Jesy Scherer-Rad­cliff probably didn’t think a Friday in June would be his last day on earth.

Scherer-Rad­cliff passed away on June 28, 2019 at 21-years old from “com­pli­ca­tions of his dia­betes,” according to his obituary, but the true story remains buried in inter­views with family members: Scherer-Rad­cliff, a dia­betic diag­nosed 11 years ago, was unable to afford the insulin required to keep him alive. His tragic death reminds poor dia­betics of the threat they face every day.

According to his mother, Scherer-Rad­cliff was a hard worker who wanted to prove to his family that he could be respon­sible for himself. He “wanted to be a pos­itive influence for his younger brothers and sisters,” she wrote in a blog post reflecting on her son’s death. She also dis­closed that Scherer-Rad­cliff had just been pro­moted and, for some time, took on a second job to help cover his cost of living.

“Insulin deaths,” as they’ve been branded, don’t happen in other wealthy coun­tries. This phe­nomenon rep­re­sents the kind of American excep­tion­alism we often try to tune out. America is excep­tionally indif­ferent to the adverse effects of its unwa­vering com­mitment to a com­mod­ified, for-profit healthcare system.

It would be easy to write a column explaining the various advan­tages of Medicare for All, including lower costs, better health out­comes, more effective research, less admin­is­tration, more com­pe­tition, and higher pro­duc­tivity. Instead, I’ll offer a simple moral premise that you can con­tem­plate on your own: No American should die of an easily pre­ventable health con­dition.

But Scherer-Rad­cliff is far from the only victim of mar­ke­tized healthcare. Esti­mates vary, but we know tens of thou­sands of Amer­icans die every year because they are unin­sured. Cases range from those like Scherer-Rad­cliff to patients who avoid early cancer screenings because they can’t afford them.

One can imagine Scherer-Rad­cliff walking into a pharmacy, staring at hun­dreds of bottles of insulin waiting behind the glass just a few feet away. The phar­macist probably smiled at him, too. Unfor­tu­nately, Scherer-Rad­cliff didn’t have the required amount of dead pres­i­dents in his pocket. That is why he died on that fateful June day.

In a dif­ferent society, this story is a horror novel. The ter­ri­fying gov­ernment death panel from your night­mares is here in the form of unseen market forces. In that society, an event like this might be called some­thing like “dystopian,” “total­i­tarian,” or “mur­derous.”

In the United States, we call it the invisible hand of the market.

How could this have hap­pened? Fun­da­mental market eco­nomics can help us under­stand what hap­pened to Scherer-Rad­cliff and why his death was both nec­essary and prof­itable for insurance com­panies and insulin man­u­fac­turers.

Insulin, along with most healthcare, is an example of what market econ­o­mists label an extremely inelastic good. As the price of insulin changes, demand for it remains vir­tually the same. In the context of insulin, this is easy to under­stand. It’s a unique hormone that users can’t sub­stitute with any­thing else. For a dia­betic, the choice is insulin or death, which explains why demand is so unre­sponsive to price changes.

Those who control insulin prices — there are three total man­u­fac­turers in the U.S. who appear to fix prices together — are left with an inter­esting choice: They can provide insulin at a low cost and forgo a certain amount of profit, or they can max­imize profit. Com­panies choose the latter because its owners want to make as much money as pos­sible.

But what are the con­se­quences? If a few dozen of the 7 million Amer­icans who use insulin die every year, but the firm is able to charge 100 times the cost of pro­duction (as of writing, this is the ratio of cost-to-market value), why wouldn’t it do so if its only respon­si­bility is to profit? This is not a thought exper­iment, but a sober analysis of the current insulin market con­di­tions. The market has no capacity to account for these deaths. The invisible hand closed Scherer-Radcliff’s coffin.

There’s another side to the story. Scherer-Rad­cliff actually did have health insurance when he died. He just couldn’t afford the copays on the insulin he needed to survive. A health insurance company, similar to an insulin man­u­fac­turer, finds itself in an inter­esting sit­u­ation: the more cov­erage it can deny, the larger its profit margin at the end of the quarter. Thus, a prof­itable health insurance company’s incen­tives are directly at odds with its express mission, which is to provide healthcare cov­erage to its cus­tomers.

Taken further, it would be disin­genuous to con­tinue calling our healthcare system “good.” A good healthcare system would exist for the purpose of pro­viding healthcare. Instead, it serves the interests of those who own the company. Those interests are almost always directed toward profit. Thus, we don’t have a good healthcare system, but a good profit system.

Behind the facade of “insulin man­u­fac­turer” and “health insurance provider” lies the true nature of our economy: it’s com­posed of profit-seekers. Health insurance and insulin are simply the mech­a­nisms through which com­panies facil­itate this profit. If you need a reminder of the con­se­quences of this, talk to Scherer-Radcliff’s mother.

We created the system of cap­i­talism and profit-seeking that dom­i­nates our access to healthcare. Our pas­sivity, non­cha­lance, and refusal to crit­i­cally analyze its effects allows a system like this to per­petuate even in the face of clear, life­saving alter­na­tives like Medicare for All. “Who killed Scherer-Rad­cliff?” is a tough question for even the best philoso­phers.

Nicole Smith-Holt attended Scherer-Radcliff’s funeral. Her son, Alec Smith, passed away in 2017. He was another so-called “insulin death.” Since then, Smith-Holt has advo­cated for Medicare for All and other solu­tions like emer­gency insulin pro­grams.

Who killed Scherer-Rad­cliff? Smith-Holt has an answer.

“My son and Jesy, they were mur­dered,” she said. “They were killed by Big Pharma. The cause of death should actually be on their death cer­tifi­cates: cor­porate greed.”

Cal Abbo is a columnist on Demo­c­ratic pol­itics and is The Collegian’s assistant fea­tures editor.