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In US, diabetics turn to black market or Canada for life-saving insulin

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5 years ago

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by Ivan Couronne

On a frosty January morning in a Minneapolis suburb, Abigail Hansmeyer leaves her car engine running and takes out a brown paper bag carrying needles and a vial, handing it over to its recipient in an anonymous shopping center parking lot.

The exchange is technically illegal, but these aren’t illicit drugs.

Instead, the vial contains insulin: A medicine that has since its discovery in the 1920s transformed a diagnosis of diabetes from a swift death sentence to a manageable disease.

Yet its price has sky-rocketed in the US over the past decade, creating informal networks of people who build up stockpiles and give to others what they don’t need themselves.

“Thank you so much,” says Annette Gentile, 52, as she takes the bag from Hansmeyer, checking the labels and doses. “I’ve been on a roller coaster in the last few days,” she adds, because of her elevated blood sugar levels.

Gentile doesn’t live in abject poverty. She receives a monthly disability allowance of $1,200 and has public health insurance. Crucially, however, that insurance does not cover prescription medicine.

The contents of the bag she just received, which will keep her going for a month, would cost her about a thousand dollars at a pharmacy. “I purely rely on donations,” she says.

Her 29-year-old benefactor Hansmeyer is unemployed and has type 1 diabetes, a chronic condition that appears in childhood where the pancreas produces little or no insulin, the hormone that lets sugar enter cells to produce energy.

People who have it need to inject themselves with insulin several times a day for the rest of their lives.

Both women are part of a group of diabetics who connect with each over Facebook or text messages to hand out or receive their prized medication, free of cost, sometimes using code words like “lifewater” to evade detection.

Nearly all of the stock that circulates comes from the relatives of patients who died.

For President Donald Trump’s rivals in the Democratic party, who begin their primary contests on Monday in Iowa, there are few scandals greater than the price of insulin: The epitome of pharmaceutical price-gouging that blights the US health care system.

“We’re not poor,” says Hansmeyer. Her husband works and has started a small business, Abigail has her own car, and the couple live in a house that pet dogs and rabbits also call home.

But her husband’s employer doesn’t subsidize its workers health insurance. Not poor enough to qualify for state insurance, and not rich enough to buy their own, the couple gave up looking in January.

They joined the ranks of the 27.5 million Americans without coverage, praying that no calamity befell them.

“My entire adult life I’ve gone in and out of rationing my insulin,” Hansmeyer tells AFP.

A few years ago, when she won a battle against her then insurer for an insulin pump, a computerized device that continuously releases the right amount of the hormone, she remembers crying with happiness.

Death of a child

Hansmeyer acts as a go-between for her community of Minneapolis area diabetics, connecting those in need with those who have. And one of her major sources is a refrigerator in the basement of a house belonging to one Nicole Smith-Holt.

Smith-Holt opens its door to reveal a treasure trove: Dozens of vials of insulin, and a large stock of syringes, test strips and other supplies. She guesses its value at around $50,000.

“It is strictly illegal,” she says.

Selling or even giving away prescription medicine is technically a minor crime. But for Smith-Holt, it’s a cause that is devastatingly close to her heart.

“We don’t need another Alec,” she says, about her late son, who died in June 2017.

Alec Raeshawn Smith was covered by his mother’s insurance until he turned 26, the age up to which insurers are obliged by an Obama-era law to allow adult children to remain covered by their parent’s plans.

After crossing that threshold, he found himself unable to afford his own insurance on his meager salary as a restaurant worker.

He died 27 days after his insurance lapsed from diabetic ketoacidosis as a result of a lack of insulin.

There was not a drop of insulin to be found in his apartment, said Smith-Holt, but there was evidence her son had tampered with his insulin pens to try squeeze out the last bit.

“I think until I take my last breath I’ll feel a sense of guilt in some sort of way,” said Smith-Holt. “I wish he would have asked for help.”

The death of her son, who was himself a father, transformed Smith-Holt into an activist. One day she’s on television, the next she’s lobbying local politicians, or protesting outside a pharmaceutical company.

O Canada

Further to the north, diabetics can look to providers on the right side of the law but the wrong side of the border: Canadian pharmacies.

Unlike the US, Canada caps the price of insulin. Every three months, alone or with others, 47-year-old Travis Paulson makes the two hour drive from Eveleth in northern Minnesota to Fort Frances in Canada’s Ontario province, crossing the Rainy River to buy his insulin without prescription.

Customs agents don’t bother him so long as his supply is less than three months’ worth.

His insurance is excellent as far as doctor visits go, but only pays half the price of medicines.

He pulls out two almost identical vials of insulin: one is labeled NovoLog and costs $345 in the US, with his insurance leaving him responsible for half the bill.

The Canadian vial is sold under the brand name NovoRapid, and costs about $25. The math isn’t hard.

“It’s pharmaceutical greed. It’s greed is all it is, simple as that,” he says.

A Bernie Sanders sticker on his fridge shows off Paulson’s support for the self-professed democratic socialist, who has vowed to cut drug costs in half.

But even that might not be enough to reduce the appeal of his Canadian road trips.

– AFP

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Current Affairs

TJC issued 3rd POFMA order under Minister K Shanmugam for alleged falsehoods

The Transformative Justice Collective (TJC) was issued its third POFMA correction order on 5 October 2024 under the direction of Minister K Shanmugam for alleged falsehoods about death penalty processes. TJC has rejected the government’s claims, describing POFMA as a tool to suppress dissent.

Published

3 days ago

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6 October 2024

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The Transformative Justice Collective (TJC), an advocacy group opposed to the death penalty, was issued its third Protection from Online Falsehoods and Manipulation Act (POFMA) correction direction on 5 October 2024.

The correction was ordered by Minister for Home Affairs and Law, K Shanmugam, following TJC’s publication of what the Ministry of Home Affairs (MHA) alleges to be false information regarding Singapore’s death row procedures and the prosecution of drug trafficking cases.

These statements were made on TJC’s website and across its social media platforms, including Facebook, Instagram, TikTok, and X (formerly Twitter).

In addition to TJC, civil activist Kokila Annamalai was also issued a correction direction by the minister over posts she made on Facebook and X between 4 and 5 October 2024.

According to MHA, these posts echoed similar views on the death penalty and the legal procedures for drug-related offences, and contained statements that the ministry claims are false concerning the treatment of death row prisoners and the state’s legal responsibilities in drug trafficking cases.

MHA stated that the posts suggested the government schedules and stays executions arbitrarily, without due regard to legal processes, and that the state does not bear the burden of proving drug trafficking charges.

However, these alleged falsehoods are contested by MHA, which maintains that the government strictly follows legal procedures, scheduling executions only after all legal avenues have been exhausted, and that the state always carries the burden of proof in such cases.

In its official release, MHA emphasised, “The prosecution always bears the legal burden of proving its case beyond a reasonable doubt, and this applies to all criminal offences, including drug trafficking.”

It also pointed to an article on the government fact-checking site Factually to provide further clarification on the issues raised.

As a result of these allegations, both TJC and Annamalai are now required to post correction notices. TJC must display these corrections on its website and social media platforms, while Annamalai is required to carry similar notices on her Facebook and X posts.

TikTok has also been issued a targeted correction direction, requiring the platform to communicate the correction to all Singapore-based users who viewed the related TJC post.

In a statement following the issuance of the correction direction, TJC strongly rejected the government’s claims. The group criticised the POFMA law, calling it a “political weapon used to crush dissent,” and argued that the order was more about the exercise of state power than the pursuit of truth. “We have put up the Correction Directions not because we accept any of what the government asserts, but because of the grossly unjust terms of the POFMA law,” TJC stated.

TJC further argued that the government’s control over Singapore’s media landscape enables it to push pro-death penalty views without opposition. The group also stated that it would not engage in prolonged legal battles over the POFMA correction orders, opting to focus on its abolitionist work instead.

This marks the third time TJC has been subject to a POFMA correction direction in recent months.

The group was previously issued two orders in August 2024 for making similar statements concerning death row prisoners.

In its latest statement, MHA noted that despite being corrected previously, TJC had repeated what the ministry views as falsehoods.

MHA also criticised TJC for presenting the perspective of a convicted drug trafficker without acknowledging the harm caused to victims of drug abuse.

Annamalai, a prominent civil rights activist, is also known for her involvement in various social justice campaigns. She was charged in June 2024 for her participation in a pro-Palestinian procession near the Istana. Her posts, now subject to correction, contained information similar to those presented by TJC regarding death penalty procedures and drug-related cases.

POFMA, which was introduced in 2019, allows the government to issue correction directions when it deems falsehoods are being spread online.

Critics of the law argue that it can be used to suppress dissent, while the government asserts that it is a necessary tool for combating misinformation. The law has been frequently invoked against opposition politicians and activists.

As of October 2024, Minister K Shanmugam has issued 17 POFMA directions, more than any other minister. Shanmugam, who was instrumental in introducing POFMA, is followed by National Development Minister Desmond Lee, who has issued 10 POFMA directions.

Major media outlets, including The Straits Times, Channel News Asia, and Mothership, have covered the POFMA directions. However, as of the time of writing, none have included TJC’s response rejecting the government’s allegations.

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Hotel Properties Limited suspends trading ahead of Ong Beng Seng’s court hearing

Hotel Properties Limited (HPL), co-founded by Mr Ong Beng Seng, has halted trading ahead of his court appearance today (4 October). The announcement was made by HPL’s company secretary at about 7.45am, citing a pending release of an announcement. Mr Ong faces one charge of abetting a public servant in obtaining gifts and another charge of obstruction of justice. He is due in court at 2.30pm.

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5 days ago

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4 October 2024

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SINGAPORE: Hotel Properties Limited (HPL), the property and hotel developer co-founded by Mr Ong Beng Seng, has requested a trading halt ahead of the Singapore tycoon’s scheduled court appearance today (4 October) afternoon.

This announcement was made by HPL’s company secretary at approximately 7.45am, stating that the halt was due to a pending release of an announcement.

Mr Ong, who serves as HPL’s managing director and controlling shareholder, faces one charge under Section 165, accused of abetting a public servant in obtaining gifts, as well as one charge of obstruction of justice.

He is set to appear in court at 2.30pm on 4 October.

Ong’s charges stem from his involvement in a high-profile corruption case linked to former Singaporean transport minister S Iswaran.

The 80-year-old businessman was named in Iswaran’s initial graft charges earlier this year.

These charges alleged that Iswaran had corruptly received valuable gifts from Ong, including tickets to the 2022 Singapore Formula 1 Grand Prix, flights, and a hotel stay in Doha.

These gifts were allegedly provided to advance Ong’s business interests, particularly in securing contracts with the Singapore Tourism Board for the Singapore GP and the ABBA Voyage virtual concert.

Although Iswaran no longer faces the original corruption charges, the prosecution amended them to lesser charges under Section 165.

Iswaran pleaded guilty on 24 September, 2024, to four counts under this section, which covered over S$400,000 worth of gifts, including flight tickets, sports event access, and luxury items like whisky and wines.

Additionally, he faced one count of obstructing justice for repaying Ong for a Doha-Singapore flight shortly before the Corrupt Practices Investigation Bureau (CPIB) became involved.

On 3 October, Iswaran was sentenced to one year in jail by presiding judge Justice Vincent Hoong.

The prosecution had sought a sentence of six to seven months for all charges, while the defence had asked for a significantly reduced sentence of no more than eight weeks.

Ong, a Malaysian national based in Singapore, was arrested by CPIB in July 2023 and released on bail shortly thereafter. Although no charges were initially filed against him, Ong’s involvement in the case intensified following Iswaran’s guilty plea.

The Attorney-General’s Chambers (AGC) had earlier indicated that it would soon make a decision regarding Ong’s legal standing, which has now led to the current charges.

According to the statement of facts read during Iswaran’s conviction, Ong’s case came to light as part of a broader investigation into his associates, which revealed Iswaran’s use of Ong’s private jet for a flight from Singapore to Doha in December 2022.

CPIB investigators uncovered the flight manifest and seized the document.

Upon learning that the flight records had been obtained, Ong contacted Iswaran, advising him to arrange for Singapore GP to bill him for the flight.

Iswaran subsequently paid Singapore GP S$5,700 for the Doha-Singapore business class flight in May 2023, forming the basis of his obstruction of justice charge.

Mr Ong is recognised as the figure who brought Formula One to Singapore in 2008, marking the first night race in the sport’s history.

He holds the rights to the Singapore Grand Prix. Iswaran was the chairman of the F1 steering committee and acted as the chief negotiator with Singapore GP on business matters concerning the race.

 

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