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?

@patnotpending

Interesting point.

saltines No, the main problem my cousin and her DH had nearly 100k in medical bills, including all 4 in the family, not just her
Being without income for 6 months for them at that stage in his career was about 50k loss, so total loss was 150k

The consequence was he had to grab the first job that had adequate medical insurance, which wasn't one that offered good promotion prospects
He couldn't move jobs after that - for middle aged employees not at the 250k+ salary level, I gather health insurance for expensive chronic ailments is an additional strike against them

So his career stalled and they never caught up to where they would have been.

If the system just failed several thousand people, then maybe you could say it's just that no system is perfect

However, if you add up all those unable to get health insurance - because their state govt won't support Obamacare -
plus those who can only afford insurance with far too low a maximum limit - I've even read of policies that only insure up to 5k per year
plus those who avoid medical treatment because they can't afford the co-pays
plus those who thought they had adequate insurance but find they are financially ruined after long hospital stays etc ...

then out of a US population of 327 million, how many have been failed ?
40 million ? 50 million ?

@DoctorAllcome

More manageable then on insurance definitely, your insurance anyway, but still so very expensive. That's without gp visits and hospital stays.

We have free prescriptions in Wales, which infuriates me. My dad has been waiting 4 years for a hip replacement, while people are getting free paracetamol, ibuprofen and sun cream when it's a pittance in the shops. Drives me mad, when prepaid certificates and exemptions are set up in England and worked well enough here for years. Much need revenue, which would also free up much needed gp appointments if people thought they'd have to pay anyway.

and no, her DH couldn't pay to continue his previous coverage, because my cousin was not insurable except under a v large group scheme

Do you remember before Obamacare how e.g. some women who thought they had comprehensive insurance were dropped by their insurance companies the minute they were diagnosed with breast cancer ?

Trump has been trying to abolish Obamacare, because of his hatred of Obama
(whereas most GOP politicians hate Obamacare because it constrains insurance companies)

If he succeeds in his 2nd term, the situation will become much worse

I agree no other country would create something like the NHS now,
because back when it was created there was only a tiny fraction of today's medical care possible
and the age demographic time bomb wasn't apparent

However, the mixture of private & public works well in Germany - where I live - or in several other European countries.
The US should look to that

@saltinesandcoffeecups
We may have to agree to disagree. I don’t think the healthcare system is kept because it works or because people prefer it. I believe it has not been replaced because of its importance to the overall economy. When AIG, one property insurance company was about to fail due to the Recession, we bailed it out as too big to fail. And it is a fraction the size of all the health insurance companies. To go to a universal healthcare system would quite literally result in millions of job losses as the entire industry would become obsolete. And not gradually over centuries like with coal, but over night. I believe our healthcare system is viewed as too big to fail and so will continue to be propped up by successive Presidents and Congresses regardless of what the average American wants or needs.

In regards to the story of job loss & loss of healthcare. I agree it is a double whammy and not solely due to loss of health coverage.
But....“And the guy could have chosen to pay for continuing coverage at the full (and more expensive) rate, ” would only be true if he were eligible for COBRA which might not have been the case.

The thing that really doesn't add up in the US is that the life of an embryo can be so crucial that abortion at any point of gestation is totally wrong but once that same being is born it is quite acceptable for them to die because their parents aren't rich! How does this make sense... unless it's nothing to do with the life of the child?

As a Canadian I am a bit annoyed that we may have shortages of insulin because Americans come here to buy it.
*
<a class="break-all" href="http://go.mumsnet.com/?xs=1&id=470X1554755&url=www.google.ca/amp/s/www.cbc.ca/amp/1.5232360" target="_blank">https://www.google.ca/amp/s/www.cbc.ca/amp/1.52323600*

get your shit together, neighbour*

I'm glad you posted this, Madge. I sympathize with Americans in need of healthcare, but why should Canadians lose out?

In the US insulin is prescribed for pre-diabetes as an initial treatment which would never happen in other countries. Even in other countries with similarly private healthcare, eg India, the first treatment for pre-diabetes is usually dietary / lifestyle related. Diabetes is a huge cash cow for the US health industries which may explain why drug companies are battling to increase the cost of diabetes drugs even more.

So to turn the thread around, how many posters on the thread vote for the Tories, and how can you rationalise a fear of the US system with what you enable through your votes?

@housemdwaswrong
(Love your username)

Yes, it’s not too bad. About the cost of a car loan. I do have a cheapo plan tbh though. Higher deductible and higher copayments than some other more expensive ones.

Your story about people getting Tylenol and sunscreen on prescription causing others to go without needed surgery is nuts! Is it poor management? Stories like yours are often used to argue against universal healthcare here as a sort of “the government is incompetent, you can’t trust them to do healthcare right”

The thing that really doesn't add up in the US is that the life of an embryo can be so crucial that abortion at any point of gestation is totally wrong but once that same being is born it is quite acceptable for them to die because their parents aren't rich! How does this make sense... unless it's nothing to do with the life of the child?

It doesn’t add up because it’s not that simple. Pro-life is focused on getting babies born. After birth, most people believe that kid should have the same chances as any other kid born to parents of the same socio-economic status. No more, no less. They don’t really think in terms of banning abortion means we then have to guarantee free healthcare for life because no other kid or person gets free healthcare for life.

@BigChocFrenzy

So he was earning $100k/year, and had savings including college funds for the kids. I’d say $50k is a pretty significant loss of income. I’m sure the medical bills didn’t help, but you really think they would have been fine and dandy without them?

I’ve never been asked in an interview what chronic conditions I have, I’d love to be, because that’s a great lawsuit since it’s it’s against the law . His usage of of health insurance is not what stalled his job prospects, it’s more likely that his age, location, and line of work had far more to do with his employment prospects than his insurance usage.

As for the rest of your post... I do consider the difference between 327 million to to the majority of your made up 40-50 million.

Patnotpending did mean England as I know it's free in Scotland, Wales & NI due to devolved governments.
However it does seem daft to give free 'scripts for all when it's causing longer waiting lists for certain operations.

Another thing I don't quite understand is why the maternity leave & benefits in the US are on the whole so abysmal (I understand that in New York State & California they're better)
And I understand some insurers won't cover contraception or is it some Republican politicians who don't want contraception covered.
Once again it's women who bear the brunt.

@doctorallcome

Virtual respectful handshake.

Like I said I’m not out to change anyone’s opinion just offering a different perspective that I don’t think gets shared very often.

Honestly I think it’s great if people are happy with their system even if I don’t want to be part of it. I encourage everyone to do what they can to find ways and fight (or vote) to either preserve or replace for what they think would work better... But I encourage everyone to to really research the issues and make informed decisions and to not take Auntie Irene’s anecdote as gospel.

Tis Murcia 🤷‍♀️ What would you expect?!

I’ve never been asked in an interview what chronic conditions I have, I’d love to be, because that’s a great lawsuit since it’s it’s against the law .

BUT during the interview they can ask how many days of work have you missed in the last year. They can’t ask why or ask how many sick days, but realistically, a high missed day count will look bad anyway. In addition, employers are allowed to require a medical examination after giving a conditional offer of employment, and then come up with a bogus reason ADA compliant reason when they decide to withdraw the offer. An unemployed person with financial difficulties isn’t going to be able to afford to file a legal action alleging discrimination so they get away with it.

@saltinesandcoffeecups
*Virtual respectful handshake.

Like I said I’m not out to change anyone’s opinion just offering a different perspective that I don’t think gets shared very often. *

Same to you!!

@JaimeBronde

I can try to answer the contraception question. Again it can get a bit complicated and my answer is simplistic.

Insurance companies don’t deny contraception coverage . The employer negotiating the group plan chooses what they want covered and that will be what the participant gets reimbursement or paid.

Contraception is tricky in the fact that it’s generally not something that a religious organization wants to pay for if it goes against their their beliefs.

Now here comes the even trickier part to the equation. When the ACA became law it said that contraception must be included in the plans that insurance companies sell (honestly insurance companies don’t care one way or another about contraception, to them it’s the same as an antibiotic or any other drug). For most companies this was a non issue since they already had them in their plans. But now religious organizations were being told they have to include it.

In the US with the separation of church and state and all that the government in most cases cannot interfere with religious practice. So an exemption was made in the law to allow religious organizations to opt out of providing something that goes against their established beliefs.

Still with me? The short answer it was a nonissue for most organizations except for the religious ones because of the law protections from the constitution.

FTR: I’m relious and do take BC so I am as impartial on subject as one could be.

It's not new and, yes, it's awful.

And fuck no to voting tory.

Thanks Saltine.
I know there are big religious differences in parts of the US but didn't know that it was that causing the contraception insurance problem.

Oh I should have added it’s not usually the contraception coverage that lawmakers care about..it’s abortion coverage that gets everyone riled up.

Which ironically is one of the reasons I tend not to want government controlled healthcare. I (and many others) don’t want the government involved in my healthcare decisions.

I think this one of the biggest reasons that a lot of Americans are against a government run system. As a whole we are generally distrustful of our government. It’s kind of one of those fundamental things about us.

That is a whole different discussion, but is definitely a factor when it comes to healthcare coverage. If I don’t like or agree with the plan my company offers, I am free to to leave that company for different coverage or buy my my own.

Blame it on the stereotypical rugged American individualism, but there are certain things I want control over and my healthcare options are at the top of that list.

Blame it on the stereotypical rugged American individualism, but there are certain things I want control over and my healthcare options are at the top of that list.

But do you have true control if it’s the insurance companies dictating the pace and necessity of investigations?

I worked once with a US doctor training to be a paediatrician, although for the NZ/Australian training system she would end up at GP with an interest level. She was intrigued by all of the children who were seen and not admitted (as not necessary) as in the US where she worked insurance companies would only pay for admissions. Also, she said it was better to do all the investigations that could possibly be thought of as insurance wouldn’t necessary pay for “observation”.

So a straightforward febrile convulsion would get a whole lot of expensive, unnecessary investigations for no reason.

That doesn’t sound like “control” of one’s health to me, it sounds like insurance companies wagging the dog and benefitting financially in the process.

Well I've read all the long posts about the American system on here and how it's really good and not at all what we think it is - and it still sounds utterly shit.

In the UK we used to get free dental care. I now have to pay for private dental care and it's no better and very expensive. This is what naturally happens when services have to make a profit.

It's the same with pet health insurance, it is a profit-making exercise. You purchase pet insurance for your pet, it takes ages to scrutinise all the policy exclusions and small print that insurance companies use to turn a claim down in the future. You can shop around but only until your pet gets a chronic condition or a condition that might recur and then you are stuck because another insurance company will exclude that condition in the future so your pet isn't covered for it. So then you are trapped with ever-increasing premiums that you can't escape from.

With the NHS I don't have to deal with any of this crap. I pay my taxes, I am covered from cradle unto grave. The end.