Congress needs to focus on this caravan

A small caravan crossed the United States border last month, but this was not the kind of caravan that has been in the news for more than a year.

The caravan was not being led by a “coyote” who was guiding hundreds of illegal immigrants to the border so they could try to sneak into the U.S.

Instead, at the head of this group of cars and SUVs from the Twin Cities was a Minnesota mother in her minivan who was leading everyone to a pharmacy five hours north in Fort Frances, Ontario.

These travelers were crossing into Canada to buy insulin, the lifesaving hormone that diabetics rely on to keep their blood glucose at a safe level.

Lija Greenseid, the group leader, told the Washington Post her 13-year-old daughter has Type 1 diabetes, and economics pure and simple was the reason for the group’s trip north of the border.

The Greenseids pay about $300 at drug stores in the Minneapolis-St. Paul area for a vial of insulin containing about a third of the liquid you would expect to receive in a shot glass at the local tavern. In Canada, in stark contrast, the price for a vial of the same brand of insulin is about $30.

"It definitely illustrated for me how wrong it is that we're paying the prices we're paying,” she said. “It just doesn't have to be like that. It feels frustrating."

It is heartbreaking for the parents of Jesse Lutgen, 32, of Dubuque.

He died in February 2018, three months after he lost his job, and his health insurance, at a distribution center.

He had Type 1 diabetes, too, but the insulin he needed to keep him alive was too expensive without health insurance. His mother found only empty insulin vials in his home after his death.

“If Jesse could have afforded insulin, he would be alive,” Janelle Lutgen told the Des Moines Register.

A similar tragedy led to the death in 2017 of Alec Smith, 26, of Minneapolis, after he “aged out” of his parents’ health insurance coverage. He died from rationing his insulin --- taking less than his doctor prescribed --- simply to make his supply last longer.

Type 1 diabetes is not caused by poor diet or the lack of exercise, unlike the more common Type 2 diabetes. There is no cure for Type 1 diabetes, so, insulin is the only answer for now.

That’s why it is so aggravating that a treatable disease is killing people because of dollars and cents.

There is bipartisan agreement in Washington, D.C., that something needs to be done about insulin prices, but Congress continues to dither. There is no reason why President Trump, Democrats and Republicans cannot reach an agreement that will make drug prices in the United States comparable to those in Canada.

After all, the same companies are making insulin for both countries at the same production plants. Americans like to believe that our health care system is the best in the world. But how can that be, if drug makers are selling identical vials of insulin in Canada for one-tenth of the price the drug sells for in the U.S.?

No one likes to think about government-ordered price controls or our government financing the production of less expensive generic brands of insulin. But free enterprise seems not to be working, either.

Insulin was first discovered 100 years ago. There are newer forms that have been developed in the past 20 years. But prices have climbed significantly --- putting families like the Greenseids, the Lutgens and the Smiths in a severe financial squeeze.

Between 2012 and 2016, the cost of insulin doubled – rising from $2,860 per year to $5,700 – for the average Type 1 diabetic.

A study by the medical journal BMJ Global Health found that drug companies could cover their production costs and still make a profit by charging as little as $200 per year.

Dr. Teck Khoo, an endocrinologist in Des Moines, has spent his career treating people with diabetes. He told the Register recently:

“Considering insulin has been around for almost 100 years and that the discoverers sold their patent for $1 each to make this more available to save lives, it sickens me to see the exorbitant price of this vital hormone therapy.”

Those exorbitant prices are being charged because the United States government is allowing drug makers to get away with it.

But that doesn’t make it right.

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Randy Evans is executive director of the Iowa Freedom of Information Council and retired opinion editor at the Des Moines Register. He is a native of Bloomfield, Iowa, and now lives in Des Moines. He can be reached at

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