My name is Soli Leal and I am a 2nd generation Mexican-American. I was diagnosed with Type 1 Diabetes about 9 months ago. This sparked an interest in me about the issues faced across the world when it comes to diabetes care and education. Although I do not come from a traditional Mexican household, I see the struggles my family and friends face when it comes to healthcare. Language barriers and cultural differences can take a toll on access. One example that I have noticed is how taking insulin is sometimes seen as a last resort or perceived to be occurring because you are doing really bad or dying. I wrote this piece for an AP Spanish assignment, but it took me on a deeper journey than I expected. I learned not just about the price of insulin but also how it affects people’s decision making, their accessibility taking priority over general wellbeing. In honor of National Hispanic Heritage month, I wanted to share this in English and Spanish, to give the Hispanic community, especially here in the USA, the representation they well deserve.

Insulin is a hormone that the pancreas makes in every animal. However, for people living with type 1 diabetes (T1D) and some with type 2 diabetes (T2D) the body no longer produces enough insulin to survive. For these patients, several insulin formulas are manufactured and made available for patients to purchase. As a product, insulin generates billions of dollars, and the prices of these products are increasing every year. In 1923 when insulin was discovered, the patent was sold for 1 dollar so that everyone who needed insulin would have access. That generosity changed after some years; a vial in 1996 was $25, but by 2019 it increased to $300 through three companies in the United States. This rapid change in affordability impacts the 1.25 million people living with T1D in the USA. Some people with T2D require insulin as well. Between patients with T1D and T2D, the cost is prohibitive, and often patients turn to dangerous methods, such as, the use of expired insulin or rationing their doses, due to the cost.

The freedom to change jobs without worrying if you have health insurance, would be a great relief. Maintaining insurance coverage is important because patients depend on insurance to pay for insulin, diabetes supplies, and other health coverage. If the insurance does not cover one’s insulin type, patients are forced to switch products, bringing unnecessary risks. Many choose each month whether to pay for their insulin, food, water, or electricity. In the US, one vial of analog insulin costs around $360 while in the UK it only costs $65 for a vial. On top of that, most people with T1D use one to three vials each month. Therefore, some travel to Mexico or Canada to buy insulin for a fraction of the cost of insulin available in the USA.

There are many proposals to fix this insulin price problem, but it is difficult to find the correct solution to our complicated healthcare system; reformation is needed on every level. Transparency is lacking, and it seems that the entire system has many issues. Unfortunately, the weight of the burden often falls onto patients. Our system is not meant to benefit the minority and the insulin problem is only a battle in the war. The longer I live with T1D, the more I understand the amount of hours, money, and education that are needed to maintain good health. The intentions of medical care have changed from benefiting some of those in need to a for-profit system in which allows for the powerful to earn money and additional power for themselves. What is the price of life? Apparently, the price that earns the most.

Insulina, una hormona que se hace en el páncreas de cada animal, es un producto que genera mil millones de dólares para las empresas que lo producen. La gente que vive con diabetes tipo 1 (DM1) y algunos con diabetes tipo 2 (DM2), necesitan insulina para sobrevivir, pero los precios de estos productos están creciendo cada año. En 1923, cuando se descubrió la insulina, la patente se vendió por sólo 1 dólar. Las personas que la necesitaban la podían tener. Esa generosidad cambió tanto a través de los años ; una ampolleta de insulina en 1996 subió a 25 dólares y en 2019 creció a 300 dólares debido al monopolio que mantiene las 3 compañías más poderosas en los Estados Unidos. El rápido cambio en la asequibilidad afecta a 1.25 millón de personas con DM1 que morirán sin ella. Las personas con DM2 necesitan insulina también, y entre los dos grupos, muchos usan insulina caducada o la racionan, siendo métodos muy peligrosos.

La libertad de cambiar trabajos, sin preocuparnos por el acceso al seguro de salud suficiente para la condición, sería un gran alivio. Mantenerse seguro es importante porque nosotros los pacientes somos dependientes del seguro de salud para pagar el tipo de insulina que las compañías de seguros cubran . Si no tienen seguro de salud, los pacientes están forzados a cambiar productos, que pueden provocar riesgos innecesarios. Muchos escogen cada mes si pueden pagar por insulina o la comida; agua, o electricidad. En los EE. UU. , una ampolleta cuesta $360 mientras que en el Reino Unido solo cuesta $65 por una ampolleta. Además, la mayoría de personas con DM1 usan entre una a tres ampolletas cada mes. Por eso, algunos viajan a México o Canadá para comprar insulina por una fracción de lo que cuesta en los EE. UU.

Hay proposiciones para ayudar y arreglar este problema, pero queda en duda cuál es la base del problema que necesita la reformación. Nuestro sistema lastima a la minoría y el problema de la insulina solo es una batalla en la guerra de nuestro sistema de salud problemático. Lo más que vivo con esta condición, más entiendo cuantas horas, dinero, y educación necesito para mantenerme sana . Las buenas intenciones por parte de los que descubrieron la insulina ya no benefician a los pacientes. Se han convertido en un sistema con fines de lucro, cuya función es ganar dinero y poder para ellos mismos. ¿Cuál es el precio de una vida? Aparentemente, el precio de aquel que gane más.