Causes or Cures is an independent health podcast hosted by "Dr. Eeks" (ErinKate Stair, MD, MPH). It is an offbeat, grassroots show driven by curiosity and a genuine love of making complicated health topics easier to understand.
Dr. Eeks is a public health professional specializing in applied epidemiology & health communication. By day, she works on challenging public health issues. By choice, she spends some of her free time asking scientists, physicians, researchers, authors, clinicians, and other fascinating people questions she hopes everyone else is wondering too.
Along the way, the podcast has wandered into everything from memory and longevity to self medicating animals, migraines, gene drive mosquitoes, strange public health history, the spiritual realm, and the occasional existential detour. If it has something to teach us about health or what it means to be human, it is probably fair game.
Recurring segments include Public Health is Weird, which uncovers strange but true stories from public health history, WTF Health News, where Dr. Eeks breaks down bizarre or buzzworthy health headlines, and Eeks Speakeasy, a more personal corner of the podcast where curiosity occasionally spills over into life, philosophy, and whatever else deserves a drink and a discussion.
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A woman named Victoria went viral after sharing that a prescription medication that would have cost her $1,000 out of pocket in the U.S. cost just $25 when obtained through a Canadian pharmacy from an Indian manufacturer.
But perhaps the most interesting part wasn't the price difference. It was the reaction.
The comments filled with people sharing their own stories about prescription prices, insurance, and the sometimes absurd cost of healthcare in America.
In this episode of WTF Health News, Eeks looks at why Victoria's story struck such a nerve, touches on some of the mysteries of U.S. prescription drug pricing, and asks what our collective reaction says about the American healthcare experience.
Because maybe the biggest WTF isn't that one medication cost $25 instead of $1,000.
It's how many Americans heard the story and thought: Yep. Sounds about right.
Here's the original IG video: https://www.instagram.com/lemonsnlyme/reel/DZYgShBBKIP/
Hello, hello everybody, and welcome to this segment of WTF Health News on Causes or Cures. I'm Ekes, your host. Hope you're doing well out there. Um, kind of loud behind me, so if you hear noises or whatever, just roll with them. I don't know what they are: people, animals, mice, construction. Now, I say health news, but that's relative to the passage of time and whether or not you even believe in the concept of time. So I'll just say that all of these WTF health news stories are all true stories that either happened recently, fairly recently, or within the last five years. Five years tops, guys. Some people take a while to catch up with all the news, and when they finally find out about something, hey, it's news to them. So, a woman recently went viral after stating on her Instagram that a medication that would have cost her $1,000 out of pocket in the United States cost just $25 when sourced through a Canadian pharmacy from an Indian manufacturer. $25, guys, that's $10 for the medication, $15 for shipping. Which means the international shipping cost more than the actual drug. Now, if that doesn't make you go, WTF, what the fu I don't know what will. And the internet had thoughts. Especially the internet in the US, because we were all like, oh yeah, yeah, we feel you, we feel you right there. And the internet in India, they had thoughts too, because they were like, oh yeah, we see you Americans coming here for health care. The video generated hundreds of comments. I went through some of them and jotted down some of my favorites, which I'll read for you guys here. You can have a lifetime of medicine for that amount of money in India. Even get a surgery for that amount. Get a $25 surgery in India? Sign me up. Here's another one. Yup. Have to do this for birth control. So frustrating. Really, America? Really? Here's another one. Recently watched a diabetic girl do the math that it will cost her less to travel to Italy to buy her insulin than to get it in the US. Another one. Only country where getting a flu can ruin you financially. Ouch. And this one, this one, this one is great. Someone wrote Life Hack. Make an Indian friend. Have them ship your basic medicines every few months. I mean are we really at that point, really? You want decent health care, you want your meds? Find a friend, everyone, who lives in India. Get to know them, get close enough. Get close enough, you know, you share your medical history. Close, so close, they're willing to go to the post office for you every three months or so. I mean, is there a site for that? There's all these sites and apps for everything, right? Like a dating site, but it would be for medication. Med buddies! Find your med buddy here. Prescription pals. Are you gonna die because you can't afford your meds? Find a prescription pal. I like my heart pumping and my diabetes under control. What about you? Do you come here often? And would there be a trade like what are we Americans going to send to our Indian friends? For real though, that may be the most interesting part of the story. Not whether this particular medication cost $25 or $1,000. Not whether the healthcare system is a scam, but how deeply the story resonated with people. And by the way, I applaud this woman for sharing her story because one, it's a common issue that many of us relate to. Two, we have to keep talking about it. We can't give up. No matter how desperate the situation may be. So her sharing this video and others sharing similar stories and leaving their comments keeps the topic front and center and harder to ignore. That's where it should be, because this is these are your health, people. This is it. That's what matters. Before we go any further, though, there's an important detail missing. What medication was it? Uh that's one thing I wanted to know, but of course, it's none of my business because HIPAA. And it's her medication story. Because when it comes to drug pricing, details matter. Was it a brand name drug, a generic? Was it still under patent protection? Was insurance refusing coverage? Was there a lower cost alternative available? Without knowing those things, it's impossible to know whether we're comparing apples to apples or apples to BMWs or apples to private yachts. But let's zoom out for what I think is the most important issue. The United States spends more on healthcare per person than any other high-income country. You guys know that. And that sounds impressive until you realize we're talking about spending, not performance. And you guys who listen to my podcast regularly already know this because it's like a broken record on here. Compared with other wealthy nations, Americans often have lower life expectancy, higher rates of chronic disease, higher maternal mortality rates, and more deaths that could potentially be prevented with timely care. That's not exactly the return on investment most people are hoping for. And prescription drugs are just one piece of that puzzle. Now, let's talk about India. India is one of the largest producers of generic medicines in the world. When patents and exclusivity protections expire, multiple manufacturers can enter the market and compete. And competition can drive prices down dramatically. Sometimes dramatically enough that Americans start wondering whether somebody accidentally left a zero off the price tag. But then we arrive at one of healthcare's most mysterious life forms, the pharmacy benefit manager, or PBM. Now, I've had PBMs explained to me multiple times by smart people, experts, health economists, policy wonks, people with charts, people with PowerPoints, people who seemed genuinely confident they understood what they were talking about. And every single time I walk away feeling like I just attended a graduate seminar on quantum mechanics. Like I just am like, what? What? Huh? Where? Who? But no, who are the PBMs? Well, okay, so they sit between drug manufacturers, insurers, pharmacies, employers, and patients. They negotiate rebates and discounts. They manage formularies, and a formulary is just a list of medications that a health insurance plan, hospital, or healthcare system agrees to cover or make available. Supporters argue that PBMs help lower cost and negotiate savings. Critics argue that they add complexity, they reduce transparency, and may create incentives that don't always align with lower cost for patients. And somewhere in that process, money changes hands. A lot. Exactly how much? Well, it dep that depends on who you ask, really. And that's part of the problem. Even people who work in healthcare often struggle to explain where the money is actually flowing. That's one issue. I can't say more about PBMs because I don't know enough about them. And then there's the GoFundMe phenomenon. If you're American, you've probably seen one. Someone gets cancer, someone needs surgery, someone's kid gets sick, and suddenly family and friends are raising money online to help cover medical expenses. The concept barely registered for them. They were shocked. They were confused. It was like I just told them Americans crowdfund their oxygen. Yeah, it wasn't because their healthcare systems are perfect. Every healthcare system had trade-offs, but the idea of routinely raising money online for medical bills felt foreign to them. And maybe that's why stories like this woman's spread. Not because they studied pharmaceutical economics, which like nobody gets. I swear nobody gets it, but because the story felt familiar. Many Americans have delayed care because of cost. Many have received surprise medical bills in the mail. Many have looked at an explanation of benefits and thought, this explains absolutely nothing. Like, what the hell is this? Many have changed jobs, kept jobs, or stayed in jobs they hate because they needed the health insurance. There's even a term for that. It's called job lock. Job lock. It's when someone stays in a job they would otherwise leave because they don't want to lose employer-sponsored health insurance. Many have stood at a pharmacy counter and wondered how a bottle of pills somehow cost more than a round-trip flight. Like, what the frick? You even make fun of it in romance, and I feel it and I feel like it's a meme that only could work in America. And it's that meme goes around every now and then and it says, You had me at health insurance. It's kind of true, right? Forget the ring. How's your health insurance? But here's the thing: an Instagram post about a medication costing $1,000 in the US, but $25 in India immediately struck a nerve with thousands of people. And that tells us something. Because whether the explanation is patents, generics, insurance design, rebates, PBMs, market exclusivity, regulatory policy, or some combination of all of the above, most people, most people are left asking the same question. How did we get from 25 bucks to a thousand bucks? Like, where is the glitch in the system? We can sequence genomes, we can edit genes, we can transplant organs, we can train artificial intelligence to do all of our jobs. And yet somehow the final price of a prescription remains one of modern civilization's greatest mysteries. At least it's a mystery to most people. Importantly the people who have to pay for it or need it, because we're all like, what the hell? How the heck does it cost this much, right? Like we've all been there. And that's the part of the story I eventually wanted to hold on to and talk about on my podcast today. Not in a roundabout, complicated way, but in a prescription prices for dummies kind of way. Uh, because yeah. Yeah. I don't know, guys. I don't know. It's a problem. But thanks for listening, and thank you to that woman for posting her story. Good for her. I shared the link to her Instagram post in the show notes in case you want to see it yourself or follow her or read some of the comments yourself. And uh don't forget to check out some of the other causes or cures episodes, the Public Health is Weird series, on all of my social medias, the Eek Speak Easy section, and other WTF Health News episodes. I'll be posting those too. And I also write about them in my blog. Alright, and now it's time for the closing quote. This one is from Eleanor Roosevelt. Do the things that interest you and do them with all your heart. Don't be concerned about whether people are watching you or criticizing you. The chances are that they aren't paying any attention to you. It's your attention to yourself that is so stoltifying. But you have to disregard yourself as completely as possible. If you fail the first time, then you'll just have to try harder the second time. After all, there's no real reason why you should fail. Just stop thinking about yourself. Um I hope she said that and like I wasn't tricked by some weird internet thing, like, you know, they assign a quote, but I'm pretty sure she she did. I'm just gonna fact check myself now. Alright, guys. I will talk to you soon. Go out there, have a great day, and yo, send me your thoughts on this. I think it's an important topic, so you know, let me know what you think. Alright, goodbye for now.
