stops producing insulin, which regulates blood sugar. Diabetes was virtually always fatal until, almost 100 years ago, scientists discovered how to process injectable insulin from animal pancreases. Synthetic insulin followed.
Type 1 diabetes still can’t be cured, but that it can be managed remains one of medical science’s greatest achievements. For the 1.25 million Americans living with type 1 diabetes today — and for many of the roughly 30 million more living with the less severe type 2 — consistent access to insulin is a matter of life or death.
Insulin prices have skyrocketed recently, far beyond rates of inflation or most other prescription drugs. One vial of insulin that sold for $31 in 2001 now costs $270. One father told a congressional hearing in December that the cost of his 13-year-old son’s three-month supply rose from $300 to more than $900 in one year.
Uninsured diabetics, or those with high insurance deductibles, have responded by using less insulin than they’re supposed to, tempting a range of health hazards. Victims include people like Alec Smith, 26, of Minneapolis, who died in 2017, weeks after aging out of his parents’ insurance coverage. He couldn’t afford a $1,300 insulin refill and tried to self-ration his existing supply.
The causes of the price spikes are maddeningly unclear. Major insulin manufacturers like Eli Lilly have blamed supply chains, the insurance industry and others. Critics allege the manufacturers engage in underhanded strategies to fix prices, obfuscate pricing methods and keep generic insulin out of the U.S. market. Congressional Democrats and some Republicans have vowed to get to the bottom of it. They must; lives depend on it.
But the insulin crisis is just one element of a broader problem: America’s entire health care system is far more expensive and far less accessible than in other developed countries. The claim that market-based medical care works just fine grows more dubious by the day.
When otherwise healthy 26-year-olds are dying because of the terms of insurance policies, it’s time to look seriously at alternatives closer to the “Medicare for all” model.