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this post was submitted on 16 Oct 2025
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Controversial take (though maybe not in this community):
If it's needed for survival, it should be free. No exceptions.
Devil's advocate: Medi-CAL (California's Medicaid program, already known for being very permissive) will likely already cover it for the eligible, and should the $11 be used in aggregate to cover distribution and manufacturing for all of California's citizens, it would be a reasonable rate to keep the program self-sustaining.
Allotting an exception for the payment for those who may have difficulty seems like a reasonable way to cover any gaps while making sure it never runs into the red.
The funny thing is if memory serves right insulin once you get it going is exceptionally cheap to produce. Unironically the 11 bucks may very well be the gross cost of production and transport per batch, probably not wages though.
originally elly lily, novo nordis, and sanofi had a stranglehold on the different types of "extended release insulin" they were behind the lack of generics for a while. until they were able to come up with alternatives insulin not based on the formulaitons of the 3 companies.
In most likely scenarios the social amortization should cover everyone including production/transportation labor.
Realistically the transportation and labor side is the most expensive, yeah. If the economy of scale gets solid enough in like year 2 of the program it probably could be cut down in price further, but California's a huge state that may have trouble lowering distribution costs.
Would really depend on how and where production takes place at that point. I'm well aware of the states size, also I'm well aware that I'd rather drive through Nevada and Idaho to get to Washington over going through the central valley and Shasta.
Agreed. I love that this is rolling out in the first place though - I remember patients that had to leave the pharmacy because of their insulin being over $50 when I worked there. Hope that never happens again in this state.
Honestly I hope this is a first step to state run hospitals and eventually universal healthcare. While it's not an ideal way to go about it it's probably easier overall long term than dealing with the preexisting mess that is the modern hospital system.
Well America voted against food being considered essential for survival...
Of course, but what California is doing is awesome, so why shit all over it?
I'm not. It's a step in the right direction.
that's how it works in most of europe with our socialist healthcare system
Canada too. My son has T1D. Never paid a cent for insulin even through my insurance.
How about exceptions for rich people who can easily afford it at no noticeable impact to their livelihoods?
Validating who earns too much or too little is a colossal task that leaves opportunities for people to lose access to food because they haven't logged in that month to report their earnings.
It also often costs more in bureaucracy, people and infrastructure than simply giving it to everyone.
It also causes social stigma as you are seen as poor for using a service.
If it's available to everyone, then none of these problems occur.
Rich people will typically self-opt out of these systems anyway, as they will want the better expensive version of the thing anyway.
For case studies where this works, see:
For places where the system doesn't work because of income cutoffs, see:
Adding means testing to programs like this generally cost more money than it saves.
No, because that just opens the path for the ever expanding "except for them" for a very small portion of the population.
I like this. Ultimately there shouldn't be any rich people, but that's a step we can figure out later.
Make them pay full price, period.
Broadly speaking I agree but I don't criticize shifting from exploitative to reasonably priced. An improvement is still an improvement.
Not a viable take though. Housing, clothing, food.. none of them are free either. A more viable solution is to control the markets by setting limits, like they did here, and then provide a safety net for people so they will always be able to buy this stuff. It would be nice if it was free, but it's a long road to get there. Social politics can provide survival without abolishing stuff like money in the meanwhile.
Some people feel like if you can't provide society with your labor, you should still be fed, clothed, and housed.
IMO, people who don't work, still contribute to society: raising family, being friends with people, creating art, and so on.
Things that aren't easily measured by the dollar bill, but key to a good civilization.
Not to otherwise disagree with you but I would argue that raising family is hard work
And arguably more important to the prevalence of human civilization. Otherwise, places like South Korea wouldn't be so worried about their shut-in youth population and declining birthrates while being currently at the top of the world's tech industry.
I think essentially everybody agrees, the debate is where to put the lines for "can't" and "needs"
I think you're giving people too much credit.
Price floors and price ceilings reliably cause market failures like shortages and unemployment. If we're not willing to let people die without it, then we end up playing stupid games like "free emergency room only".
Economics is a social science and every proposal should be based on empirical results, not intuition.
Look at European economics. Healthcare isn't free but sure feels like it. Lifesaving medication is not free but you can ask social services for the money that you need and you can always survive. Water isn't free but if you can't pay you get the money to buy water. "Free" can be the same as having a price and providing people with the funds to pay that price.
So my argument was against "free as in beer".
I understand your argument. We certainly aren't the first to investigate this. Would you please provide a source for your claim?
What claim? That social services can provide money if you do not have it? Here's an example for the Netherlands. There's tons of socialist constructs in European countries that provide support if you have trouble.
No, the "more viable" claim. Compared to free as in beer.
This I agree with 100%. Why it isn't a standard in the world is totally abhorrent. Anyone with health issues should receive medication for free or at a minimal cost to cover transport, delivery, etc.