The cheap generic doesn't have the same effect profile. It's much harder to match an insulin bolus for the carbohydrates you're eating at a meal. The combination of fast acting and basal insulin can do a much better job of keeping your glucose readings in a good range.
That said, the same kinds of insulin cost a lot less in many foreign countries than they do in the United States.
I am aware that insulin costs a lot less in other countries. I have read the stories of Americans going to Canada to buy insulin. I have also read the stories of diabetics in the United States who died because they tried to make their insulin last longer by rationing their dose.
If I didn't have insurance my insulin would cost me either $245 (fast-acting) or $700 (basal) a vial.
I was just pointing out that getting insulin for $35 a vial in the United States is a very good deal.
These prices are not high. I went through a period when I had no health insurance, and I had to rely on generic insulin, the kind you can buy at Walmart for $25 a vial. I have insurance now and the insulin I take now costs me a co-pay of $100 a vial. Paying $35 a vial without insurance is not bad at all.
I wonder if Colin has decided to re-join Hacker News, and if so, would he care to comment on the changes to Hacker News since 2011 that prompted him to change his mind.
That said, the same kinds of insulin cost a lot less in many foreign countries than they do in the United States.