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'Mecca Of Reasonably Priced Medicine'

Cover image for podcast episode

Photo by Kinsee Morlan

We’re continuing our series on medical tourism at the border with a story about two women and their journeys to find more affordable insulin in Tijuana.

It’s really a story about the fine line between life and death; the balancing act people with diabetes have to navigate every single day; and how crossing the line between the U.S. and Mexico can be a life raft.

Follow “Port of Entry” online at www.portofentrypod.org, or on Facebook (www.facebook.com/portofentrypodcast) or Instagram (www.instagram.com/portofentrypod).

Editor’s Note: An earlier version of this podcast did not clarify that Erin’s savings card works only after she’s paid out her insurance deductible.

From KPBS and PRX…

This… is Port of Entry…

Where we tell cross-border stories…

That connect us.

Soy Alan Lilienthal.

And..quick heads up...a few f-bombs make an appearance in this episode…

***

Erin Audio Diary Clip 5
Hey, you're at 69. here You want a piece of chocolate or a piece of chocolate too.
Mmhhmm...

So...this is Erin and her son Kyle…

And Kyle has type one diabetes…

Erin Audio Diary Clip 2
Hey, you’re high, I gotta give you a shot...

Kyle’s glucose level swings up….and down…

When he’s low, he needs to eat or drink sugar immediately…

And when he’s high, he needs an injection of insulin.

Actually...he needs insulin every time he eats...so he’s injecting himself anywhere from three to seven times a day…

BEAT

It’s a constant balancing act...

A delicate dance mom and son have to do every single day and night...just to keep Kyle alive.

Erin Pre Interview Clip 5
I mean, people say things like. Oh, but it's a controlled disease, so you can control it. You know, the technology is so great now it's, you got this covered. Well, yeah, you're controlling it. You're, you're basically controlling not dying every meal.

BEAT

As if managing diabetes wasn’t stressful enough…

It’s even more stressful because in the U.S., insulin is really expensive…

NEWS MONTAGE
.The average price of insulin tripled….the rising cost of one medication in particular is causing anger and desperation among people who need it to survive.

BEAT FADE

But having to pay so much money just to survive?

Erin says it doesn’t feel right.

She says she just can’t stomach forking over all that cash to Big Pharma…

INSIDE PEY PHARMA AMBI

Erin in Tijuana Clip 2
It's so maddening. I'm so furious about it.my kid needs this to, to live
Erin in Tijuana Clip 25
It's just wrong. It's just so wrong…..

INSIDE PEY PHARMA AMBI FADE
BEAT

The high price of insulin feels wrong for Erin…

But for others….

It means that sometimes...people who need insulin to live are forced to ration it….

risking their lives because they can’t cover the costs….

Liz Salcido Clip 6
So I'd have to take less insulin and we'd try and ration it a little bit because it was just so expensive….

BORDER Turnstile gate ambi

But….here’s where the U.S.-Mexico border swoops in to the rescue….

BEAT

Because just across the wall... in Tijuana….

are farmacias stocked with more affordable drugs….

ERIN
can I just jump up and down? $4 a box for needles,that's insane

BEAT

Today in “Port of Entry”...

We’re continuing our series on medical tourism at the border….

With a story about two women and their journeys to find more affordable insulin.

BEAT

It’s really a story about the fine line between life and death…

The balancing act people with diabetes have to navigate every single day.

And how crossing the line between the U.S. and Mexico can be a liferaft.

Liz Salcido Clip 24
If you live here and you can cross the border, why not? It's, it's, it's saving your life basically.

BEAT

No se vayan a ningún lado.

BEAT FADE
MIDROLL 2

Ya estamos de vuelta…

Erin Audio Diaries Clip 3
Kyle: No, this is stupid.
Erin: All right. Whatever.. So Did you alcohol your arm
Kyle: yeah
Erin: Ok, right? Or left?

So this is Erin and her son Kyle again…

Erin Audio Diaries Clip 3
OK, Turn around

We asked Erin to record these audio diaries for us…

So we could get a better glimpse of what it’s like living with diabetes…

And...we’re not not gonna use their full names, by the way…. because they want to keep their family’s health information private.

Erin Audio Diaries Clip 4
Kyle and I are putting his CGM continuous glucose monitor sensor on his arm. And it sort of uses an in a contraption to, to stick a filament underneath his skin. So there's like a loud pop and it does hurt.

So yeah….Erin was getting ready to insert this tiny monitor just underneath the skin on Kyle’s arm.

The monitor connects to an app on both of their smartphones..

And that app shows them how Kyle’s blood-sugar levels go up and down in real time…

Erin Audio Diaries Clip 3
OK, ready...one, two three. POP.
Kyle: Incredible
Erin: Ok, it’s in.
Kyle: Bangin’.

BEAT

So….Kyle was diagnosed with type one diabetes back in 20-18.

When he was 15.

And Erin says it was a total shock.

It hit him hard and fast…

Nearly killing him before they even knew he had it.

Erin Pre Interview Clip 1
Do you want me to tell you the, the story? They call it the dia-versy story or something like that? The diagnosis story. I don't know. There's all these new terms I'm learning about.

BEAT

Erin Pre Interview Clip 2
Um, so he, um. He was drinking a lot of water at night and peeing at night. And he'd do that two or three times in the middle of the night for a couple of days in a row. And, uh, I thought, Oh my God, he has diabetes. Because I thought that because my friend, uh, had a child when she was. Well, she had a child who was one when he was diagnosed. He's now 23. Um, and I asked her, how did you know to take him to the hospital? And she said, well, um, he was, his diapers were just wet and just, he was constantly drinking. He couldn't hit. I couldn't get him to stop drinking. And, um, so I knew that that was a symptom. And I called her and I said, Hey, Kyle's been doing this last few nights. Um, I think he has diabetes. What do I do? I called his pediatrician. We got an appointment for tomorrow morning. Um, do I wait or what? And she goes, Oh, he doesn't have diabetes. Just go to CVS and get a blood glucose monitor and poke his finger and then call me and I'll tell you what the number means.

BEAT

Erin Pre Interview Clip 2
So I run to CVS and I get. A blood glucose meter and I go home and he's like, no, I'm not poking my finger. What are you crazy? And I said, no, I think you might. I'm going, this is going to sound crazy, Kyle, but I think you might have diabetes. What? I don't have diabetes cause he's walking around, he's fine. He feels, he says he feels fine. Um, and I say, look, let me poke my finger. And I poke my finger and I put it in the meter and it goes, beep, beep. And it says, I'm at 110, and I'm like, look, see, it works. This, this is how you do it. You need, I don't know what that means, 110, but, uh, it seems to be working, so let's do you next. And, and he was like, Nope, I'm not doing that. And I said, all right, we have, you have a choice. We're either going to urgent care tonight or which is going to be like four hours or. You poke your finger and it's going to be two minutes.

BEAT

Erin Pre Interview Clip 2
He says, fine, I'll poke my finger. So we poke his finger and I put it in and uh, the machine starts to beep and it starts to blink and it just says, hi, HI. And I'm like, hi, what? What is this? He starts to cry and I'm like, Oh my God, what is this? He has diabetes. So I call Linda, my friend, and I say. So the machine says, hi, I don't know what, what that means. And she said, you need to go to the emergency room right now. He needs insulin.

BEAT

Erin and her son got in her car and she drove over 80 miles an hour to an emergency room.

When she told the people at the front desk the issue, they rushed Kyle right back instead of making him wait.

It turns out...Kyle was likely just moments away from Diabetic ketoacidosis - a life threatening condition when your body isn’t producing enough insulin and your blood becomes acidic.

BEAT

And from that moment on…

The family’s life was forever changed…

At the hospital….

Kyle got the first of what would become a constant routine of insulin injections.

And that’s when Erin and her family first learned about the delicate balancing act that is managing diabetes.

Erin Pre Interview Clip 4
This insulin is, it's lifesaving, but it can also kill you. Because if you give too much, if, for example, you eat, you think you're going to eat 50 carbs and you give your five units of insulin and, and it turns out that whatever you ate only had 10 carbs in it, then you've given yourself four units too much and you're going to sink and you could actually die….. So you have to sort of learn and adjust and it's, it's complicated.

BEAT

So in an ongoing effort to not die ...throughout the day, both Erin and Kyle are looking at their phones.

...at that app connected to that tiny monitor inserted in his arm…

And they watch the levels go high and low….

Erin Pre Interview Clip 7
It's like a mountain range.

If Kyle’s high, he has a few hours before he has to get insulin in his body to prevent problems...but if he’s low, it’s a real emergency.

He literally only has a few minutes to get sugar in his body before he could die...

Erin said that watching her son’s ups and downs 24 hours a day.

...It takes an emotional toll.

BEAT

Erin Pre Interview Clip 9
It is a lot of worry, anxiety, but not fear.

Not fear because Erin can get the insulin Kyle needs…

She makes pretty good money so they would never ration it…she doesn’t have to fear for his life the way other diabetics might...

But...like everyone else with type-one diabetes….Kyle needs a lot of insulin…. about three to four pens of short-acting insulin and 3 pens of long-acting insulin every month..

Insurance helps a little.

But it doesn’t cover all the costs of the drug plus the needles and all the other supplies he needs.

Erin could afford the over two thousand dollars a month she was having to pay out of pocket. But she was just...done.

She says it felt.....gross…

Just too unjust to let powerful pharmaceutical companies profit off her son’s disease.

Erin Pre Interview Clip 14
I feel very privileged to be in that position. but, Um, nobody should, I mean, insulin is, it should be a right, nobody should be needing to take out a loan to have a drug that keeps them alive.

BEAT FADE

Erin turned her anger and frustration into action…

She started doing online research…

And...eventually...the answer to her problem came in the form of a video about getting insulin in Tijuana...

CAFE AMBI UP

So...me and my producers…..Kinsee Morlan and Emily Jankowski….We met up with Erin back in January 2020…a few months before the pandemic hit us.

Cafe Ambi
How are you?
Good, how are you?

The four of us started out at a cafe in an outlet mall in the U.S….

At the Las Americas shopping center that butts right up against the border fence with Mexico.

Erin in Cafe Clip 7
The pharmacy, I found, I watched the vice episode and they went there

So yeah...that Vice video...it made it seem super simple....

Erin in Cafe Clip 7
They recorded the whole way across. The guy spoke English behind the counter. I don't speak Spanish, so I figured, hopefully that guy is still there and he'll speak English to me and I can get what I need…

Erin lives pretty close to the U.S.-Mexico...border…..about 35 to 45 minutes away.

So she decided to go for it and she invited our little podcast crew along for the ride.

BEAT FADE

Erin in Cafe Clip 7
Um, I did call ahead my, my daughter speaks fluent Spanish. She called ahead and found out that they do have insulin there. They have the kind I need and they said it's $17 a pen if I buy more than four pens at a time, and. Uh, four pens would get us through two months. So I'm going to try and buy three. I'm going to try and buy six pens for three months. Um, and I, and, uh, and I know they have it and we'll see when we get there, whether or not they speak English or Spanish, but you guys are with me so...
Alan: Yeah I think we’ll be fine.

AMBI

Erin in Cafe Clip 6
Alan: Are you ready to cross the border?
I'm ready. Let's do it.

From the cafe…

We headed across the street to the San Ysidro Port of Entry….

Walking through border AMBI

Erin in Tijuana Clip 40
We just went through the border. It was exciting. I had to fill out some paperwork and put our bags on a conveyor belt. I guess they x-rayed them to make sure we wouldn't bring drugs into Mexico or something. Not sure what they were. Maybe guns. They don't want guns here. And everybody was super nice and that was a breeze and, and there's no reason to be afraid really. Alan: Way easier than going into America.
Oh my gosh. It took 30 seconds. It may. Okay. It took two minutes. It took two minutes. Okay, so we're going to a place called pay pharma..it’s right near…
Yeah it’s right where the plaza is….

Just arrived in Tijuana Ambi

Once we got through the pedestrian crossing at the San Ysidro Port of Entry…

We all started looking at our phones…

Using our map apps to try to figure out how to get to that specific pharmacy that Erin heard about in the Vice video..

Walking to first pharmacy ambi

Erin in Tijuana Clip 8
Do I need to change my money? Do you think I need to change my money?
Alan: 90 percent of places in Tijuana take U.S.
OK And it's 18,,,,18 to one?
Kinsee: like 18 point three-four.
Okay. Okay. Oh, he wants us to come in there. Good Mexican food.
Tequila, Margarita Ambi
We have some storefront owners wanting us to come in and eat mexican food and their place.

So…yeah...there are plenty of restaurants right here after you walk through the border and into Tijuana…

But mostly...you’re surrounded by tons of dentist offices and farmacias.

BEAT

Most of these pharmacies are painted in bright yellows, blues and reds on the outside and like…...gleaming white and super sanitized inside….so they really stand out…

BEAT

Some even play super loud music from huge speakers set in front of their entrances…

They’re hoping to attract the folks like us who’ve just walked through the border and don’t know exactly where they’re going yet...trying to convince them to choose their pharmacy instead of the one next door…

BEAT

Some farmacias even hire these funny mascots to twirl signs and dance in front of their stores. The ones I’ve seen were dressed as cartoonish pharmacists or, like, hilarious giant pill bottle characters.

So yeah... farmacia competition at the border...is real.

Erin in Tijuana Clip 9
Alan: This area is like filled with pharmacies. I bet a lot of them have what you need, but let's, let's go to pey pharmacies. It's so close.
Erin: Let's go right in here.

Erin couldn’t resist all the temptation….ha.

She decided to check out a few other pharmacies that we came across.

Erin in Tijuana Clip 9
Alan: This is like Pharmacy row.
Okay. Okay. Should we, uh, I wonder if we should go in and see how much it costs. Don't let us tell you what, let's, let's go in one. Let's just go on one besides pay pharma and just see what it would cost. Okay.
Alan: They say We'll beat any price.
Cialis. Levitra
Erin in Tijuana Clip 10
Alan: You want to check here?
Sure, sure. Hi. Lantus insulin, insulina? How much is it for a pen? Let me, I'll pull out what I have. Let's see if I can find my sample.
Pharmacist: Okay. Let me, let me get it.
Okay. Now if he gets it, he shouldn't get it because it's refrigerated, so if he's just going to get it and pull it out to show me it's a. I guess, yeah, I would never buy it. Right. Oh, he just, yeah. I'll be able to tell if it's cold.

Erin in Tijuana Clip 11
Pharmacist: Which one?
How much is that?
Pharmacist: Okay. $24.60 one pen or, mm, $99.95 for three
for three $33 for three and 24 for one that doesn't make sense. Okay. You can put it back in the refrigerator. Thank you. Have a good day. So it was more expensive to buy a three pack, which makes no sense. And in the United States, they're sold in five packs. So it is a little bit different, but it did look the same. It had the same manufacturer name on it. Uh, and it was the same kind of flex pen that people use for multiple daily injections. I'm not at all worried that it's counterfeit. It was refrigerated. Um.
Kinsee: Maybe that’s just the close to the border tax, what do you think Alan?...
Alan: Um, that could have something to do with it.
Erin in Tijuana Clip 42
Alan: Maybe it just went up in price

Taxi guys taxi: placemaking ambi

Walking to second pharmacy ambi

So...the price the pharmacist quoted was lower than the price in the U.S….

But Erin? She admitted to us that she’s very frugal…actually she said she comes from a long line of very frugal women in her family.

She said she wanted to score the best possible price...

So we kept walking toward Pey-Pharma...the place Erin saw on Vice.

Buuuuuut….we still had some trouble finding it.

In part...because medical tourism has just totally changed the urban landscape surrounding the Port of Entry…

Walking Ambi

Erin in Tijuana Clip 13
Alan: They're doing a lot of construction here. If you see these like satellite buildings, like it looked like there was structures there before, but it seems like they took everything down and are rebuilding. I mean, they're investing billions of dollars into the medical industry.
That's so weird. Our pharmacy might be gone.

We wandered in what we thought was probably the right direction….

Walking a bit deeper south into Tijuana…

Erin in Tijuana Clip 16
On the hunt for insulin, I feel a little bit like this is a...well, or a drug deal. It is. It just feels funny. Insulina… That's the right word, isn't it, Alan?
Alan: Yeah.
My daughter taught me that
Erin in Tijuana Clip 14
All right. Let's keep going.

AMBI FADE
BEAT 6

Ok, we’ll come back to our insulin drug deal again….I promise...

But first..

We’re gonna talk to Liz…

She’s a 53-year-old grandma with type two diabetes who’s had to ration her insulin in the past…

First because it was so expensive in the U.S….and then because of the virus and its impact on the border.

Quedate con nosotras. Volveremos en un minuto
MIDROLL 2

Ahora de vuelta al podcast.

Liz Salcido Clip 1: Introduction
My name is Elizabeth Salcido. Um, everything you need to know, just ask.

So...Liz Salcido lives about 10 minutes north of the U.S.-Mexico border, in Chula Vista…

My producer Kinsee and I met up with her at a cafe there a few weeks ago.

Liz Salcido Clip 27
Kinsee: Chula Vista, man, this is such a cool town, this is such a cool street.
Oh yeah, It's getting there. Yeah. All these nice new restaurants popping up everywhere.

Liz has type-two diabetes...

And...at first, she just needed a pill to manage it.

But...the disease progressed…. and eventually…she had to start relying on insulin - just like Kyle.

And she says it’s been tough….she’s had a hard time keeping up with all the costs…

Liz Salcido Clip 6
…...You know, we were living paycheck to paycheck. And it was a little, there were, there were months, not every month, but there were months where, where things were a little bit difficult to get the insulin. We had to make a choice, pay this bill or buy the insulin.
Liz Salcido Clip 3
So I've struggled in the last few years because of the high cost of health insurance, um, that sometimes I'm without insurance. And so I don't have my medications.

Not having medications, though?

That’s super dangerous when it comes to diabetes…

BEAT

People have died from rationing insulin…

Or they suffer serious long-term complications...like kidney failure or blindness...

Rationing to save money is really just not a safe option….

Liz, could’ve died.

BEAT

Luckily, though, Liz’s parents are from Tijuana…

And Liz actually lived in Tijuana herself for a few years in her late teens and early 20s...

So eventually...she realized what was right in front of her the whole time...Mexico.....

Liz Salcido Clip 26
I just started crossing the border and, and getting it there.

Liz Salcido Clip 22
we were living paycheck to paycheck and it was a little bit harder. And so, you know, we were crossing anyway. So I figured why not? Why not try this and why not see how much it costs? You know? So just walking into the pharmacy, asked him, I was like, bet, give me four of them, you know? Yeah. You know, and so I was able to have that extra and still, you know, occasionally get my insulin here. And then, you know, I didn't have to ration. I didn't have to worry about it. I had an extra little stock there, you know, in case anything happened, I had an extra vial there that, you know , that I bought in Tijuana. And that if, if at that moment I couldn't afford it. Or, you know, it was a choice between this or that, that I had that extra vial there. So it was very important to me to go to go, even when I did have enough money to. Pay the copays.
Liz Salcido Clip 4
At the same time, I was still paying less in Mexico for the insulin than the price that I was getting for it here, paying my copay.

So...problem solved, right?

Thanks to Tijuana….Liz could finally afford the insulin she needed…

But then...the pandemic hit….

Border Closed News Clip
The U.S. and Mexico have agreed to restrict non-essential travel across our shared border…

BEAT

Suddenly...crossing the border became just too risky for Liz…

Starting in March of 20-20...people were told not to cross the U.S.-Mexico border unless they absolutely had to…

And even though Liz had a really good argument for why she needed to keep on crossin,’

She says she didn’t want to expose herself to the virus by crossing the border and being around crowds….

Especially because people with diabetes like her...are considered high-risk when it comes to the virus.

So, Liz had to start rationing her insulin…. again…

BEAT

Liz Salcido Clip 28
I did ration a little bit…..So, you know, I would just mostly take it, take the afternoon. Um, Doses and not take anything in the morning, just try not to eat anything that had any kind of sweetness in it that, or any carbs that could turn into sugar. So, um, you know, a lot of cinnamon tea and natural things that lower your, your glucose level and that's how I got through it.

BEAT

We’ll come back to Liz a little later.

Walking Toward Pey Ambi
Yeah, there it is...Baja Latte...

But first….

I want to drop back in on our insulin trip with Erin…

Erin in tijuana Clip 43
That was in the video. That's how I knew where we were going.

Eventually, we found the pharmacy Erin was looking for...

It was actually sorta hidden in the shadow of one of the huge new medical centers being built at the border.

And..you can hear it in the tape...the unrelenting drone of construction was everywhere around us….

Erin in Tijuana Clip 18
Yup. Okay. This looks right. We're revisiting
the steps of the Vice video.

Erin recognized the pharmacist….

Erin in Tijuana Clip 19
Hi there….I need some lantis...yes, lantus pens….
Do you know how many you need?
Um….I know if I buy them in bulk it’s a cheaper price.

The pharmacist is a Mexican-American man who told us he’s lived on both sides of the border…..hence his perfect English...

Erin in Tijuana Clip 19
They have the single or the five pack.
The five pack.
Quire una..o?
Just the one, the one five pack?
Yeah, just the one.

His name is Rodrigo Romero...and he says Erin’s not the only one who saw the Vice video and then searched him out in Tijuana.

Erin in Tijuana Clip 20
We actually have quite a few, actually got a few phone calls and stuff after that. Um.
Just a handful? Really?
Well, we had quite a few people saying like, Oh, we saw you. And then I had phone calls from, um, uh, labs and stuff that you were like, Oh, we do research with diabetics and stuff. Um, in San Diego, stuff like, Oh, would you mind if we send patients and stuff and refer them to they're like, send whoever you want it. Yeah, absolutely.

So...Rodrigo had to call over to another Pey pharma location to get more insulin...

While we waited….he told us more about the medical tourism industry in Tijuana.

He said the reason insulin is so much cheaper in Mexico isn’t because it’s a different..like...cheaper or crappier product…

Erin in Tijuana Clip 21: Pharmacist
yeah..it’s the same pen, it's patented. It comes from the same labs, all, all of that. It's just, you know, the difference, the government negotiates prices here…
Ah...and you have a better negotiating government..
because the government doesn't negotiate them over there, over there in the U S it's just, it's privatized. They let the pharmaceuticals set their prices and go straight to the, um, to the companies. And then they set their prices on what they want to sell it to you and you kind of just stuck there. And here it's negotiated down by the government. And after that. That's the price you, you can't mess with. Like, once we get it, we can't mess with it. We can give a discount maybe, but we can't bump it up. Yeah. Right.

BEAT

Basically, Rodrigo said Mexico has fewer rules and regulations when it comes to getting drugs on the market.

But more regulations when it comes to how those drugs are priced.

Erin in Tijuana Clip 31: Pharmacist Talking
Yeah, the support of the government helps a lot. The government really, um, sticks its hand in trying to keep prices down for the common people. It's not just, um, profits. It's, they really look out for the, uh, the citizens here. Um, and obviously, you know, that spills over in and benefits, uh, whoever lives across the border.

BEAT FADE

So yeah...this is why so many Americans come here...to take advantage of these cheaper prices that are set by the Mexican government…

Outside Pey Pharma Construction Ambi

Rodrigo said pretty much all of the new construction we were hearing that day was to accommodate the flood of medical tourists…

Erin in Tijuana Clip 30: Pharmacist Talking
So all of this is just going to be medical tourism and it's, you know, you're walk across the border. Do what you need to, and you head back. If you drive, they have the medical lane, um, where you get the passes. So you don't have to sit in line for three hours. You just kind of come to your thing and head on out.
Erin in Tijuana Clip 32: Pharmacist Talking
So we've seen the boom. Everything that's happening here is very recent in the past few years. It's just, you know, all of a sudden it built up enough. Um, there was enough demand. There was enough profit where they could finally invest in, do something to make it world-class. So we’re kinda going through it all right now.

Rodrigo told us that insulin is, by far, the most in-demand medication his U.S. clients are buying.

Erin in Tijuana Clip 35: Pharmacist Talking
We get stuff. Um, a lot of stuff that I'm surprised, you know, you would think most of the people are just like coming from San Diego and stuff. I've had people tell me like, um, yeah, no, we came from Florida. I was like...that one really blew my mind. I'm like, that's not a cheap flight. And then hotels in San Diego aren't cheap either.

So…just how cheap was the insulin Erin was about to buy from Rodrigo?

At first, he quoted her $12 a vial..which was ridiculously affordable.

Erin in Tijuana Clip 2
That’s exciting It's only $12 it's unbelievable….12 fucking dollars. Yeah. $12 compared to $110 in the U S it's 10% where's the 90% going? Who's, who's taking the 90%?

But then when Rodrigo went to ring up the insulin…

Erin in Tijuana Clip 29
nat sound of register ringing up insulin

The price shot up big-time…...to 20 dollars a vial...almost double…

Erin, was not stoked about the sudden price change…

Erin in Tijuana Clip 34: Erin and Pharmacist Convo
…..Um, I'm feeling a little duped here. I don't, I, I, ……

Rodrigo explained what happened…

He said small price fluctuations throughout the year are normal…

Erin in Tijuana Clip 45
Usually the pattern is twice a year. You get, you see a little bit of a bump. Um, sometimes it drops, which is weird, but, um, that's the way it goes.
Rodrigo said those bumps typically happen right at the beginning and then again in the middle of the year…

So… since we crossed in January of 2020..

Erin got the higher price.

But the price tag was still way lower than it is in the U.S, so Erin went ahead and bought it.

Erin in Tijuana Clip 34: Erin and Pharmacist Convo
So... I'm getting 10 vials for 20 bucks each. $10 for 20 bucks each. It's still quite a deal and I'm going to be pissy about, I almost got them for 12 one two, yeah.

[Sound of Erin counting Money]
Before we left...
Erin asked Rodrigo about crossing the insulin back to the U.S.

He told her she didn’t have to worry too much...

Erin in Tijuana Clip 22: Pharmacist
Usually the recommendation is if they ask you, say you have something…….This, you really don't need anything. But just to play it safe. Cause sometimes you'll get a guy and you'll be like, Hey, I have this. Yeah, I don't care. Just go through. Sometimes you get someone even with all the paperwork, but why you have it? Why are you coming here? How many days is that for? Are you doing it for more than 30 days? You know, are you trying to sell it? What's this? It's just a luck of the draw with the agent.
BEAT
You're going to get best bet. Just play it safe. Be like, yep, I have it. Insulin, stuff like that. You don't have your prescription, so they can't really give you a hassle for it…

BEAT
Walking back to border Ambi

As we walked back toward the border crossing….
Erin told us she felt extremely lucky that she was able to save so much money.

But also….conflicted...

Erin in Tijuana Clip 25
…..I am so happy for myself and I am so sad for all the people that don't have this privilege.
Because it's just not right. It's wrong that I'm able to cross the border and get this like this.
Erin in Tijuana Clip 2
Um..you know...my kid needs this to live and other people need this to live who don't have resources and who can't drive an hour to cross the border. They live in Kansas or. Wherever Utah and they don't have access to this Mecca of Reasonably Priced Medicine. And so it's interesting that he said the government negotiates the prices. So where is our government in this? Why are they not helping us? It's so frustrating.
Erin in Tijuana Clip 25
Uh, it's wrong…so I feel like I have this privilege but .it’s wrong what’s happening on the U.S. side. They’re just screwing us.

BEAT

Walking back to border ambi

As we got closer to the port of entry….

The delicious smell of carne asada filled the air around us….
Erin in Tijuana Clip 36
Kinsee: how about some tacos?
Erin: I'd love some tacos. Should we go to the food truck?

Taco Ambi
BEAT FADE

After our taco pit stop...we got in line to cross back to the U.S.

Clip
Alan: Sometimes the lines are longer in the morning because people are going to the U.S.

And...about 45 minutes later….
Erin After Crossing Clip 1
Okay. Made it.
Emily: So what just happened, what happened?
Um, he said, where are you going in a very serious voice? I said, I'm going home to San Diego. And he said, why were you here? Where were you in Mexico? I guess he said, and I said to get medication for my son. And he said, do you have it with you? I said, yes. And he said, let me see it. And I opened it up and I said, it's insulin. It needs to be refrigerated. And he looked at my little. Refrigeration pack. And he said, okay, thank you…….And that was it. And I've got two boxes. I've got 10 pens in each box, three to four months supply and woo saved a thousand bucks. Wow.
Just like that
Success.
AMBI FADE

BEAT

OK, so…

Flash forward to now…
Erin Follow Up Clip 1
So you want me to hold it so you don’t have to reach like that? Why don't we both sit on the couch. Okay. I'm flexible. Yeah. Well, I want to get my spreadsheet….

It's been about a year and a half since our trip to Tjuana to buy insulin with Erin.

So, my producer Kinsee met up with Erin back in San Diego to check in.
And...since then, Erin says she hasn’t crossed the border at all...

In part, because of the pandemic…

Erin Follow Up Clip 1
…. . I didn't go back because everything got shut down.
But also because Erin...being the savvy spreadsheet-making...deal-loving woman she is…

Did some research and figured out a way to get more affordable insulin on this side of the border.
Erin Follow Up Clip 2
I found a savings card, which. I don't think I knew, I don't think I had when we were walking across and the savings card is this bizarre thing that says, Oh, instead of paying $700 a month for your insulin, you pay zero or you pay $25. And it's, if you don't know about it, like it's a big deal. It's a big difference.
Kinsee: So that's offered through the insurance company?
No it's offered through. The pharmaceutical company and you just have to know to search for it online.
Kinsee: oh. Oy vey.

BEAT
So...yeah….Erin has found yet another price hack for insulin...though it doesn’t come into play until AFTER she pays out her insurance’s $3000 deductible.

BEAT
And Liz Salcido???

She actually lost her job right before the pandemic hit….

And...like I said before...she had to start rationing her insulin because she was just too afraid to get the virus while crossing the border...

But…. the unexpected upside was that being unemployed meant she eventually qualified for Medi-Cal…

So...a few months into the pandemic...for the first time since her diabetes diagnosis...Liz got insurance that now covers the full cost of her insulin.

Liz Salcido Clip 7
Now they cover everything. So I don't have to go to to Tijuana…it makes it a lot easier… it makes life a little different...

But here’s the thing...….Liz says she feels completely stuck in this ridiculous catch-22…

Because…. if she gets a job, she’ll lose Medi-Cal…

And if the job doesn’t have good benefits…

Her insulin affordability problem could come right back…

And she’ll be back to crossing the border...

Liz Salcido Clip 16
It's still, so sort of in the back of my mind, you know, that I, once I go back to work, my insurance will go back to being Covered California, and then I'll go back to having a copay. And, um, well then, you know, I'll have to worry about crossing the border.

BEAT

Liz Salcido Clip 8
I love having that option of being able to cross the border and going to Mexico because you. You know, you really pay what things are worth, not the exaggerated prices that we have here in the United States and, you know, and then we get tacos. So that's the bonus. Yes.

BEAT FADE

Next time on the podcast….

BEAT
Mark IVF Forward Promote
for me, it was like the light bulb thing. I was like, well, TJ is right here and we love Mexico. I was like, why don't we just think about Mexico?
We continue our series on medical tourism at the border with a California couple who tries one more last-ditch effort to make a baby…

Grecia IVF forward promote
So I was just like, Oh my gosh, no, like, I, I don't want to do that down there. And I was like, Ooh, they're probably gonna steal my babies …..

It’s about what happens when the future you envisioned is suddenly ripped out of your hands and you’re willing to do anything to try to get it back.
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Port of Entry is written and produced by Kinsee Morlan. Emily Jankowski is the co-producer and director of sound design. Alisa Barba edited this episode. Lisa Morissette is operations manager and John Decker is the interim associate general manager of content.

This program is made possible (in part) by the Corporation for Public Broadcasting, a private corporation funded by the American people."

I’m Alan Lilienthal… Gracias por su atención.

Editor’s Note: An earlier version of this podcast did not clarify that Erin’s savings card works only after she’s paid out her insurance deductible.

Port of Entry podcast branding

Port of Entry

These are cross-border stories that connect us. Border people often inhabit this in-between place. From KPBS and PRX, “Port of Entry” tells personal stories from this place — stories of love, hope, struggle and survival from border crossers, fronterizxs and other people whose lives are shaped by the wall. Rooted in San Diego with tendrils reaching into Tijuana. Hosted by Alan Lilienthal, produced by Kinsee Morlan and sound design by Emily Jankowski.