At 15, I was diagnosed with Type 1 diabetes. That was 21 years ago, when a vial of insulin cost $25. Today, that same vial can cost up to $600.
Without health insurance, supplies to treat my diabetes would cost more than $1200 a month. If I had to pay that out of pocket each month, I would end up rationing my insulin and potentially dying from this disease, a fate many people have succumbed to.
I was born and raised in Helena, Montana where I still live with my husband and stepson. I work at the Department of Corrections and receive incredible insurance through the state. This coverage makes the cost of my health care manageable, but that hasn’t always been the case.
Back when I was first diagnosed, the technology to monitor your blood sugar level was not as advanced as it is today. As a result, my eyesight worsened. Diabetics go through vision changes and problems — it just comes with the territory. To save my eyesight, I get injections in both eyes every three months. Even with great insurance, each eye injection costs $500 totalling $4,000 a year. This treatment prevents my retinas from detaching, saving my eyesight and allowing me to continue working. It is as essential as my insulin.
About 10 years later, I worked at a bank that didn’t have great insurance. I had to pay a $3,000 deductible out of pocket before insurance would start to cover the cost of any of my medication. That means that for two months every year, an entire paycheck would go to pay for my diabetic supplies. Thankfully, we had my husband’s paycheck to draw on. I held a second job to help pay for necessities, since most of my income was going towards insulin and medical supplies.
This past decade alone, insulin prices have tripled in the United States, despite the costs of producing the drug remaining virtually unchanged. I think back sometimes to a childhood friend who rationed his insulin. He was always sick, because he couldn’t afford his treatment.
But it’s not just diabetics who struggle to afford their life-saving medications. Three in 10 Americans don’t take their medicine as prescribed due to the costs. We live in the richest country in the world, so why are there so many people working full time who can’t afford the medication they need to live?
My journey has not been easy, but it is much better than what many diabetics face. I’ve never gone without my basic needs covered, and that is a luxury that a lot of diabetics don’t have.
Nearly nine out of 10 Americans agree that the government should be able to negotiate lower drug prices. It just makes sense. Regardless of whether you are a Republican or a Democrat, this is good policy and the right thing to do.
Diabetics face a daily struggle: Counting carbs, adjusting insulin for everything we eat, waking up with low or high blood sugar, which can cause us to go into a diabetic coma. We should not have to also worry about whether we can afford our insulin. Diabetics have been abused by pharmaceutical companies for far too long, it’s time that Congress stand up for us.
It has been over a year since the World Health Organization declared the coronavirus pandemic a public health emergency of international concern. The pandemic has left in its wake fear, death, and economic ruin to millions of people worldwide. However, for Big Pharma, Big Tech, outsourced corporates, management consultants, military outfits, politicians and their cronies, and a select number of scientists, life has been good. These individuals and organizations benefiting from the pandemic constitute what I call the COVID-industrial complex (CIC).
The COVID-industrial complex is a transnational multi-billion dollar public-private partnership. It is a well-oiled machine, hence why it is only appropriate to add it to the select list of industrial complexes where “Businesses become entwined in social or political systems or institutions, creating or bolstering a profit economy from these systems.”
Under this industrial complex, the government, which sits at the top of the food chain, uses its financial power to create an enabling environment that rewards other participants in the CIC. Some may justify the existence of the COVID-industrial complex because overspending and waste are permissible if it results in saved lives.
Others may argue that capitalism rewards those who produce things that are rare and valuable. While there is nothing wrong with making a profit, there is something morally wrong when the excessive gain is made on the back of people’s misery, primarily when characterized by secrecy, overpricing, cronyism, inefficiency, and unfairness.
Several COVID contracts have been awarded without a proper competitive tendering process. An investigation by USA Today on 15 of the states most impacted by the pandemic revealed over 1,600 COVID contracts with no competitive bids.Some of the contracts even went to vendors engaged in tax fraud.
According to the National Audit Office, between March 2020 and July 2020, the British government awarded £10.5 billion (roughly $14.4 billion) in COVID contracts without a competitive tender process. NPR identified 250 companies that got COVID deals worth more than $1 million without going through a fully competitive bidding process. These companies included a company that imported vodka.
In 2020, the British government introduced the NHS Test and Trace scheme to help track and prevent the spread of COVID-19. The government earmarked £22 billion (roughly $30 billion) to the system for the 2020 financial year, which was more than the combined police and fire service budget. Despite the astronomical budget, the project was characterized by data breaches, unqualified staff, and inefficiencies. In July 2020, over 100 public health experts, academics, journalists, and trade union leaders wrote to the British Health Secretary asking for details of the contract awarded to the private sector to run the track and trace program. The authors noted that 90% of the funding was unaccounted for.
Cronyism has been a key feature of the COVID-industrial complex. According to Public Citizens, a non-profit consumer advocacy organization that champions the public interest in the halls of power, 27 clients of Donald Trump-connected lobbyists received federal COVID aid, totalling more than $10.5 billion.
As people socially distance globally, they have come to rely on technology to go about their daily lives. Governments have also engaged the services of tech giants. A consortium of Big Tech firms such as Microsoft, Oracle, and Salesforce has teamed up to develop a digital vaccine passport.
‘It’s a crisis though’
Some may argue that Big Pharma and Big Tech deserve to make excessive profits from the pandemic because they are working towards ending the crisis. But this argument cannot withstand analysis. Big Pharma and Big Tech have benefited significantly from taxpayers’ government-funded research. The US government has spent $10 billion to support the development of potential drugs and vaccines to fight coronavirus. Also, Big Pharma has benefited historically from tax breaks that increase its cash flow – an intellectual property regime that enables it to overcharge patients and a legal framework that gives it the upper hand in prescription drugs price negotiations.
Furthermore, concerning the production of the COVID vaccine, the risk-reward principle has been turned on its head. The UK and US governments have given Pfizer indemnity, protecting it from legal action should people die or have a severe vaccine reaction. According to CNBC, “If you experience severe side effects after getting a Covid vaccine, lawyers tell CNBC there is basically no one to blame in a US court of law.” As a consequence of these legal protections, the government has provided an asymmetric environment whereby Big Pharma privatizes the gains from the vaccine rollout. At the same time, the risks are socialized by the public.
Even though the COVID-industrial complex appears to be headquartered in the global north, it has branches in the global south. The Kenyan government ordered an investigation into 15 government officials and business people who misappropriated $7.8 million designated to purchase PPE for hospitals throughout Kenya. In Nigeria, during the “End Sars” protest against police brutality last fall, protesters overran several government-owned warehouses where relief materials funded by a private-sector coalition against the coronavirus were hoarded instead of distributed to people suffering from the economic impact of the virus. Recently, protesters in Paraguay have accused the government of colluding with private contractors to acquire COVID medical supplies that were ineffective.
On January 17, 1961, President Dwight D. Eisenhower delivered his final address to America. During the speech, he introduced the concept of the military-industrial complex. He cautioned on the influence of the military-industrial complex, the power of money and state capture by a scientific-technological elite. Sixty years after the speech, his words ring true in our present age where the COVID-industrial complex continues to make gains from people’s pain. To paraphrase President Eisenhower, we must guard against the acquisition of unwarranted wealth, whether sought or unsought, by the COVID-industrial complex.
In the year since Prince Harry and Meghan Markle stepped down from their official duties as extensions of the British monarchy, scandalous, albeit unverified accusations came about from either side of the conflict. It all culminated in the royal couple’s primetime interview with Oprah, which revealed allegations of racism and abuse.
While the interview exposed the royal family’s callous treatment of Harry and Meghan, the conversation it drove online inadvertently exposed how broken the US healthcare system is. The interview aired from 8 pm to 10 pm Eastern in the United States, meaning that UK residents had to stay awake until the early morning hours to watch. As they did so, they became shocked and concerned by the existence of something Americans consider normal: a swarm of pharmaceutical ads.
“watching american adverts during the megan and harry oprah interview is so surreal, why are so many of them for meds?” tweeted one UK-based viewer.
“HELP why are all american ads about medicines??” tweeted another.
The answer is just as ridiculous as the existence of the ads themselves. The United States’ healthcare system was constructed on the idea of making money. Helping sick people is just a side effect.
Money is the motive
It’s easy to forget just how messed up the US healthcare system is – we Americans have lived with it our whole lives, which makes it “normal” – but the reaction to pharmaceutical advertisements by people living in Europe illustrate just how convoluted the American arrangement is.
“American adverts make me feel like I’m in some post-apocalyptic world” one viewer tweeted.
That’s because in the UK, the vast majority of people’s healthcare is administered by the National Health Service (NHS). When you get sick, you go to the doctor and are cared for at no cost “at the point of use,” meaning that the service itself is subsidized by taxes, but the actual care is free. If you are sick, you go to the doctor and are treated at no cost. If you have an accident, you are delivered to the hospital and operated on at no cost.
You don’t need insurance in the UK because it is provided through the NHS. Some supplemental insurance can be added, but only 10.5% of UK residents have that extra insurance.
Since the government is the almost exclusive buyer of medicines, the NHS negotiates a rate that it pays pharmaceutical companies and then provides the medicines to NHS users. Therefore, there’s no reason for pharma companies to aggressively advertise, and, in fact, these types of direct-to-consumer pharmaceutical ads are banned in the UK.
In America however, pharmaceutical companies are competing to win over consumers and drive up their profits. Instead of having a nonprofit government entity to negotiate on their behalf, average Americans either have to fend for themselves or rely on insurance companies – who are also profit-driven – to negotiate the price for them.
That’s also where the ads come in. There are often multiple, competing brands of any given medication, so drug ads are designed to drive people towards more expensive name brand drugs and push people to try drugs they may not need. All of this is moot in a UK-style system where the government does the negotiating with drug companies.
The results of the profit-driven US model are devastating. Let’s use diabetes type 1 for example, a condition where the body can’t make enough insulin, which causes high blood pressure and affects more than 1 million Americans.
There are three competing insulin manufacturers in the US, the lack of competition and ability to negotiate for higher profits has in turn driven the cost of insulin so high that people are engaging in “insulin rationing,” or using less insulin than they should be, to make the doses last longer. This sort of rationing has led in some cases to death. The Twitter user above may have been joking when they described this as “post-apocalyptic,” but a system where it’s necessary to ration anything you need to live fits pretty squarely into that definition.
And on top of these drug costs, American also have to deal with soaring insurance premiums and high, uncertain costs for basic needs, like ambulances.
It makes sense how dumbfounded UK viewers were when they saw American commercials for medication. They live in a system that doesn’t penalize you for something you cannot control.
The need for an American universal healthcare system, like Medicare For All, only intensifies with time. As long as our healthcare system prioritizes profit over people, we will continue to look ridiculous to the rest of the world.