When Everyone Could Afford the Best Medicine We Had
For most of the 20th century, a bottle of aspirin was a fixture in every family's medicine cabinet. When a child came down with a fever, it was the go-to remedy, trusted by parents and recommended by doctors. It was cheap, effective, and available on every pharmacy shelf - a truly democratic solution to a common ailment.
Then, in the early 1980s, the consensus shattered. Scientists discovered a terrifying link between aspirin given for viral illnesses and Reye's syndrome, a rare but often fatal condition that attacks a child's brain and liver. Public health warnings were issued, and an entire generation of parents learned to reach for acetaminophen or ibuprofen instead. We didn't ban aspirin; we refined our understanding. We replaced a universally accessible solution that carried a hidden risk with a safer, more targeted approach. We celebrated it as progress.
Then: Universal Access
Best available solution accessible to everyone, regardless of income
Now: Stratified Benefits
Revolutionary treatments reserved for the wealthy and well-insured
What we lost in that transition, however, was not the aspirin itself, but the simple paradigm it represented: that the best available solution should be accessible to everyone. Today, we face a new kind of trade-off, one that is far more troubling. We have developed revolutionary, safe, and effective medical innovations for some of our most complex health challenges - from obesity to hearing loss to diabetes management - but we have made them so expensive that they are effectively reserved for the wealthy.
We have moved from a world of equal-opportunity risk to a world of stratified, unequal benefit. This isn't progress; it's the systematic rationing of medical breakthroughs.
Of course, we shouldn't expect cutting-edge medical technologies to cost the same as century-old aspirin. The issue isn't that modern treatments cost more - it's that they cost so much more that they've become luxury goods rather than medicine accessible to those who need them.
My Place in the Divide
For me, this isn't theoretical. I'm diabetic, and I also have a history of unexplained heart issues. My cholesterol is fine, my arteries are clear, but I've had arterial clots that doctors can't fully explain. It runs in my family, but not in the usual way - no known clotting disorders, just a pattern of dangerous clots appearing without warning.
I need GLP-1s not for vanity, but for survival. It's brought my A1C into control and, according to the research, it's protective for the heart. The "bonus" is weight loss - if you're lucky.
I'm fortunate to have insurance that covers most of the cost, reducing my monthly payment to something barely manageable. But I'm acutely aware that this puts me on the privileged side of a growing divide.
My health outcomes are better not because I'm more deserving, but because I have better coverage.
This knowledge sits uncomfortably with me. I know there are people with the same family history of clots, the same diabetes risk, the same need for cardiovascular protection who can't access these medications because they can't afford them. They're left with the same old advice about diet and exercise, or worse, they're turning to dangerous alternatives.