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?

They support new mums. The poor one I had even checked the blood clot that I passed after giving birth.

Yes @LordProfFekkoThePenguinPhD mine checked my stitches too. I forgot that.

DoctorAllcome

I was asking the person who said they don't want them.

Ok a health visitor is a nurse or midwife (in the UK it's a profession with 4 years training) who had decided to specialise.

Health visitors visit when you are in late pregnancy and then again after you have your baby within 2 weeks of the birth and then at periods until your childis 2.5.

Theoretically they can be involved until the child starts school and there are health visitors who work in other areas but mostly when someone talks about them they mean the ones who visit new parents.

They give advice on feeding whether breast or formula, check your baby is meeting milestones and sign post you to other services if necessary.

Basically their job is to help parents give their baby the best start in life health wise.

A HV comes and does home visits until a child is two, or four if they are adopted. They weight children, make sure parents are okay, advise on things like breast feeding, weaning etc.

I saw mine once at home - she made sure that I had support around me, that I was managing we and that me/DS were well and that I didn’t have any worries or burning questions.

What’s the issue with having specialist help if/when you need it?

@DoctorAllcome does no one come to visit new mums at home to check on her and baby?
We get midwife visits for 2 weeks then over to HV.
I found these visits very reassuring as I'd had a difficult birth and was struggling with breastfeeding.

In the US, receive emergency/life saving treatment if you have no insurance, but not the rehabilitation side. So for example, my friend's dad was run over and had emergency surgery to pin some of his bones and fix internal bleeding, but he didn't get any physiotherapy or home care afterwards.

The fact that we have postnatal care from midwives and health visitors significantly improves our child mortality/morbidity statistics.

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.

That doesn't really happen, yes there are policies decided at government level but most are more local and actual day to day decisions are between Dr (or other HCP) and patient.

Obviously this is not without problems and means some things are available i some areas and not others. I'm sure similar must happen in the US, I can't see hospital in California having more broken bones due to slipping on ice than in New York.

The sun cream on prescription is a bit of a red herring, my mum got it, because she had lymphedema. I get shampoo on prescription, but that's because I have pustular psoriasis on my scalp and the shampoo keeps it at bay. I'm in England where we pay for prescriptions but not everyone pays, I'm in an area where most people are entitled to free prescriptions so there is a system where you can get OTC meds without paying and without a prescription.

I think the thing that would improve access to US healthcare is stopping insurance companies making profits.

We in the UK have far more choice over our healthcare than in other countries. Remember in the US, your doctor can refuse to see you for not following recommendations like if they say you have to have a caesarean. My husband's cousin was told about 4 years ago that if she didn't have a caesarean for her big baby then she would have to find another provider and she couldn't do that in the time she had left so she had the caesarean. Now they won't let her even try to deliver normally this time around.

That's why even now people who are pro-vaccine often reject the idea of excluding children who haven't been vaccinated from schools. We value informed choice/consent.

DoctorAllcome - the hospital are covering his liability insurance AND paid off the rest of his student loans. He is an ER doctor in his 2nd post, a high achiever and a good DR i’m Sure but $280k as a starting salary ?? Get a grip.

People talk like the US system has to be like that, or like the NHS but according to WHO the best healthcare service in the world is the French one which mixing private and state and everyone is covered. And i’m Pretty sure junior doctors there aren’t being paid £250k ...

To all,
Thank you for explaining a health visitor.
To answer your question, no. No one visits pregnant women or infants at home in the US. We go in to the Drs office for all prenatal check ups. Then after birth, we go to the Drs office for checkups down there on how we are healing, how our uterus is contracting, etc All the infant checks are with a paediatrician at their office. The first appointment was at 2wks post partum. Other than that, you are home alone. Most drs will give you a phone number though so you can talk to an on duty nurse if you have any worries or the baby gets sick or your bleeding gets too bad.

Private healthcare is available here - I pay about a 5th of the cost per month for private insurance in the U.K. than my retired in-laws with full government coverage after 40 years of military service pay a month as the ‘top up’ costs to keep them covered for everything. My FIL has a bout of cancer and if the same cancer re-occurs his insurer doesn’t have to cover the treatment...

This conversation has reminded me of an elderly acquaintance whose son, now in his 50s, moved out to work in Silicon Valley in the late 90s and was earning what seemed like a fortune at the time. A few years after he'd arrived there he married an American and then developed MS. He lost his job and his health insurance not long after that. He struggled on as a self-employed IT specialist for some years but his disease was aggressive and the periods where he could work became shorter and shorter. They sold the house in California and moved somewhere cheaper and downsized again a couple of years ago but he was eventually made bankrupt over health care costs. He's now home in Wales, living with his mother and receiving treatment on the NHS. His wife can't come and join him because he can't work and so she can't get a visa.

I don't hear anyone singing about the land of the free-to-be-bankrupted-and-lose-your-marriage.

“Remember in the US, your doctor can refuse to see you for not following recommendations...”
Yes, this is true. I remember a tense conversation with a paediatrician when we had moved cross country. She was saying she could not accept my kids as her patients because they were not fully vaccinated. I was like “What? But they ARE fully vaccinated! Did you not get all the records?” She then said “not with chicken pox”. To which I said “yeah, because they caught it and had actual chicken pox before the vaccination schedule requires it “ (at the time it was a brand new vaccine and not required until entering 1st grade at age 6). She hemmed and hawed, paged through the medical records....looked at my prior paediatricians notes written in there saying no vaccine needed because clinically confirmed they had presented in the Drs office with chicken pox....and then acted like she was doing me a big favor by taking them on.
I think this is wrong because kids of antivaxxers deserve healthcare too. It was sobering to me to realize that the reason why many anti-vaxxer kids grow up never seeing a doctor or dentist is not 100% caused by their parents since many Drs apparently refuse to treat unvaccinated kids. Kind of hypocritical because these same Drs would have no qualms treating an unvaccinated kid while doing charity work in Africa or S. America.

It's terrible that a modern, advanced country like the US is allowing this to happen. I have several prescriptions every month and if I lived in the US I don't know how I would or could pay for them every month it would be hundreds of pounds!

If I felt that my HV/GP were making me vaccinate my kids rather than recommending it, I'd be suspicious and less likely to agree. I'd be looking up all the ingredients and all that.

Because a medical professions knows nothing and strangers on twitter are far more informed.

The US system fails new mothers and babies, as it is not designed to pick up on post partum depression or psychosis in the way the UK system does. I've also found people in the US to be ignorant about PPS.

A lot of new mums in the US must feel totally unsupported and then most go back to work when I was still recovering from childbirth. It sounds hellish.

a modern advanced country like the US
I'm not sure if the US really counts as a modern and advanced country I appreciate it's very rich and very dominant and so in that sense it is advanced, but in terms of being progressive I'm not so sure.
I think it depends what criteria we use to evaluate a country, for example if you look at levels of inequality, the gini coefficient, USA does badly there
Ditto infant mortality levels, social mobility.

''In the US, nearly 25% of mothers go back to work within 2 weeks of giving birth. To put this into context it is illegal to separate a dog and her...pups before 8 weeks in several states.''

This is not how civilized, medically advanced, or Christian countries behave.

www.huffpost.com/entry/nearly-1-in-4-new-mothers-return-to-work-less-than-2-weeks-after-giving-birth_n_55d308aae4b0ab468d9e3e37

I think the USA is going backwards, regressing in many ways

In the US 25% of mothers go back to work within 2-weeks
Gestating, giving birth to and caring for children is extremely important work, we should be valuing and supporting the humans that undertake this task in order that our species can continue.
These women shouldn't have to go back to work they should be supported to do the work that they are already doing, ie parenting.
Parenting is vital work, we need parents to do the best job that they can for the good of society as a whole.

@Leaannb in the States you pay more per head of the population for Medicare and Medicaid that most of you can’t access, than we do for the universal NHS 🤯