How Privatized Healthcare Keeps Us Down: Briana’s Story of Type One Diabetes

They say that capitalism motivates people to work hard and achieve, but Briana’s story shows how our current privatized, capitalist medical system actually does the opposite, forcing people to choose between essential, life-saving medical care and professional advancement.

A woman wearing a Rosie the Riveter costume stands in an industrial kitchen flexing her right arm.
Bri at work.

At the age of twelve, in the sixth grade, I was diagnosed with Type One, or Juvenile, Diabetes. Within a few days my life took a 180-degree turn; I had to learn a new way of living and thinking, spending three days and nights in the hospital receiving training and education about my newly diagnosed autoimmune disease. I remember being angry and frightened–what did I do to deserve this? How will the other children look at me and think of me when they see me doing such things as pricking my finger or taking injections? I wanted to hide; I wanted to ignore the burdensome tasks I’d be required to perform (and think about) every single day; I wanted to be “carefree” and “normal.”

Obviously having to deal with health issues is extremely stressful in and of itself; add extra stress from having to deal with medical expenses and health insurance companies on top of those personal stressors and it is no wonder that our society faces a mental health epidemic. Growing up in a low-income, single-parent household, our already tight budget was suddenly stretched even more thinly after my Type One diagnosis. Syringes, glucometers, test strips, lancets, vials of insulin, ketostix, emergency glucagon kits, alcohol wipes, and glucose tablets are just some of the monthly supplies needed in order to control diabetes–each with a co-pay attached; periodic blood/urine tests and monthly/quarterly visits to the endocrinologist, ophthalmologist, psychiatrist, therapist, etc. also each accompanied by required co-payments, all adding up to thousands of dollars spent every year on healthcare

Diabetes is an extremely expensive disease to have. As a Type One, insulin is required from the time of diagnosis–an auto-immune disease, Juvenile Diabetes cannot be prevented nor controlled with diet and exercise and is irreversible. There are no alternative options for treating Type One Diabetes–insulin is necessary for survival. Part of the reason why diabetes is such an expensive health condition is because of the fact that pharmaceutical companies are able to continue renewing patents on insulin as they are continuously developing new products; most medications are available in more affordable generic options after having been on the market for about twenty years–insulin as a treatment for diabetes has been around since the 1920s and absolutely no generic options are available.

One vial of insulin can cost as much as $500–Type One Diabetics taking injections need more than one type of insulin and use roughly four bottles per month.

Without healthcare coverage, only the wealthy can afford to survive with Type One Diabetes; even with healthcare coverage, many Americans cannot afford the outrageously expensive deductibles, co-payments, and other out-of-pocket expenses.

Motivated by frustration and outrage, after living with Type One for only about six months, I began to research alternative treatments. Having spent the previous summer at a week-long camp for children with diabetes, I was intrigued by the more seasoned diabetic kids who used insulin pumps instead of syringes to deliver their medication. Arriving home, I pleaded with my mother and my endocrinologist to allow me to get an insulin pump and say good-bye to giving myself multiple daily injections. Unfortunately, at the time, there were absolutely no endocrinologists in the Dubuque area who were willing to  take on a client under the age of sixteen with an insulin pump. My only option if I wanted to be prescribed an insulin pump was to switch to an endocrinologist in Iowa City at the University of Iowa Hospitals and Clinics.

Due to insurance restrictions, I was not able to simply choose a new doctor in Iowa City–a referral from my primary care physician was required before every single quarterly appointment with my new endocrinologist. As a rule of thumb at the time, I was told, diabetics were usually not prescribed insulin pumps until they’d had sufficient experience living with the disease (generally at least a year). My new endocrinologist required me to prove to him that I was mature, responsible, and knowledgeable enough to handle having an insulin pump

By the time that the following spring had arrived, I was finally deemed ready for an insulin pump. I had made it over the first hurdle only to find another standing in my way. Insulin pumps and the supplies needed to use them were (and still are) extremely expensive. My mother’s health insurance plan was not going to cover the full cost of this equipment and the portion that we were expected to pay was way out of our price range.

The total cost for the insulin pump was about $5,000–my mother was expected to pay for about $1,000 of that total. We would have to be patient and save up the money, my mom told me.

We were devastated; we had already been waiting and working so hard to get my pump for months. Just when we thought that we could see the light at the end of the tunnel, another obstacle came along requiring us to wait even longer, and for an indeterminable amount of time at that.

Then one day out of nowhere I came home from school and my mom told me that we had the money to pay for me to get an insulin pump. I was happily surprised. How did this happen so quickly? My mother’s co-workers had pooled their money together to donate toward my new pump. I remember sobbing tears of joy and gratitude—I could not believe that people whom I had never even met would give so much money to help me. If it had not been for those kind, selfless people, who knows how long it would have taken for me to get an insulin pump, or if it would have even ever happened at all? With the initial hurdle of purchasing the pump out of the way, each and every subsequent year brought the issue of paying for the monthly pump supplies (which were substantially more expensive than the supplies used when taking injections). Every now and again I would switch back to taking injections for a while to relieve this financial burden a bit.

As the years passed, my mom practically beat it into my mind that I needed to get good grades, go to college, and get a job with good health insurance. Thanks to the Affordable Care Act, or ObamaCare, I was able to remain covered under my mother’s health insurance plan until the age of twenty-six. As I am sure that we are all aware, life does not always go as planned, curveballs are thrown, and we end up in situations we never expected, forced to do things we thought we would never have to do. As my twenty-seventh year approached, panic and fear began to set in. I had been unable to finish college and had been working at various restaurants as a part-time server—hardly the industry that offers “good health insurance plans.” Having heard horror stories of diabetics struggling to pay for their supplies, even with coverage, I was petrified.

Luckily, my hometown insurance agent was able to help me to find an acceptable health insurance plan through the private market. Unfortunately, after having this new coverage for only about two months, the company was liquidated and once again I had no idea where to turn. This time, my insurance agent found that I was eligible to receive Medicaid coverage through the state of Iowa.

Due to my low income, I qualify for no/low-cost healthcare; only now, another problem presented itself:  I can’t make too much money, or I will be in that same predicament again of finding affordable private insurance

(which is practically unheard of for individuals with diabetes unless you are fortunate to have a good plan through your employer). So, now that I am in a better place in my life in which I am able and willing to finish my college education and/or work more hours, I am prevented from doing so because of my health insurance situation.

There are approximately 29 million Americans still uninsured, and another 31 million people are underinsured. Imagine how many of those individuals are like me—willing and able to do better, not reaching their full potential because our country’s healthcare system (or lack thereof) is holding them back. This is why I support Universal Healthcare;

a Single-Payer, Medicare for All healthcare system would save the typical middle-class family $5,000 per year in health insurance costs, and would save businesses over $9,400 in healthcare costs for the average employee.

The United States is the only industrialized nation in the world without Universal Healthcare, yet we spend more money on healthcare and other related costs and are less healthy than those recognizing healthcare as a human right. It is time that we, as a country, join the rest of the developed world and put an end to the current for-profit system run by the pharmaceutical companies.



We need a healthcare system that prioritizes the health of working-class Americans over the profits of insurance companies and their billionaire executives. We need a single, universal system with comprehensive coverage that is free at the point of service.

Help the Democratic Socialists of America (DSA) fight to replace our broken, for-profit health system with Medicare for All!

 

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