GOP lawmakers–including, of course, Indiana’s two Senators–recently blocked a Biden Administration effort to cap the price of insulin for Americans with private health insurance. (Americans on Medicare will see their out-of-pocket costs decline, thanks to other provisions of the Inflation Reduction Act.)
GOP opposition to the measure, which I can’t help thinking of as a manifestation of the Republican “Let them eat cake” approach to policymaking, reminded me of a recent discussion with my sister. Her doctor had rordered some medical tests, and when she was scheduling them, she was told that one of them–a test for cancer!–wasn’t covered either by Medicare or by her private insurance. The test was $300, and she told me that her first thought was “I can afford this, but what about all the people who can’t? What about people who don’t have an extra $300 but do have cancer?”(Fortunately, she didn’t.)
This conversation, rather obviously, wouldn’t have occurred in most Western democracies, because in those countries, health care isn’t just for people who can afford it.
When it comes to capping the price of insulin, the influence of Big Pharma–particularly Indiana’s own Eli Lilly–was front and center with the GOP.
Lilly’s enormous profits owe a lot to the high price of insulin. That’s especially ironic, given the generosity of those who first held the patent.
Before the 1920’s, a diabetes diagnosis meant a death sentence for people all over the world. The main treatment was starvation diets to prolong the inevitable.
In 1920, a Canadian physician and scientist named Frederick Banting began working on an idea to isolate and extract insulin. He worked in the laboratories of J.R.R. McLeod, a professor of physiology at the University of Toronto. The medical student Charles Best aided him in his work to test out insulin on dogs. Chemist James Collip worked with Banting and Best to purify and refine insulin for clinical trials in humans.
On January 23rd, 1923 Banting, Best, and Collip were awarded the American patents for insulin. They sold the patent to the University of Toronto for $1 each. Banting notably said: “Insulin does not belong to me, it belongs to the world.” His desire was for everyone who needed access to it to have it.
In order to make insulin widely available, Eli Lilly, Sanofi and Novo Nordisk were given the right to produce it, and they’ve turned it into a massive profit generator. As the linked article reports, “by 1923, insulin was the highest-selling product in Eli Lilly’s history, and profits from it accounted for over half of the company’s revenue.”
And that brings us to the recent refusal of Indiana’s Senators and other GOP recipients of Lilly largesse to ensure insulin’s affordability.
As The Intercept reports, Lilly Endowment–ostensibly separate and independent from the company–is not neutral when it comes to funding entities opposed to controlling the price of medications. The Endowment,”led in part by former Eli Lilly executives and still financed by corporate stock options” funds think tanks that “work to shield corporations from taxation or government regulation,” and has given millions of dollars to libertarian groups that lobby against price controls on insulin, categorizing those recipients as “community development organizations.” (The Endowment is also the largest shareholder of Eli Lilly, Inc., holding 104,161,053 shares worth approximately $31 billion.)
The Federalist Society, for example, has received over $1.5 million from the charitable arm over the last decade and is listed under “community development” grantees of the Lilly Endowment. The Washington, D.C.-based group is a professional society for conservative attorneys, with an eye toward pro-business ideological positions.
The Federalist Society funds included a $150,000 grant last year, at the same time that the group was sharply criticizing a new Minnesota law that forces manufacturers to provide free or affordable insulin to low-income residents. The law “[inflicts] an injustice upon companies that are regularly demonized in the media,” an attorney for the Goldwater Institute writes on the Federalist Society’s website.
Last year, Eli Lilly collected over $2.4 billion in revenue from its insulin products, including the brand Humalog, with roughly $1.3 billion of that from U.S.-based sales.
“One vial of Humalog (insulin lispro), which used to cost $21 in 1999, cost $332 in 2019, reflecting a price increase of more than 1,000%. In contrast, insulin prices in other developed countries, including neighboring Canada, have stayed the same,” wrote S. Vincent Rajkumar in the journal of the Mayo Clinic in 2020.
There’s much more detail in the linked article, and I encourage you to click through and read it. That said, the real issue is the one my sister identified: if government is supposed to provide a physical and social infrastructure within which citizens can flourish, isn’t access to health care and lifesaving medication as essential a part of that infrastructure as police, firefighters, roads and bridges?