The Price of Diabetes in the U.S.

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Price of Diabetes in the U.S.

If you’re sick in the United States, one way or another, you’ll pay.

I learned this when, as a type 1 diabetic, I lost my health insurance not once, but twice.

The first time I lost my insurance was five years ago. I was a few years into paying more than $500 per month for my own coverage that I took with me from my corporate job before I started my career as a self-employed writer. Then one day this insurance company sent me a letter saying that in two weeks they were cancelling my policy. They didn’t give a reason. I guessed it might be because, in addition to being a diabetic, I had recently undergone an experimental islet cell transplant procedure to cure diabetes, which was apparently a faux pas if you want to keep your insurance. So I called my company (not to name names, but the first word of this company rhymes with Munited, and the second rhymes with StealthCare) and said, “Hey, you can’t do this.” They said, basically, “Yeah, we can.” I called the insurance regulators in the state where I live and they said, “That is an outrage! But, yeah they can do that.”

I shopped for insurance and was told repeatedly that I couldn’t get any, at any price. No one came out and said specifically that it was because I was over age 40 and a diabetic since age 11 and had taken part in an experimental procedure. They just said they did not have an individual plan that would cover me. So, I found myself uninsurable. Then, I had an epiphany. I had not made a direct, paid living, or had an income, for six months. This meant that I might qualify for Medicaid in Arizona, where I live near the U.S.-Mexico border.

I went down to the local state Medicaid office and, what do you know, I qualified! I had total, head-to-toe coverage and I paid nothing. It was, honestly, so grand to be a little embarrassing. But, I had no other options so I took the coverage and vowed it would be temporary until I got a decent job and could pay my own way.

In the next few years I got my master’s degree, had two books published, started teaching English composition as an adjunct faculty member at a nearby college, and looked constantly for a full time job with benefits. But, living in a seriously depressed economy along the border makes finding a job with health coverage tough. Or, as Mishka Shubaly said in his book, I Swear I’ll Make It Up To You, “I’d learned to bitterly envy my friends with health insurance the way I once bitterly envied people in love.” Then, last year I was assigned four classes to teach instead of the usual three. That meant more money, but it also put me over the earning limit to receive Medicaid. I made $83 a month too much. The state dropped my coverage.

I totally understand why they dropped me, and I have no gripe about it, but, I found myself still uninsurable and making too much to receive state assistance all while pulling down about $12,000 per year.

That led me to looking at the cost of being a retail diabetic, doctors not included. Two bottles of Lantus per month would run about $800. One bottle of Novolog would cost about $400. Blood testing strips would cost about $200 per month. All told, if I lived cheap, it would cost $1,400 per month to stay alive as a type 1 diabetic without insurance. It was more than I was making.

But wait! Obamacare! Duh. I can get full care from the government. A Sweet Life’s own Karmel Alison wrote so movingly about the benefits of the Affordable Care Act for diabetics that she was invited to the White House to stand with the President for a speech celebrating the Act. So, I went online and looked at what it would take to get health care through the Affordable Care Act. What it took was about $4,000 a year in monthly premiums and coverage that kicked in after I met a $6,850 deductible. That left me with $1,150 to live on for the year.

While panicking and struggling to find ways to stay alive with a week to go until my insurance ended, one thing about my situation struck me as truly sickening: No matter what I did or did not do, being sick in the United States was about money.

If I had money, I could afford to be sick. If I didn’t have money, the state would help me because I was poor and needed health care. But, either way, the formulation by insurance companies and the government was not about my wellbeing, my care, my health, or my quality of life living with a condition I did nothing to contract. It was about money.

While I applaud the efforts of the Affordable Care Act to allow more people better access to health insurance, and while I think it’s good that recently the rate of uninsured in the U.S. dropped below 10 percent, I also realize it’s only a first step. That’s because the fundamental premise behind providing health care based on how much money you have—whether too much or too little—is wrong. There must be a next step. The next step must be to stop formulating health care along economic lines so that some people are included, some are excluded, and some end up with no care and no options for receiving care. 

While living on the Mexico border has not been good for my job prospects, it does give me access to low cost drugs. I can go across the line and buy NPH insulin for $10 a bottle, and Regular for $10 a bottle. Testing strips are an indulgence because they’re still fairly expensive, even in Mexico.

As I sit and send out resumes and interview for a job that will allow me to one day see a doctor again, I wonder what I would do if I did not have the ability to cross into Mexico and buy low cost insulin. Perhaps I could save enough to see a doctor, and get a prescription for cheap insulin at WalMart. Or, better yet, perhaps one day I’ll live in a country that doesn’t make you pay, on way or another, for simply being sick. 

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Comments (5)

  1. Lisa B. at

    Wal-Mart does not require a prescription for its low-cost NPH insulin.

  2. Tracy at

    And that is why my thirty Year Old Diabetic son does not test…maybe once or twice a week. He guesses his insulin needs on meals and how he feels. Because to test would require he spend money he does not have…and that is with his super high deductible insurance.I fear the day I don’t work and end up at the VA where they don’t even understand what type 1 diabetes is…sigh…

  3. Britt at

    Every time I read about diabetics in the US (and other countries where you pay for health care) I feel blessed to live in Denmark. I know we pay A LOT in taxes, but when you are diagnosed with a serious disease you will not have to worry about the costs. I feel lucky to live in a country where my 7 year old son gets an insulin pump and cgm without having to pay for it. And I feel so sorry for all the people having to worry about money instead of how they can take care of themselves in the best possible way.

  4. Dave Reisch at

    Amen, brother, amen. I was in the same boat you are until I managed to get on disability. The regular insulin is outrageous after I get in the doughnut hole, but my endo gives me extra strips and insulin to help me and others out. He is wonderful!

  5. nancy at

    Dear Alex, I’ve read several of your articles here and just want you to know that your writing is delightful.

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***The opinions and views expressed in this blog belong to the individual contributor and not to ASweetLife or its editors. All information contained on this blog is intended for informational purposes only. The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.