# Losing job/insurance and the options that follow

**URL:** <https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330>\
**Category:** Insurance\
**Created:** [January 25, 2018, 1:32am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330 "2018-01-25T01:32:06Z")\
**Posts on this page:** 20\
**Page:** 8

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**Author:** ![Katers87](https://avatars.discourse-cdn.com/v4/letter/k/a9adbd/32.png) [@Katers87](https://forum.fudiabetes.org/u/Katers87)\
**Post date:** [January 27, 2018, 6:40pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/141 "2018-01-27T18:40:37Z")

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The benefit of having a government negotiate drug prices is that it eliminates the need for PBMs entirely and also nearly eliminates the cost of drug companies negotiating with insurance companies. Also, laws against advertising lowers those costs too.

If everyone negotiated individually with drug companies, costs would skyrocket

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [January 27, 2018, 9:06pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/142 "2018-01-27T21:06:25Z")

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Guys, this thread is getting a bit too heated up, let’s give it a rest! We all know that each one of us would give his shirt to help another in this community, but political threads still heat up too much and can create animosity.

So let’s close this one. If you disagree, pm me, and, if there are enough requests, we’ll reopen it.

{EDIT] OK, reopened, but please be sure to keep this thread without tension!

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [January 27, 2018, 9:06pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/143 "2018-01-27T21:06:34Z")

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [January 27, 2018, 9:08pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/144 "2018-01-27T21:08:31Z")

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> [@Katers87](#):
>
> If everyone negotiated individually with drug companies, costs would skyrocket

The notion of individuals negotiating themselves isn’t really how it would work…

If humalog cost 80% as much as novolog and people were purchasing their own meds, or even paying a direct proportion of the costs themselves, then the demand for humalog would go up and demand for novolog down… across many thousands of people, none of them whom had to negotiate anything themselves. To stay competitive, novolog prices would have to then lower.

Instead we have novolog and humalog both simultaneously and in lock step raising their fake list price, while negotiating a increasingly huge rebate behind the scenes…

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [January 27, 2018, 9:11pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/145 "2018-01-27T21:11:19Z")

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**Author:** ![kmichel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/kmichel/32/3085_2.png) [@kmichel](https://forum.fudiabetes.org/u/kmichel)\
**Post date:** [January 27, 2018, 9:11pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/146 "2018-01-27T21:11:45Z")

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Gads. Time to put my foot in my mouth and support @Sam a bit … Seems like he is on his own here 😛

> [@cardamom](#):
>
> I’d switch to R and NPH before I’d cancel cable TV, personally.

I’d cancel the cable TV, but I would switch before canceling my internet… maybe even if I had to cancel internet, cell phone, etc.

> [@cardamom](#):
>
> proliferative diabetic retinopathy

Me too. And I developed it after 15 years on an insulin pump. So I can’t tie that to NPH/R, which I did relatively well on for the first 1/2 of my life. Exceptionally well, in fact. It was just that I had to follow a specific routine that did not work well for me in the long term. A pump was a better option, but the Humulin/Novolin was awful for me. Everyone’s mileage varies with every treatment.

I do know people who use beef/pork insulins (outside the US), as well as NPH.

In a [2016 market research study by Boston University](http://haiweb.org/wp-content/uploads/2016/04/ACCISS_Insulin-Market-Profile_FINAL.pdf), they said:

> _Glargine vs. NPH_  
> _All identified studies found no significant differences in HbA1c concentration after treatment_  
> \_with glargine compared to NPH. \_  
> _Detemir vs. NPH_  
> _None of the identified studies showed a significant difference in HbA1c concentration between_  
> _detemir and NPH treatment groups._

> [@Katers87](#):
>
> Can you give an example of a country that has made this work?

Meh - it is more like things are priced to the country and ability to pay. We in the US/Canda get to pick up the slack on the cost. I did see a post in another thread about Tresiba in Russia. It was funny to me, as they price it per milliliter, and not per box. I think the ad had 100 rubles per ml (about $15 USD). However, I have priced it there back in September '17 - it would cost me $300 per box. Humulog would cost me about $67 per vial.

But then there far more insulin producing companies in Asia, Eastern Europe, and Latin America versus high income countries (Again, see that Boston U report).

Just my $0.02 +/- worth.

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [January 27, 2018, 9:16pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/147 "2018-01-27T21:16:38Z")

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> [@kmichel](#):
>
> A pump was a better option, but the Humulin/Novolin was awful for me.

Did you mean to say not awful?

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**Author:** ![kmichel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/kmichel/32/3085_2.png) [@kmichel](https://forum.fudiabetes.org/u/kmichel)\
**Post date:** [January 27, 2018, 9:18pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/148 "2018-01-27T21:18:28Z")

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Nope. On the pump, with Humulin/Novolin, my A1C’s went way out of whack and I had complications as a result. Humulog/Novolog didn’t work well either. Apidra was my “savior” on the pump, until I had absorption issues and scarring.

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [January 27, 2018, 9:19pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/149 "2018-01-27T21:19:25Z")

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Oh I see I get what you mean… was confused by the wording…

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**Author:** ![kmichel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/kmichel/32/3085_2.png) [@kmichel](https://forum.fudiabetes.org/u/kmichel)\
**Post date:** [January 27, 2018, 9:20pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/150 "2018-01-27T21:20:27Z")

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A dudn’t knew wat u ment. I rit gud…

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [January 27, 2018, 9:21pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/151 "2018-01-27T21:21:04Z")

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Lol all my posts are from an iPhone, cut me some slack

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**Author:** ![kmichel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/kmichel/32/3085_2.png) [@kmichel](https://forum.fudiabetes.org/u/kmichel)\
**Post date:** [January 27, 2018, 9:33pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/152 "2018-01-27T21:33:38Z")

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Hey - I was picking on _MY OWN_ writing. 😉

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<div class="post-metadata">

**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [January 28, 2018, 12:11am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/153 "2018-01-28T00:11:05Z")

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9 posts were split to a new topic: [Trying out R+NPH: an experiment](https://forum.fudiabetes.org/t/trying-out-r-nph-an-experiment/3355)

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**Author:** ![TiaG](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/tiag/32/594_2.png) [@TiaG](https://forum.fudiabetes.org/u/TiaG)\
**Post date:** [January 27, 2018, 11:57pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/158 "2018-01-27T23:57:10Z")

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> I love cable.

Honestly, I think this may be the sticking point for most of us. 🙂 I don’t even have cable, so to me this is just a very bizarre idea… it’s very possible, however, @Sam loves cable way more than most of us can even imagine, meaning he’d be fine with, say, developing neuropathy or retinopathy, etc., as long as he could watch Game of Thrones or whatever else it is that’s currently on TV.

Realistically, there _are_ some people who choose (if not consciously) to worsen their health significantly in order to maintain certain other creature comforts. People who choose to smoke or like my dad, who will continue to eat high salt diet despite it worsening his heart condition, etc…

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [January 28, 2018, 12:01am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/160 "2018-01-28T00:01:23Z")

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I probably do love cable more than average joe… but my point was to show that I’d switch to any different insulin and i really don’t expect it to be that horrible or detrimental to my health . We will see. I hope my experiment makes some other people feel more empowered and less dependent on a system that doesn’t value their well-being.

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**Author:** ![bkh](https://avatars.discourse-cdn.com/v4/letter/b/da6949/32.png) [@bkh](https://forum.fudiabetes.org/u/bkh)\
**Post date:** [January 28, 2018, 9:21pm UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/161 "2018-01-28T21:21:48Z")

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> [@Sam](#):
>
> If humalog cost 80% as much as novolog and people were purchasing their own meds, or even paying a direct proportion of the costs themselves, then the demand for humalog would go up and demand for novolog down… across many thousands of people, none of them whom had to negotiate anything themselves. To stay competitive, novolog prices would have to then lower.

The economic theory on oligopoly pricing (that I read about 40 years ago?) would tend to disagree with your conclusion. If there are only a few “competitors” their prices tend to converge and to rise more or less in lockstep even if they aren’t explicitly colluding.

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**Author:** ![kmichel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/kmichel/32/3085_2.png) [@kmichel](https://forum.fudiabetes.org/u/kmichel)\
**Post date:** [March 7, 2018, 2:34am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/162 "2018-03-07T02:34:01Z")

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Hey @Sam - they stole the experiment:

> **[Troubleshooting Diabetes: Life Hacks For D-Management](https://www.healthline.com/diabetesmine/troubleshooting-diabetes)**
>
> Diabetes experts discusses the complications that arise from diabetes and share tips and tricks for better diabetes management and care.

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<div class="post-metadata">

**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [March 7, 2018, 3:28am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/163 "2018-03-07T03:28:45Z")

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Yeah, so did beyond type 1… I say anything and people get mad, they say it and it’s a public service

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<div class="post-metadata">

**Author:** ![Katers87](https://avatars.discourse-cdn.com/v4/letter/k/a9adbd/32.png) [@Katers87](https://forum.fudiabetes.org/u/Katers87)\
**Post date:** [March 7, 2018, 3:50am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/164 "2018-03-07T03:50:04Z")

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His intent was not to prove that “it’s not that big of a deal.” Perhaps that was the difference…

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**Author:** ![MM2](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/mm2/32/3032_2.png) [@MM2](https://forum.fudiabetes.org/u/MM2)\
**Post date:** [March 7, 2018, 5:40am UTC](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330/165 "2018-03-07T05:40:18Z")

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> [@Sam](#):
>
> Yeah, so did beyond type 1…

Sam did you do an experiment and post an update? Did you also use dexcom like the one in the link ?

The true challenge would to do NPH, Reg, without dexcom, and minimal BG tests. Having CGMS makes a big difference, since the action of NPH is less predictable/repeatable with each dose. Person without insurance is not likely to have CGMS.

[Previous page](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330.md?page=7)

[Next page](https://forum.fudiabetes.org/t/losing-job-insurance-and-the-options-that-follow/3330.md?page=9)
