With Canada and Mexico borders closed, Americans are trapped in their own health care system

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      Many medicines and medical services are cheaper in neighboring Canada and Mexico, thanks to price controls and the power of the US dollar. The difference is great enough that US insurer PEHP, which covers Utah’s state employees, offers partially paid trips to Vancouver and Tijuana “to help you save money on your prescriptions.” In popular Mexican resort towns like Cabo San Lucas on the West Coast, or Tulum on the East Coast, pharmacies, doctors and dentists targeting US clientele dot the main drag, their prices on bright display. And the difference between those prices and the costs of the same drugs at US pharmacies can mean life or death.

      No drug is a better-known example of that calculus than insulin, a vital hormone in the body’s metabolism. Seven million American diabetics don’t produce it naturally — or not enough of it — and need to inject it throughout the day. Without it, dangerous levels of glucose build up in the blood, damaging organs and producing a painful stupor. In a worst case scenario, lack of insulin can kill within three days.

      Americans have been going to Canada for insulin since scientists learned how to produce it in labs at the University of Toronto in 1921. One of the first patients to try it was an American: Elizabeth Hughes, the teenage daughter of then-US Secretary of State Charles Evans Hughes.

      “I’m so happy and elated,” she wrote in a letter to her mother from Canada, describing her first self-injection and the “enormous” meal she enjoyed afterward. Before crossing the border, the 15-year-old had managed her condition by starving herself — the only life-prolonging trick available to diabetics before insulin. Five feet tall, she weighed only 45 pounds.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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