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Skipping Doses: Why We Need a Single-Payer Health Care System

When we deny someone a vital medication, we strip them of their right to live, says Karyn Wofford, who has Type 1 diabetes.

(Photo: Iggy7117; Edited: LW / TO)

Part of the Series

This piece is part of Fighting for Our Lives: The Movement for Medicare for All, a Truthout original series.

This summer marks the 17-year anniversary of my Type 1 diabetes diagnosis. This disease often strikes the healthiest people and so far, no preventative methods are known. Escalating drug prices and high deductible health care plans have made it increasingly difficult for my husband and I to own a home, have children or control debt, despite both having decently paying jobs.

Over the years I’ve discovered — sometimes dangerous — ways to cut corners. Primarily, skipping insulin doses has proven to be the most effective way to save a huge chunk of change. Type 1 diabetics take two varieties of insulin; one short acting and one long acting. My short-acting insulin comes with a $500 price tag until I meet my high deductible. Although I skip meals to account for the bypassed doses, my blood sugar still rises as my liver continues producing sugar.

You may see this as reckless behavior, but what choice do I have? Diabetics all around the world are dying because they can’t afford insulin. I’m lucky enough to be able to afford enough to scrape by, for now, but complications down the road will almost be a certainty.

Fighting for Our Lives: The Movement for Medicare for AllMy Current Health Care Plan

I’m on a high-deductible plan, and pay largely out of pocket for vital medications. This year, I may not even reach my deductible. My mind rationalizes, “I can skimp on insulin and I can sometimes do without my continuous glucose monitor, but the money is just not there to pay an even higher monthly premium to reduce my deductible.” Compromising my care is a dangerous practice, but I’m left with no choice. To cast further light on the expenses of my disease, my glucose monitor sensors come in at $400 a month, the $600 transmitter must be replaced every six months and a recently prescribed oral medication will set me back $223.95 monthly.

Basically, good jobs mean nothing for my husband and I, and I swear our health care plan is designed to be unnecessarily confusing.

What Is a Single-Payer Plan?

Canada, the United Kingdom and Australia are countries that already have successful, tax-funded, health care for all. The United States has developed a similar, not-for-profit health care proposal: H.R. 676, also known as “Expanded and Improved Medicare for All.” Existing federal health care funds, payroll taxes and income taxes based on ability to pay would largely cover the costs; very high income groups would contribute an additional sur tax. Lastly, profit-driven insurance companies would be taken out of the picture, meaning astronomical savings for the country: The savings on paperwork alone could amount to $400 billion per year.

Why I’m for It

When you remove greed from the picture, motivation shifts in the right directions. You’ll have a health care system that truly aims to fix people and prevent catastrophic illness, thus increasing everyone’s quality of life. Rather than throwing money to the wind via advertisement and ridiculous salaries, these funds would supply people like me with medications that are vital to life.

Some critics have expressed concerns of “overconsumption” of health care. These are laughable. No one is yearning to go on a health-care-consuming rampage for fun. Will people really be chomping at the bit to get an extra prostate exam or allergy test or MRI? Doubt it.

Not everything single-payer’s opponents are saying is untrue. To be sure, with the disassembly of insurance companies, people will lose jobs. However, there are times where decisions have to be made for the greater good. As a Type 1 diabetic who has been unjustly placed under immense financial strain, a single-payer plan would give me hope. According to the JDRF, 1.25 million individuals in the US are living with Type 1 diabetes; that’s a lot of changed lives, and we are only talking about one disease.

Several companies that supply insulin in the US — including Sanofi, Eli Lilly and Novo Nordisk — are under severe scrutiny for drastic price increases. CBS reported a 700 percent increase in insulin prices over the past two decades. There are “an estimated 50 million people worldwide who cannot afford insulin,” says, adding that, globally, the most common cause of diabetes deaths among children is lack of access to insulin. This is happening right here in the US. By shifting health care costs to one governmental pot, a fire would be lit under our society to combat drug price gouging. And every American Type 1 diabetic would have access to this essential medication.

As an advocate for T1International, an organization working to make diabetes supplies available worldwide, I’ve made it one of my life goals to raise awareness of diabetic health care injustices and, by extension, what health justice would mean. I love sharing this bit from the United Nation’s Declaration of Human Rights: “Everyone has the right to life, liberty and security of person.” Take a look at that first part: “the right to life.” When we deny someone a vital medication, such as insulin, we have stripped them of their right to live. We must grant that right to all people, and the first step is convincing society that a health care plan that cares for all citizens is attainable.

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