Healthcare: A Human Right or a Privilege?

Health insurance is something most of us don’t think about unless we must. The United States doesn’t have a national health care service, so if you need treatment you need to have an insurance plan or you pay out of pocket. I feel like most of us don’t tend to worry about this until we get sick or get into an accident. But the thing with that is that an accident can happen to anyone at any time. No matter how hard you try, you can’t really prepare for the unexpected. I can’t even count how many stories I’ve seen and heard about people who have a sudden accident or the onset of an illness and are stuck struggling to pay. If you go on GoFundMe, you can find countless people who are struggling to pay their medical bills and are relying on crowdfunding to cover the high costs of their health. These are people who might be in danger of losing their homes or already have, who are working multiple jobs all to pay off medical bills. It’s scary to think how an accident or a diagnosis can turn your entire life upside down, which is probably why people don’t like thinking about it. I mean, you don’t want to think about healthcare because you’re healthy, you take the right precautions, you watch your diet, and you don’t take unnecessary risks, so there’s no way this could happen to you, right? Unfortunately, it’s not so simple. Believe me, I would know.

I was diagnosed with type 1 diabetes when I was about 10 or 11. I remember being sick and feeling horrible for about a week. I was vomiting and couldn’t keep any food down and overall, I just felt awful. I ended up being taken to the hospital in an ambulance and after a few tests, a doctor came in to explain the diagnosis to my parents and me. Now I know that when most people hear diabetes, they immediately think of sugar right? I can’t count the number of times I’ve heard people refer to a dessert as a “plate of diabetes” or say that if you eat too much sugar, you’ll get diabetes. Well, let me assure you that is not how it works. I did not get diabetes from eating too much cake. Currently, the exact cause of type 1 diabetes is unknown, but genetics and exposure to viruses and other environmental factors are somewhat involved. Type 1 diabetes is an autoimmune disease, which means that my immune system mistakenly attacked my own body specifically the insulin producing cells in my pancreas so now my pancreas produces little to no insulin. I’m not going to go into too much detail, but basically insulin is very important and not having any can cause life-threatening complications. Did I mention there’s no cure? The lifelong treatment is taking insulin through daily injections or through an insulin pump. If you want to learn more about type 1 diabetes, and I urge you to do so, visit https://www.jdrf.org/ or https://www.diabetes.org/diabetes/type-1

So, all it took was one diagnosis and my life had completely changed. I was suddenly dealing with learning how to function on a day-to-day basis with a chronic condition. I had to learn how to check my own blood sugar, recognize the symptoms of high blood sugar versus low, how to respond, and how to give myself injections. One benefit from all of this was how quickly I got over my fear of needles. What I wasn’t aware of at the time was the financial strain that came from the hospital bills, the ambulance, the equipment, the insulin, and the doctor appointments. My parents were the ones who had to figure out the insurance, I barely remember it. Now, there are still many headaches involved when dealing with insurance. There have been times where I’ve had to have medication, supplies, and even doctors switched to ones accepted by my insurance company. That is the least troubling thing though. But I am grateful, I know I am one of the lucky ones. I am covered by my parents’ insurance for now, and I can get access to what I need. There are so many people, not just diabetics, who are not so fortunate.

According to some studies, in the U.S. approximately 62.1% of all bankruptcies are caused by high medical bills and more than 2 million people are critically affected by their medical expenses ^[1]. Specifically for diabetics who need insulin, like me, the rising costs of insulin have made things extremely difficult. Insulin does not cost much to produce, yet its price keeps increasing. By 2016, the price of insulin has jumped by 700% in just two decades ^[2].

• In 1996, when it was introduced, a 10-milliliter vial of Eli Lilly’s Humalog insulin cost $21, while in 2019 the same vial costs $275.
• In 2001 Sanofi’s insulin brand Lantus was introduced at $35 a vial, which increased to $270 in 2019.
• In 2001 Novo Nordisk’s Novolog cost $40 and as of July 2018, it costs $289 ^[2].

Now keep in mind that a lot of type 1 diabetics need more than just one vial of insulin per month. Some, like me, even take more than just one type of insulin (fast-acting and long-acting). And this is just the cost of insulin, there are plenty of other medical expenses involved. The American Diabetes Association’s (ADA) research from 2018 shows that the average total costs of diagnosed diabetes has risen from $245 billion in 2012 to $327 billion in 2017 (26%). This makes diabetes the most expensive chronic disease in the United States ^[3]. Now breaking down 2017’s total estimated cost of $327 billion, $237 billion is used in direct medical costs and $90 billion in reduced productivity. Based on this research:

• 30% of the total medical cost is used up in hospital inpatient care.
• Another 30% is used is prescription medications to treat complications of diabetes.
• 15% in anti-diabetic agents and diabetes supplies.
• 13% in physician office visits ^[4].

So, I think you get the point. Living with a chronic condition is incredibly expensive in the United States. You may be wondering what happens if you can’t afford treatment, how do people cope, what happens to them? Unfortunately, our bodies need insulin, and people cannot survive without it.

• Jesimya David Scherer, age 21, Minnesota (June 28, 2019): Jesimya had been working two jobs to support himself and was working towards becoming an electrician. He did not have enough money for the insulin he needed and began to ration what he had. He was hospitalized in April for diabetic ketoacidosis and died in June.
• Jada Renee Louis, age 24, Virginia (June 22, 2019): Jada was forced to make a choice between paying her rent that year or paying $300 for her insulin. She had to ration the insulin she had, which landed her in the hospital for a week in June. She died a week after coming home.
• Kayla Davis, age 28, Kentucky (June 5, 2019): Kayla could not get her insulin prescription filled until her doctor submitted the necessary forms to get it covered by Medicaid. She had to ration the insulin she had while she waited, getting sicker and sicker. She died from diabetic ketoacidosis. The approval for her insulin came through the next day.
• Meaghan Carter, age 47, Ohio (December 25, 2018): After losing her job and insurance, Meaghan struggled to afford her insulin which was more than $800 a month. She had to buy a cheaper more unpredictable insulin from Walmart. She died one day before she would have received a paycheck.
• Micah Fischer, age 26, Wisconsin (November 4, 2018): When Micah turned 26, he couldn’t be on his father’s insurance plan anymore. Under his new insurance his insulin would cost $1200 out of pocket. Micah was going to start a new job in October, a job that came with an insurance plan that covered his insulin. This plan required a one month waiting period, so Micah was forced to ration the insulin he had. He died two and a half weeks before his new insurance started.
• Alec Raeshawn Smith, age 26, Minnesota (June 27, 2017): When Alec turned 26, he was no longer covered under his parents’ insurance plan. Alec’s job did not provide insurance and he made too much money to qualify for Medicaid. Alec went uninsured because the cheapest insurance plan had a $7500 deductible. He was paying $1300 a month for his insulin and other medical supplies, which was almost half of his salary. He died from diabetic ketoacidosis, less than a month after having to go off his parents’ plan ^[5].

You can learn more about them and many others here: https://rightcarealliance.org/activities/insulin/

It is truly heartbreaking to read these stories. Unfortunately, the cost of medical expenses keeps rising and because our healthcare system does not provide much help, more and more people have been turning to crowdfunding. Sites like GoFundMe are becoming more and more popular. Research shows that between May 2010 and December 2018 26.7% of fundraisers on GoFundMe were for medical expenses and those fundraisers sought a total of $10.3 billion and raised about $3.7 billion ^[6]. It’s outrageous that people must turn towards fundraising just to afford life-saving treatment which, unfortunately as you’ve seen, doesn’t help everyone in time. I think you know that there is a serious healthcare crisis when people are getting the most help from crowdfunding sites rather than from the actual government. Why is it that things like insulin, wheelchairs, glasses, and other medical expenses cost so much? It is absolutely ridiculous that so many people have to pay so much money just so they can live their lives like everyone else. In the case of insulin, people should not have to pay money to not die. Action must be taken by the local, state, and federal levels of government to put price-caps on life saving medication and equipment. Or better yet, maybe it is finally time for America to change its entire health care system and provide free health care for all.

Ways for you to help now:

• https://affordableinsulin-change.org/
• https://www.petition2congress.com/ctas/reduce-insulin-costs

Works Cited