Our real issue here is that there is absolutely no incentives to control costs.
You’d think our ins companies would do it, but I’m practice, they end up negotiating sweet deals with the drug manufacturers. say med X @ $1000/mo msrp, but the ins companies negotiate it down to $400/mo. The drug company makes out like a bandit, and the ins people get kick backs for buying from the drug co, and passes on the costs to the insurance buyers.
I believe they offer R (short acting / 2-5h), N (medium), and L (long acting / 24h). The problem with the older insulins isn't so much that they're faster, it's that they're less "specific" (from my experience). A newer short acting insulin (Apidpra, etc) has a spike in the 15-30 minute range and the spike is steep and the tail (while up to 5 hours) is low. Whereas R peaks in the 30m-1h range and the peak is low and the tail is much higher. As such, you need to plan ahead much better for your eating. It's frustrating, but not horrible. The N and L have similar problems (L is the reverse, where you want a tail equal to the spike, but it isn't).
The newer insulins a just much more convenient and require a lot less planning of what you eat and when... and not as close an eye on your blood.
Like I actually use an open source pancreas to control my glucose levels so now I can sleep every night without having to worry about dying. This is in Europe where the insurance covers everything and prices are cheaper than in US.
Using the Walmart insulin makes everything much much more complex, and even for the smartest of us, even with the best possible insulins, managing T1 is a HUGE pain and can kill you quite fast.
I hope I misread your comment...
> The high price of tier 1 insulins is killing people
Is (more or less) a lie. While
> The high price of tier 1 insulins is making people's lives considerably worse and their diabetes harder to manage.
Is (more or less) true.
When you try to push for change and use, as part of your argument, a lie, you sabotage yourself. People can point at what you're saying and, ignoring the validity of what you're trying to achieve, say "you're lying". That's bad.
The truth is that there are good reasons why tier 1 insulins should not cost as much as they do, not by a long shot. And destroying your own progress towards changing things is counter productive. Just don't do it.
One in four patients in the US have rationed insulin because of the cost: https://news.yale.edu/2018/12/03/one-four-patients-say-theyv...
It is simply untrue to say the high cost only forces people to use the cheaper Walmart generic. That isn't what happens. They ration it, and sometimes they die.
Finally, it doesn't make sense to say that the high price is making diabetes harder to manage, but isn't killing people. That's like saying speeding doesn't kill, it just makes the car harder to manage.
> One in four patients say they’ve skimped on insulin because of high cost
> say they've
^ is the key component. I expect the vast majority of those people had a choice, and they chose not to take it. A poor choice, and a choice they shouldn't have to make, but a choice nonetheless.
The point is, if you're going to fight for positive change, use an argument that can't be trivially dismissed because it isn't true. Fight effectively.
I would argue these two statements are equivalent:
- My patient was killed by the high price of insulin.
- If the price of insulin had been lower, my patient would still be alive.
I suspect that you accept the second statement, but not the first. What's the difference?
1. If the fatty and sugary foods were too expensive for them to buy, they would not have died from those things.
2. They did not die because fatty/sugary foods weren't expensive. They died because they chose to eat fatty/sugary foods. [1]
Just because X (good insulin being cheaper) would have helped prevent Y (deaths) doesn't mean that <not X> caused Y.
[1] I'm ignoring the fact that truly healthy foods tend to outside the price range of the poorer segment. The analogy only really goes so far here.
- People drive cars.
- Cars are car jacked.
- If people did not drive cars, carjackings could not happen.
- People driving cars is a requirement for carjackings.
- People driving cars is not a cause of carjackings.
I understand that it is possible and truthful to argue that people driving cars is a cause of carjackings; it's just not my view of the meaning of those words.
When people learn that the "old insulin" and "new insulin" are completely different products and that "old insulin" is still available at a low cost, the narrative and goodwill is shattered.
People hate being lied to and they hate being manipulated.
If you want to have a discussion that we should make the "new insulin" available for at low cost of for free, that is great! We can talk about the cost to manufacture and to develop drugs.
There are many smart people here and around the world, when we put our minds to a problem, we can find a solutions.
But by not acknowledging and downplaying the time and effort that companies and people have put into the "new insulin", then you are cheapening the work they have done and are signaling to everyone that you would do the same to their time and effort as well.
It's well known that you need to keep all sorts of things under control with type 1 to avoid long-term health complications. Blood sugar is the most obvious.
I watched my father manage his for decades, starting in the 1980s. The technology improvements were interesting - his first insulin pump (about the size of a VHS tape), the custom software to data-dump his glucose meter, "supply-hacking" to keep the infusion sets affordable...
He still had management challenges despite being a dedicated, disciplined, marathon-running Mormon on the leading-edge of treatment. He was fortunate enough to be involved in the DCCT/EDIC trials at the University of Washington, and took the early lessons about future complications very seriously.
You make Diabetes harder to manage by removing modern improvements to the standard of care, and you are certainly going to see increases in deaths and severe negative outcomes.
However, actually _saying_ that tends to get people up in arms, harassing you about how it how it shouldn't be necessary for people to use the older insulins, and how the newer insulins shouldn't cost what they do. Even though everyone actually agrees with them and they're arguing against a point that nobody it actually trying to make. It is... frustrating trying to get people to understand that you agree with them, but you're talking about something different.
I had this exact discussion with one such person yesterday, and I was trying to explain that they are sabotaging their own goals by misrepresenting the issues. And that I WANT them to succeed in changing things, but they're making it harder to do so.
Edit: You're already being downvoted for stating something that is obviously and undeniably true, because people are not bothering to understand what you're saying. I'm sorry for that.
In a way it is killing people, blood sugar control is much easier with a mix of the newer insulins, and patience compliance is much higher. This directly translates into better quality of life and lower disease burden from diabetes complications.
No one can argue that pharmcos shouldn't be paid for R & D that increases quality of life, in civilized countries the taxpayer should and will pay for your medication if it's an improvement over what's already at market.
But here people seem to be arguing that if you can't afford anything else there's still Walmart short-acting Humalog, and you get to bear all the risk, and that's just fine.
I found some references for "old" versions that claim price increase from $17 in 1997 to $138 today, another from $21 to $255.
Going by inflation only those would be around $30-40.
I don't know how much a typical diabetic needs per month (I imagine it varies) but I could see that being a problem for a lot of people if that is, say a monthly supply.
About $25, that last I checked. The ones you're talking about, I believe, are the "newer" ones (which are not very new). The prices of those have shot up over the years (in the US) for no good reason. It's shameful.
For example, Basaglar is a "generic" of Lantus, but it's still expensive.
Here’s How to Save on Basaglar, the Expensive Lantus “Generic” https://www.goodrx.com/blog/basaglar-expensive-lantus-generi...
> Basaglar contains the same kind of insulin as Lantus (insulin glargine), and while it is cheaper—Basaglar costs about 15% less than Lantus—it is still expensive, with a cash price of around $450 for a 30-day supply.
Unlike normal generics, the bio-similars need to go through their own clinical trials and prove they work the same as the original. They can't just "use the same ingredients" and release it. Mind you, that doesn't explain the extreme price markup, but it does explain why these "generics" don't follow the same "85% cost reduction" of normal generics. They still have, effectively, a costly R&D phase.
At least, that's my understanding.
By the way that same site had an interesting article breaking down costs normalized by insulin unit
https://www.goodrx.com/blog/how-much-does-insulin-cost-compa...
By that table and some assumptions about approx 40 IU/day it looks like the cheapest you could get away with at full retail would be about $120/mo, assuming optimal usage etc. The most expensive version would be at least 5x that.
There are plenty of cases of people literally dying because of difficulty managing insulin due to cost. It’s nice to say other low cost forms are available while handwaving away actual deaths as well as accumulative long term damage from difficult insulin management.
https://khn.org/news/insulins-high-cost-leads-to-deadly-rati...
Many of the “newer” forms are 20+ years old, and are also extremely low cost to produce.
I pay zero attention to people and news sources that repeat that behavior more than once. Lead with the truth.
I wonder how different the production costs are though, my understanding is the costs to consumer are greater than 10x
Source: a T1 diabetic, used all possible insulins in my life. Very happy in Europe.
Admittedly, they're not cheap w/o insurance, which sucks. But if you can get one, so do. You won't be disappointed.
Just repeating the question, when I gave you the answer, isn't very productive.
We should ask what are the outcomes that these systems produce, not how new the drugs are.
A cutting-edge healthcare system plagued by inequality and extreme costs can produce worse results than a more efficient healthcare system which is not as high-tech.
But yes, I agree. Sometimes the juice isn’t worth the squeeze.
It’s a for-profit system where literally every cog from drug company to pharmacist has an incentive to separate you from your money.
When Europeans can pick from 5 different spring loaded epinephrine injectors and Americans can only legally buy one from a specific manufacturer, of course Americans pay 5x as much.
In plenty of places around the world you can buy all humulin you want without a doctor or the FDA for $30 vial.
If the state was the single largest negotiator for purchasing hamburgers and representing tens of millions of people odds are you would have more competitive hamburger supply bids.
The thing we can't talk about without risking cancellation is that nearly all Type 2 Diabetes is preventable. In other words, the choices of the many have a significant negative impact on those (i.e., Type 1'ers) who don't really have a choice.
Our situation has nothing to do with demand and everything to do with corporate greed. Many western European countries empower their governments to set upper bounds on the costs of medication to reduce the ability of pharma-bros to make disgusting amounts of personal wealth off the suffering of others.
Insulin is made in massive facilities in large batch runs. Making 5X to 10X is basically cost of materials, which haven't really increased enough to justify the price increase.
This is (mostly likely) a rent-seeking situation where a few providers who are allowed in the market are milking it for all the profit they can.
That is also known as demand. They do because they can.
1) Healthcare is a limited resource, like anything else.
2) Prevention, which few if any "leaders" highlight, is a viable alternative to healthcare price increases.
Are there there some nefarious undercurrents? Yes, of course. But to blame all our ills - and remove diet, lifestyle, etc. - on ever increasing demand only makes the current system stronger. People who believe they have no control aren't part of the solution.
Exactly. The preventable T2D is driving up demand (read: prices) for both T1D and T2D.
I don't know about Canada. I do know about supply and demand. We all do. In the context of healthcare it makes no sense that ppl abuse their health and then expect prices to fall.
What you fail to consider it that the company that controls the particular type of Insulin that Type I diabetics require is charging 80% less in Canada than in the USA with everything else equal.
Do you get it?
Do you get it?
I’ll never know and I’m stuck with it.
Diet. Exercise. Etc. All known to change T2D.
Sorry, but regular people don't make "campaign contributions" of any noticable size, so all we get back is a form letter acknowledgement based on whatever box you checked for subject.
Big Pharma, Big X and Big Y, on the other hand, "donate" enough "campaign contributions" that the campaigner can all but ensure (re) election based on recent name recognition to get the nomination, then counting on "their" voters being unable to vote for the opposite party even with the discovery of a live boy or a dead girl.
https://duckduckgo.com/?q=live+boy+or+dead+girl&t=fpas&ia=we...
What always amazes me is how much this is tolerated in the “Land of the free”. At what point do Americans stand up for democratic principles?
This pathetic “we can’t do anything” attitude will be how democracy dies.
If my electoral district was gerrymandered or corporate donations through PACs we’re allowed in Canada I would be planning protests instead of typing this. Our system is far from perfect, but I have a hard time imagining a scenario in which the public here would passively accept many of the things we can see to the South.
Why is there so much apathy towards these issues?
Shouldn’t the fairness of the democratic system in the US be the #1 issue for both Democrats and Republicans?
[0] https://www.marketwatch.com/story/trump-and-democratic-polit...
[1] https://www.rollcall.com/2019/06/06/what-is-mcconnelling-how...
[2] https://www.theatlantic.com/politics/archive/2015/09/10-ways...
[3] https://www.latimes.com/nation/la-na-politics-superpacs-impa...
This kind of influence is completely untraceable through all the normal disclosure mechanisms since no money actually gets spent. And worse still, it offers enormous leverage— once you have that war chest, you can use it to issue hundreds of threats and only occasionally have to actually follow through.
It's just a completely different ballgame compared to a "normal" campaign finance option that directly spends donations.
https://en.m.wikipedia.org/wiki/Citizens_United_v._FEC
Walk softly and carry a big purse.
We need to pick something. If we're going the free enterprise way we need competition, price transparency, quality and outcome transparency, more open markets, and much lower taxes. If we're going the state-run or state-insured way then we need to whole-ass it and vertically integrate and drop the state-backed private insurance hybrid nightmare.
The US does this pessimum thing all over the place. We are taxed almost like a more "socialist" country (unless you are rich enough to offshore and play tax loophole games) but do not get the benefits of one. Either cut my taxes down to Costa Rica levels or give me benefits at least as good as Canada please.
There are no free market health systems in leading economic nations (unless maybe you take a very small niche corner of the systems)
That also does not exist in the US and hasn't in more than half a century. The US could hardly be any further away from a free market in healthcare. It's hyper regulated, and hyper dominated by government programs (Medicare, Medicaid, and dozens of other programs and agencies).
The US healthcare system is controlled top to bottom by rigid, strict government regulations and oversight. It's the way it is precisely because there is no free market at all. The corporatist interests like it just the way it is, and work with the politicians to constantly maintain that highly regulated environment: it's regulated in their favor, exclusionary of nearly all potential competition. And it's insanely expensive to try to start anything in healthcare, which favors the incumbent further.
Try starting a hospital or opening a clinic. Try becoming a doctor. Try getting a drug to market. Try getting a medtech device to market. Hyper regulation every direction you look.
Free market? Ha.
We don’t really know what a true free market would do with modern healthcare because as you say there is no such thing. Personally I think it could work for middle class and above but would leave a big coverage cliff down below because it’s not profitable to insure or treat the really poor.
The question is whether real transparency with price competition and efficiency gains would make it cheaper to then add a safely net for the poor.
https://www.google.com/search?q=lieberman+public+option&oq=l...
The issue, though, is not that it's half-assed and fucked up. It's working by design, to use legislative schemes to funnel money to incumbents and friends/donors, while still supporting the "free market" ideology, when really it's just regulatory capture.
The system is designed for graft, and it's working as intended. Those with the power to "fix" it won't, because to them it's not broken at all.
The US has the same problem in telecommunications, war/defense, and medicine. The largest vendors become integrated with the budget- and policy-makers, and the whole system exists to extract maximum value from the consumer class.
But as it is, insulin is high demand and increasing. Prices simply don't fall when demand increases.
unfortunately not likely to do anything as long as the big pharma lobby remains as powerful as it is
They instead resort to the language of the unheard.
Votes are too diluted, and there is no accountability for campaign promises.
Le référendum, c'est Place de la Bastille!
Look for ways to make the patents unenforceable. If diabetics had the ability to make their own safe insulin at home that would be best. Then all they would need is an internet connection and some basic components. The closer we get to that ideal the more empowered they are.
This would actually solve a lot of price gouging for drugs.
However that's only a stop gap measure. What's happening with gating access to insulin is happening to a thousand other products in a thousand other industries right now. Start looking at alternative governance structures. Lord knows everyones got a blog and a half-assed plan to run things better at this point (since the bar is so low).
Just don't poke the bear. As cathartic as hanging 'congresscritters' would be it wont actually solve the problem.
Basically act like you don't expect anyone else to fix this problem for you because nobody is going to; especially if you voted for them.
The question is why no one is calling for price controls for other products that are produced in a relatively free market. Then ask yourself whats different about the market for insulin that prevents price competition.
Using "fixed" prices to control costs is like using "fixed" thermostat readings to control global warming.
The alternative would be to allow people to break the third party payer system and allow people to buy and import drugs from whomever they want. You can do this now on the grey market, but it would be great if it were legalized. Then you can probably get it for the same price as any other country, probably even lower. If you want, you can have the state cut every insulin user a check for $10 a year or whatever it would cost in a free market
Americans vilify their politicians and then expect that somehow really “good” people will get into that profession. I don’t get it…
"African American adults are 60 percent more likely than non-Hispanic white adults to be diagnosed with diabetes by a physician."
Given that the middle class is very white and employed with insurance coverage, it virtually doesn't affect white people. Our politics takes black people's votes for granted and don't do anything for them.
It's worse than that. If they sufficiently pandered to them to the point of actually solving their problems then they wouldn't be able to take those votes for granted, so they'll never solve their problems.
Not every problem has it’s root in division.
IMO it's more helpful to look at this through an economic lenses than a race one. T2 diabetes is very much a poor person's disease.
And while various poll access restriction measures are an injustice one could almost think is intentionally targeted at black people, I imagine those obstacles aside they'd be as free and capable of conscientiously assigning their votes as anyone else.
I say this as a leftist: the Democratic Party is the party of the health industrial complex.
https://www.jacobinmag.com/2021/01/joe-biden-public-option-h...
I await the explanation of your model revealing the drivers of healthcare costs and connecting them to predominately Dem responsibility with baited breath, nigh weeping for hope of policy-capable leftists in the meanwhile.
> Mandatory insurance
You know that's how socialized insurance works at one level or another, right?
> COBRA payouts
Is this a mantra or a point?
> Did you know Gretchen Whitmer’s dad was the CEO of BlueCross?
This is definitely not a point.
> the party of the health industrial complex.
As long as we consider approach healthcare primarily as an industry, yeah, there's going to be industrial interests tangled up with it. Should we do it some other way? Maybe. In which party do you think that conversation is even possible?
The Democrats are the party who put massive amounts of effort into derailing the only viable candidate to argue for public healthcare.
Maybe you don’t care about keeping predatory insurance companies afloat with COBRA payouts, or forcing healthy people to pay tens of thousands of dollars to insurance companies, but plenty of people do.
Sigh.
Look. I appreciate passion for the topic. I absolutely care about this too. I probably spend waaaay more time than a layperson should reading about healthcare problems and policy. Like a lot of other people here on an engineering forum like this, I know the power of approaching things as their own kind of system.
And it kinda looks like you don't yet. That's something I've no doubt you could fix, but you'd have to want it. Maybe even enough to google the term "socialized insurance." Or understand that when healthy people pay into risk pools... that's what insurance is.
> The Democrats are the party who put massive amounts of effort into derailing the only viable candidate to argue for public healthcare.
Presumably you're talking about Sanders. I encourage you to talk to his office while he's not running about other people who are supportive and enthusiastic about public healthcare efforts. There are plenty. Arguably not enough: if they'd had few more Senators to get past Joe Lieberman in 2010, Medicare-for-all-who choose would have been a reality then. As it was the ACA was a mixed but significant policy victory.
They do have regulatory capture, mostly given to them by the Democratic Party.
I can't tell whether you're saying "Health insurance in the US is a commercial industry right now" or "there's no such thing as health insurance that is not commercial."
The latter statement is not true. Medicare for all would be socialized insurance, as would any single payer plan. There are other kinds of socialized insurance you can find in other countries.
The former statement is mostly true with notable exceptions, so we'll assume that's what you mean. You may not be aware there is socialized insurance in the US, though: Medicare and other state programs (and again, the vast majority of Democratic officeholders supported expanding access to that to everyone in 2010 via what was called the "public option" at the time, unfortunately they needed every last D Senator and Lieberman held out). There are also some non-profit private insurers.
> these companies are getting paid tens of millions of dollars. They are INCs.
The money flowing through these companies is not the problem. Getting paid to provide valuable services is not a problem. Even if you had a magic wand that you could wave that made Bernie king and M4A a reality, you would still need to employ people to source revenue for the general insurance fund, provide good financial stewardship over it, manage relationships with competent providers, provide service to people like you and I, etc etc. You'd have to pay all those people. Like Medicare already has to (and hires private parties to help).
It's likely that entirely socializing insurance would cut down on overhead (and certainly on any profit taking), but the thing is... that's already been limited. By who? Well... these Democrats you're suggesting are somehow primarily responsible for nurturing insurers. Where did this happen? The Affordable Care Act required insurance companies to reveal how they spend consumer premiums, and spend 80% of those premiums on care and efforts to improve quality of care. What companies can take in operating expenses and profits is limited by law to 20%.
Did you know that? If you didn't, why are you so confidently holding forth on this topic? If you did, why are you insisting on repeating the line that Democrats don't care and in fact are responsible for increasing expenses and capture of revenue?
> They do have regulatory capture
They have representation and influence in a democratic system. Arguably too much? Yeah. What's your plan for that?
> mostly given to them by the Democratic Party.
Again, you're welcome to lay out your model of how the democrats are responsible. If it's really limited to "other people in the party thought they'd make a better candidate/President than Bernie", though, you might want to see if you can come up with something stronger. And while you're at it, maybe start to admit at least to yourself that maybe you have some more to learn about this topic.
Simple, prior to the ACA I was able to cover my health expenses out of pocket. I’m healthy and literally went to the doctor 3 times in a decade. After being forced by the ACA to buy unneeded and unwanted health insurance, I ended up paying >10k /year for literally nothing.
I’ve since paid so much in health insurance that I could have covered my own cancer treatments, out of pocket. I have received nothing for that $100,000+ dollars.
Add to that the “marketplace” with limited time windows, limited competition, the inability to get insurance from another location…
These were all Democrat initiatives that I lived through.
Then, twice the Democratic Party fought tooth and nail to kill M4A. Biden literally said he would never implement it. I’m no fan of the GOP, but when it comes to healthcare costs, no one is worse than the Dems.
Insurance is not something you have because you are ill, it's something you have as a hedge against the probability that you will be ill. Whether you're healthy now has limited bearing on that.
And if you want to be able to have it when you are ill, you need to be willing to contribute to premiums even when you're not. Whether that contribution comes in the form of an explicit premium paid into a risk pool administered by private insurers or in the form of a percentage of your tax dollars paid to a socialized insurance plan (like M4A), that's how insurance works.
From a political standpoint, the individual mandate might have gone down more smoothly if people had been given a choice to opt out of it, in return for agreeing that they could be denied for pre-existing conditions. Democrats at the time made the calculation from a policy/values that too many people wouldn't understand what they were doing and end up shooting themselves in the foot. I used to think that was wrong.
> I ended up paying >10k /year for literally nothing.
> I could have covered my own cancer treatments, out of pocket. I have received nothing for that $100,000+ dollars.
Your numbers don't add up.
Out of pocket costs for a course of cancer treatment usually run well over $100k (and those stats might be for people who do have insurance).
There haven't been many years that the individual mandate was in effect. It went into effect in 2014. Tax for not buying insurance was lowered to zero by 2019. Your yearly premiums would have needed to be not ">$10k" but around $20k for you to have spent $100k in premiums.
And if you didn't want the insurance, it was always legal to simply pay that tax on not having it. How much? Well, for the median income household, that'd be about $700. Much less than You would need to be pulling something north of $500k a year in order for your tax to be $10k. Please, tell us where you worked, and why they were paying you that much while... not offering you insurance?
Or if you were making $500k a year as a business owner / contractor... why you didn't have any accountant or other financial professional giving you better advice? $10k a year in individual premiums is cadillac plan territory, even in expensive metro areas. Generally not what people who are healthy and go to the doctor three times in a decade buy. High-deductible plans with premiums below $300/mo are available to individuals in Los Angeles today. Your individual max required premium shouldn't be more than $3500 a year in 2021 (and in 2014, you could probably get away below $2400/year). Hell, you could cover a family of four in Los Angeles on less than $500/mo in premiums with ACA assistance, for a total cost topping out below $6000/year, so we know that's not what you're talking about (on top of the fact that you spoke in terms of your own health rather than mentioning any family).
Maybe there's some reasonable explanation for why all your numbers are so far outside of credibility here?
> the Democratic Party fought ... M4A
Please. M4A wouldn't even exist as a relevant concept in American political discourse without the Democratic Party. The only reason you know the label at all is because it was advocated in primary contests and by Democrats in congress. Yes, Democrats plural. For an example, read one piece of introduced legislation:
https://www.congress.gov/bill/116th-congress/senate-bill/112...
Notice the list of D Senators as co-sponsors. Notice that it is not short (nearly a third of the caucus at the time). It is profoundly wrong to characterize the Democratic Party as the primary obstacle to something like M4A when it is the only reason why M4A is a potential reality in the US. And saying "I'm no fan of the GOP" doesn't ameliorate that mistake: you can guarantee that the list of Senators sponsoring anything remotely like that bill in the GOP would have a length of 0 (and of course, given when the bill was introduced, only someone who was also ignorant of the composition of the senate at the time could think the primary reason it didn't go anywhere was D efforts).
Also, maybe check your misconceptions about Biden:
https://www.vox.com/21540041/election-2020-joe-biden-health-...
That's him trying to find a way to make medicare for everyone who wants it.
When I was a single contractor: $900 /month
After I married a healthy partner: $2100 /month for the both of us.
After transitioning to full time employment: $2300 /month
These numbers align with my friends. In no way was paying $300 /month an option.
Health insurance is not health care. I don’t want it. I want public healthcare, barring that I want affordable healthcare. Pre-ACA was much more affordable.
I really wish neo-liberals could just admit when their policies fail. This one is not on the GOP. It’s 100% the result of DNC policy and actions.
I assume you want people to vote Democrat. To be effective there, step one would be to listen to people who have legitimate grievances and when your party is at fault, own it. Do not go on a tirade about how paying for insurance is actually a good thing. It’s not, it’s a failure of our social safety net.
I have no misconceptions about Biden. He was part of the admin that screwed me with the ACA, I watched every debate and heard him repeatedly state that he was going to continue to enrich the insurance industry on my back. Which is exactly what he’s done since taking office.
Edit: source
https://www.cnbc.com/2019/05/20/cramer-bidens-2020-bid-is-se...
https://www.healthsystemtracker.org/chart-collection/u-s-spe...
Spending and costs are distinct, of course, but they're related, and you'll see spending track costs directly unless there's a factor that increases/decreases demand for services
What do we see? An acceleration bump in 2014/2015, and then it settles back into data whose variation is much like pre-ACA dynamics. 2014 would have been when the exchanges and wide reach of access went into effect. The spending acceleration bump was almost certainly people who didn't have access before using medical services.
The idea that the ACA drove some kind of unprecedented increase in costs doesn't track:
https://www.thebalance.com/causes-of-rising-healthcare-costs...
And lots of stocks rose when Biden was nominated (and elected). Sensible leadership prospects have their own positive effect on enterprise.
But in America you are supposed to take "personal responsibility" for your own health and biohack your way ouf of type 1 diabetes?! Srsly?
This s a political, not a scientific problem. Call your congresscritter.