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?

While folks in America die without insulin, thousands of pounds of it are wasted in the UK by patients irresponsibly ordering and wasting it as they don't pay so don't see the value attached to it.
This picture was shared by a GP, items all returned by one patient and it included over £1000 of diabetic supplies. This happens every single day.

Actually, even if I don’t pay taxes/NICs I’m covered. That’s the beauty of it.

That needs stamping out Kummerspeck but it hardly compares to people dying from lack of insulin.

It's greed and selfishness. The American dream.

This picture was shared by a GP, items all returned by one patient and it included over £1000 of diabetic supplies.

That does look like quite a lot of supplies to have at one time, although some people do find it brings more peace of mind to order their repeat prescriptions a few days earlier each time and build up stocks as a 'buffer zone' in case of shortages or inability to get to the GP or leave the house etc.

I may be wrong, but it looks to me like the supplies include insulin. Even if the patient kept getting testing strips but never bothered using them, surely they'd always use the insulin? Unless, as often happens, some GPs/diabetes nurses seem very keen to keep trying different kinds of insulin or meter and want to switch you immediately rather than once you've used up your existing stocks.

Even so, I'd still be interested to know if that was a living patient with diabetes just deciding one day to give up trying and return the lot to the surgery. It could very easily have been returned by a recently-deceased diabetic patient's family, as it's no longer needed.

One American's opinion:
It's not the NHS we are against. It's the fear of all the other "socialist" stuff that might come with it.
-Health Visitors - we don't want anyone coming to out homes and telling us how to live. We want to choose our own health advisors.
-Schools telling us what we can/can't put in packed lunches and doing weight checks on children and reporting them to SS/HV.
-Closed courts. Parents have children taken and put up for adoption and not allowed legal representation or an avenue for appeal. Worst
that the newspapers/TV stations cannot report on these cases.
The US is certainly not perfect (and we aren't as rich as people think we are) but we are very independent and very conscious of the importance of a free press.

Yup this is literally the bull shit they are fed and they would literally die rather find out the real facts.

I lived in the USA and to send my children to school in our state they had to have all vaccines before admission (I am really pro vaccinations but I don't want Children’s education affected by parental choices) they also used to have to pledge allegiance to the flag which is one of the most commie things I have ever come across! Totally bonkers. They are the most oppressed people I have ever met (obviously I have never been to a war zone) and they impose these rules on themselves it is truest heartbreaking they believe they are "free"
PS I loved living in America and have many amazing friends but I just couldn't deal with embedded selfishness justified with an apple pie for the new neighbour and fundraisers for people like them.

....and, as has been illustrated throughout the thread, £1,000-worth of diabetic supplies sounds like a huge amount, but that's probably only two months or so of all the items regularly needed by a lot of people with T1D.

You'd need a very big car to transport £1,000-worth of, say, potatoes, but £1,000 of insulin and associated supplies could easily be contained in one medium carrier bag.

@nolongersurprised

And that’s the crux of it.

Every system has it’s it’s rationing, it’s downsides, and it’s inefficiencies doesn’t it? There will always be cases where a a person is denied that potentially life saving treatment, be it denied by their personal finances or the those of the government. I prefer to have the options to, within my means, make choices. And that includes paying out of pocket if I’m able for something or choosing a different healthcare plan.

I won’t say I’m close minded to other systems, as others seem genuinely happy, but I’m more than skeptical that I would choose any of those other systems if given an informed choice.

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 agree with this. The very wealthy will always have control over their health options, as they need never use the NHS at all if they don't want to (equally, they have every right to use it for all health matters, however rich they are). Anybody is free to choose whichever private healthcare provision they want - even employ a full-time live-in medical team - anywhere in the world, if they have the money. It's just that most people, even those who are very 'comfortable' can't afford this if the worst happens and runs up a multi-million £/$ bill.

Same as anybody with the right of residency is allowed to buy a mansion in Knightsbridge/Beverley Hills etc - the reason that most people don't do so isn't because they simply 'prefer' to live somewhere much smaller and cheaper. If you need (and can manage to get) a social housing property, you're far more limited as to whereabouts it will be (usually not the most desirable neighbourhoods) - but if you have the money to buy elsewhere, nobody is stopping you from doing so.

The money that health companies generate is astounding, and one reason I can't ever see fair/equal access to healthcare coming to the US. I live in Minnesota. We have some big, multinational companies based here: Target, 3M, Best Buy. The number one grossing company (with more than three times the revenue of the number two company, Target) is United Healthcare. I've lived in the UK and Canada and am a vocal supporter of universal healthcare, but I just don't see how it could ever happen here. I hope to be proven wrong one day.
www.bizjournals.com/twincities/subscriber-only/2019/04/05/minnesotas-75-largest-public-companies.html

DH and I also often talk about how medical insurance here is essentially bankruptcy insurance. We are lucky, we are in a good program which also pays for my daughter's ASD therapies. But really, what most people are paying for is protection against that terminal illness or chronic condition which would mean you'd have to sell your house to fund your treatment.

I'm in Aus- a few years ago I was talking to a mate in US about bowel testing programme here. They take a stool sample, test, then -if required- perform a colonoscopy. These ops come with risks.

US mate said she refused bowel cancer check as it is straight in with an operation. Being a health care professional, she is aware of risk- and cost.

Her view is that US over medicalise and take the most cost inducing path to check your well-insured wellbeing.. Uninsured? your wellbeing is less of a concern.
The UK tends to try and make the resources go round, so are less gung-ho with CT scans and invasive procedures.

Here in Aus, I have not bothered with insurance and cope beautifully with the public service (Prescriptions are subsidised but not like UK- so we may pay 10 quid for antihistamine cream, 45 quid for antibiotics etc)
A lot of things such as x rays are covered by the government but things like physio you pay for....if you want them.

Social(ism) is a dirty word. when it suits, not all roads are toll roads - they are paid for through taxes - so some people are happy to pick and choice there Socialism

The NHS is an amazing concept but the truth is it hugely insulates UK citizens from the true cost of health care. Health care is expensive. Many of the US prices quoted here are similar to NHS costs, people just perceive NHS treatment as 'free'. It's not. As a nation we need to be very careful about abusing it, or it will end up changing as the current level of abuse and waste is unsustainable. One local NHS trust has worked out if people bought their own over the counter medications (e.g. paracetamol) they'd save £1.3m, which is 43 extra nurses or 211 extra new hips just in their local area. In Wales, where prescriptions are free for all, people even get camomile lotion for 'free'. It's not free and this attitude of 'it's free and I'm entitled to it' is destroying the NHS. Perhaps people should be handed a list of costs with what their treatment/meds costs the NHS, just so they can understand the true costs and therefore appreciate the NHS beyond "isn't the NHS amazing, and it's free". It very far from free, in fact the NHS often overpays for drugs due to their procurement processes.

@intermittentfasting but you can pay for that prescription and you should. Clearly the person meaning about paying £11 for creams was expecting the NHS to cover it.

@GeorgiaGirl52 what a load of shit. You must believe everything the "free press" tells you

I love the the way ppl in us are so sure that the NHS is going to be here forever. I may be under illusions but I really am failing to believe that it will sustain itself. I think before you know it the uk system will adopt a subsidized system somewhat like Ireland and other countries. Ppl will have to start paying to visit the GP, health insurance will be needed to cover certain costs and for better treatment (which happens now anyway if you want to go private I know!)

I asked my American friends the same question once and the overwhelming consensus was that there is an attitude in America of "why should I pay for you to have xxx?

Which Is how the 'New York' strain of TB was created and why New York City started paying people to take their meds.

People would take antibiotics while they felt ill but not for the 6 months afterwards because they felt they needed to feed their family or pay for public transport to get to work.

Sothe TB became active again,and now it is antibiotic resistant.

This becomes a public health issue so the city started sending out nurses /HCP with antibiotics and a few dollars to someone's home every day.

And of source that strain has now been exported to the world.

-Health Visitors - we don't want anyone coming to out homes and telling us how to live. We want to choose our own health advisors.

Do you know what a health visitor is?

On the other hand - I do love American tv as the ads for medication are so common (“do not take it over 5”2, may cause skin to drop off and head to explode”). It shows what a medicalised nation it is. When you see a liver surgeon advertising on the side of a bus you know it’s a Big Business.

It’s absolutely crazy over there. I know a newly qualified DR in the USA in his 20s who’s salary is $280k. His family are all so proud etc and I was the only one going, hang on a minute-YOU’RE all paying for this. Your mental health care premiums are going to making this young man a bloody millionaire by the time he’s 35! How is that a good thing??

intermittentfasting but you can pay for that prescription and you should. Clearly the person meaning about paying £11 for creams was expecting the NHS to cover it.

I live in Scotland, no one pays for prescriptions here.

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.

No, you just want money making corporations involved instead.

@Monkeyseesmonkeydoes
I know a newly qualified DR in the USA in his 20s who’s salary is $280k. His family are all so proud etc and I was the only one going, hang on a minute-YOU’RE all paying for this. Your mental health care premiums are going to making this young man a bloody millionaire by the time he’s 35! How is that a good thing??

If he’s a surgeon, malpractice insurance premium is probably over $50k/yr. if he’s an OB/GYN, it will be at least $100k/yr. No shit. The #1 reason why a regular Dr has a high 200s salary is because he or she is a type of surgeon or OB and our malpractice insurance is so high. Oh, and you can’t deduct insurance premiums from your taxes, so he’s paying tax on the full amount.

“Do you know what a health visitor is?”

Can’t speak for whoever you are asking, but I have no idea what a health visitor is. We don’t have any house call type services unless it’s paramedics coming to haul you away in an ambulance. Can anyone explain who they are and what they do?

@DoctorAllcome a health visitor is an optional service for babies and children under 5.
They do some weight checks when a child is a baby to make sure they're feeding ok. Some time before 6 months you'll get some advice on introducing solid foods. Around 12 months there is a developmental check. Around 2.5 there is another developmental check.
You can ask them about things like; breastfeeding, diet, language development, tantrums, toilet training etc.

The service varies in different areas but that's the basic idea.

I should add that I only ever had a health visitor come to the house when ds was a new born. All other checks have been done at a clinic.