The Fight for His Life: An Uninsured Immigrant’s Plight for Medication
By AC Fernández
75% of undocumented immigrants in the United States serve as “essential workers”. These estimated 5 million people work in industries ranging from agriculture to manufacturing to domestic and service positions. What’s more, according to a report by the Center for American Progress, 225,000 serve as doctors, nurses, and home health aides, while 190,000 work in custodial or administrative positions in health care centers, at the front lines of the pandemic response.
Everyone deemed an “essential worker” by the U.S government has put their own health on the line to provide for their families, often times without extra compensation for the heightened risk of their pandemic-era labor. But undocumented immigrants are uniquely vulnerable in this workforce. Without valid immigration status, this vital swath of the American labor force is systemically barred from accessing formal health insurance. These employees are often denied or disincentivized from taking sick days if they experience COVID-19 symptoms, and are more hesitant to seek medical attention for fear of the cost.
José Luis is one such example. He had lived and worked in the United States for seven years when the COVID-19 pandemic struck in March 2020. He served as a mechanic, repairing and painting cars in New Jersey. When he developed a cough and shortness of breath last April, he was left to treat his symptoms of COVID-19 at home, afraid that his lack of insurance and immigration status precluded him from care and fearful that he would be unable to pay for medical treatment if he sought help. After weeks of nursing himself back to health at home without seeking medical attention, he finally regained enough strength to work a few days a week. But his respiratory symptoms lingered. As the months wore on, breathing became harder and, deciding that his condition had worsened beyond what he could manage, arrived at his local hospital’s emergency room despite his fear of the cost. After being admitted to Trinitas Regional Medical Center in Elizabeth, New Jersey, José Luis spent fifteen straight days in in-patient care, during which time he received a diagnosis for late-stage pulmonary fibrosis.
José Luis is now fighting for his life. At 52 years old, his best option is a lung transplant, a treatment option for which he is ineligible as a result of his insurance status. Nintedanib, a first-line medication for people with pulmonary fibrosis that is often sold under the market name Ofev, costs a minimum of $6,000 in the United States just for a month’s supply. Yes, you read that right; Ofev costs approximately $194 per capsule in the United States. The same drug in Canada costs a fraction of that at $43. Why the stark difference? Ezekiel J. Emanuel, a physician, bioethicist, and senior fellow at the Center for American Progress wrote in 2019, “The simple explanation for excessive drug prices is monopoly pricing. Through patent protection and FDA marketing exclusivity, the U.S. government grants pharmaceutical companies a monopoly on brand-name drugs. But monopolies are a recipe for excessive prices. A company will raise prices until its profits start to drop.” The result for people who pay out of pocket like José Luis and the other 24 million uninsured workers in this country often proves catastrophic.
Left with few options, José Luis has launched a GoFundMe page to pay for a month’s supply of the medication, and is hoping that it will help decelerate the degeneration of his lungs enough to travel to his native Colombia, where health insurance is nationalized and he may receive a transplant. Quetzales de Salud, a grassroots immigrant advocacy organization run entirely by medical and college students, is helping promote the campaign. It is hard to understate the gravity of Jose Luis’ situation and the grit he is mustering to give himself a fighting chance at delaying the advancement of this disease, even as his lung capacity continues to degrade.
José Luis’ campaign for health care fundraising is unfortunately an all too common occurrence. Since March 2020, social media outlets have been replete with campaigns asking for help with healthcare, food, and funeral expenses. A third of the money raised on GoFundMe in 2017 was for healthcare costs alone. The site has served to display the gaping inequities plaguing the American healthcare system.
While it is true that José Luis needs more than a one-month’s supply of Nintedanib, he hopes that what he can acquire through the fundraising campaign will help him regain enough strength to travel back to Colombia for a potential transplant. On his GoFundMe page, he asks his community and others for support, underscoring that no donation is too small: “I’m trying to organize everything for my departure [to Colombia] but the truth is that I need a supply of this medication urgently, which is why I am asking for your collaboration. Any contribution you can make, no matter how small, is greatly appreciated. It may be that some of you feel bad only being able to give a little, but you shouldn’t feel that way. A gift of $1, $2, $3 is a big help to be able to buy this medication.”
José Luis’ family, including his wife and daughter, have supported him through his illness and are actively involved in the fundraising efforts. His wife Yolima says of this process, “the fundraising campaign that we’ve launched is vital for my husband and for all of our family to know that he will be able to be with us for a while longer.”
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If you would like to learn more about José Luis’ story and donate to his GoFundMe campaign, please visit his page here.
AC Fernández is a rising second year dual-degree student at the UC Berkeley-UCSF Joint Medical Program. Originally from New York City, she has been volunteering with Quetzales de Salud since May 2020 and currently serves as VP of Communications.
