To be appalled at people dying in the USA because of the cost of insulin

[WeBuiltThisBuffetOnSausageRoll]

A 27yo man in Virginia, who had type 1 diabetes, died last month because he couldn't afford to pay for the insulin that he needed to keep him alive and healthy.

Up to the age of 25, he was covered on his step-father's medical insurance, but once he turned 26, he was on his own. He was in a low-paying job which didn't come with adequate health insurance, so he saw no alternative but to buy the much less effective (and much less suitable for his needs) cheap variant over-the-counter at Walmart and then ration it to eke it out as much as he could.

I saw a report today suggesting that this is far from the norm. One family has a child whose insulin costs them £1,200 a month. It's their biggest single family outgoing and they sometimes have to sit in the dark or the mother go without food herself to be able to afford it. Of course, as he grows, he will be needing to eat more food and therefore need more insulin. Whatever would the family do if they had another child who developed T1D?

At best, it seems that ordinary people can find themselves very limited in their job/career choices and will often have to take any job based on what insurance cover it comes with, rather than one based on their skills, abilities, qualifications, experience, interests etc. At worst, the poorest, most vulnerable and/or least educated will not be able to get into any job that comes with the cover they or their families need.

It's much, much cheaper in Canada, so Americans who live anywhere near the northern border travel over and stock up there whenever they're able to; but the USA is a huge country, so this will not be a feasible option for the vast majority.

We see and hear all of the heartbreaking reports and appeals from poor countries in Africa, Asia and eastern Europe, but THE USA?!?!

I know our NHS is far from perfect, but we have an immense amount to be grateful for.

How do American MNers manage to deal with this; or indeed, people from anywhere without an NHS or similar public set-up? Are these the full, true facts? Are people in the richest country on Earth really just tossed into the trash so easily and left to die for getting ill?

Makes me really sad. I've been T1 diabetic since aged 1, in the UK, so have never needed to pay for insulin.

It's so disgusting that money can be valued more than a life.
Money can be the root of all evil.

You think money isn’t guiding the NHS treatment protocols? Nobody except for people who 100% private pay have full control of their healthcare. The difference for the rest of us is which entity we give that control to.

From what's been reported on the news here, aren't the cuts in funding to Planned Parenthood due to fundamentalist mainly Republican politicians? Absolutely outraged that PP offers abortions?

It's so disgusting that money can be valued more than a life.

The NHS does it all the time, they just don’t tell you. There are many treatments that are available around the world that the NHS doesn’t offer because they are too expensive.

Exactly. So I really struggle to understand why people think that it’s a good idea to hand control to those same people.

Bombomboobah, I think for many years the US was held up as the greatest nation on earth but I think that image was broken some years ago when the full extent of the poverty and discrimination became clear.

From a European perspective there are some things about the US seem increasingly insane. That such a wealthy country should have no universal healthcare system is the most obvious one but there are many others including the gun situation, the privatised prison system and women's rights. As Europe slowly progresses, the more bizarre and undeveloped the USA looks.

Of course money guides things but I have received mainly excellent treatment on the NHS & at least I haven't had to sell my house to pay for it.
We (if employed by an employer) pay our taxes at source each month as we have PAYE (pay as you earn) so that's why it's not so much as a shock compared to getting an annual tax bill.
Am I right in thinking that I'm the US, you pay your tax to the IRS annually?

Am I right in thinking that I'm the US, you pay your tax to the IRS annually?

No it’s a PAYE system that’s an estimate, to then do a tax return at the end of the year and more often than not get a refund.

It’s fucked up
probably the only conclusion we can all agree on!
There are no easy solutions to healthcare, what ever system we devise various middleman will see opportunities to prise their way in and siphon out the profits, we need checks and balances, properly structured incentives etc

I live in the USA. My company covers my premium but we pay for my husband (who doesn’t work) to be added to mine at $400 a month for medical, vision and dental. Our maximum out-of-pocket for the year is $5000 between both of us. My company pays the first $1000. So the maximum we will ever pay on a year is $8800 for both of us - and that’s if we use the maximum. For everything. That might sound like a lot but we live in a state with no income tax. Despite being a high earner (I’m in the top 8% of salaries) I pay less than 20% tax. So the $8800 sounds like a lot but on the UK in the same job I was paying 45% tax PLUS national insurance. And I paid that month after month whether I saw a doctor or not. And it didn’t cover eyes and teeth. Or prescription charges.

Last year my husband had three major surgeries costing over $500,000. He received excellent care nothin the hospital and afterwards at home. I have epilepsy and have spent time in a NHS hospital prior to moving here. Our experiences of hospital stays were so different. If either of us ever is unfortunate enough to have to stay in a hospital again, I’m glad it’s going to be here.

I’m sorry for the man who couldn’t afford insulin. But we also have plenty of cares where the NGS couldn’t afford or didn’t offer a treatment that could help or save someone. I’ve seen so many GoFundMes shared on FB where people are raising money for treatment overseas because the NHS cannot or will not provide it. That’s just as tragic.

I prefer the US system. I have more choices with my healthcare and more control. Back on the IK I was dictated to as to which GP I had to see, only this dentist will accept NHS patients, postcode lottery waiting lists, etc. Here I choose my GP, choose my dentist, etc. Sure they have to be in network but my insurance has a really good network.

I also find that preventative care is a lot better here. The UK doesn’t routinely offer mammograms until you are 50. It’s 40 here. Bowel cancer screening is not offered until you are 60 on the NHS. It’s 50 here. We have annual physicals just to check everything’s ok. I know that if you made an appointment with the GP on the UK just to ask her/him to “test everything just to see if anything’s wrong” without any symptoms, you’d probably be told that is not what the NHS is for.

In short, the NHS has its good qualities. It saves lives. It treats the sick. Our system here is more about a whole package of lifestyle and wellness. More preventive care. Things like yoga and meditation included to help relieve stress before it becomes a heart attack. Nutrition advice before obesity becomes type 2 diabetes, that sort of thing.

Ok so you pay an estimate each month from your salary, file your tax return & usually get a refund as you've overpaid.

the USA has done amazing pioneering things, in some ways still the greatest nation but cultural/tech changes mean that what succeeded then doesnt do as well now.
I feel it still has greater peaks (compared to other 1st world countries) but it's increasingly let down by it's deeper troughs(?)
As Saltines said, It is also just really hard to grasp how different parts of the country are from each other. Things that work in one part fail miserably in others
It's a vast country!

But BritWife great if you can afford the insurance to get all that cover.
As you know we can in the UK pay extra via insurance if we want it or can afford it.

Nutrition advice before obesity becomes type 2 diabetes, that sort of thing
I'm not disputing your experiences but if it's so good why does the US have higher rates of obesity, it sounds to me like wellness for the wealthy while everyone else rots in a trailer park?
(I know the UK is also pretty bad for obesity)

@bombomboobah

The same question could be asked why obesity and T2 exists in a country with free healthcare...the answer to both questions is the same...each system depends on the people to use the services offered and take medical advice.

That's all fine and dandy @britwifeinusa you have a job and are a high earner.

You said yourself you're in the top 8% so I'm sure the system does work well for you. However it's a not a system based on equality. What about those who lose their job at a moments notice (especially since redundancy notice doesn't exist), aren't able to work (through circumstances not by choice) or aren't in as strong as financial situation as you are? They go without. They don't get care. They don't get medicine. They die. Or they get into debt. Lose their houses. End up on the streets where they probably die. For a first world country that is inexcusable.

I understand what you are saying about the NHS and tax etc. However at least in the UK if ever you were to lose your job you know you wouldn't have to worry about your health and if you needed it, you would get a hand out until you're back on your feet. You're paying into a system which you might not benefit from immediately but at some point may be grateful for. Even if you don't use it, you're contributing to a fair system.

I can see how it works for you, but you are not the average US citizen. I acknowledge that the NHS is not without its flaws and there is always the choice to go private should you wish and can afford to do so. However, at least with the NHS those who are unwell are helped when they need it most and not robbed of dignity, treated as a profit or loss making exercise or at worse left to die.

Obesity is a problem in all first world countries not just UK/US.

Obesity is a problem in all first world countries not just UK/US
indeed, but rates of obesity vary and very likely correlate with levels of inequality.

@BritWifeinUSA

GPs aren’t NHS, they are private and charge the NHS for your treatment. You aren’t at all limited as to which surgery you can use, you can choose the one you like. My GP moved surgeries, so I moved to that surgery.

You can also go to any NHS dentist, even if they are ‘full’.

GPs here offer health MOTs if people want a yearly health check. So no, you wouldn’t be told that’s what the NHS is for.

Mammograms start at 47 in most areas, bowel screening is 55. Of course there is nothing stopping anyone being screened earlier, all they need do is ask, those in at risk groups are offered screening much earlier. I am in an at risk group for bowel cancer so I’m screened every year and I have been since 18.

The NHS does offer preventative care (no matter your earnings), those at risk of type 2 diabetes, heart disease etc can access a dietician, free gym membership, free slimming world membership etc. Those at risk of falls are often referred to physio group sessions to improve physical strength.

the USA has done amazing pioneering things, in some ways still the greatest nation

Yes, Trump, guns, racism, wars, tearing families apart, MAGA, ignorance of climate change and media bias. All that good stuff! Go America!

@zxcvhjkl

We do have safety net programs for those situations mentioned. It doesn’t work for everyone and in every situation but no system does.

I’m not sure where the misconception that the US doesn’t provide help to it’s citizens comes from, but it is just clearly untrue.

Most Americans happily pay into these safety nets. There starts to be disagreements when determining what those nets cover and for how long, but I can confidently say that there is not a general want to see granny starving in the streets or Jr. not eating.

If you were to lose your job in the US, you can file for unemployment, you can opt to pay for continuous insurance at a higher rate, you can purchase an individual plan, you can apply for Medicaid, or disability.

We have all of the same programs you have.

But we here don’t have to be in “at risk” group to get things. We get things before the risk becomes apparent or just because we want them. It’s our health, our choice. Heart disease rates are lower here. I have lost so many relatives on the UK to heart disease, I’m glad I’m here where there is no limit to what will be spent on my health.

You can try all you like to convince me that the NHS is better, and maybe it is for your personal situation, but having lived in both countries (and other countries), I know that I have a much better quality of life here and it’s not just because of better healthcare. And no one can convince me otherwise so there’s no point in even trying. Have you lived here?

“If you were to lose your job in the US, you can file for unemployment, you can opt to pay for continuous insurance at a higher rate, you can purchase an individual plan, you can apply for Medicaid, or disability. ”

Unemployment pays a fraction if your salary.
The option to pay for continuous insurance while unemployed at higher rate is only if you are eligible for COBRA and have savings
Yes, you can purchase a plan on the marketplace but you need savings for that
Medicaid you are out of luck if you’ve already earned over the poverty line in the past 12 months
Disability takes 2-3yrs to get approved...most are denied.

The safety net is more like tissue paper

@BritwifeinUSA

You don’t have to be in an at risk to access any screening here either, however if you are in an at risk group you are frequently reminded to attend a screening. If I’m even a week late I end up with phone calls, letters and automated texts. If I wasn’t in an at risk group I would still have full access to bowel screening if I wanted it, you can do it at home or hospital, which ever suits the individual.

I lived in the States for 18 months (Washington DC), as a type one diabetic I really struggled to get the type of insulin that works best for me as my insurance decided it was too expensive and the doctors my insurers covered wouldn’t treat me if I sourced my own insulin. So my choices were poorly managed diabetes or self manage and hope I didn’t need hospitalisation.

Insurace also wouldn’t cover my bowel screenings as I was under 30, luckily it was ‘only’ about $3000 to be screened.

I know doctors in the US (hugely paid - and I mean HUGELY paid) and people with critical illness/on disability. I would not want to be sick out there.