For the next few weeks, Literary Hub will be going beyond the memes for an in-depth look at the everyday issues affecting Americans as they head to the polls on November 5th. Each week at Lit Hub we’ll be featuring reading lists, essays, and interviews on important topics like Income Inequality, Climate Justice, LGBTQ Rights, Reproductive Rights, and more. For a better handle on the issues affecting you and your loved ones—regardless of who ends up president on November 6th (or 7th, or 8th, or whenever)—stay tuned to LitHub.com in October. Read parts one and two, Income Inequality, and The Importance of Labor.
Today we’ve gathered the best stories published at Lit Hub about one of the most important issues affecting Americans: the high costs (literal and figurative) of America’s for-profit approach to healthcare. With an introduction, below, from Maris Kreizman.
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We Can’t Rely on Drug Companies to Keep Insulin Prices Low
We won. That’s the message that the Biden administration wants us to believe about the price of insulin in 2024.
For years the prices of the drug that diabetics like me need to inject multiple times a day in order to survive had exploded, increasing more than 1000 percent between 1999 and 2019. In 2018 GoFundMe was full of campaigns for people who couldn’t afford insulin, while Twitter was full of politicians tweeting about how it should be more affordable. For years nothing else aside from a lot of hand wringing actually happened.
The 10 Best Books for Understanding the Opioid Crisis
The opioid crisis and the punitively high cost of insulin seem like two sides of the same terrible coin: when healthcare is more about profit than healing. We are barely beginning to understand the full scope of the devastation wrought by the corporate pharmaceutical companies who prioritized stock price over pain relief and tore apart generations of American families. Below are ten books that shed a little light on that.
What the Toxic Morality of Crowdfunded Healthcare Says About American Society
The first time I saw a medical crowdfunding campaign, it was in the form of a flyer posted to a telephone pole in Seattle. At the time, in 2014, people who started a GoFundMe were provided with a printable flyer they could circulate since the site had little name recognition. Much like dog walking or babysitting flyers, the tear-off tabs at the bottom directed passerby to a campaign’s web address.
At the time, it reminded me of an electronic version of the donation jars I often saw in grocery and convenience stores for a neighbor’s surgery or cancer treatment. Though the Affordable Care Act (ACA), or Obamacare, had been passed several years earlier, many Americans still went uninsured or struggled with the costs of care that insurance would not cover.
“One of the Single Most Expensive Substances on the Planet.” The Insulin Crisis of the 21st Century
In 2017, almost a hundred years after insulin was ‘defensively’ patented for the express purpose of preventing unethical profiteering, Alec Smith was found dead in his Minneapolis home at only 26 years old. He had been diagnosed with T1DM two years previously, but seemed to have adapted well to the demands of insulin treatment. What had gone wrong? Smith’s great misfortune was that he had been lucky enough to be born a citizen of Earth’s wealthiest nation. Unlike most industrialized countries with the finances to do so, the United States offers no universal health coverage to its population. When he ran out of insulin and could afford no more, he was simply left to die.
“Good Medicine and a Very Bad Drug…” Reckoning With the Deadly Duality of Fentanyl
The bowling ball on my chest is always heaviest at 3 a.m. Its steady pressure pushes me out of sleep most mornings before the sun rises on either coast. I could set my alarm by it, but I don’t need to. Wherever I wake up—in hotel rooms, at friends’ houses, or in the home I share with my husband—the bowling ball is there, in the pocket right between my ribs and a little bit north of my stomach.
When the weight wakes me up in the morning, it’s never for a good reason. Every day, I talk to friends, parents, loved ones, and peer workers as they face yet another unspeakable tragedy. One in ten Americans has lost someone to an overdose, and that number is only rising. An entire generation is dying off, as though killed by a plague that nobody is brave enough to name.
Potions, Pills, and Patents: How Basic Healthcare Became Big Business in America
The Great War was a short one for the United States. But in sixteen months of fighting alongside the Entente powers, 116,000 American soldiers were killed. Contemporaries grasped that a break had occurred, forming two distinct periods in the political and cultural life of the country. The defining novel of the prewar decade was Upton Sinclair’s The Jungle, a work of social protest and journalism that captured the tone and preoccupations of the Progressive Era. Sinclair’s depiction of the Chicago meatpacking industry will forever be paired with the Pure Food and Drug Act of 1906, signed by Teddy Roosevelt six months after the novel’s publication.
In the postwar decade, the shrunken public imagination and concerns of the Harding Era were indelibly recorded by the other Sinclair of American literature. Sinclair Lewis’s 1922 novel Babbitt depicted America’s stultifying embrace of the idea, expressed with pith by Calvin Coolidge in 1925, that the country’s natural concern is not civic duty or social improvement, but “the business of business.”
Where There’s Smoke… How Wildfires Across North America Are Making Children Sick
“What is happening?” a young father asked me in the summer of 2018, as he sat on the hospital bed of his three-year-old son. He was looking out the window at a blanket of gray smoke covering Reno for a third week; in front of him, gauzy shadows of downtown buildings came and went in the slow-moving haze.
The smoke had flowed over the mountains from the Carr and Mendocino Complex fires in Northern California, filling our pediatric ward with coughing children. His son and the other child in the room, my four-year-old patient Liam, were both on oxygen, delivered through a nasal cannula. The thin clear tube crossed from ear to ear, with prongs in both nostrils and a circle of tape on each cheek, holding it in place. Neither boy had ever wheezed, or needed oxygen, before.
Patrick Radden Keefe on the Opioid Crisis, the Sacklers, and the Unsavory Game of Philanthropic Reputation Laundering
One evening last December I made a visit to London for a gala dinner at the National Gallery on Trafalgar Square. I had recently published a book, Empire of Pain, which was an investigative chronicle of three generations of the wealthy Sackler family. Known for their philanthropy, the Sacklers had become famous for making lavish gifts in the arts and the sciences, always with the stipulation that their family name be recognized in relation to this generosity; there were Sackler galleries and wings and lecture halls and libraries at countless prestigious institutions on both sides of the Atlantic, from Oxford University and the British Museum to the Smithsonian in Washington and the Metropolitan Museum of Art in New York.
How Our Kidneys Keep Us Healthy—And What It Means When They Fail
The great French physiologist Claude Bernard developed the concept of the milieu intérieur: the delicately regulated fluid environment that surrounds our cells, courses through our arteries and veins, bathes every muscle and nerve, organ and bone in our bodies. Kidneys do many things to maintain the equilibrium, or “homeostasis,” of this fluid environment. They remove substances of varying molecular sizes from our blood, which our body produces as it makes and burns energy—by-products that become toxic if they accumulate. (The liver removes other chemicals directly after digestion, including alcohol and drugs, while the bowels, lungs and skin perform additional excretory functions.)
While sieving these toxins from our bloodstream and voiding them as urine, the kidneys also conserve scores of essential blood components, preventing their loss during urination. And kidneys manufacture a number of hormones and vitamins that control bodily processes like red blood cell production, blood pressure regulation and bone building.
One Pill for All the Pain: On the Devastating Consequences of the Nationwide Opioid Epidemic
Not long after my last book, Dreamland, came out, I was speaking in the small town of Portsmouth, Ohio, where part of that book is set.
After my speech, an older couple—thin, short, and pale—came up to a table where I was signing books. We were alone. Quietly, so only I could hear, the man said that their daughter was in prison for many years for a crime related to her opioid addiction. He said they were raising her young daughter and didn’t know what to do. They were exhausted. They were concerned they wouldn’t live long enough to see the girl through to adulthood. He was a man of few words and no tears. He looked shell-shocked.
“It’s so hard,” he said.
What Longer Lifespans Mean For Overall Human Health
In Greek mythology, the goddess Eos had a mortal lover, a Trojan named Tithonus. Eos asked Zeus to make Tithonus immortal but forgot to specify eternal youth. The result (given that Zeus had a mean streak) was that Tithonus lived forever while his body continued to age. According to Tennyson, “when loathsome old age pressed full upon him, and he could not move nor lift his limbs… she laid him in a room… there he babbles endlessly and no more has strength at all.”
The moral of the tale, of course, is to be careful what you wish for. Continuing to live while your body and mind fall to pieces is not an appetizing prospect. If lives are getting longer and your deepest fear is ending up like Tithonus, then focusing on the evergreen imperative to age well must be your priority.
