Controversial take (though maybe not in this community):
If it’s needed for survival, it should be free. No exceptions.
Devil’s advocate: Medi-CAL (California’s Medicaid program, already known for being very permissive) will likely already cover it for the eligible, and should the $11 be used in aggregate to cover distribution and manufacturing for all of California’s citizens, it would be a reasonable rate to keep the program self-sustaining.
Allotting an exception for the payment for those who may have difficulty seems like a reasonable way to cover any gaps while making sure it never runs into the red.
The funny thing is if memory serves right insulin once you get it going is exceptionally cheap to produce. Unironically the 11 bucks may very well be the gross cost of production and transport per batch, probably not wages though.
originally elly lily, novo nordis, and sanofi had a stranglehold on the different types of “extended release insulin” they were behind the lack of generics for a while. until they were able to come up with alternatives insulin not based on the formulaitons of the 3 companies.
In most likely scenarios the social amortization should cover everyone including production/transportation labor.
Realistically the transportation and labor side is the most expensive, yeah. If the economy of scale gets solid enough in like year 2 of the program it probably could be cut down in price further, but California’s a huge state that may have trouble lowering distribution costs.
Would really depend on how and where production takes place at that point. I’m well aware of the states size, also I’m well aware that I’d rather drive through Nevada and Idaho to get to Washington over going through the central valley and Shasta.
Agreed. I love that this is rolling out in the first place though - I remember patients that had to leave the pharmacy because of their insulin being over $50 when I worked there. Hope that never happens again in this state.
Honestly I hope this is a first step to state run hospitals and eventually universal healthcare. While it’s not an ideal way to go about it it’s probably easier overall long term than dealing with the preexisting mess that is the modern hospital system.
Well America voted against food being considered essential for survival…
Of course, but what California is doing is awesome, so why shit all over it?
I’m not. It’s a step in the right direction.
that’s how it works in most of europe with our socialist healthcare system
Canada too. My son has T1D. Never paid a cent for insulin even through my insurance.
How about exceptions for rich people who can easily afford it at no noticeable impact to their livelihoods?
Validating who earns too much or too little is a colossal task that leaves opportunities for people to lose access to food because they haven’t logged in that month to report their earnings.
It also often costs more in bureaucracy, people and infrastructure than simply giving it to everyone.
It also causes social stigma as you are seen as poor for using a service.
If it’s available to everyone, then none of these problems occur.
Rich people will typically self-opt out of these systems anyway, as they will want the better expensive version of the thing anyway.
For case studies where this works, see:
- Free school meals
- UK NHS
For places where the system doesn’t work because of income cutoffs, see:
- UK benefits (working a little will cut you off, plunging you back into poverty
- Basically all welfare programs
Adding means testing to programs like this generally cost more money than it saves.
I like this. Ultimately there shouldn’t be any rich people, but that’s a step we can figure out later.
No, because that just opens the path for the ever expanding “except for them” for a very small portion of the population.
Make them pay full price, period.
Broadly speaking I agree but I don’t criticize shifting from exploitative to reasonably priced. An improvement is still an improvement.
Not a viable take though. Housing, clothing, food… none of them are free either. A more viable solution is to control the markets by setting limits, like they did here, and then provide a safety net for people so they will always be able to buy this stuff. It would be nice if it was free, but it’s a long road to get there. Social politics can provide survival without abolishing stuff like money in the meanwhile.
Some people feel like if you can’t provide society with your labor, you should still be fed, clothed, and housed.
IMO, people who don’t work, still contribute to society: raising family, being friends with people, creating art, and so on.
Things that aren’t easily measured by the dollar bill, but key to a good civilization.
Not to otherwise disagree with you but I would argue that raising family is hard work
And arguably more important to the prevalence of human civilization. Otherwise, places like South Korea wouldn’t be so worried about their shut-in youth population and declining birthrates while being currently at the top of the world’s tech industry.
I think essentially everybody agrees, the debate is where to put the lines for “can’t” and “needs”
I think you’re giving people too much credit.
Price floors and price ceilings reliably cause market failures like shortages and unemployment. If we’re not willing to let people die without it, then we end up playing stupid games like “free emergency room only”.
Economics is a social science and every proposal should be based on empirical results, not intuition.
Look at European economics. Healthcare isn’t free but sure feels like it. Lifesaving medication is not free but you can ask social services for the money that you need and you can always survive. Water isn’t free but if you can’t pay you get the money to buy water. “Free” can be the same as having a price and providing people with the funds to pay that price.
So my argument was against “free as in beer”.
I understand your argument. We certainly aren’t the first to investigate this. Would you please provide a source for your claim?
What claim? That social services can provide money if you do not have it? Here’s an example for the Netherlands. There’s tons of socialist constructs in European countries that provide support if you have trouble.
No, the “more viable” claim. Compared to free as in beer.
This I agree with 100%. Why it isn’t a standard in the world is totally abhorrent. Anyone with health issues should receive medication for free or at a minimal cost to cover transport, delivery, etc.
No need to stop at insulin.
Gotta start somewhere.
What I don’t like is that it follows the piecemeal approach that centrist liberals do where it is always too little and ineffective for the entire population which makes it mostly invisible.
“Let’s do socialism for 11% of the people while everyone else gets to pay taxes and get nothing”.
“Perfect is the enemy of the good”
Yeah no progress until we can instantly have 100% goal attainment!
Don’t forget to not vote next midterms or primaries to show Newsom and the Dems we mean business!
Sorry. I’m not voting for an anti trans bigot, even if they happen to have a D next to their name.
Fortunately, the odds of protest non-voters in California allowing a Republican to win is extremely low.
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Look, I’m all for incremental progress, but you don’t start from a compromise position and then compromise further like the centrist Democrats have done whenever they’ve had power. You start with the hardline position (free, universal, single-payer healthcare funded by a progressive tax system) and then compromise from there only if necessary to get something done. Centrists stupidly think that they can get what they want without a fight by proposing something that’s already a compromise, but the hardline conservatives are just going to fight anyway and the centrists are forced to negotiate. The result is that the right always gets a favorable outcome and the left feels betrayed.
Often the good is the enemy of the perfect. Obamacare was such a joke that it set the Democrats back a generation. They managed to get something passed, but their clinging to norms and refusal to nuke the filibuster meant that the bill was a pro-corporate mess so convoluted that people didn’t even realize they were benefitting from it. It legitimately helped people, but it also so sabotaged the Democratic brand that it set progress back decades in many fields. We got Obamacare, but we traded Roe v Wade for it. Without Obamacare, abortion would still be legal nationwide. People saw what Democrats would do even with a supermajority, and many voters just gave up on politics entirely due to Democratic corruption and timidity.
We lost abortion because Democrats thought it was more important to keep it as a wedge issue to rustle up votes than to enshrine it in law.
That is a saying by centrists for suckers. Nobody is asking for perfect. People want effective leadership.
Seems like the only solution centrists support is stupid sayings to make people accept ineptitude and corruption.
The DNCs ineffective leadership under Obama led to thousands of political positions lost throughout the country. They didn’t even bother locking up Bush and his cronies for their crimes.
Like I said: gotta start somewhere.
My point is that the start is so small that it allows republicans to demonize and ultimately kill it since it doesn’t help the vast majority of people.
You’ve given up before you’ve even began (believe me, I know that feeling).
But don’t let your paralysis leak out to other people. If you see someone taking baby steps to make this world better, you be their cheerleader. You give them your energy so that they can take bigger strides.
And who knows, maybe in the process you’ll have taken your first baby steps too.
I haven’t given up. I’ve seen these baby steps from centrist liberals for the last four decades. They’re stringing us along like donkeys.
Centrist liberals will only do the bare minimum for the working class while fully enabling the capitalists.
Homes, food, insurance, cars, etc are much more expensive than ever and wages are not even close to catching up. Corporate profits are through the roof though.
Tell me how 8 years of Clinton plus 8 years of Obama plus 4 years of Biden improved the life of Americans. That’s 20 years of millions of Americans dying from being denied care and/or going bankrupt because they got sick.
All they did was stabilize the markets for capitalists.
Tell me how the republicans have done any better.
Look we can sit here and back and forth all day long. Yes, our system fucking sucks donkey balls. Will it get better? Who the fuck knows. But I guaran-fucking-tee you that shitting over things like affordable insulin is not the way to go. We gotta take our wins where we can. And when our centrist D’s don’t, we gotta get out there and hold their feet to the fire; whatever that means.
But giving up is not a fucking option, because that’s how we got Trump and friends in the first place. And look at where that’s got us.
We gotta a fucking gestapo in the US. We are at the cusp of a new nazi regime. And NOBODY that matters is freaking out about it.
What. The. Fuck.
So you know what: I’ll take a state 3,000 miles away from me FINALLY doing something right. Even if it’s not perfect. Because right now I need some goddamned good news. Even if it doesn’t affect me personally. Because what else do I have, if not that?
Just give me a goddamned gun otherwise so I can paint my walls in red.
Edit: as pointed out below, these numbers are for type 1 and 2, so the population is requiring insulin is much lower than this.
Among the U.S. population overall, crude estimates for 2021 were:
• 38.4 million people of all ages—or 11.6% of the U.S. population—had diabetes.
• 38.1 million adults aged 18 years or older—or 14.7% of all U.S. adults—had diabetes (Table 1a; Table 1b).
https://www.cdc.gov/diabetes/php/data-research/index.html
Sure, the majority of folks don’t have diabetes, but come on, this affects a huge number of people, and I would bet that a vast, vast majority of people at least know someone with diabetes.
And yes, those are national whereas this is California—but it’s also about changing hearts and minds. When someone from Texas, struggling to pay for their kid’s insulin, learns about this, they might just question some things.
Not to mention those that know someone who has diabetes.
type 1 is the one that needs insulin the most but they dont make up a large part of compared to type 2.
Good point, edited to add comment.
11% is not insignificant. It’s just too small and it leaves most people out. I can already see the “most diabetic people make themselves diabetic” talking points.
The ACA was supposed to be transformative but it ended up being more of a patients’ bill of rights that anything to make care affordable.
Baby steps gave us Trump and their fascists regime. America needs someone with vision like FDR that isn’t afraid of upsetting the wealthy donors.
Sometimes that may be true but neurologically, empathy is often driven by experience and most people have a relative with diabetes and many people have a diabetic relative who struggles financially with it. This would be hard to demonize.
This reads like you’re saying diabetics don’t deserve cheap insulin in California. This is not too little and is not ineffective for the people living in poverty with diabetes.
I’m getting really tired of defending progress from attacks by progressives.
I’m just tired from the lack of progress. It shouldn’t take decades to fix simple things but centrists love money too much.
We’ll see how many red-staters cross state lines to buy their evil, demonic $11 insulin.
Watch them take advantage of this while acting like “California is the worst state”
I have family that loves to say this. They moved from CA to live in a red, welfare state that siphons more federal funding than they generate.
I remind them often that my state pays for their state.
and still spit fire und fury about that bein communism or something
“I deserve-it/actually-need-it not like those other free loaders” is a very real attitude that many Americans have.
“I’m not one of those welfare queens… I’m disabled!”
Millions, weekly.
Socialist insulin isn’t as good as the American stuff.
Yep, time to flee the leopards to save their faces from being eaten.
Shame there aren’t as many farming opportunities on the Pacific coast as there are out midwest. Oh well. I’m sure those ones will just have to pull themselves up by their bootstraps.
As a Newsom hater, I have to admit this is a big win for everyone. While he’s still very far from an actual solution to the country’s root problems - you can vote for him (if that’s an option), and then continue protesting and pushing for more reforms. I’m not quite as optimistic to believe this will happen, let alone succeed, but it’s an idea.
Newsom can be shamed into doing the right thing. Trump/Vance/Miller will disappear the shamers. Completely different realities.
The most transphobic version of Newsom is a return to needing several doctors to write a letter saying you are trans. We’re already seeing Trump denying the right to exist and forcing the next generation of trans kids into navigating black markets for T shots or forced to grow with the wrong hormones.
navigating black markets for T shots or forced to grow with the wrong hormones.
california has been looking for a low cost insulin for a few years, i think they were moving towards this for a while. the resistance is coming from the trioply that owns the other formulations of insulin.
Quick reminder that insulin was invented when Hitler was still a struggling art student.
Invented by a Canadian who sold the patent to a Canadian public university for a (Canadian) dollar, because he recognized that this should not be commercialized.
Insulin is available for pennies almost everywhere in the world because of this decision, but not in the USA
the original version, but elly lily, novo nordisk, and sanofi made the other variations which was more effective and potent(depending on the person), they just prevented any other person from making a cheap or generic version through lawsuits originally.
$11 per month, that’s only about double what it costs in most of the world. Wait… Still $11 PER PEN
Wtf did it cost before!!??
As a former pharmacy worker in California, anywhere from $40 to $200, depending on the patient’s insurance. There’s a reason Eli Lily and other companies monitor the supply truck drivers and call the cops if they stop.
lol the next Fast and Furious should be about the crew robbing trucks full of insuline. For family.
They’re more likely to do product placement on the movie for a Pharmaceutical company than to actually have such a plot.
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At 3ml/pen and 100units/ml, that puts it on par (retail price) with Canada and Germany and around 50% more than France and UK.
As with a lot of US health prices, listed prices are massively inflated compared to average out of pocket expenses, creating horrible holes for uninsured people. In the US there are some recent caps for insulin cost of $35/month at the low end, and other caps in the $100/month range from what I’ve read.
Here is a good price comparison https://pmc.ncbi.nlm.nih.gov/articles/PMC11147642/
I don’t want to go down the rabbit hole, but I’m wondering is this ia CA paying the difference on what would be price gouging, or CA actually controlling the process, to erase any opportunity for that price gouging. That latter would likely be permanent, the former would last only as long as the administration isn’t seeking budget cuts.
They’re partnering with a non-profit 501©(3) generic manufacturer that was set up by groups of hospitals.
https://en.wikipedia.org/wiki/Civica_Rx
Seems as legit as you’re going to find in the US.
Would they sell out of state? Like deliver meds to another state? Not American, just curious.
I could see both Oregon and Washington wanting to jump on that band wagon.
I fucking loathe Newsome - but this is hard to complain about
Holy shit, I can’t believe this is real
What took them so long?
Go away.
because the 3 companies that made the different variations were fighting tooth and nails for anything similar to even being developed for years and years.
“Myeeeeh I have to find something to complain about this objectively good thing that is occuring”
For comparison…
In Aus I’m paying ~$32 for 25 pens
We have it decent in Australia, but for the Americans reading on, the bar is so ridiculously low you can walk over it.
I hope one day Medicare can actually be universal, and not the private subsidy model we have currently.
I dunno about you, but finding bulk billing is a pain the arse now, and in certain areas it simply doesn’t exist. Not to mention my premium mouth bones which aren’t covered for some stupid reason.
I just wish we’d finally kill off private health. Private health is such a scam we only take out because we have a two tiered system and there’s a tax discount.
I really don’t like Australians talking about how good we have it, when it’s kinda meh, and actively getting worse.
That all being said, yeah, the PBS is pretty good and I’m glad insulin is affordable.
Thank Christ we didn’t get the Libs back (for American readers, that’s the conservative party), we could do SO much better given how wealthy we are per person.
But, anyone who doesn’t want to pay more in tax in order to get truly public healthcare doesn’t know how to do maths. We could just pay what we pay in private health premiums already, in tax, and we’d probably get way better care per person (because profit is inherently inefficient).
Abolish private health.
Thanks for being accosted with my rant.
100% agree. Dental should be covered.
I don’t mind private health existing but it should only exist without all the bs policy to force you into it and without leeching off public funding through tax breaks and Medicare funding.
Bulk billing fortunately doesn’t impact me because I see a team at hospital outpatients for almost everything.
Fortunately PBS brings one of my speciality meds down to affordability from a few hundo K per year.
My big gripe at the moment is ndss funding for CGM sensors is non-existent if you aren’t type 1. So it’s ~100 per fortnight if you want good glucose monitoring but have some non type 1 need for them.
I stopped going to the dentist, it is simply way beyond what my budget can handle. That sucks.
I must be preaching to the choir, but remember this when they don’t tax large corps, or propose another tax cut for workers (you and me).
We don’t need tax cuts, we need to stop wasting money on subsidising the already wealthy so we can afford to finally abolish private health for good!
(Dentists don’t like the sound of this, because they won’t be able to charge whatever they like anymore. But tough, my mouth bones aren’t a luxury)
Oh damn, that must suck (regarding the glucose monitoring)
Thanks for sharing your thoughts.
I do have one extra Response:
I don’t mind private health existing but it should only exist without all the bs policy to force you into it and without leeching off public funding through tax breaks and Medicare funding.
The problem is that the private health model in our country only works with tax breaks and Medicare funding.
If we made them ACTUALLY compete with Medicare (i.e., if you have private health cover, you’re no longer eligible for Medicare), the business model would collapse.
I for one, propose this as a method for killing it off.
By making them compete, hehe
After almost 20 years of big L Liberals in Aus, we should just consider ourselves lucky we still have Medicare. I want dental too, but I also want them to repair the basic model first
Our of curiosity, what does this look like in your view?
Do you mean the basic model? If so, it means everybody has access to free medical. Although, in order to include dental earlier, it would need to be restricted at first on need.
Yeah I was curious as to what reforms you would propose. We already have a system that purports to have universal medical care, but it’s only true in limited ways. There are many avenues to free medical care, but it’s still a for-profit system under the hood (for non-hospital care, which includes seeing specialists).
There are government run parts of the system, like emergency hospital which runs very well, but outside those, the gap fees are getting larger, and the “elective” surgery system where people on the public queue wait months for life altering surgery is an embarrassment.
I’m proposing we end the subsidy model, make all health care publically provided, not just some, everyone goes through the same system, not two tiers for those who can afford it. This is the only way there is extremely strong incentive for everyone to want healthcare to be extremely good.
Although, in order to include dental earlier, it would need to be restricted at first on need.
Why though? I’m guessing hospital care is vastly more expensive than getting a check up at the dentist. The peak body of dentists rail against dental into Medicare because it’ll dampen their profits. Preventative dental is cheaper than emergency dental.
We should pay medical employees actually doing the work more, and give practice owners nothing.
The “free market” is a stupid way to run an essential service. Thank god ours at least is regulated decently (but, not enough)
People need to look at the last 40-50 years and realise privatisation has not worked, it’s time to roll back the clock on government ownership and running of essential service.
We have a say over the government’s decisions, not private companies (outside regulation and legislation). Why are people so allergic to government ownership (it’s propaganda, if we’re being honest)
Profit motive needs to be taken out of healthcare and elder care yesterday.
Sure, universal health would be great, but, we are a very conservative country, the best we can hope for in reality is a subsidy model that doesn’t subsidise private. We need to unwind the changes of the past 2 decades while also expanding it.
Profit itself isn’t the issue imo, profit above all is. We have to get back to making people the priority, not profits.
US user here: I REALLY appreciate the context. I hear surprisingly little about the Australian side of this kind of thing. Thank you!
No worries mate. All the best in improving your country’s situation!
Thanks for being accosted with my rant.
No need for that. I feel informed by this. Thank you.
Thanks for this haha, I do often feel like I’m just projecting “things are bad” into the world. Appreciate you saying this.
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I also hate private health, and in fact, cop the additional medicare levy on the chin because id rather pay 2-5k in tax that funds medicare, than get some junk private health cover. The problem with bulk billing is it’s so dependent on location. I have great GPs that can get an appointment within a day or two. More rurally you’re waiting 6-8 weeks and paying $90 a pop. Despite their being flaws in Australia you can still at least get emergency life saving care that won’t bankrupt your family. I’m not as well versed but there’s also the safety net for medications which I believe stops the horrendous out of pocket expense across a year
Yep, safety net changes slightly each year but it’s usually based on the cost of a certain number of scripts.
This year it’s $1,694.00 for general patients and $277.20 for concession card holders.
When you hit it as a concession holder the cost becomes 0 and as general you get the concession card price for the rest of the year.
This will be the first year of my adult life where I won’t hit it which feels pretty amazing. One new drug lets me drop multiple existing ones and not get sick as often.
This will be the first year of my adult life where I won’t hit it which feels pretty amazing.
Heck yeah!
I have a relative that needs about 1800 a month for their Insulin. They’re disabled but if they applied for disability they wouldn’t be poor enough to qualify for public assistance and the disability payments wouldn’t be enough to cover the price of insulin so they’re forced to live in poverty until they old enough to retire.
That’s like covering rent for two extra people. That’s insane.
In Portugal - which has a National Health Service - I’m getting 5 pens for €0 with a doctor’s prescription (and there are mechanisms for just getting new prescriptions regularly or on request without needing to go for a doctor’s appointment every time), as would anybody else that needs it, by the way, as it’s not means tested.
That said, without said prescription it would be about €70 for 5 pens.
Also the local politicians are slowly but surely destroying the National Health Service in order to privatise Healthcare bit by bit.
Yeah that’s what we’re doing in Australia too, our Medicare system used to be great free doctors everywhere etc.
Now they’re fewer and far between and private health companies got a boost from the government since the government said if you don’t have private health you will pay more in tax
Hey look! A liberal doing some actual fucking liberalism for once. What a nice change of pace.
Newsom is all over the place. Sometimes his position is straight from the GOP playbook (criminalizing being homeless) and sometimes it is liberal like this. He is trying to be everything while preparing for a '28 presidential run.
Some of the only good government policy I’ve seen in my lifetime.
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It doesn’t have to be a good look, but it seemed more like cowardice and being manipulatable than it did actively hating trans people.
That’s the case for a lot of Americans. They’re opposed to the idea of their tax dollars being used for gender surgery; when it’s pointed out people pay for them themselves, they’re like “…Well, then I don’t care, do what you want.”
And yes, I’m aware that kind of cowardice is sometimes just as bad as hatefulness. I’d certainly rather a leader with a stronger spine than him.
That’s the case for a lot of Americans. They’re opposed to the idea of their tax dollars being used for gender surgery;
That’s ignorance and bigotry as all healthcare should be covered even when individuals have rare conditions that cost millions to treat, covering trans care costs peanuts in comparison and improves health outcomes. The sky didn’t fall when the Yukon fully funded gender affirming care.
It doesn’t have to be a good look, but it seemed more like cowardice and being manipulatable than it did actively hating trans people.
So in other words, even worse than over bigotry.
US trying to do a single thing not-for-profit challenge (apparently possible).
Yeah! Good job, guys. Keep it up.
Socialism!!! Let me pay an arm for my 'murica insulin! /S
That might still turn out a profit, just not as much as it could. Once you have the tech running it & distributing it is cheap.
Born with immune system that destroys its own insulin producing cells -> forced to pay $11 a week (depends on person) for the rest of your life.
Better than the 100 or so private companies are asking.
I get what you are saying but it’s still a step in the history of this:
Step 0: Die of diabetes as only option
Step 1: pay exorbitant pricing to NOT die of diabetes
Step 2: pay high but much more reasonable price to NOT die of diabetes
Step 3: ???
Step 3 != profit
Gotta play life in hard mode for all the achievements
Or do what Sociopathic Oligarchs do, and put it into Cheat Mode, make a ton of money, then use your money to change the rules so nobody else can use Cheat Mode.
So it takes less labor to sustain your insulin needs than to sustain your food requirements. Universal Healthcare would be better but this is pretty reasonable.
Insulin is only a part of the treatment/cost, and most of us are on several different types (fast-acting/long-acting). If you’re on a pump, it’s usually just fast-acting, but pumps are expensive. There’s also monitoring devices like glucose monitors and test strips, which are pricey. The sensors for continuous glucose monitors are about $100 a piece without insurance and last a week or two. Glucagon is a pretty useful thing to have on hand if you’re on insulin. It’s like Narcan for insulin, and it’s not inexpensive. There’s also that little matter of increased doctor’s office visits and frequent bloodwork, even with insurance, the copays and deductables can be burdensome. They won’t write the script if you don’t show up regularly. My diabetes doesn’t cost as much as my food, but it’s close, and I have decent insurance. All of that, and you’re still likely to have complications to some degree in your old age. Nothing about having diabetes is reasonable- universal healthcare would make the pill easier to swallow though.
I firmly believe “From each according to their ability, to each according to their need” and support universal healthcare. But I also live with a disabled diabetic relative who would make too much money to qualify for public assistance to afford their insulin if they applied for disability so must live in poverty until old enough to retire. $11 dollars a pen would be a dream come true.
Means testing is the stupidest thing. 🤦
I don’t mind at all if rich people have to pay more for certain things
Definitely a win! It’s important to note what type of insulin this is, insulin glargine (a long acting insulin). For those who are already on Lantus or Toujeo it will definitely be a plus. Hopefully next they’ll do short acting insulins (lispro and aspart)
