Insulin wars in the US

Hmmm! The POTUS said this "There has never been a better time to start living the American Dream".

I expect to see a lot more of this kind of thing going on as the world begins to wake up to the fact that T2DM is a dietary disease best treated with dietary intervention, and that in fact exogenous insulin makes it worse. There’ll always be a market of course, and T1 is a different matter, but T2 is surely where most of the money is in terms of market size.

On the face of it, it’s despicable behaviour, but unfortunately this is what happens in business, and diabetes is very big business indeed. Business is about making money, not making people healthy.

EllieM said:

https://www.nytimes.com/2019/01/18/opinion/cost-insurance-diabetes-insulin.html

Read this and weep.

I guess you already know this if you live in the US - for the rest of us, it makes my blood boil. Manufacturers triple the price of insulin and insurance companies constantly change the brand covered by insurance so that patients have to constantly change their medication and end up with no insulin covered without a copayment. (Goodness knows what you do if you don't have insurance.)

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It's a big issue, Ellie.

I don't know the ins and outs of American politics and insulin supply, but a while back, my attention was caught by a twitter thread which a USA T1 Laura Marston contributed to (she was, correctly, telling prominent low carber Professor Tim Noakes to go f**k himself about hypo treatments but that's another story!).

She's up-front and full-on about what a disaster area it is, is clearly an activist about it, but I have no idea about how effective she is - a big struggle, but hats off to her, she's shouting and I've seen her mentioned a lot by others in the doc.

Here's her twitter thingy:

https://mobile.twitter.com/Kidfears99

Probably fair to say that this problem has been there since long before Trump, so blaming him doesn't carry a lot of weight.

Where are the so called powerful doctors' lobbies when this crisis is happening?
The ADA and AMA - too self-centred to give a ****?
Trump made noises about pulling the drug companies into line ?more fake news. Like Nero, fiddle while Rome burns.
But I agree he inherited the problem but he and his party have made life more difficult for the poor health-wise and nobody has had the guts to stand up to Big Pharma or try to implement a Govt scheme to buy up drug supplies at discounted prices for people to be able to afford and to try to keep medication supply more constant.
Insurance companies - the same - entrenched rip-off merchants. Obamacare was not perfect but it gave many people a better deal including insurance without exclusion of pre-existing conditions, a 'right' other countries and Governments have taken on board for years. Some individual US States have done good with their use of healthcare but a concerted approach of States and Federal Govt is needed to prevent what is becoming akin to genocide.

EllieM said:

If I were the parent of a T1 child diagnosed in the US I would attempt to emigrate to Canada just so the child could afford his/her insulin as an adult.... Not sure whether Canada excludes immigrants who need on-going healthcare????

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Micheal Moore made a docco 12 years ago called Sicko, it's two hours long but it is worth the time to watch it.

You will be surprised who he reckons has the better health system.

Jim Lahey said:

I expect to see a lot more of this kind of thing going on as the world begins to wake up to the fact that T2DM is a dietary disease best treated with dietary intervention, and that in fact exogenous insulin makes it worse. There’ll always be a market of course, and T1 is a different matter, but T2 is surely where most of the money is in terms of market size.

On the face of it, it’s despicable behaviour, but unfortunately this is what happens in business, and diabetes is very big business indeed. Business is about making money, not making people healthy.

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The issue is much more acute for T1s than it is for T2s, seeing as we'll die within a week or two without insulin, whereas T2s will get by ok by just eating bacon.

I've posted above about how Laura Marston is trying to kick some ass for T1s.

Could you please stop using serious T1 issues to advance your low carb ideas?

EllieM said:

If I were the parent of a T1 child diagnosed in the US I would attempt to emigrate to Canada just so the child could afford his/her insulin as an adult.... Not sure whether Canada excludes immigrants who need on-going healthcare????

Apparently there's also a grey market in blood testing strips

https://www.nytimes.com/2019/01/14/health/diabetes-test-strips-resale.html

Though I would have thought that at those prices it would actually cheaper to import from another country - in NZ anyone can buy strips from a pharmacy at the equivalent of 30US cents each....

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Hi @EllieM, I gather some US citizens seek medical care in Canada. I presume they are cashed -up to do so. And some do import medications from Canada but I think this has been restricted. I guess it also depends on customs and how much could be sent undetected by mail and whether need for import licenses are in place to discourage this 'trade' Cannot have Big Pharma done out of its obscene profits.
On the face of it, if I had the influence and money I would be sponsoring every US child with T1D in need to emigrate to NZ, UK, Canada, or Australia. Of course there are some restrictions by these countries on who they will accept, such as parents having suitable work skills etc. That the US cannot sort out its own healthcare problems, gun culture etc, things that are of their own doing, is a poignant lesson to the rest of the world. In a sense they have many citizens captive to third world country conditions and a potential future refugee crisis in the making.

Scott-C said:

The issue is much more acute for T1s than it is for T2s, seeing as we'll die within a week or two without insulin, whereas T2s will get by ok by just eating bacon.

I've posted above about how Laura Marston is trying to kick some ass for T1s.

Could you please stop using serious T1 issues to advance your low carb ideas?

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Good morning. Would you run that one past me again please? I’m thinking perhaps you missed the part of my post where I said T1 is a different matter?

To clear up any confusion, the point of my comment was that I expect to see more of this kind of thing happening as business reacts to reduced insulin needs in T2 diabetics. It wasn’t an endorsement. It was a criticism. Apologies for not articulating my point more clearly.

Jim Lahey said:

I expect to see a lot more of this kind of thing going on as the world begins to wake up to the fact that T2DM is a dietary disease best treated with dietary intervention, and that in fact exogenous insulin makes it worse. There’ll always be a market of course, and T1 is a different matter, but T2 is surely where most of the money is in terms of market size.

On the face of it, it’s despicable behaviour, but unfortunately this is what happens in business, and diabetes is very big business indeed. Business is about making money, not making people healthy.

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Did your diabetes get worse on insulin? I lose weight IF my insulin is keeping my bgs in the 4s and 5s. I don't understand it but that's what happens. I'm not gaining weight like I would be if I wasn't on insulin. It's about getting the insulin therapy to work for you.
If done wrong it adds weight, on even type1s.

EllieM said:

Do you really think that T2 insulin needs are going to reduce globally? I agree that low carb can reduce/eliminate them, but I very much doubt that the low carb message is going to get through in time to eliminate the T2 time bomb caused by the high sugar modern diet. Maybe I'm overly cynical?

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Yes that’s my view. I believe that in the fullness of time, T2DM patients will require less and less pharmaceutical treatments as it becomes more widely accepted that the most effective treatment is intensive dietary intervention. I don’t have any figures to lend credence to my opinion, but personally I feel that this is already happening. Additionally, if dietary behaviours shift toward lower sugar and starch consumption, we may also see a downturn in the increasing prevalence of people developing the condition. Net result of all this will be lower profits - resulting in continuing higher prices.

These are my views only, and it’s not my intention to offend anyone who relies on insulin and/or carbohydrate in order to lead a full and happy life. For the avoidance of doubt, I’m again referring only to type 2