Photo: AP

The rolling disaster of the insulin market in this country is one of the most shameful stories of our healthcare system today.

The cost of insulin has doubled over the last five years to an average of $450 per month, even for older styles of insulin. (The drugs aren’t twice as good.) A recent study found that the rate of ketoacidosis, a potentially lethal complication of diabetes that is prevented by regular use of insulin, is far higher among U.S. young adults than their Canadian counterparts, in part because “uninsured rates rise dramatically in young adulthood in the United States.”

Because of this cost, one quarter of diabetics ration their insulin. Sometimes, these patients die.

One such patient was Alec Smith, who died in 2017 just a month after he aged out of his mother’s health insurance. A bill named for him in Minnesota would have provided a supply of free emergency insulin for those who could not afford it—for example, if they couldn’t afford to meet their deductible, or if, like Smith, they didn’t have insurance. This is long overdue; last week, Colorado became the first state to even put a cap insulin co-pays, doing so at $100 a month, but only for those who have health insurance.

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But the Minnesota legislature failed to pass the insulin bill during its 2019 legislative session, which ended on May 26. According to CBS Minnesota, the bill’s supporters were “blindsided” by the failure.

One Republican state senator who initially supported, but then voted against, the bill told CBS that there were “too many loopholes,” with “too many questions about who would qualify and for how long.” (How about “anyone” and “forever?”) CBS reported that the bill failed because Republicans, who hold a narrow majority in the chamber, thought “too many details about who might qualify and how to pay for it were not included.”

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The “How Will We Pay For It?” question—a cousin to “who will be covered” and “how long for,” which are really questions about cost—is one that is always proposed by opponents of government funding of any kind, even when the answer to that question is that whatever would be provided is currently being paid for by taxpayers in the form of drug costs or premiums. Why is it “cheaper” for individuals to buy their own insulin, or any drug, than for the government to buy it for them according to need and provide it for free?

It isn’t. It’s just a question of who the “we” paying for it is. And defining only government spending as spending that “we” do, instead of including the ridiculous costs paid by individuals who have no choice, is how conservatives keep government lethally small and allow private drug companies to keep gouging the public.

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If they were actually interested in reducing the costs, the government taking over the provision of insulin would save a lot of money, since that price-gouging profit layer would be removed. But no, the question is asked because saying “we prefer a situation in which people die if it means redistributing the payment of these costs towards the wealthy or to business” is less palatable.

We already pay for it. We pay in the lives of our neighbors, friends, and family who suffer and die because of profiteering pharmaceutical companies. But nothing changes, because it’s not Republican politicians whose kids are dying. How’s that for a loophole?