- By Levi Rickert
Opinion. Several decades ago I was an executive director of an urban Indian center in my hometown of Grand Rapids, Michigan. During that time I developed a friendship with an Odawa elder. Our friendship became meaningful because he shared with me his life’s story growing up in his tribal lands in northern Michigan.
As with most Native American life stories, his was mixed with love of family, respect for his Odawa culture, and the hardship of attending an Indian boarding school. Even as an elder, he struggled financially, which caused him to make difficult decisions on whether to eat or take needed medications. He was a diabetic and shared with me that some months he would have to only take half of the recommended dosage of insulin because he had to spend money for food.
This Odawa elder’s story is not different from many Americans — regardless of race or ethnicity — who have to choose between purchasing insulin or food. AARP estimates that 28 percent of adults living in the United States skip medications because of high costs.
In a 2021 AARP survey of registered voters age 50 and older, nearly one-fifth (19 percent) said they had not filled a doctor's prescription in the past two years, with the most common reason being that they could not pay for it.
The Biden administration has focused on fixing this problem.
As part of the Inflation Reduction Act, diabetic American Indians and Alaska Natives on Medicare Part D qualified for savings on insulin because the Act provides for a $35 per month cap as of January 1, 2023. On July 1, 2023, those on Medicare Part B coverage (which covers insulin taken through a traditional insulin pump) will benefit.
According to a report released on January 24, 2023 by the Health and Human Services Assistant Secretary for Planning and Evaluation (ASPE) - Office of Health Policy, some 7,000 American Indians would benefit from the Inflation Reduction Act’s provision.
During his State of the Union address, President Biden challenged large pharmaceutical companies to provide the same $35 cap for all Americans who use insulin.
This past Wednesday, Eli Lilly, the largest manufacturer of insulin in the country announced it would be lowering the cost to meet President Biden’s challenge by lowering the cost of insulin by 70 percent and capping patient’s out-of-pocket for insulin at $35 per month.
All of this is welcome news for Indian Country because American Indians and Alaska Natives have the highest rates of diabetes (14.7 percent) among all racial/ethnic groups in the United States. Diabetes is the fourth-leading cause of death among Native Americans across Indian Country.
It wasn’t always the case among the Indigenous people across the land that is now the United States of America.
Dr. Valarie Blue Bird Jernigan (Choctaw Nation of Oklahoma), director of the Center for Indigenous Health Research and Policy at Oklahoma State University maintains that income, food insecurity, access to exercise, and community resource funding as main drivers of the diabetes epidemic in Native populations.
There is no question the pre-Columbian Indigenous eating habits were healthier than they are today in the United States. Today’s diets are laden with foods that have preservatives filled with sodium and sugar products that contribute to diabetes.
Congresswoman Sharice Davids (D-KS), a tribal citizen of the Ho-Chunk Nation, has worked hard to make sure insulin is affordable for all Americans. She previously voted to pass legislation capping co-pays for insulin at $35 for all Americans, and has hosted roundtables to hear about how the prohibitive cost of insulin impacts Kansans. In 2019, Davids released a report finding that Kansans pay nearly 5 times more for brand-name diabetes medications than patients in other countries.
As inflation continues to linger and cut deeper into Americans' pocket books and savings, more pharmaceutical companies and members of Congress need to jump on the bandwagon led by President Biden to ensure Native Americans — and all Americans — can afford to eat and take the medications as required.
Thayék gde nwéndëmen - We are all related.
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