Not a hearing. A person.
Politicians want it fixed. Patients already paid. These are not opening statements. They are a mother who buried a 26-year-old over a vial, a brother who found his sister in the bed, a woman who dilutes insulin against her doctor’s orders, a newborn’s $50,000 surprise, a $5,500 charge just to walk into a freestanding emergency department. Watch the faces. The drug and hospital pages are the prices. The historical page is a century of the same sentence. This is who the sentence is about.
Nicole Smith-Holt · Antroinette Worsham · Gail deVore · Sonji Wilkes · Littleton patient
The expensive 5% is not a chart. It is a kid who ages off a parent’s plan, a night the family cannot drop, a door fee that looks like urgent care. The plan does not invent the 2–3×. The manufacturer does not need a funeral to keep the list. They already have the list.
The 5% · Journey · Drug voices · Hospital voices · Evil
2018 · Mother of Alec Smith, 26 · patient
Nicole Smith-HoltInterview — Alec aged off her plan, then rationed
On June 27, 2017, my son Alec was found dead, alone in his Minneapolis apartment. It shouldn’t have happened. His insulin and supplies cost almost $1,300 a month. The best plan we found was $450 a month with a $7,600 deductible. I should not have buried my son at 26 because he couldn’t afford the one thing in life that was created to keep him alive.
WantsThat a kid with a restaurant job does not have to choose between rent and a vial. That aging off a parent’s plan at 26 is not a death sentence. She is not asking for a hearing. She is asking for her son back, and since she cannot have that, that nobody else has to do this.
On this siteAlec died of diabetic ketoacidosis three days before payday. Insulin $35 is Medicare. He was 26 with a job. Humalog is still a PBM-list story: rebate off a high sticker. The 4× is RAND. This is what the list does when there is no fortune in the family.
Why US brands are ~4× · Drug voices · Insulin $35 is Medicare
2019 · Mother of Antavia, 22 · patient
Antroinette WorshamHouse Oversight — drug companies raising prices (Jan 29)
My older daughter, Antavia, was diagnosed at 16 and only lived six years with this disease, due to the high cost of insulin. She started rationing when she was kicked off the Ohio children’s program because of her age. My son found her deceased in her bed one morning. How detrimental is that to happen to anyone, especially a sibling, to find their sister passed away. I am crying out and asking Congress to review the pharmaceutical drug gouging.
WantsThat her younger daughter, also type 1, does not age off the same cliff. That a working mother does not have to tell a second child the vial is optional. She took the pain to Elijah Cummings’s committee because the funeral was not a policy memo.
On this siteSame machine as Alec: a young adult ages off, the list is $1,000 for three months, they stretch the pen, DKA. The No Surprises Act does not touch this. Inflation Reduction Act insulin $35 does not touch this until Medicare. The sister was 18 when this tape was made.
2019 · Type 1 since 1972, Denver · patient
Gail deVoreHouse Energy & Commerce — Priced Out of a Lifesaving Drug (she is the first witness)
These four bottles are one month’s prescription — $1,400. In 1972, four bottles of insulin cost my family about five dollars. I drive a 17-year-old car. It’s seriously doubtful that either of us will ever have the opportunity to retire. To make it last longer, I ration it by diluting with Novolog, which is against the advice of both Novo Nordisk and my doctor. Children and adults are still dying only because insulin is no longer affordable.
WantsRelief now, not next year. She has been on this molecule since she was 11. She went into a coma as a kid when she went twelve hours without it. She is 58, middle class, insured, and still stretching the bottle. She wants to stop doing that.
On this siteShe is the living version of Alec and Antavia. Insured, still rationing the analog that is not on formulary. $5 then, $1,400 now. That is not inflation. That is the US list. Medicare $35 came later and only for seniors. In 2019 she was not 65.
The 4× vial · Politicians on the same vial · What seniors got
2019 · Mother, Englewood, Colo. · patient
Sonji WilkesHouse Energy & Commerce — surprise medical billing
I pay my insurance premiums. I do my part and I expect the bill to be paid. There’s only so much I can do to control that. I don’t really care how the reimbursement works, and quite frankly I think the insurance industry is probably doing better on their bottom line than my bottom line. I want to go to the best provider possible and I want to get the best care possible.
WantsThat a newborn with hemophilia in an in-network hospital does not generate a $50,000 second bill because the neonatal intensive care unit was a subcontractor. She refused to pay. It went to collections. It ruined their credit. She is done being the float between the tower and the plan.
On this siteThis is the ambush, not the 2–3× contract. The hospital was in network. The NICU down the hall was not. The No Surprises Act later banned this for emergency and in-network-hospital ancillary. It does not set the in-network night. The plan did not invent the $50,000. The subcontract did. The plan passed the fight onto her.
No Surprises Act · Hospital voices · The night that is still 2–3×
2017 · Freestanding emergency department · patient
Littleton patientDenver7 — she asked not to be named
I had bronchitis for a few weeks and started having a little difficulty breathing. I just remember seeing a small freestanding building right off the freeway. The actual treatment was very inexpensive. The x-ray was only $300 and that treatment was only a dollar. Just walking in the door was $5,500. Just for the visit. I didn’t know that a little freestanding building could consider themselves a hospital.
WantsA posted number before she sits down. She thought it was urgent care. It billed like an emergency department. After insurance she still owed about $3,600. She is not asking for a statute. She is asking not to be ambushed by a building that looks like a clinic.
On this siteSpell it out: emergency department. A freestanding ED can copy the hospital facility fee. That is the outpatient extra, not a cash menu. The plan did not write $5,500 to walk in. The facility did. Transparency files still do not read as a door price. See Shop for a posted menu.
The hallway: Drug voices · Hospital voices · Historical voices · Evil · The 5% · Problems / solutions · Journey · Flagship · Faith