Pay or Die was enthusiastically received at its world premiere at the SXSW Film Festival. The film uses the powerful personal stories of those who have been unable to pay the ridiculously high costs of insulin so that they can stay alive and manage their type 1 Diabetes. Insulin is an extremely inexpensive drug to manufacture making the behavior of big Pharma particularly reprehensible. They focus in on younger patients who are often unable to afford insurance and in some cases have actually died as a result of rationing their insulin. They show patients who have to go to Canada to attain their drugs at a reasonable price where access to medication is treated as health care not as a profit-making business. It is no exaggeration to say that audience members were in tears watching this modern-day American tragedy play out on screen.

Pay or Die also focuses on the activists fighting back and trying to change state and federal laws to make insulin more accessible and affordable. The fact that access depends on different laws in different states is a failure of our highly inefficient and decentralized Federal health care system. While the reforms are imperfect, some states, including amazingly Texas, have begun to change laws to make improvements and public pressure has begun to force drug companies to lower prices.

The film makers also made sure to point out that insulin is only the tip of the iceberg. Insulin is crucial, because unlike a lot of drugs loss of access is life-threatening within a few days. But they want us to realize that many other vital drugs are also too expensive (sometimes even with health insurance) to attain. This applies to life-saving cancer treatments among many other drugs. Pay or Die is an urgent call for universal access to accessible life-saving medications. Our health care system is an American tragedy. Pay or Die is an urgent call to begin to address some of its devastating tragic flaws. I urge everyone to watch this important film and then act on its message so we can begin to save lives.