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Opinion A caravan for insulin demonstrates how the American health-care system is failing us

Diabetes supplies, including insulin, needed for Lija Greenseid's 13-year-old daughter, who has Type 1 diabetes. (Jenn Ackerman for The Washington Post)

Americans like to be known for our can-do spirit. We view ourselves as optimists who can figure out a way around any obstacle. So let’s hear it for a group of problem solvers who figured out how to take those tropes, and use them to demonstrate the horror of the financial succubus that passes for our nation’s health-care system.

The Post’s Emily Rauhala reported this weekend on Lija Greenseid, the mother of a 13-year-old daughter with Type 1 diabetes. Greenseid organized a caravan of people to drive to Canada to purchase insulin for themselves or their loved ones. The people on the trip say they are all but forced to take this action by the surging and unpredictable price of insulin in the United States.

If this isn’t a powerful condemnation of American society’s values, I don’t know what is. It’s the opposite of a feel-good story. In other developed countries, access to high-quality, low-cost health care is considered a right. Here in the United States, on the other hand, the ill remain primarily a profit center for rapacious corporations.

The plight of the insulin-dependent is a good place to look at the problem. In the period between 2012 and 2016, overall inflation in the United States was about 6.5 percent. But a study published in the journal Diabetes Care in 2018 found that for the same period, the cost of insulin increased between 15 percent and 17 percent annually. According to the Health Care Cost Institute, the cost of the insulin needed to treat Type 1 diabetes surged by almost 100 percent during the same time frame. Between 2006 and 2013, seniors on Medicare found their out-of-pocket cost for insulin rising up at a rate of 10 percent.

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Here’s how this works out in practice. In Canada, the caravan ultimately paid $1,200 for an amount of insulin they calculate would have cost $12,000 in the United States. One woman on the trip, Quinn Nystrom, said in the late 1990s, a vial of insulin cost about $15 to $20. Now one can cost up to $300.

Diabetics are hardly alone in their financial struggles. More than 40 percent of people with cancer will use up their life savings within just two years of their initial diagnoses. The Kaiser Family Foundation’s polling earlier this year found 30 percent of people between the ages of 50 and 64 said they find it hard to pay for their needed prescriptions. Gaps in Medicare, including the fact it does not cover long-term care, mean that the typical 65-year-old couple who retire this year will need $285,000 in after-tax income just to cover expected medical expenses for the remainder of their lives.

None of this can be explained by hypochondriacal Americans mobbing medical offices demanding unnecessary care — despite the popular myth, studies show working Americans are seeking out health-care professionals less than they did five years ago. In fact, we don’t visit doctors or use hospitals with anywhere near the frequency of people in other First World countries. Worse, increasing health-care costs have led Americans to budget in ways that can damage their health. Surveys repeatedly show large numbers of people resorting to such things as cutting pills and prescriptions in half, or delaying or forgoing needed treatment entirely because they cannot afford the ever increasing medical bills.

In short, the problem isn’t excessive usage. It’s that the cost is too damn high.

President Trump and his administration talk tough, but their efforts to handle the issue of out-of-control pharmaceutical prices have been woefully inadequate. A regulation demanding pharmaceutical companies include the price of the medication in all drug advertising is likely to prove both ineffective and confusing, since few people pay the list price. (It might also end up tied up in the courts. Last week, Amgen, Eli Lilly and Merck joined up and filed a lawsuit to stop the new rules.) At the same time, a proposed Democratic initiative to take on out-of-control drug prices has yet to be introduced into Congress. Medicare-for-all legislation, of course, stands no chance in the current political environment.

So that leaves people such as Greenseid hitting the road, driving to Canada in a frantic attempt to afford the medications for themselves or their loved ones need. The caravan is obviously not a long-term solution for anyone. But it succeeds on two levels. First, the few people on the trip save a significant amount of money. And they give lie to the popular notion that Americans enjoy the best medical care in the world. If that were true, no one would be going to Canada so they can afford the drugs that permit them life.

Read more:

Megan McArdle: There’s a high cost to making drugs more affordable for Americans

Robert Gebelhoff: People love to hate pharma middlemen. Congress isn’t buying it.

The Post’s View: The opioid epidemic is no time for risky pharmaceutical marketing

Elizabeth Warren: It’s time to let the government manufacture generic drugs

Ezekiel Emanuel: The Trump administration’s latest plan to lower drug prices is hollow