In a wealthy and powerful nation you can die because you’re short on cash

And you don’t even have to be poor.

One way this can happen is if you have diabetes and don’t have good insurance.

“Nobody cared or nobody understood that without this next vial of insulin, I wouldn’t live to see another week,” said 28-year-old Kristen Whitney Daniels.

She started rationing her insulin after she was kicked off her parents’ insurance plan two years ago.

“I can’t really explain how isolating and how terrifying it is,” she said.

She’s now a patient at the Yale Diabetes Center, where a recent Journal of American Medical Association study found one in four patients reported “cost-related underuse.” Dr. Kasia Lipska treats patients at the clinic, and was the study’s lead author. She testified on Capitol Hill last week.

“This vial of insulin cost just $21 when it first came on the market in 1996. It now costs $275,” she said.

You don’t have to be very poor to have trouble paying a couple of hundred dollars a month for insulin. Why is it so expensive? Well, there are no generics, manufactures tweak their formulas regularly to keep them under patent. And… it costs that much because they can charge that much. This is the United States; there’s nobody negotiating on behalf of uninsured patients. This is not the case in places like Canada and the UK (where there are no uninsured patients, and the health services negotiate prices with the manufacturers).

(And before someone says “free market,” it’s not a “free market” when the customer dies without the product and the product is protected from competition by patents.)

But you know, I’m not really asking what the mechanisms are that produce this situation. We all know about that. What I’m asking is, why do we put up with it? There’s no reason an American should die because of the cost of insulin other than that we’ve decided we’re happy running our society this way.

We have the resources to fix this. We just don’t seem to have the moral sense to do it. As a country we should be ashamed.

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