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?

JFC. As someone sitting here recovering from gallbladder surgery on the NHS I’m gobsmacked at what I’m learning about the US system. I’m a woman who took 10 years out of my working life to look after the kids because the sums didn’t add up for me paying for childcare and working. Granted my partner had a good job that equates to us both earning the average UK wage (£24k?) But we’ve no savings and pay a hefty mortgage. I was feeling panicky about our situation so can’t imagine factoring in the fear that comes with a diagnosis of a serious/chronic illness or just something as ‘routine’ as a gallbladder op. Or just a random accident. I pray we can protect our NHS from privatisation in the coming shitstorm that is Brexit.

'@saltinesandcoffeecups'. You seem to be completely missing the point of what HV are about.

It's not a case of HV 'wanting to enter our homes' and apart from the stupid ideas of the poster who said that anyone who doesn't want a HV has something to hide, no one, but no one, assumes that refusal to have a HV in your home would make you suspected of having something to hide.

That is the opinion of the poster not the opinion of HVs or anyone else I've every come across, and certainly not the opinion of NHS or our government.

Yes, the NHS is a government department but nurses and HVs are not instruments of the state and no one in the UK would view them as such.

I think you're being disingenuous to imply that as government employee they somehow have some sort of weird agenda.

Are you so fearful of the powers of your government that you would assume a nurse because she/he is a government employee would and could be used in such a way?

What on earth do you imagine these, 'employees of the government' are going to be doing if they come into a new mother's home in order to help her with any issues she might be having with her new baby or herself.

I can assure you whatever you imagine they might be doing they are there to care for their patient/client not to spy on them or look for things they can report back to their 'masters' in some sort of health visitor dictatorship.

I was asked if I wanted the HV to come and I jumped at the chance. My mum was 600 miles away and elderly and it was with my first baby. He had jaundice and I obviously didn’t know what I was doing.

But there to snoop - there to support and we don’t pay them. That’s what some Americans can’t get - there is no agenda! Big Brother is not watching.

On the HV subject , I am not sure what other explanation is needed from me. You can explain all you want, but it doesn’t change the fact that this would be perceived as a huge privacy violation from a gov’t entity by a significant portion of Americans.

It is a fundamental difference between the citizens of of our respective countries.

To you it’s a helpful perk, to us (in general) it would be a privacy violation and intrusive. Neither is right or wrong,but is an indication of the general feeling of the populace.

I do understand from what I’ve learned what the purpose is of a HV, what you don’t seem to understand is how the average American would feel about that.

Let’s put it this way, you’ve been ingrained from birth to believe that your government has your best interest at heart. Most Americans are brought up to believe that they should be wary of their government and that we need to preserve our checks and balances and to question and challenge the authority at at every opportunity.

It’s no surprise then that we may have an overdeveloped sense of skepticism when it comes to strings attached to whatever is being offered.

This is honestly one of the fundamental differences that I suspect neither population can truly understand of the other.

But you can say no to a visit from a Health Visitor, so it's not a violation of your privacy! They come to your house (once!) in order to save the new mother from having to get out and about. You can refuse a visit or see them at the baby clinic instead if you prefer. All subsequent visits take place at the baby clinic.

US attitudes to healthcare do seem to be very much a fixed mindset of any state help is bad, regardless of whether it may improve their lives. What is the view in the US of Northern European/Scandinavian health and social models which generally report amongst the happiest citizens in the world?

Saltines, I think it's an age-old problem with the us and the UK, that we conflate shared language with shared culture and are unable to fully appreciate the implications of the historical and geographical differences

The USA and the UK!

@bombomboobah

Agreed! It’s like we feel like we should be similar and then are surprised when we aren’t. That last 200 or so years has really made a difference.

That’s why I’m the first to say...hey if it’s working for you great! I don’t presume to think a different way is better. I will though be one of the first to say if I don’t think it’s right for us and why. And I saw this knowing that are many in my country who disagree with me.

But at the end of the day a chance to hear different perspectives is good, no?

My officemate was moaning about the NHS and not being able to have appointments when he wanted and how at home (not the US) he could. So I asked if there was a healthcare system there. 'Oh no, it's all private, I spent 1/3 of my income on private medical insurance' he said. NHS doesn't sound so bad when you hear that (and he lives in a country with an enormous divide between rich and poor so many people don't have any healthcare).

I work with people in the States, they all are professionals who work for Pharma, so have very good insurance through work. But the exemptions and copays mean they are spending thousands a month on healthcare. It's insane.

Healthcare cost the US twice as much per person as it does in the UK but fewer people are covered. Giving birth is 10x the cost it is in the UK but they have higher maternal death rates. Their cancer survival rates is about the same as ours (so worse than most of Europe) despite spending more and having all those tests.

@saltinesandcoffeecups. Do you honestly believe that the majority of people in the UK think that any government has the best interests of the citizens of its country at heart.

Do you know many British people?

In the USA is it much of an advantage if you're someone who's a health freak, I mean if you're really into exercise and healthy eating does that mean you'll get lower premiums?

Hahahahaha, lower premiums? No.

Seriously, who could be bothered spending hours trawling through insurance policies for healthcare? We all know they are weighted in favour of the insurer anyway - we all have insurance, just not necessarily for healthcare, and we all know it's a rigged system.

I note that many of the people on here who defend the US system of healthcare are people who are wealthy anyway and would flourish in any system of healthcare because they have the choices given to them by their own good fortune.

I can't even pretend to understand the weird tin-hattery of thinking anyone working in the public sector is a government spy. In the UK we're most certainly not brought up to think our government is always benign but we view people who work in the public sector as other human beings just doing a job, who are more than likely on our side since they are just like us. The idea that they are the UK equivalent of the Stasi would be ludicrous to us. Most Brits are by nature cynical but, in general, we aren't paranoid. If that is how Americans think then I genuinely feel sorry for them because thinking that your government is out to get you must be pretty unpleasant.

The death was tragic, no question, but it's their system. They voted for it. And compared to many in the third world, it's quite efficient.

saltinesandcoffeecups

I think the 'why wouldn't you let a HV in' is not about having anything to hide it's more like, you have fallen off a ladder and broken a couple of bones, an ambulance and a couple of paramedics have turned up so why on earth would you send them away?

As for NHS staff being government employees - go talk to a couple. There is a bit of a standoff with government and midwives here, the government want to charge women not entitled to health care for maternity services. The royal college of midwives have come out clearly against it.

In the UK emergency health care is available to all regardless of why or how you are in the country.

www.theguardian.com/society/2019/sep/09/end-nhs-maternity-charges-for-vulnerable-migrants-say-midwives

because the state isn't going to help you when you get into trouble.

A lot of people here really don’t want state involvement in their lives.

I showed friends here the Sid the slug NHS adverts and they were astounded and confused, they couldn’t understand why people were happy having a government treat them like children

Yes, the UK government does usually use ridiculous, childish adverts. They've even recently started using the words 'pee' and 'poo' because, presumably, they think that people won't know what 'urine' or 'faeces/stools' mean. They also have adverts trying to encourage people to pay into pension schemes (not a bad thing at all) with the slogan "It's like having another you", with the normal-sized actor playing the employee 'earning for now' and a miniature-sized version of them 'earning for your retirement'. Ugh.

We currently have TV adverts imploring us to 'get ready for Brexit'. Considering that Boris and his cronies and all the 'experts' don't seem to know what to do to prepare for a still mainly-undecided quantity, I'm baffled as to what they expect ordinary folk to do. It reminds me of when Homer Simpson was promoted to Safety Manager (mainly to get him out of the way where he was causing most of the accidents!) and all he could really think of to perform his role was to tell everybody to "Safen up!"

However, I think this and some other replies is demonstrative of the chasm between rich and poor. If you're self-sufficient, you're completely at liberty to scoff that "I don't need your charity/help/assistance/interfering" - but what about the people who do need it and don't have the luxury of turning offers of help away?

For the majority of people, they'd be absolutely stuffed if they ended up with a major medical emergency and ended up having to pay hundreds of thousands or even millions - but there are plenty of us for whom a few thousand, or a few hundred, or even a few tenners are beyond our reach.

It's completely irrelevant if you could potentially get $1million of treatment every month for an insurance cost of $1,000 per month if you don't even have $100 available, much less $1,000. The frequent reaction? You need to prioritise, work harder, get a better job etc. Try telling that to the chap upthread who did exactly that whilst he was able, but once MS struck, his successful life was over and his wife stuck living on a different continent.

The NHS covers most things apart from eyes and teeth.

Currently, we're skint for a number of reasons and I recently had an eye test (which I qualify for to get free on the NHS - most adults under retirement age have to pay) and the result was that my eyesight prescription had changed. The optician is a friend, but even with mates rates, it will approximately £75, so it's gone on the 'wish list' and we'll see what the new year brings. My eyesight isn't as perfect as it could be, but my current glasses are still serving me OK; I can wait and it's no big disaster.

However, if I were suddenly told that I had to pay for my own insulin.... That would be me instantly stuffed right there.

The death was tragic, no question, but it's their system. They voted for it. And compared to many in the third world, it's quite efficient.

But did the man who died vote for it? Were the Democrats offering a guaranteed solution for people in his position, had they been elected? Even if they had, democracy means that 51% can get what they want (in practice, it's often far fewer) - and that's assuming there is something they 'want' rather than having to choose which of the two options they hate less - and the other 49% (or more) have absolutely no further say in the matter. Yes, that's democracy, but it's far too simplistic to just say "Well, that's what they voted for".

From everything I hear, it is quite efficient for most middle-class people who have insurance and which doesn't refuse to pay out for whatever reason, but not for millions who slip through the cracks - quite often those who have the most need for healthcare in the first place.

No one really likes paying taxes but we know it's for the greater good of society.

In my experience, many in the US (of those who could afford to pay more tax )
are terrified of social-based healthcare because they see it as eroding the work ethic. The thinking is that If people are given handouts they will have no motivation to work

And, of course, people who can afford health insurance are afraid that the service they receive would get worse if the system was run to cover everyone. They feel that they have worked hard to get where they are and just do not see the privilege that support them while they worked hard.

There again, they blame the rise in homeless people in LA on the (relatively new) commuter trains, saying that there were many few homeless before the trains were built. The homeless must be travelling in on the trains.

It is truly shocking.

I am 100% convinced that Johnson and his coterie want the HMO type US medical approach in the UK. They believe that if it walks it should be privatised. He won't say that now, obviously, but only if he won an election. I really believe that.

OP I read about a mother whose son died because he couldn’t afford insulin too, and she is now very vocal and pushing legislations To make insulin more affordable , wonder if they are the same person. ?

I get the sense it’s more about making money and not making people better.

but Aren’t insurance company worried about people traveling to Mexico or Canada for medicine? It’s estimated that close to 1million American get their insulin/BP tablets from Mexico as it’s a fraction of the cost, even if they are not allowed to get more than a 90 days worth of pills , it’s still much cheaper to travel and get them across the border.

I use the French health service both private and semi private which technically is not very different from US? . and it’s so much more affordable,

my mother’s insulin and BP medication is so much cheaper compared to the US, i was told it’s even cheaper than Mexico .
And people are generally healthier in France, for having a better affordable health care plan.

*but Aren’t insurance company worried about people traveling to Mexico or Canada for medicine?

No - at that point you are Someone Else's Problem. As long as they didn't have to pay even if it means you cause yourself complications down the line they're satisfied.

American attitudes towards socialised healthcare, health visitors, and the government do tend to be very regional. I've met very few people with attitudes like the ones being described on this thread and they invariably fall into a few categories:

1. 60+ -- attitudes towards health insurance are very different as this group is the "bridge" group who grew up with affordable doctors before the rise of health insurance but will end their lives in a world where health insurance is necessary, but who have likely begun to draw down on either a pension-linked plan or the limited socialised care.
2. Privileged -- very employable, have always had steady work, and generally falling into a higher income bracket. Many of these simply can't understand why some people can't "get it together" and just do the same thing, without understanding that opportunity doesn't come equally distributed in life.
3. Tinfoil hat. They think the government gives WAY more shits about them than it really does.

Saltines said that employer provided insurance does not discriminate.
I know someone who works for Planned Parenthood. Apparently a lot of employers will not cover contraception nor terminations- which are of course the result of no contraception.

The Catholic influence of employers and insurance companies is more invasive than you would think.

Insurance companies are not benign entities.

I could never understand it Gwenneh TBH

It’s everyone’s right to an adequate health plan.

We take these things for granted in most European countries, we never think “god how will I afford it”?

When we lived in the ME a couple of years ago, I asked an American DR who worked there about the Obamacare and what she told me sounded just like any progressive country health care system. So why is trump trying to tear it down? It’s not just personal ,is it to do with insurance/medication companies?

@DemiGorgon I don't think it's the case that "a lot" of employers request the exemption of contraception and terminations, but the cases where this exemption is being used are quite high-profile. You can't just rock up and request an exemption since the ACA requires that coverage -- this explains how companies can exempt themselves from the legal requirement.

The fact that it exists at all is ridiculous but there it is.

As to why the current administration continually attempts to dismantle the ACA, one only has to look at where the lobby money comes from -- pharmaceutical industry companies spent nearly $200m last year in lobbying. It's not a partisan practice either; candidates of all parties receive this money to push agendas through. It just happens to be the party in power also wants to appease a voting base who were disenfranchised with the previous administration.

The thinking is that If people are given handouts they will have no motivation to work

But can't they tell the difference between giving people money that they can spend on whatever lovely things they might want and giving people prescription drugs that they need to stay alive? Do they think that children who are born with a serious condition or develop it in early childhood should be denied life-saving drugs because, otherwise, a sick 4-year-old just won't have the drive to go out to work?