Food or medicine: our choice
Sherry Fortin sat against a mailbox outside Pinocchio’s in downtown Northampton, knitting a winter hat. On the sidewalk lay her finished products: several hats and scarves, which cost $20, mittens, which cost $15, and bracelets, a bargain at only $1.
A colorful sign advertised her wares: “I have diabetes and need medication. One dollar donation for a bracelet. I can knit anything you want, and will take orders.”
Sherry, 45, has had Type 2 Diabetes for 18 years. She is supposed to take insulin and prescription pills everyday to manage her blood sugar. Diabetic coma or death, along with minor symptoms such as dizziness, nausea and extreme sweating can result from blood sugar that is either too low or too high.
However, Sherry has not taken insulin or pills since July. The medicine requires a $30 monthly co-pay through Mass Health, a state insurance program. This payment makes the medicine seem more like a luxury than a necessity, as Sherry is more concerned with finding enough to eat.
Someone with a steady income wouldn’t expose themselves to such serious health risks, but Sherry has been out of work for over a year. On good days, she makes about $20 selling her knitted products, enough to buy food and service her addictions to soda and cigarettes, but what about insulin?
“I can’t afford it right now,” she said.
Sherry said she can’t quit cigarettes or soda, and thus save money to buy medication, as she is addicted to both. She started drinking Pepsi heavily when she was eight, and started smoking at 12.
Now when she goes without soda for long periods of time. “I get sick to my stomach, and really bad headaches,” she said. Meanwhile, going without cigarettes makes her extremely irritable and stressed. She must satisfy these addictions – along with hunger – to feel normal, which makes them a bigger concern than managing her long term health.
“Whenever I make some money, I’m like, “Do I want my medication or do I want food?” she said. “Most times, food wins.”
Unfortunately, medication has been “losing” for a while. Although Sherry was employed until last year, she had no health insurance until she recently became eligible for Mass Health, and thus little or no access to medication over her 18 years with diabetes.
Inadequate medication, failing to quit smoking and eat properly explains why Sherry now suffers from neuropathy. A common ailment among those with diabetes, neuropathy is nerve damage in the hands and feet caused by either too low or too high blood sugar levels for extended periods of time. Amputation is often needed to prevent the nerve damage from spreading.
“My feet hurt really bad; they have numb feeling of being asleep, but still ache all the time,” Sherry said. “They have been threatening to cut my feet off for a while, but I won’t let them.”
Recently, her pinkie has also started to feel numb, which has made Sherry especially apprehensive.
“If anything happens to my hands, I would really be in trouble,” she said. “My hands are how I make my living.”
Sherry epitomizes the failures of America’s health care system, according to Gloria DiFulivo, a professor in University of Massachusetts Amherst’s Public Health Department.
DiFulivo said if Sherry had had insurance when she was diagnosed – which would have provided medication and helped her correctly manage the disease – she would probably not have neuropathy now.
This preventive care “would be way cheaper than amputating her legs, if that is what it comes to,” DiFulivo said. She provided some figures to make her case: America spends $174 billion a year in health expenses related to diabetes, yet it’s estimated 80 percent of Type 2 Diabetes – by far the more common type – could be prevented through lifestyle changes. These changes include proper dieting, physical exercise and stopping smoking, which are all easier when one has a supportive doctor and comprehensive health insurance.
Even though Sherry is uninsured, the Emergency Medical Treatment and Active Labor Act, passed by Congress in 1986, ensures that hospitals must provide her emergency care. Living with diabetes and without access to medication is dangerous, and Sherry has been hospitalized several times. Since she can’t pay, the federal government partially reimburses the hospital, which covers the rest of the bill by charging health insurance companies more. The companies then pass along these higher costs to everyone else in the form of higher premiums, which have risen 119 percent in the last decade, according to the Commonwealth Fund.
To recap: The government subsidizes costly hospital visits for those it denies health insurance. Doesn’t it seem more logical to give people actual insurance rather than the super expensive “emergency room only” health care plan?
“People ask ‘How are we going to pay to cover [uninsured people]?’” DiFulivo asked. “Well who do you think is covering them now?”
Chris Russell is a Collegian columnist. He can be reached firstname.lastname@example.org.