fresh voices from the front lines of change







My name is Carrie McBane, and I live in Sylva, North Carolina. I have Type 2 diabetes, so my life depends on daily access to drugs I can’t afford out of pocket, and I don’t have healthcare coverage.

Every day when I wake up, I am reminded that my life, and all aspects of it, are contingent upon whether giant, powerful, pharmaceutical companies will allow me access to the drugs my life depends on.

Big pharma holds the power of life and death over millions of Americans like me.

I grew up in South Florida, but moved to North Carolina about fourteen years ago to be closer to my sister and father. My family is small, as most members have died from cancer or cancer-related conditions, so keeping the familial bond between us was very important to me.

Last year, I started to experience a variety of physical ailments – to the extent that it felt like all of my organs were shutting down at once. I’d worked for years in restaurants and fast food places – always without health insurance.

In small and rural towns, restaurants don’t offer health care coverage, and fast food places restrict working hours so they don’t have to offer health insurance to their employees. Working full-time, my annual income was just barely over the cap that would have qualified me for Medicaid - by less than a hundred dollars.

I was used to being on my feet for long periods of time, but all of a sudden I was exhausted all the time. I would come home and just lay on the couch. I had zero energy and no interest in doing daily chores; I just didn't understand what was happening.

My physical ailments included loss of appetite, a change in my eyesight, mood swings, severe dry mouth, and oral canker sores. Water was the only thing that alleviated the dry mouth symptoms but I ended up drinking large amounts of water all day, every day.

My sister told me I should see a specialist, but I didn’t have any extra money to do so. I ended up borrowing money and using money that was set aside to pay for utilities so I could see several specialists.  Without healthcare coverage, these specialists charge anywhere from $400 to $500 if you pay the same day.

My appointments usually lasted about five minutes, and these specialists would end up saying to me, “I don't really know what's happening, but I can refer you to somebody else if you'd like.” I had no more money left, so when I couldn’t manage my pain anymore I ended up in the emergency room, more often than not.

You see, I didn't know these symptoms were related. I really had no idea what was happening - I just knew that I was really sick and all these so called specialists weren't helping me.

Finally, a neighbor referred me to the Blue Ridge Health Clinic, which accepts low-income patients. I had to wait for an appointment, because so many people in our area need help, and the clinic can only see two new patients per week. However, after a few minutes of clarifying questions and a mini physical, both the Doctor and the Family Nurse Practitioner (FNP) said to me, “It sounds like type 2 diabetes.”

I promptly started to cry in front of the staff because finally someone, in our broken healthcare system, was listening to me, cared about my well being, and actually gave me their time and attention; they didn’t try to explain their way out of why they couldn't help me, or why they thought I didn't know my body better than they did.

They ran a full panel of blood tests and the outcome was they prescribed me Metformin and Glipizide, which improved some symptoms but seemingly made others worse. I also worked very hard to change my eating habits, once I realized how much added sugar there is in nearly everything we eat, and that helped.

But because my biological systems didn’t work properly for such a long period of time, my body can’t regulate insulin, for now, without medication.  I am currently prescribed Metformin, Tresiba, which is a daily insulin injection, and Trulicity, a weekly injection. Of these three, I can only afford to pay for one: Metformin.

Metformin comes in a generic pill form, so I can get it through a subsidy at our local pharmacy for $4. Blue Ridge Health Clinic, through their medication assistance program, also helps me get Tresiba, the insulin injection produced by Novo Nordisk.

But Trulicity, which is under patent by Eli Lilly & Co., costs upwards of $700, per dose. That’s $33,6000 a year. There’s absolutely no way I could ever afford to pay for that.

Lilly does offer Trulicity to some without health insurance, but it can be an exhausting process to apply for this program. The paperwork is laborious, so mistakes can happen and these lengthen the time it takes to access and receive the medication.

Twice I was told by Blue Ridge that I had been approved, only to hear, once I came in for my appointment, that “we just got a phone call from Lilly; they said they did not get all your paperwork, you have to redo your paperwork and you are still denied your medication.”

For almost six months, I was at my wits’ end, filing and refiling my paperwork and then waiting for an approval from Lilly. My life depends on a medication only Lilly can provide.

How can it be that my life hangs in the balance every time they evaluate my file, and that I might die because of a bureaucratic snafu? Every time this happened, it not only stressed me out physically, but caused my fear and depression to deepen and be prolonged.

My application for medication assistance was finally approved, so for now I have access to this life-saving drug. Lilly has agreed to cover my Trulicity for only a year, so after that I’ll have to go through the whole process yet again.

When you're sick, and you don't want to be sick, you’re often in denial. One thing that cannot be denied any longer is that the healthcare system in this country is broken.  No one’s life should hang in the balance because they can’t afford preventative care, a doctor’s visit, the right medication, or because their file gets lost.

I’m extraordinarily thankful and grateful to the doctors, nurses, and office staff at the Blue Ridge Health Clinic for their kindness, compassion, and generosity. I am also glad that programs exist to help me get the medications I need to survive.This shows there are still compassionate providers who try to put patients before profits.

But I’m also well aware that in our healthcare system, profits almost always win. I’m one of the lucky ones. Millions more in this country aren’t so lucky. No one should have to rely on luck – or charity – to access life-saving care.

Health care is a human right, and should be available to every one of us.

Carrie McBane is a member of Down Home North Carolina, part of the People's Action national network of grassroots groups.

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