# The High Price of Insulin Is Killing US Citizens **URL:** \ **Category:** The BBQ Pit\ **Created:** [June 18, 2019, 1:12pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676 "2019-06-18T13:12:47Z")\ **Posts on this page:** 14\ **Page:** 7
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [June 24, 2019, 7:48pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/121 "2019-06-24T19:48:23Z")
> [@Bookkeeper](#): > > And note that the $45 is not for revenue generation, it’s simply to discourage people from using the ambulance instead of a taxi for non-emergency trips to the hospital. But also note that not all provinces are as generous in this regard as Ontario. In my province, ambulance bills can be quite high. That’s one of the ancillary costs that employers may cover in their benefits package, or individuals can buy private insurance to cover. Canadian Medicare is a federal system, as I’ve repeatedly said on these boards, so different provinces and territories cover ancillary issues differently. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [June 25, 2019, 12:06pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/122 "2019-06-25T12:06:45Z")
> [@drachillix](#): > > Anyone more advanced than a rookie Medical assistant knows insulin dosing, you don’t need a dedicated doctor to help you. Insulin dosing is not an arcane formula only pharmacists and endocrinologists can understand. OK, that REALLY made me laugh out loud. I’ve been T1 for ~10 years now, an engineer, got all the fancy diabetes gear… and insulin dosage is still a frikkin’ calculus problem for me on some days. There are SO MANY THINGS that affect blood glucose - activity, weight, what you eat on a given day, any sort of hormonal fluctuations, stress, I could go on and on. In fact, [here’s](https://diatribe.org/42factors) a list of 42 things that can affect it. That’s only a subset in my experience. Then you add in food. Can YOU look at a plate of food and accurately guess the number of carbohydrates it contains? Spoiler: you can’t. I can’t, and I’ve been doing it for everything that goes through my mouth for the past 10 years. I can make semi-accurate guesses, but that’s as good as it gets. Then add in that if there’s a lot of fat or protein, that will also affect how fast your body raises your blood glucose in response to the carbohydrates. So put all that together, and decide how much insulin to give yourself. Do this every time you eat anything. If you make a mistake and go too low, you die quickly. If you make a mistake and go too high, you could die quickly (if you go REALLY high) or you could just slowly rot, eventually go blind, kidneys fail, then you die. Just last week I typed in a dosage to my pump incorrectly (gave myself 8 units instead of .8). Luckily I’m low-blood-sugar aware (not all folks are) and have a continuous glucose monitor (not all folks can afford) and was able to identify and correct. Had I not, it’s not out of the range of possibility that missing that decimal point could have killed me. Insulin dosage is as close to an arcane formula that I’ve ever come across in my life. Folks talk about WalMart insulin as an alternative - sure, I believe you can do that - but it’s not like you can be taking Novolog one day then switch to WalMart the next and just go on your merry way. The dosage is different, getting to know how your body reacts to it is different, the peaks and highs need to be attended to in a timely manner etc etc. This shit is hard. The price of insulin is insane. Our government is corrupt and people are dying. This shit has to stop. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 25, 2019, 12:53pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/123 "2019-06-25T12:53:37Z")
> [@Athena](#): > > This shit is hard. The price of insulin is insane. Our government is corrupt and people are dying. This shit has to stop. So true. And anyone who thinks an individual’s insulin dosing is easy to figure out is severely mistaken. In addition to the factors you discussed, throw in a varying degree of diabetic gastroparesis, which will alter how fast the carbs get absorbed, variability of food labeling and measuring which incorrectly labels just how many carbs are in the stuff, diurnal variation in intestinal peristalsis rates, and the inherent inaccuracy of even the best glucose monitoring devices, all means that a diabetic has to be on top of their game to manage their insulin. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [June 25, 2019, 1:46pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/124 "2019-06-25T13:46:05Z")
> [@Treppenwitz](#): > > OK, Nava, you got my attention. _Twenty?_ This has to be the synthesis, right? And presumably done principally to apportion added value to favourable tax regimes? And I still can’t think of a common analgesic which could match the description. > > j I have no idea about why it moved around so much, but yes, we counted the steps: 20. This included synthesis and mixing the active ingredient with filler etc. Eventually the pills were formed, blistered and boxed in the last factory: sometimes they would be recalled, the boxes opened, the blisters emptied and the whole thing repackaged, in what was supposed to be the “emergency” procedure but actually took place more often than the “normal” procedure of sending trucks, trucks arrive to distribution center, pills get distributed. For some reason that company had decided that sending trucks before there was actual demand was a Good Idea and that, if you got a purchase order from a different place than the one to which you’d already sent the truck, it made more sense to recall and repackage than just, you know, keep on truckin’. The repackaging was because we’re in Europe, where languages change every few hundred km. That company was one of those where everything and everybody is treated with complete paranoia, but where at the same time it’s relatively easy to get access to data which really should have been better protected. Support personnel couldn’t “display a bill of materials” but we could extract all bills of materials. It’s been my experience that the more paranoid a company is, the lousier they are at actual security. ---
**Author:** ![John.St](https://avatars.discourse-cdn.com/v4/letter/j/b38774/32.png) [@John.St](https://boards.straightdope.com/u/John.St)\ **Post date:** [June 25, 2019, 6:01pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/125 "2019-06-25T18:01:52Z")
Sorry, wrong thread. ---
**Author:** ![Treppenwitz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treppenwitz/32/3445_2.png) [@Treppenwitz](https://boards.straightdope.com/u/Treppenwitz)\ **Post date:** [June 25, 2019, 9:12pm UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/126 "2019-06-25T21:12:12Z")
> [@Nava](#): > > I have no idea about why it moved around so much, but yes, we counted the steps: 20. This included synthesis and mixing the active ingredient with filler etc. Eventually the pills were formed, blistered and boxed in the last factory: sometimes they would be recalled, the boxes opened, the blisters emptied and the whole thing repackaged, in what was supposed to be the “emergency” procedure but actually took place more often than the “normal” procedure of sending trucks, trucks arrive to distribution center, pills get distributed. For some reason that company had decided that sending trucks before there was actual demand was a Good Idea and that, if you got a purchase order from a different place than the one to which you’d already sent the truck, it made more sense to recall and repackage than just, you know, keep on truckin’. The repackaging was because we’re in Europe, where languages change every few hundred km. > That company was one of those where everything and everybody is treated with complete paranoia, but where at the same time it’s relatively easy to get access to data which really should have been better protected. Support personnel couldn’t “display a bill of materials” but we could extract all bills of materials. It’s been my experience that the more paranoid a company is, the lousier they are at actual security. It’s so tempting to guess, but I suppose I shouldn’t. One job I started, literally the first thing I saw as I walked in the door (it wasn’t even in a proper process area) was half a dozen youths in a room, on stools, popping blisters into those big blue kegs. I had to ask what they were doing. And _why?_ And this was a generic company - they _still_ figured it was cheaper to deblister and repack than make a new batch. j ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [June 26, 2019, 12:36am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/127 "2019-06-26T00:36:24Z")
> [@Grim\_Render](#): > > They spend more on advertising in the US than on R&D. A signal that prices are too high by far. > > Note that many other nations do as much research per person, and have far cheaper drugs. Yet the pharmas are still profitable. Yeah, but are they profitable _enough_? This ain’t the 1990s anymore, bub. Twenty years ago I could get by with only six race-horses. But in the 21st Century everything’s different. These days I need 30 or 40 thoroughbreds just to keep up with the common rabble. I’m truly very sorry if the prices are hard on folks, or kill folks, but hey… I’ve got mortgages too, you know—like, 10 or 12 of them so… let’s keep things in perspective, k? K. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 26, 2019, 1:10am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/128 "2019-06-26T01:10:14Z")
> [@Nava](#): > > I once called la migra, explained that my work permit was about to expire and my employer’s legal department was refusing to provide me with a Proof of Employment letter and asked if one from my manager along with my W-2 and last paystub would suffice. > > The lady on the other end of the phone called me a “stupid fucking Hispanic whore”. > > Maybe there was something I could have done, but apparently I was too stupid to know what and that lady’s attitude can’t be called “helpful”. I’m uncertain what your experience has to do with people calling the Medicare number. Also, I don’t know what you mean by “la migra” ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [June 26, 2019, 1:11am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/129 "2019-06-26T01:11:59Z")
> [@Kimstu](#): > > Needless complexity and expense in a system that’s supposedly designed to serve the public is also relevant. Exhorting people who are complaining, with reason, about serious systemic problems to just take some initiative and bootstrap their way through their difficulties comes across as kinda threadshitty. > > Yes, “there are telephone numbers you can call”. And some of those calls do successfully answer the questions that people have about this needlessly complex and expensive system. Good! > > Does that mean that the people complaining about the needless complexity and expense of the system don’t have a valid point? No. So, you know, _“fuck a bunch of ‘what a person does is relevant’ personal-responsibility pep talk”_ is not an unreasonable reaction. I don’t think there is “needless complexity”. Sure, maybe people have anecdotes of friends or family that had some problems, but that doesn’t mean the entire system has “needless complexity”. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [June 26, 2019, 1:54am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/130 "2019-06-26T01:54:32Z")
_ **Piper** pulls provincial health card from wallet._ \*Contemplates posting how a non-complex health-care system works. \* “Nah, too easy.” _Returns health card to wallet._ ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [June 26, 2019, 3:14am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/131 "2019-06-26T03:14:45Z")
> [@Slash1972](#): > > I don’t think there is “needless complexity”. Sure, maybe people have anecdotes of friends or family that had some problems, but that doesn’t mean the entire system has “needless complexity”. Have you never interacted with our healthcare system? Yes, there is needless complexity. I asked my doctor how much something would cost. He said, “I have no idea. I work here, for a salary much less than I could in private practice, so I don’t have to deal with that.” ---
**Author:** ![Monty](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/monty/32/47_2.png) [@Monty](https://boards.straightdope.com/u/Monty)\ **Post date:** [June 26, 2019, 3:28am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/132 "2019-06-26T03:28:34Z")
> [@Northern\_Piper](#): > > _ **Piper** pulls provincial health card from wallet._ > > \*Contemplates posting how a non-complex health-care system works. \* > > “Nah, too easy.” > > _Returns health card to wallet._ I was quite pleased with the National Health Insurance plan when I lived and worked in South Korea. Sadly, I no longer live there so I don’t get that great and simple plan. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [June 26, 2019, 3:41am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/133 "2019-06-26T03:41:52Z")
> [@Slash1972](#): > > I’m uncertain what your experience has to do with people calling the Medicare number. Also, I don’t know what you mean by “la migra” The term “la migra” is Spanish slang for _inmigración_, otherwise known as Immigration. In current day that would presumably be the be the U.S. Citizenship and Immigration Services (USCIS) which is a component of the Department of Homeland Security. \*\*Nava \*\*seems to be explaining her experience calling one federal office and how the attitude displayed by the person answering the call was abusive and unhelpful. Nava was focusing on a problem she had that was not of her own making and asked about whether a solution she proposed would be acceptable. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [June 26, 2019, 6:44am UTC](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676/134 "2019-06-26T06:44:03Z")
What Iggy said, but thing is, whether one understands “la migra” or not, I would have thought the rest was clear: “I called this place asking for help and the person on the other end was a completely unhelpful bitch. How is that MY responsibility, and how did HER attitude not damage me?” Oh, are you going to claim that there is no relationship between her actions and her attitude? The actions stem from the attitude, oh you disingenious genious. [Previous page](https://boards.straightdope.com/t/the-high-price-of-insulin-is-killing-us-citizens/835676.md?page=6)