Written by: Digital Warrior Marianne
The cry for help for many Americans are the cries for their children and their medical needs. We have seen the “freeze” of an Executive Order (EO) 13937, which can be found here:
https://www.federalregister.gov/documents/2020/09/28/2020-21358/implementation-of-executive-order-13937-executive-order-on-access-to-affordable-life-saving, on the price of insulin along with the EPI pen. Videos have circulated around the internet of mothers crying out for help with the price of insulin. As a wife of someone who is a diabetic, those cries for help resonated deep within my soul because I understood their pain. The pain of knowing that a medicine like insulin was so imperative to the person they love and how much it is needed. Insulin cannot be rationed and it cannot be replaced for another drug because it is the one thing that keeps diabetics living.
For many people reading this article, it may be hard to understand the differences in diabetes. Let me help you to try and understand. There are two types of diabetes, Type 1 and Type 2. For many of us, we know a lot of people who have type 2 diabetes. So, what’s the difference? According to Corinne O’Keefe Osborn, “type 1 diabetes does not produce insulin. Type 2 diabetes does not respond to insulin as well as they should and later in the disease often don’t make enough insulin” (Osborn, 2020). Insulin is normal in everyone’s body and is something that everyone should produce. According to Pietrangelo and Goldman, “Insulin is a natural hormone produced by your pancreas that controls how your body uses and stores blood sugar…it is a vital part of metabolism. Without it, your body would cease to function” (Pietrangel & Goldman, 2020). This is why many Americans were feeling relief when it came to an Executive Order that President Trump put into place when he signed it. The Executive Order 13937 states that “whether by receiving federal award or by subaward, and who also participate in the 340B Drug Pricing Program, must establish practices to provide access to insulin and injectable epinephrine to low income patients at the price the heal center purchased these two drugs through the 340B Drug Pricing Program.” This means that insulin and the EPI pen were to be sold at the price that the drug company bought it for. Executive Order 13937 goes onto state “that it supports the improved access to these life-saving medications by low-income individuals who do not have access to affordable insulin and injectable epinephrine due to either lack of insurance or high cost sharing requirements.” Diabetics felt a sense of relief that the price of insulin would be affordable. Diabetics everywhere felt a relief because it covered many of them. As the Executive Order 13937 stated, those that would see this relief in payment for their life saving medication are those that “have a high cost sharing requirement for either insulin or injectable epinephrine; have a high unmet deductible; or have no health insurance.”
Writing this right now, the day that Biden put a “freeze” on the Executive Order 13937 played in my mind over and over again. I had heard about it, but decided to keep my thoughts to myself and just let this play out. I went home that night to see my husband looking defeated. He looked at me and told me that he didn’t understand why his insulin all of a sudden was not being covered by his insurance through his work. I called the insurance company and spoke with a representative who informed me that the type of insulin he was on has just been moved to a higher tier and that we would need a doctor’s note to continue the insulin he was currently on. If we did decide to go that route then his insurance wouldn’t even cover half of the price of the insulin; however, if we decide to go to the lower tier, we would be charged a lower co-pay.
Now, many of you are probably wondering why is this important? So, you have to move to a different type of insulin. Not a big deal. Right? Wrong. Just like any other type of medication, these insulins affect a person differently. In fact, it is described by Diabetes.co.uk that in “1996 Analogue insulin is a genetically modified form of insulin whereby the amino acid sequence is altered to change how the insulin is absorbed, distributed, metabolized and excreted” (Editor, 2019). In my opinion, it would be safe to think that insulins before this time would not be made the same way. We have come a long way in the study of insulin and the effect that it has on many diabetics and the way that they live.
Getting back to the topic of the insulin crisis that we are facing, it is one that we have fought for years, but it hasn’t been until just recently that many people have taken notice, thanks to President Trump it was pushed into our faces. It showed that he had seen a need for it to be brought to light. The prices for this medicine that diabetics need to live must be brought into the spotlight. We have seen the advertisements and charity drives for groups such as Juvenile Diabetic Research Foundation and the American Diabetes Association, but have we really paid attention to it or was it just another advertisement we saw on television or when we scroll by it on our phones, tablets, or computers? The videos from real people crying for help snapped us back into reality. This life saving medicine affects everyone who has diabetes. In fact, in doing research I found that on the Medicare.gov website it clearly states that Medicare Part B doesn’t cover: Insulin and Insulin pens; this becomes a real issue for some of our senior citizens (Medicare.gov, n.d.). It does state, however, that if you would like to move up into the Advantage plan then it would help to cover certain diabetic needs. This means that ultimately the patient would be paying a price for health care along with the medicine. I thought that Medicare and Medicaid were put into place for those struggling? I thought just like through the name it was to “care” and “aid” those who needed it.
President Trump has done many things by pushing into our view things that we needed to see. The insulin crisis is one of them. The price for insulin needs to be affordable to all of those who need it to live. In the end, my husband and I decided to that we are being forced to take the lower tier insulin and we’ve had our ups and downs with it because he has to readjust his intake and redo calculations when he eats or drinks and this is something that is normal for diabetics, having to count calories and checking their blood sugar, but it doesn’t need to be this way. He could have stayed on the insulin he was on and not have to do those adjustments or have to readjust his way of living. The real questions are why? Why do we have to sacrifice a better insulin to an older insulin? Why do the American people have to sacrifice our children’s, seniors’, and loved ones health because of greed for money?
Editor. (2019, January 15). Diabetes.co.uk. Retrieved from History of Insulin: https://www.diabetes.co.uk/insulin/history-of-insulin.html
Medicare.gov. (n.d.). Insulin. Retrieved from Medicare.gov: https://www.medicare.gov/coverage/insulin
Osborn, C. O. (2020). Type 1 and Type 2 Diabetes: What’s the difference? Healthline.
Pietrangel, A., & Goldman, L. (2020). The Effects of Insulin on the Body. Healthline.