When I first started talking about doing a show about the cost of health care… everybody had a story. Including me.
It’s like that famous speech by the writer David Foster Wallace called This is Water. It starts with a joke about two young fish swimming along. An older fish passes by and says, “Morning boys. How’s the water?”
He goes, then one young fish turns to the other and says, “What the hell is water?”
To understand it, we went back almost 100 years and dug up a story of sweaty Canadian researchers — swatting away flies and doing business with probable dog-nappers, on the way to a Nobel Prize… and a deal with corporate pharma.
We also found hopeful signs out there today, including the folks at the Open Insulin Project in Oakland, California, who are working on their own recipe for insulin, which they hope to share as widely as possible.
If it sounds crazy — well, we talked with a listener who has hacked together an artificial pancreas from outdated equipment, raw computer parts, and open-source software, all with the help of her fellow “rogue, cowboy hackers,” who are growing in number. So, you never know.
I filled a prescription recently, and the drugstore said they wanted more than 700 bucks… for an old-line generic drug. My insurance ended up knocking that down, but it was WEIRD. And it meant a big homework assignment for me.
Luckily, I got help. Both from some experts, and from the classic Christmas movie It’s a Wonderful Life (source of the pictures above and below, of course).
I mean, what I actually learned was not a hundred percent cheerful.
We get these unpredictable prices thanks to companies that — surprise! — make a big profit from driving prices up. (They’re called “pharmacy benefit managers” — PBM for short.)
Theoretically, they work for insurance companies and employers who pay the premiums, and they’re supposed to keep drug prices down.
They got sued in several states, saying, ‘Hey, you should be acting in the best interest of your clients.’ And they’ve won in court saying, ‘No, we have no obligation to do what’s best for our clients. We do what’s best for us.’
So, not all sunshine.
But: Feeling a little smarter about the whole thing? It’s a victory. Also kinda fun.