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Thinking as a society on the insulin crisis and health care

The site might offer tips for Minnesota patients who might want to drive into Canada to purchase drugs and insulin.
REUTERS/Carlos Osorio
I recently returned from visiting family in Norway and traveling in several other European countries. A common question I was asked is why a wealthy nation like the United States does not provide universal health insurance for all its citizens. As I was departing in early June, the health crisis created by the high cost of insulin was fresh in my mind. A bill in the Minnesota Legislature to provide emergency insulin to those in need had just failed to pass.

Not surprisingly, news of the insulin crisis was covered by European media, including the case of Alex Smith, the 26-year-old Minnesotan who died in 2017 as a result of rationing insulin after he was no longer covered by his parent’s plan. As most Minnesotans know from media coverage, the legislation was named in Smith’s memory.

France24, a major French television station, reported on a diabetic in Kentucky who had gone to purchase insulin in Canada, where a vial costs $22, while the same retail pharmacy in the U.S. charged over $300. The headline read: “The price of insulin is killing Americans.” A sad commentary on our nation. Successive U.S. governments — from George W. Bush’s Medicare D plan to Obamacare to the Trump administration — bet on the marketplace to lower costs. Yet costs continue to rise and U.S. health care outcomes have declined to nearly last among our peer nations.

Not an isolated problem

The insulin crisis is not an isolated problem, but a result of our relying on an ineffective, bureaucratic, private, for-profit health insurance system. Public systems in Canada and Europe keep drug costs in check because pharmaceutical firms and pharmacy distributors are prevented from gouging the public. Competition from generic producers is encouraged, and negotiations on prices provide for accountability and transparency.

If we followed the best practices of our Canadian and European friends and created a single-payer health insurance system – improved Medicare for all – we could end the insulin crisis and deliver effective, quality and timely health care to all Americans. No worries, no health care bills and with less cost to the nation.

Wayne Nealis
Wayne Nealis
As presidential candidate Sen. Bernie Sanders often says, if Canada and European nations do it, so can we. He rightly asserts that private insurers and for-profit medical and administrative firms are simply transfer entities that siphon off premium and tax dollars to reward shareholders and fund lobbyists, CEO salaries, political campaigns and advertising firms. These are the other reasons our health costs are nearly twice that of comparable European nations.

Next time you see a TV ad, billboard or online ad for drugs, hospital care, health insurance or the lobbying arms of these industries, ask: Are these dollars providing health care? Do any of these activities add value? These dollars are simply a revenue stream of  federal and state taxes, and premiums, co-insurance premiums and co-payments paid by companies and individuals. With single payer almost all these resources could be spent on delivering health care. Advertising makes sense for most products, but health care is not a product, it’s a necessity. Our doctors know where the hospitals are; they know what drugs to prescribe and what diagnostic procedures a patient may need.

Lies at worst, exaggerations at best

Critics who disparage national health insurance as a socialist idea are correct. It is. So is Medicare. So is Social Security. Decades ago, workers in Europe and the U.S., through their trade unions, and indeed socialist parties, fought for and won public health insurance and other benefits. These same critics spread rumors of long wait times and other shortcomings of “socialist health care” in Europe or Canada. Such rumors are lies at worst, and exaggerations at best. In short, they are scare tactics designed to distract our attention from the real problem.

Another distraction is the allegation that single-payer would damage the economy. On the contrary, public health insurance would be an economic boost. Several million Americans could retire early, opening jobs for young people. Single-payer would create a more flexible, higher-paid workforce because employees could more securely switch jobs, consequently putting pressure on employers to compete more vigorously on wages. Yet, employers would also benefit. With the volatility of health care costs in check, they could forecast and plan future investments with more confidence.

One fear that is understandable is that of the million-plus people working for health insurers whose livelihoods would be threatened as private insurers are phased out. This too is a scare tactic. Each single-payer legislative proposal in congress addresses job displacement and provides for a just transition through retraining and employment with no loss of income. The only way we can use our resources more effectively is to streamline administration, which is possible with a single-payer financing system. Medicare is a good example of this, as its administrative costs are far less than private insurers.

Resist the negative propaganda

If we as a nation continue to believe the negative propaganda, as repeated by the corporate media, Trump and far too many Democratic politicians, our families and nation will continue to experience health care insecurities, mounting bills and worries.

A majority of Americans, including many GOP voters, now support an improved Medicare for all that would cover dental and eye care and mental health and lifesaving drugs like insulin. Health studies, and a bit of common sense, tell us that improving our nation’s overall health outcomes would bring about a more prosperous, more competitive and safer society. Would the transition be challenging? Of course, but we are known as a “can do” nation and people. It is time to think bigger and inclusively. All in and all covered, so we have no more tragic deaths like that of Alec Smith.

Wayne Nealis is a writer and longtime peace and labor activist living in Minneapolis.


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Comments (5)

  1. Submitted by David Markle on 08/09/2019 - 04:09 pm.

    And as I’m sure Mr. Nealis knows, at this point it’s important to make a distinction between national health insurance and socialized medicine.

    • Submitted by Wayne Nealis on 08/12/2019 - 10:23 am.

      Indeed and a good question to ask. All legislative proposals for single-payer or Medicare for all or NHI, which ever name is used, retains our traditional private delivery of medical services. There would be no limitations on choice of doctor or hospitals, dentists etc. I personally would oppose a bill that did not retain private delivery and the measure of accountability and privacy it affords. We could and do have publicly funded/owned hospitals, but the medical staff even when they are VA employed typically retain their autonomy. Hope this is helpful response.

  2. Submitted by Tom Anderson on 08/09/2019 - 11:05 pm.

    As long as everyone knows that 40-50% of their paycheck will go to the government to pay for the healthcare (see the U.K.) we can all agree to move forward. Private health insurance will still exist (see the U.K.) as people with the means will pay to get the doctors they want, the procedures they want, and when they want them. Advertising for various drugs will still exist since while the government plan might not pay for them, people still want a choice, especially during end of life care and terminal illness care. The only real concern, and it is a small one, is that finding enough doctors to work for the government plan could become a problem as there are presently limits as to how many immigrants can come into the country to fill those jobs.

    • Submitted by Wayne Nealis on 08/12/2019 - 11:07 am.

      The concern about the overall tax bill is something I did not cover but is a point well taken. A couple items to consider. First, all legislative proposals for single-payer or Medicare for all or NHI, which ever name is used, retains our traditional private delivery of medical services. There would be no limitations on choice of doctor or hospitals, dentists etc. I personally would oppose a bill that did not retain private delivery and the measure of accountability and privacy it affords. Secondly, the amount and percentage of a new tax for NHI or one added to what is deducted for Medicare today, would be offset by savings in out of pocket expenses like co-payments, co-insurance premiums which for tens of millions of Americans add up to thousands of dollars. These burdens we could call TAXES and they fall most heavily on workers of modest earnings. Economic analysis of the current bills show single-payer would save individuals and families real dollars. On UK tax rates….only very high wage earners would pay 40 plus percent. At 100 percent of avg wage combined taxes are 30 percent. In Norway 35. Not that much more than US rates…about 10 percent perhaps. Yet, if Americans added up all costs for education, health, etc that we pay from our paychecks we pay significantly more “taxes” than it appears. I support having a national discussion before we adopt Medicare for all. Hope this is helpful. Much to digest and consider.

  3. Submitted by Tim Smith on 08/12/2019 - 03:07 pm.

    Wayne, Do the health care providers get paid the lower medicare fee shedule or the much higher provate insurance fee schedule where they shift the costs because they dont make what they want on medicare/medicaid? Our docs, clinics and hospitals make significantly more there then in other countries and that seems to be biggest obstacle to single payer, not insurance companies. Providers have support/protection (bought and paid for) from both parties.
    Insurance profits are small fraction of costs compared to trillions in health claims per year.

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