Can’t Afford to Live

By Dylan James / Winter 2020

Around five years ago crisis struck my family, my grandmother’s large intestine ruptured and she went in for emergency surgery. She spent two weeks in intensive care and five months in a convalescent hospital recovering from the surgery, we watched in dismay as the numerous drugs hollowed her into a husk of her former self. To add insult to injury the bills for all of this were three hundred thousand dollars, yes $300,000 and without her two private insurance policies and Medicaid, she would have spent the rest of her life paying for it, luckily enough my family was able to cover the nearly fifteen thousand in deductibles. Her story is not an isolated incident, beyond emergency medical there are people like you and me out there living day to day relying on life saving medicines just to live. A fitting story of the first patients treated with bovine pancreas extract (insulin) comes to mind, the scientists that discovered insulin went into a ward of comatose children waiting to die from diabetic ketoacidosis and started to inject them with insulin, by the time they made it to the last child in the ward the first few started waking from their deathly slumber (Diabetes UK). This drug turned what used to be a death sentence into a manageable condition, well for those who can afford the nearly $1300 per month in insulin its manageable. We as Americans use the same amount of drugs per capita as other high income nations such as France, Germany, Netherlands, United Kingdom, Sweden, but for some reason we spend more for medicine and healthcare than the rest. We all face this problem of astronomical medical expenses and only a few of us are lucky enough to have a family to fall back on when we lose everything for getting sick and can’t work. We all, meaning the bottom 90% of the population when it comes to wealth, that is. I urge you to think for yourself if you could afford to drop fifteen grand at this very moment, for me that’s a year's tuition that I pulled out loans to sling, I would have no chance. As we can see there is a major issue we face within the healthcare system and the only solution available to us right now is simple, be rich or die young. Being poor, or rather not rich is a disease in itself in our country, costs keep us in a perpetual cycle of being unable to afford the things that let us maintain our health, like healthy food and dietary supplements, money is the thing that prevents us from going to the doctor, acquiring medicine, paying for procedures. This money depraved cycle targets the lower rungs of society including the impoverished, the working class, and particularly Blacks and Hispanics, all in all people like you and me. I believe this is a product of the ideologies adopted by our nation, the ideologies of profit over people and though we lead the world in drug development and manufacturing, we still are more concerned with the money produced by the industry instead of the people the industry is built on and meant to support.

Let us take a look at the system in place that promotes the lack of access for pricey lifesaving pharmaceuticals for marginal groups, in particular underinsurance or lack of insurance for marginal groups including Blacks and Hispanics and the relationship of private insurance to wealth level. The very fundamentals of this problem lie in the notion that medicine in the U.S. costs too much, based on that, we see that those without insurance or are underinsured (defined as out of pocket healthcare costs that amount to over 5% of total income) are the ones that are affected most by the pharmaceutical companies. Following this, we can look at the groups most affected by looking at which groups are the most uninsured and according to statista.com 7.8% of whites were uninsured compared to 12.2% uninsured for blacks and 20.1% uninsured for Hispanics in 2018. Now it is important to note that these figures just show uninsured, not specifying if it is by choice or by necessity. Some might say they simply choose not to have insurance, but this simply isn’t the case and according to results by healthaffiars.org “Median income among the privately insured is 2.9 times that of the uninsured, but median wealth among those with private insurance is 23.2 times that of the uninsured”, we can see that wealth is directly related to access to insurance and therefore the impact of high pharmaceutical on those marginal groups. These facts begin showing us the groups impacted by the problem, the problem that pharmaceutical and healthcare companies overcharge for their products/services and it is allowed by the government solely on the argument that regulating the industry will lower profits.   

Now that we’ve seen the groups that are impacted by the problem, let’s take a look into how the problem exists, private wealth influencing on behalf of large pharmaceutical companies and healthcare organizations to keep their industry largely unregulated in the way of service and product pricing. There is a common practice called lobbying that consists of private companies providing donations to government officials districts or campaigns in order to influence them to make certain legal decisions in their favor, Big Pharmaceutical companies healthcare organizations are no exception. In 2019 alone over 220 million was spent by 400 clients enacting nearly 1400 lobbyists for the pharmaceutical/health product industry (opensecrets.org). So why are they spending so much money on influencing the officials that oversee the regulation of their industry? Well the answer is rather simple; they spend so much so that they can continue to operate deregulated and charge the prices that net them maximum profit on their self-proclaimed risky investment in the industry. To the heads of the drug companies the concern is about the money not the people in their industry and that ideology is a major problem that brutally impacts the population. It has remained this way though because our government currently exists in the mindset that money and economy is their utmost concern, it’s how they control their oversees interests and maintain themselves as one of the most powerful nations. Some call this mindset the neoliberal ideology, an ideology that focuses on enriching the people with wealth and power regardless of the impact on the people and the planet. The ideology’s prime tenet is that competition and the market economy will sort things out in the natural way, with a few at the top who were most fit, and everyone else fighting over their scraps. The pharmaceutical and healthcare companies rely on the very same hegemony founded in neoliberalism, the notion of money over people is how it plays out in society. To characterize the mindset I am trying to describe even further, requires some scarcely spoken terms as of late, like neoliberalism which is hard to put into explicit words. George Monbiot from the Guardian describes it fluently:

“So pervasive has neoliberalism become that we seldom even recognize it as an ideology. We appear to accept the proposition that this utopian, millenarian faith describes a neutral force; a kind of biological law, like Darwin’s theory of evolution. But the philosophy arose as a conscious attempt to reshape human life and shift the locus of power.”

Fitting, that to describe neoliberalism we must resort to accepting that we are so far absorbed into it that we “seldom recognize it as an ideology” and we accept it’s tenets as a “neutral force”. The natural and neutral force of the market will sort everything out as if it is the neoliberal’s God, the world is their church and everything belongs to them, instead of everything belonging to everyone. There is hope for the rest of us though, we provide the basis for all their power and we can just as easily take it back and not let them make a profit off the people that make the foundation for their very existence, for without the people they would have no profits. If you’re starting to get concerned about the motives of our elected officials, you’re paying attention.

So, why does the mindset of profits over people matter? What is the impact on you and me? Well as you may have guessed, the higher the prices for life saving medications are, the less likely we are to have access to them and therefore the higher the mortality rate. I want you to make the jump in logic with me but what do the numbers say? The numbers according to health inequality.org of life expectancies for the rich can be up to 15 years longer for men and 10 years longer for women when compared to their lower income counterparts. Alarming right? The idea that we will die a decade sooner than the small group of people at the monetary top should be alarming, that in the wealthiest nation on the planet, the poorest people have a life expectancy that more closely relates us to the people of impoverished countries rather than to that of the richest of our own country. What makes the circumstances much worse is when we look at the fact that the wealthy few people coercing and bribing to have the system made this way aren’t affected by the system’s shortcomings. Sounds familiar at this point doesn’t it? We live in a society breathing on the idea that money and corporate persons have more value to our government than the society of people themselves. If you ask me, the problem here should concern the majority of us because it is us, the majority that are being affected and losing our lives because of the fact that big pharmaceutical and healthcare companies are going to charge what they like and the government will do nothing about it. I urge you and everyone that you can reach, be a drop of water in the bucket that causes it to overflow, the cascade that sparks a change in the way we view money and the way we view one another in this world, the only world we have to live in. The world inhabited by us, people just trying to lead a happy life and share what we have to offer. 

I can ask everyone to act all day long, but that doesn’t remove the circumstances that put us in our current hegemony. We are the ones that they are pulling the cloth of consumerism over, we are the fools of the joke the elites have been playing for the past fifty years. Why is it seemingly so hard to change anything in our country? Money, we lack the money to influence our elected officials the way the rich do and we are coerced by targeted consumer media to think and act in a certain norm that doesn’t see the idea of profits over people as a problem. It praises it as a virtue, but it’s hard to see from within what is happening, did the soviet people think of themselves as communists? Did the Nazi’s think they were the bad guys? The neoliberal world we live in is very hard to see as something happening to us instead of something happening because of us. We are taught from a young age that to succeed we have to effectively market ourselves to earn a job at a company and one day make it to the top. I’ll be honest, the way out of this dystopian future we are starting to inhabit isn’t clear to me. Though I think it starts with realizing that there are other people out there to take care of and support, without the notion of profit or favor either. Democracy that allows for all people to have a fair and equal fight in the game of life has been buried and a sort of pseudo-democracy has been left in its place. Even though the people with all the money and power are the ones we need to change the mindset of, without us they are nothing. Without us they cannot continue to charge whatever they please for our basic necessities, we can bring the power back to us the people. Voting is a major first step, the next is giving back, giving back to everyone around you for the sake of doing so, for the sake of enriching each other’s lives. I don’t want to suggest that we the people are solely responsible for cleaning up our country, we need to hold the people that have ushered in this era of wealth and destruction accountable. The future of our world at stake and the stakes have never been higher. I’m tired of not being able to afford to live anymore, I’m tired of some old white men telling me I’m just not working hard enough. The reign of those that seek to put people like my grandmother in debt for the rest of her life so that they can profit and let the market exercise its will on the masses of my people, Americans just like me.

Works Cited

Didem M. Bernard, Jessica S. Banthin, and William E. Encinosa, “Wealth, Income, And The Affordability Of Health Insurance”. Accessed 25, Nov. 2019.

Diabetes UK, “First use of insulin in treatment of diabetes on this day in 1922”, accessed 11, Dec. 2019.

Monbiot, George. “Neoliberalism – the ideology at the root of all our problems”, The Guardian, accessed 11 Dec, 2019.

Statista, “ Percentage of people without health insurance in the United States from 2010 to 2018, by ethnicity”, accessed 25, Nov. 2019.

“Industry Profile: Pharmaceuticals/Health Products.” The Center for Responsive Politics, 23, Oct. 2019 accessed, 25, Nov. 2019.

The Health Inequality Project, accessed 25, Nov. 2019.