Few issues within America’s dysfunctional health care system are more pressing than the astronomical price of insulin — access to which is, for millions of Americans, literally a matter of life or death. Congress is finally moving toward approving legislation that would partially address the problem. But passage will rely on the willingness of some hesitant Republicans, including Sen. Roy Blunt of Missouri, to set aside their free market absolutism and acknowledge that the apparent price-gouging going isn’t what markets are supposed to do.
Almost 2 million Americans have Type 1 diabetes, which typically requires daily insulin shots. More than 30 million more have Type 2 diabetes, which often requires insulin therapy.
In the past decade alone, the cost of that lifesaving insulin has tripled. Today, even insured patients, depending on the terms of their policies, can end up paying $300 or more monthly for their insulin, while uninsured patients can face monthly costs of well over $1,000. The situation has spawned horror stories of diabetics self-rationing with less insulin than they’re supposed to take, with sometimes tragic outcomes.
The reasons for the price explosion are complicated and contentious, with the pharmaceuticals, insurance companies and wholesalers essentially blaming each other. An investigation by the Senate Finance Committee in 2020, headed by then-Chairman Sen. Charles Grassley, R-Iowa, blamed them all. “This industry is anything but a free market” because of anti-competitive practices between those various players, Grassley said in a statement accompanying the committee’s report in early 2021. He called for “bipartisan legislation and oversight to address this problem.”
The reins of the Senate have changed, but the bipartisan legislation Grassley called for has finally arrived. Sens. Susan Collins, R-Maine, and Jeanne Shaheen, D-N.H., last week unveiled a measure that would cap the monthly insulin costs for insured diabetics at $35. It doesn’t cap costs for those who are uninsured — a more complicated issue that would have to be addressed in broader legislation — but it’s a start. The bill is similar to one the House passed earlier this year, but in addition to capping out-of-pocket patient expenses, it also targets distribution issues that are partly blamed for the price hikes.
Blunt told The Washington Post this month that he won’t rule out the bill until he sees it, but that “generally I’m not supportive of price controls … I’m supportive of competition and things that encourage competition.”
That may sound a solid free market stance, but this particular market has clearly colluded to the detriment of its consumers — some of whom have died because of it. We encourage Blunt and others with reservations to consider that when a given market becomes detrimental to its customers’ health, a hands-off approach by political leaders isn’t conservatism, but abdication of responsibility.
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