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President Joe Biden’s Build Back Better plan includes a $35 monthly cap on the cost of insulin.

For those with diabetes, it’s the stuff that dreams are made of. Presently, the typical insulin-dependent individual’s cost is about $590 a month, including co-pays. The dream of an affordable cost could come true, if only Sen. Joe Manchin, D-W.Va., and Sen. Shelly Moore Capito, R-W.Va., vote for it.

But Manchin seems to find himself searching for a reason to vote against Build Back Better, which also includes funds for housing, child tax credits, Pell grants, Pre-K, Medicare, clean energy and more. The senator’s concerns ought to be eased by economists and the Congressional Budget Office who say that the bill virtually pays for itself.

An affordable source of insulin, as but one example, makes it less likely that a person with diabetes will suffer costly treatment for complications such as heart disease, stroke, kidney disease, blindness and amputations of the feet and legs.

And if Capito were to vote for the bill, she would have to endure a blast or two from the former president, whose status has risen to that of cranky old coot because of his opposition everything that does not involve his own daily deification.

But if Manchin and Capito can’t get past whatever hobgoblins they fear, if they can’t look out for the 12.7% of West Virginians who are diabetic, why are they in Congress at all?

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It costs the drug makers about $6.16 to produce a vial of insulin. Yet, the purchase price is $332 for the same vial, according to the Mayo Clinic Proceedings. Insulin availability is a matter of life and death, given that diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control.

Fortunately, I do not have diabetes. Nor am I pre-diabetic. But I learned about the disease many years ago when I served for six years as director at Camp Kno-Koma. The wonderful residential camp for diabetic children then was located on Blue Creek in eastern Kanawha County. The children came from all over the state and ranged in ages from 7 to 15. They were Type-1 diabetics. That is, their diabetes developed early and was not related to obesity, as is the case with many who have Type-2 diabetes.

Many arrived at the camp not knowing another diabetic child. But they soon were swimming, playing ball, creating crafts, hiking and doing all the other summer camp activities that were organized by the excellent camp staff. Additionally, I saw many who returned home having learned to administer their own insulin injections, an important result of living in a cabin where they observed other campers doing it. Today, the camp lives on, although in a different location, and continues doing its vital work, teaching youngsters to be courageous in the face of a disease that they are learning to master.

My years directing the camp ended four decades ago, when the cost of insulin did not overwhelm a family’s ability to pay. Back then, few families had to make monthly “food or insulin?” decisions. But it’s different today, as the profit motive has caused the cost of the lifesaving medication to skyrocket.

Manchin and Capito have an opportunity to show the sort of courage that is demonstrated by those children — the courage to be heroes to the nearly one person in eight in West Virginian who is diabetic. I hope they don’t let their opportunity slip away.

Joseph Wyatt is a Gazette-Mail contributing columnist and emeritus professor at Marshall University. He may be contacted at

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