Nick Keller

TOPIC: Why insulin should be free.

PURPOSE: At the end of my speech, the audience will want to help contribute to the push to
making insulin free.
THESIS: Many Americans are forced to pay thousands of dollars per year, just to keep them
alive.

INTRODUCTION*

I.Attention Getting Device: When I was 16 I was diagnosed with Type-1 diabetes. Last year
alone, my parents spent $1200 on insulin. It wasn’t always that way, but then one day our
insurance just wasn’t good enough.
II.Relevance Statement: You or someone you know may be diabetic. It’s also entirely
possible that someone is spending hundreds to maybe even thousands of dollars every year
on insulin.
III.Credibility Statement: As I said, I am a type-1 diabetic myself and some time ago, our
insurance covered my insulin entirely, but one day our insurance just wasn’t enough.
IV.Thesis Statement: Many Americans are forced to pay thousands of dollars per year, just
to keep them alive.
V.Preview of Main Points: In this speech, I will be touching on the cost of insulin with and
without insurance, how many Americans have trouble affording insulin and how you can
help fix this problem.

BODY:

[connective/transition: I will jump right in to my first main point.

I. First Main Point: In January 2024, the average price per pen/vial without insurance
ranged from $65.74 to $393.
A. First subpoint: That same month, the price per pen/vial with insurance was
significantly lower. It truly depends on which insurance company you have.
1. Support: In an article for Mira by author, Spencer Lee (2024) it says,
“Depending on the tier, copays can range from as low as $5 to $10 for
generic versions, $25 to $50 for preferred brands, and potentially $50 to
$100 or more for non-preferred or specialty brands per month. Some
plans may also have coinsurance (a percentage of the drug's cost)
instead of a flat copay.”
a. For those of you who don’t know, a copayment, or copay, is a
fixed amount for a covered service, paid by the patient to the
provider of service before receiving the service.
b. As you can see, even having insurance doesn’t mean you don’t
have to pay a monthly fee.
2. Support: Lee (2024) also mentions the effect that President Biden’s
Intflation Reduction Act had on the price by writing, “Due to the rising
prices of insulin, some states in the U.S. have implemented or are
 considering caps on out-of-pocket insulin costs. Where these are in
place, insured individuals may have a capped copay, like $25 or $50 per
month regardless of the insulin's list price.”
a. Clearly, due to President Biden’s bill, there has been a significant
drop in prices, but not a complete drop.
b. Before this, there has actually been a startling trend in the rise of
insulin prices every year for a long time.
B. Second subpoint: Did you know that insulin prices have raised drastically in the
last 20 years alone?
1. Support: Well, according to an interview and press release with
Minnesota congresswoman, Angie Craig (2023), The price of insulin has
skyrocketed over 600% over the past 20 years, despite the fact that it
costs about $10 to make a vial of insulin.”
a. (Will add a photo showing the rise in prices to the slideshow)
b. Clearly this is a problem that isn’t new. In fact, It’s been bad for a
long time.
2. Support: Craig (2023) also addresses President Biden’s plan to cap the
rpice of insulin by saying, “The bill has earned several industry
endorsements including the American Diabetes Association, Social
Security Works, Protect Our Care and the Juvenile Diabetes
Foundation.”
a. Due to this information, it’s clear that this is something that so
many Americans have wanted for a long time.
b. With the proper initiatives and funding, the government can make
insulin not just cheap, but free.
[connective/transition: I will now transition into my second point which is:

II. Second Main Point: How many people min the U.S. can actually afford their necessary
amount of insulin?
A. First subpoint: A large number of U.S. citizens who suffer from diabetes spend a
large chunk if their income on insulin alone.
1. Support: In an article for Yale News at Yale University in 2022, Mallory
Locklear writes, “In a new study, Yale researchers provide much-needed
data on Americans who use insulin, whether and how they’re insured, and
who is most at risk of extreme financial burden. According to their
findings, 14% of people who use insulin in the United States face what are
described as a “catastrophic” levels of spending on insulin, meaning they
spent at least 40% of their post subsistence income — what is available
after paying for food and housing — on insulin.”
a. This is personally, very ridiculous. To take out such a big chunk of
your income just to keep yourself alive should not have to be an
option.
b. If insulin was cheaper, or free, then those statistics would be much
smaller.
2. Support: Locklear (2022) also spoke with Baylee Bakkila, a medical
student at Yale. Locklear writes, “She (Bakkila) and her colleagues found
 that Medicare beneficiaries were most burdened by insulin costs,
accounting for more than 61% of those burdened by “catastrophic” levels
of spending.”
a. Insurance companies clearly don’t care enough to help pay for it
for free, so thus, diabetics have to struggle not just with their
disease, but financially.
b. The total fraction of people who struggled with getting what they
need is startling.
B. Second subpoint: The financial toll could leave many in debt.
1. Support: Locklear (2022) says, “While such a cap will help some
individuals reduce their spending, researchers say, even $35 per month will
be cost-prohibitive for many Americans.”
a. There’s also those who are homeless that are probably more than
not, unable to get insulin.
b. Along with young workers with no living relatives to help them
out.
2. Support: Locklear (2022) also writes, “Medicare beneficiaries who use
insulin had lower incomes than those with private, other, or no insurance.
This fact, combined with Medicare’s insulin coverage limits, makes this
group more vulnerable to financial burden, said the researchers.”
a. The financial burden is something that can easily be helped, but
there has been little push.
b. Many consumers could go bankrupt from the burden.

[connective/transition: I will now be jumping into my last main point:

III. Third Main Point: How can we fix this problem?

A. First subpoint: You can donate to The American Diabetes Association.
1. Support: On the ADA website, it says, “Through tireless advocacy and
powerful partnerships with health organizations and insulin
manufacturers, we’re breaking down barriers to affordable care.”
a. The ADA was a big help into getting the insulin cap pushed.
b. (Will put qr code to the website)
2. Support: When you sign up to become an advocate on the ADA website,
it says, “Access easy-to-understand resources to learn more about how
the American Diabetes Association’s advocacy efforts are bending the
curve and helping people with diabetes thrive.”
a. Further development/explanation (if needed)
b. Further development/explanation (if needed)
B. Second subpoint: You can sign a petition to make insulin more affordable.
1. Support: The owner of the petition, Ellen Smith writes, “In much of
Europe, insulin costs about a sixth of what it does here. That’s because
the governments play the role of pharmacy benefit managers. They
negotiate with the manufacturer directly and have been very effective at
driving down prices. In the United States, we rely on the private sector
and a free market for drug pricing. But in order for this to work, we need
 to regulate it better and demand greater transparency.”
a. (Will put QR code to petition in slideshow)
2. Support: Smith writes, “The big three have simultaneously hiked their
prices. From 2010 to 2015, the price of Lantus (made by Sanofi) went up
by 168 percent; the price of Levemir (made by Novo Nordisk) rose by
169 percent; and the price of Humulin R U-500 (made by Eli Lilly)
soared by 325 percent.”
connective/transition: I will now wrap up this speech.

CONCLUSION

I. Review of Main Points: So in this speech we talked about the price of insulin, the economic
effects on its consumers and the call to action.
II.Thesis Restatement: So many U.S. citizens are struggling to stay alive due to the price of
insulin.
III.Call To Action: Change starts here. I need you all to go donate to ADA and sign that
petition. In order for people who use insulin to have access to it for free sooner.
 References

Goozner, M. (2019, December 10). Insulin Should Be Free. Yes, Free. Democracy Journal.

https://democracyjournal.org/magazine/55/insulin-should-be-free-yes-free/

Insulin Cost & Affordability | ADA. (n.d.). Diabetes.org. https://diabetes.org/tools-

resources/affordable-insulin#:~:text=As%20of%20March%201%2C%202023

Lee, S. (2021, December 1). How Much Does Insulin Cost Without Insurance? Up to $300 |

Mira. Www.talktomira.com. https://www.talktomira.com/post/how-much-does-insulin-

cost-with-and-without-insurance

Locklear, M. (2022, July 5). Insulin is an extreme financial burden for over 14% of Americans

who use it. YaleNews; Yale University. https://news.yale.edu/2022/07/05/insulin-

extreme-financial-burden-over-14-americans-who-use-it

Smith, E. (2018, February 18). Sign the Petition. Change.org. https://www.change.org/p/sanofi-

make-insulin-affordable

The White House. (2023, March 2). FACT SHEET: President Biden’s Cap on the Cost of Insulin

Could Benefit Millions of Americans in All 50 States. The White House.

https://www.whitehouse.gov/briefing-room/statements-releases/2023/03/02/fact-sheet-

president-bidens-cap-on-the-cost-of-insulin-could-benefit-millions-of-americans-in-all-
50-states/

U.S. Reps. Craig, Kildee and McBath Reintroduce Legislation to Cap Insulin Copays at $35 per

Month | Congresswoman Angie Craig. (2023, March 9). Craig.house.gov.

https://craig.house.gov/media/press-releases/us-reps-craig-kildee-and-mcbath-

reintroduce-legislation-cap-insulin-copays-

35#:~:text=The%20price%20of%20insulin%20has