美国国家公共电台 NPR Insulin's High Cost Leads To Lethal Rationing

 

SCOTT SIMON, HOST:

In June of 2017, Nicole Smith-Holt lost her 26-year-old son Alec when he couldn't afford the insulin he needed to treat his diabetes¹. Since his death, Smith-Holt has been vocal² about the rising price of insulin, which has more than doubled since 2012. Last month, she testified before Senate Democrats³ in Washington, D.C.

(SOUNDBITE OF ARCHIVED RECORDING)

NICOLE SMITH-HOLT: I received a call that no parent ever wants to receive or expects to receive. I was told that my son was found dead in his apartment on his bedroom floor. He was found all alone.

SIMON: Bram Sable-Smith, who is health policy reporter and host of the podcast The Workaround, lives with diabetes, so this story hits close to home for him.

BRAM SABLE-SMITH, BYLINE⁴: Diabetic ketoacidosis is a terrible way to die. It's what happens when you don't have enough insulin. Your blood sugar gets so high that your blood basically turns to acid, your cells dehydrate⁵, and your body stops functioning. Diabetic ketoacidosis is how Nicole Smith-Holt lost her son.

SMITH-HOLT: It makes me sad. It makes me very angry. It makes me feel frustrated⁶. It shouldn't have happened.

SABLE-SMITH: I met Nicole earlier this year when I started wondering why my own insulin prices were going up. In 2011, I was diagnosed with Type 1 diabetes, which is what Nicole's son Alec had, too. Most people's bodies create insulin, which regulates the sugar in your blood. Us Type 1 diabetics have to buy our insulin at a pharmacy⁷ because our pancreases stopped producing it. My first vial cost $24.56 after insurance. Seven years later, I pay more than $80. That's nothing compared to what Alec was up against when he turned 26 and aged⁸ off his mom's insurance.

SMITH-HOLT: He had gone to the pharmacy prior to losing my insurance to get an estimate of, you know, how much he should plan for and when they told him, $1,300.

SABLE-SMITH: That's $1,300 every month without insurance, mostly for insulin. There are many reasons why insulin prices are rising so high. Patents have pretty much kept generics⁹ off the market. Middlemen in the supply chain take their cuts. The Eli Lilly Company, one of the so-called big three insulin makers¹⁰, didn't make anyone available for an interview. But a spokesman noted¹¹ the rise of high deductible health plans is exposing more patients to higher prices. Alec encountered those higher deductibles when he was shopping for insurance in Minnesota. His $35,000 salary was too high for Medicaid, too high for Obamacare subsidies¹². What he found was a plan that cost $450 a month with a $7,600 deductible.

SMITH-HOLT: At first, he didn't realize what a deductible was because he was like I can make that work. Maybe I'll pick a part-time job, you know, and help cover the cost. I'm like, but you have to pay the $7,600 out of pocket before your insurance is even going to kick in.

SABLE-SMITH: Alec decided¹³ going uninsured would be more manageable, but he didn't make it one month. His family thinks he was rationing¹⁴ insulin, taking less than he needed to try to make it last till he could buy more. He died three days before payday. Rationing is a dangerous solution, but 1 in 4 diabetics admits to having done it. I've done it. Actually, a lot of Alec's story sounds familiar to me. We were both diagnosed at age 23 - that's pretty old. Then there's this.

SMITH-HOLT: I've had people actually comment online that he should have married his girlfriend for insurance. I'm like, really? It's like what's wrong with that? I'm sure you've thought about that too, right?

SABLE-SMITH: It's crossed my mind.

SMITH-HOLT: (Laughter).

SABLE-SMITH: It's more than crossed my mind. I'll be freelancing soon without benefits. So my fiance, Emma, and I did get married, last weekend, one year before our actual wedding so I can get insured. Talking about Alec doesn't get any less painful for his mother.

SMITH-HOLT: The reality of the situation - it hurts every time I have to share this story, but I know that I am doing it for a good cause.

SABLE-SMITH: It is worth sharing, she says, so long as it helps someone who hears it. For NPR News, I'm Bram Sable-Smith.

SIMON: And that story comes to us from a reporting partnership¹⁵ between NPR, Side Effects Public Media and Kaiser Health News.

1 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

2 vocal   

adj.直言不讳的；嗓音的；n.[pl.]声乐节目

参考例句：

• The tongue is a vocal organ.舌头是一个发音器官。
• Public opinion at last became vocal.终于舆论哗然。

3 democrats   

n.民主主义者，民主人士( democrat的名词复数 )

参考例句：

• The Democrats held a pep rally on Capitol Hill yesterday. 民主党昨天在国会山召开了竞选誓师大会。
• The democrats organize a filibuster in the senate. 民主党党员组织了阻挠议事。 来自《简明英汉词典》

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 dehydrate   

vt.使脱水

参考例句：

• People can very quickly dehydrate in the desert.人在沙漠里很快就会脱水。
• Without these structures, many warm-blooded animals would quickly dehydrate,especially in dry climates.没有这样的结构，许多温血动物将很快脱水，特别是在干燥的气候条件下。

6 frustrated   

adj.挫败的，失意的，泄气的v.使不成功( frustrate的过去式和过去分词 )；挫败；使受挫折；令人沮丧

参考例句：

• It's very easy to get frustrated in this job. 这个工作很容易令人懊恼。
• The bad weather frustrated all our hopes of going out. 恶劣的天气破坏了我们出行的愿望。 来自《简明英汉词典》

7 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

8 aged   

adj.年老的，陈年的

参考例句：

• He had put on weight and aged a little.他胖了，也老点了。
• He is aged,but his memory is still good.他已年老，然而记忆力还好。

9 generics   

n.（产品，尤指药物 ）无厂家商标的，无商标的( generic的名词复数 )

参考例句：

• Pfizer has set up an in-house division to handle such generics. Pfizer已经建立了一个内部机构来处理这些学名药。 来自互联网
• Payers are being more pushy about getting patients to take generics. 药物费用的支付者更倾向于让病人使用非专利药。 来自互联网

10 makers   

n.制造者，制造商（maker的复数形式）

参考例句：

• The makers of the product assured us that there had been no sacrifice of quality. 这一产品的制造商向我们保证说他们没有牺牲质量。
• The makers are about to launch out a new product. 制造商们马上要生产一种新产品。 来自《简明英汉词典》

11 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

12 subsidies   

n.补贴，津贴，补助金( subsidy的名词复数 )

参考例句：

• European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
• Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》

13 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

14 rationing   

n.定量供应

参考例句：

• Wartime austerities included food rationing and shortage of fuel. 战时的艰苦包括食物配给和燃料短缺。
• Food rationing was abolished in that country long ago. 那个国家早就取消了粮食配给制。

15 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。