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WAKINEKONA — ʻO kēia kūlana olakino, ʻo ia kahi maʻi koko kōpaʻa i kapa ʻia ʻo ka mimikō, a hoʻopilikia kēia mea i nā ʻAmelika he 34 miliona. Ma �Ჹ�ɲ���ʻ�� nei, he 11% nā mimikō o ka nui kanaka, a ua ʻoi iki aku kēlā helu ma luna o ka helu awelika aupuni, a nui nā kānaka i kuhi ʻia me he mea lā, e mimikō ana lākou.

Hoʻopilikia ʻia kekahi mau hui kikoʻī, e laʻa nā Kānaka Maoli he 14.2%, nā poʻe Pakipika he 17.7% a nā Sāmoa he 22.1% i kuhi ʻia he mimikō.

Ua lilo ka lāʻau mimikō i laʻana nui no ka pōpilikia ma ke koho ʻana i ke kumukūʻai o ka lāʻau i kuhikuhi ʻia ma ʻAmelika. ʻO ka lāʻau, ʻo ia ke hoʻohana ʻia e lapaʻau i nā kūlana ʻino o ka mimikō, a ua haku ʻia kēia ma kahi o 100 mau makahiki aku nei, a kala loa ka hoʻopalapala kila ʻia ʻana. Akā, ʻo ke kumukūʻai no ka lāʻau mimikō — a hāʻawi ʻia ma o nā ʻano like ʻole — ua māhuahua loa aʻe ia, ʻoiai ua hoʻonui pono pū nā hui ʻekolu e mālama i 95% o ka mākeke lāʻau mimikō i ke kumukūʻai he pā ʻumi ma o kēlā mau kekeke aku nei, a ua ʻoi aku ka wikiwiki o kēia ma mua o ka emi waiwai ʻana o ke kālā, wahi a kahi noiʻi ʻahaʻōlelo lāhui no ke koho kumukūʻai lāʻau.

Ke kauoha aku nei ke kumukūʻai pipiʻi no ka lāʻau mimikō i nā ʻohana ma �Ჹ�ɲ���ʻ�� a ma ʻō e koho paʻakikī i nā mea e kāpae ʻia ma kā lākou moʻohelu kālā e uku aku ai i nā��lāʻau e pono ai. ʻO kahi ʻōmoleliʻi o kahi lāʻau i kapa ʻia ʻo Humalog, he $21 ke kumukūʻai ma ka makahiki 1999, a he $332 ma ka makahiki 2019, wahi a ka

“ ʻAʻohe kumu iki e ʻāpono ʻia ai ke kumukūʻai pipiʻi no ka lāʻau mimikō,” wahi a Mariana Gershenson, ʻo ia ke alakaʻi no ma ke kula kauka ‘o John A. Burns School of Medicine ma ke Kulanui o �Ჹ�ɲ���ʻ��.

ʻO Shelsea Deng, ʻo ia ka makuahine o Coral, he kaikamahine i piha ka makahiki 7 iā iā, ma ka ʻaoʻao ʻākau, ua ʻōlelo akula ʻo ia, ua haʻalele kona ʻohana iā �Ჹ�ɲ���ʻ�� ma muli o ke kumukūʻai pipiʻi loa no ka lāʻau mimikō.

He ʻinikua ko ka poʻe he nui, a ʻo ia ke uku i kahi māhele o ke kumukūʻai mahina, akā nui ka poʻe i nele i kēia kūpale ʻole. He mau hōʻike ko ʻoneʻi no nā mimikō e uku ana a hiki i $1,000 i kēlā me kēia mahina no ka lāʻau.

ʻO ke kumukūʻai lāʻau mimikō a me ke kumukūʻai pipiʻi no ka noho ʻana ma �Ჹ�ɲ���ʻ��, he ʻauamo i keu a ke kauama kēlā no Shelsea Deng, a nāna ke kaikamahine i piha ka makahiki 7 iā ia, a ua kuhi ʻia ka mimikō ʻAno 1 i loko ona, a ʻo kona kaukaʻi akula nō ia i ka lāʻau mimikō. Ua hoʻoneʻe akula ʻo Deng i kona ʻohana mai Honolulu mai a i Kaleponi Hema e kiaʻi pono ʻia ai ke olakino o kāna kaikamahine.

“Ua haʻalele akula mākou iā Oʻahu,” wahi a Deng, a ʻo kona ʻohana he �Ჹ�ɲ���ʻ��. “ʻAʻole i hiki iā mākou ke uku pono i ka noho ʻana ma laila ma muli o ke kumukūʻai no ka lāʻau mimikō.”

Ua hoʻonui ka ʻauamo kālā i ko Deng makaʻu ma kona nānā mau ʻana i ka nui koko kōpaʻa o kāna kaikamahine a me nā hoʻololi nui ʻino ʻana e pilikia nui ai kona ola.

Loaʻa ʻē nā hopena ʻino i kēia kumukūʻai. ʻO ka helu o nā mimikō i make ihola ma ka makahiki 2020, ua māhuahua aʻe kēlā he 15% mai ka helu okēlā makahiki aku nei o ia makahiki, wahi a kahi hōʻike hou no nā helu make i hoʻolaha ʻia e ka N ma kinohi o kēia mahina. Ua kālele nā hui kūkala nūhou i nā make i pili iā Covid, akā ua hōʻike ka noiʻi, ua hoʻonui ʻia nā make mimikō ma ʻAmelika ma ke ʻano he 100,000 mau kānaka ma ka makahiki 2020.

ʻO kahi anamanaʻo na , ʻo ia kahi hui e paipai i ka hōʻoi ʻana i ka hoʻolaha lāʻau mimikō ʻana, ua ʻike ʻia ma ua anamanaʻo nei, ma o kēlā me kēia mimikō ʻAmelika he ʻehā, hoʻokahi o lākou i kīhau a maukoli i ko lākou ʻai lāʻau mimikō ʻana ma kēlā makahiki aku nei, ʻoiai ua keu ua lāʻau nei a ka pipiʻi. Ua ʻōlelo lākou he 63%, ua hoʻopilikia ʻia ko lākou lako lāʻau mimikō ponoʻī ma o ka pōpilikia covid, wahi a ka hui.

ʻO kekahi o nā kūlana kaulana i pili i ka make mimikō, ua pili ia iā Alec Smith, he kāne ʻo ia no Minekoka i piha ka makahiki 27 iā ia, a ua nalowale kāna ʻinikua mai kona mau mākua mai ma muli o ka piha ʻana o ka makahiki 26 iā ia. ʻOiai, ʻaʻole i hiki iā ia ke uku pono i nā uku hoʻopaʻa ma kāna ʻoihana, ua hoʻāʻo ʻo ia e uku kālā no kāna lāʻau mimikō, a ʻo kona kīhau akula nō ia i ka nui i mea e mālama ʻia ai ke kālā. Ma Iune o ka makahiki 2017, ua hala loa ʻo ia ma kona keʻena noho i ke ketoacidosis mimikō, wahi a kahi hōʻike na ka Mayo Clinic.

ʻO kahi noi i hiki ke hoʻēmi i ke kumukūʻai no ko ʻAmelika mau mimikō a me ko lākou mau ʻohana, ua ālai ʻia ua noi nei ma kēlā pule aku nei, ʻoiai ua hoʻolaha aʻela ke Kenekoa Kemokalaka ʻo Joe Machin no Wilikinia Komohana, ʻaʻole ʻo ia e ʻāpono mai ana i ke kumukūʻai uku a me ka pilikia o ke emi waiwai o ke kālā ma loko o ka hoʻolālā kau kānāwai i noi ʻia e ka Pelekikena ʻo Joe Biden, i kapa ʻia ʻo Build Back Better Act. Ma o nā noi, aia kahi hoʻolālā e kāohi i ke kumukūʻai mahina no ka lāʻau mimikō i $35 no nā mea maʻi i loaʻa ka ʻinikua a me Medicare iā lākou, a he hoʻāʻo hoʻi ko laila kekahi e hāʻawi i ke aupuni pekelala i kuleana nui e kūkākūkā me nā hui lāʻau e pili ana i nā kumukūʻai.

Ma kahi ʻaha kūkala nūhou i kēlā pule aku nei, ua ʻike akula ka Pelekikena ʻo Biden i ka ʻōlelo ʻino a Manchin, a ua hāpai leo ʻo ia i kona kākoʻo ikaika a walohia no ka hoʻēmi kumukūʻai lāʻau mimikō. Ma mua, ʻo ke kumukūʻai no ka lāʻau mimikō pākahi, aia ma waena o 10 kenikeni a $10, wahi āna, akā i kēia manawa, hiki ke uku ʻia he $1,000 i kēlā me kēia mahina. No nā mākua o nā keiki i loaʻa ka mimikō ʻAno 1 iā lākou, he pipiʻi ʻino ke kumukūʻai, i ʻōlelo aku ai ʻo ia me ka ikaika.

“He aha ana kāu hana inā he makua ʻoe e hana ana me ka uku liʻiliʻi loa, me ke kuʻupau ʻana i ka hana nui, a nānā ʻoe i kāu keiki me ka ʻike, inā ʻaʻole ʻoe kiʻi i kēlā lāʻau nāna, e aha ana lā? E hāiliili ana ʻo ia a make nō paha,” āna i ʻī aku ai i nā mea kūkala nūhou. “Ma luna aʻe o ka hoʻopilikia ʻana i ke ola o ke keiki, e hao ʻia ka hanohano o ka makua e nānā ana i kāna keiki. ʻAʻole kēia he hoʻomakeʻaka. E noʻonoʻo me he makua lā, ma ka nānā ʻana i ke keiki, a ʻaʻole hiki ke uku — ʻaʻohe ou hale e hōʻaiʻē ʻia ai ke kālā, ʻaʻohe ou kālā hoʻāhu. Ua hewa loa.”

Ua hiki paha i nā Kenekoa Kemokalaka a me ka Hale Keʻokeʻo ke ʻimi i alahele kūpono e hoʻoponopono ʻia ai kekahi o nā kūʻēʻē i kēia mau mahina e hiki mai ana. ʻŌlelo pinepine akula ʻo Manchin, ʻo kahi māhele āna e kōkua ai ma ka BBB, ʻo ia ka hoʻēmi kumukūʻai ʻana i nā lāʻau i kuhikuhi ʻia, e laʻa ka lāʻau mimikō.

Ua kaumaha nā Kemokalaka a me nā paipai mea maʻi i ka ʻaelike ʻole ʻana ma ka noi nui, e laʻa ka hoʻolako lāʻau mimikō.

“ʻO ke kumukūʻai no nā lāʻau i kuhikuhi ʻia — a laʻa ka lāʻau mimikō — ua pupule loa,” wahi a Kenekoa Brian Schatz, a he Kemokalaka ʻo ia e kū ana kokoke i ka ʻaoʻao hema o ke kuanaʻike politika. “ʻO ia ke kumu o ke koʻikoʻi o ka hoʻāpono ʻia ʻana o Build Back Better Act, ʻoiai ʻo ia ka mea e hoʻēmi i ke kumukūʻai o nā lāʻau a e hoʻokū i ke kumukūʻai no ka lāʻau mimikō ma ke ʻano he $35 i kēlā me kēia mahina no ka hapanui o ka poʻe, e laʻa ka poʻe me Medicare. ʻAʻole kēia lāʻau hoʻopakele ola e kāohi ʻia i nā kānaka e pono ai ua lāʻau nei.”

Ma kahi hoʻolaha, ua ʻōlelo akula ka Lunamakaʻāinana Kemokalaka ʻo Ed Case, a kū ʻo ia ma waena o nā kuanaʻike politika, he kākoʻo kona i ka Build Back Better Act, ʻoiai e hāʻawi ʻia iā Medicare ʻo ke kuleana e kūkākūkā pololei i nā kumukūʻai no nā lāʻau e kuhikuhi ʻia.

Ua hāpai hoʻi ʻo Case i mau pila ʻē aʻe e hoʻomaʻalahi ʻia ai ke kiʻi ʻana i ka lāʻau mimikō, e laʻa ʻo , ʻo ia ke hōʻoi aku i ka ʻinikua no nā lāʻau, e laʻa ka lāʻau mimikō, a me , ʻo ia ke kālele i nā kālā no ka mālama maʻi mimikō.

He kumuhana pilikia nui ke kumukūʻai pipiʻi no ka lāʻau mimikō no nā makahiki he nui.

Wahi a ka noiʻi ʻahaʻōlelo lāhui, ʻo nā hui ʻekolu — ʻo Lilly Corp no ʻInikiana ʻo Sanofi no Palani; a me Novo Nordisk no Kenemaka — ua “hoʻonui kumukūʻai pū” lākou ma o nā makahiki i hala. He $35 kahi ʻōmoleliʻiliʻi i kapa ʻia ʻo Lantus ma ka makahiki 2001 a he $284 ma ka makahiki 2019, a ʻo NovoLog, ʻo ia kahi mea e hana ʻia e Novo Nordisk, he $40 ma ka makahiki 2001 a he $289 ma ka makahiki 2021, wahi a ka noiʻi.

Wahi a ka hōʻike, ʻo ia kai nānā pono i nā palapala hui hana, ua hiki i nā hui ke hoʻonui i nā kumukūʻai ma o ka ʻimi ʻana i nā hana e “hoʻopunipuni i ka ʻōnaehana palapala kila,” ma o ka hoʻolohi a i ʻole ke ālaina ʻana i ke komo ʻana o kahi hoa hoʻokūkū i ka mākeke, a me ka hana ʻino ʻana i nā nāwaliwali ma ka ʻōhaehana hoʻopololei ma ka U.S. Food and Drug Administration.

Ma kahi ʻōlelo hoʻolaha, ua ʻōlelo akula kahi ʻelele, ʻaʻole hana pū ʻo Lilly Corp. me nā hui ʻē aʻe, a kūʻokoʻa lākou ma ke koho kumukūʻai ʻana. Waele aku ua hui nei i nā alahele like ʻole e kiʻi ʻia ai ka lāʻau mimikō me ke kumukūʻai i hoʻēmi ʻia, wahi a ka ʻōlelo hoʻolaha. Ua ʻōlelo ʻia aku hoʻi, e aho ke kāpae ʻana i nā ālaina hoʻopololei e kāohi ʻia ai ke komo ʻana o nā lāʻau palapala kila ʻole i ka mākeke, a he pono “nā haʻina ʻōnaehana a me nā kulekele lehulehu hou” i mea e hoʻomōakāka ʻia ai ke koho kumukūʻai ʻana a e lawe ʻia mai ai ke kanaaho i nā mea maʻi i hoʻopilikia ʻia ma ka uku ʻana no ka lāʻau.

ʻO Kristin Kruse Zeji, ʻo ia kahi ʻelele no Novo Nordisk, ua ʻōlelo akula ʻo ia nei ma kahi ʻōlelo hoʻolaha, ua hōʻike ka noiʻi a ke kōmike ʻahaʻōlelo lāhui i “kiʻi haiki o nā hoʻāʻo” e hana ʻia nei e ka hui e hoʻokahua i nā hoʻolālā hoʻoponopono, akā he mea i hōʻike ʻia ai ka pono no nā “haʻina nui” e “hoʻopaʻa ʻia ai nā kumukūʻai kūpono iā kākou a pau.”

ʻAʻole i pane maila ʻo Sanofi i ka noi hāpai manaʻo.

Ke ʻimi aku nei nā mimikō he nui i kōkua mai ka Federal Trade Commission, ʻo ia ke keʻena aupuni e hoʻokō i ke kulekele hoʻokūkū a me ke kiaʻi mea kūʻai. Ua lilo ko lākou mau noi ʻana i māhale o ka palapala moʻolelo lehulehu, no ka mea, ua wehe aku nei ka FTC i ko lākou mau hālāwai komikina no ka lehulehu e komo ai, a he 20 makahiki i hala ma mua o ka hana pēia.

Ke koikoi aku nei kahi hui leo nui i ko ka FTC hoʻoponopono nui ʻana aku, a ʻo ia kahi e alakaʻi ʻia nei e Lina Khan, he alakaʻi hōʻoiʻoi i piha ka makahiki 32 iā ia, a he mea hoʻouluulu ʻo ia ma mua no ka hoʻokūkū ʻana no ke akeakamai a me ka lehulehu, a ua hoʻohiki ʻo ia e hana me ka ʻoʻoleʻa ma nā kaʻalilo a me nā mea hoʻopaʻa kumukūʻai.

ʻO Matthew Dinger, he mimikō ʻAno 1 no Salt Lake City, ua ʻōlelo akula ʻo ia i nā komikina no FTC ma ʻOkakopa, ua nalowale kāna ʻinikua iā ia no kahi wā pōkole ma kona hoʻololi ʻana i ka ʻoihana, a he pono kona ʻai ʻole ʻana i ka lāʻau mimikō i kuhikuhi ʻia, no ka mea, ʻaʻole hiki iā ia ke uku i ke kumukūʻai kole.

No ke kumu o ke kumukūʻai pipiʻi o ka lāʻau mimikō, ua hoʻāhewa ʻo Dinger i ke kāohi ikaika ʻana a nā hui ʻekolu, a ʻōlelo akula ʻo ia, na kēia i haku i “moʻolelo noho loa o ka hana kūʻē hoʻokūkū, ka hoʻonui kumukūʻai ma loko o kekahi mau lā a i ʻole kekahi mau hola ma waena o kā lākou hana e ʻimi ʻia ai ka ʻoi o ka huina loaʻa, a he mea ʻole ka pono o nā mea maʻi,” wahi āna ma ka noi ʻana i ka FTC e nānā pono i ka nele o ka hoʻokūkū ma ka mākeke lāʻau mimikō.

Ma kahi ʻōlelo hoʻolaha i leka uila ʻia, ua ʻōlelo aku ka wahaʻōlelo no FTC ʻo Betsy Lordan, ʻaʻole hāpai manaʻo a ʻaʻole hōʻoia ka FTC i ka holo pono o kā lākou noiʻi ʻana.

Akā, ua ʻōlelo akula ʻo ia, na nā luna keʻena i “māliu pono i nā manaʻo o ka lehulehu i hāpai ʻia ma nā hālāwai lehulehu a me nā palapala i hoʻouna ʻia i ko FTC waihona palapala.”

Ua hoʻomau akula ʻo ia, ua hoʻolaha nā luna keʻena i ka haku hou ʻia ʻana o kahi hui e hana ma o nā aupuni like ʻole e “hōʻoi i kā lākou hana e noiʻi ʻia ai ka hopena o ka hoʻohui pū ʻana i nā mea kāwili lāʻau.”