We won. That’s the message that the Biden administration wants us to believe about the price of insulin in 2024.

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For years the prices of the drug that diabetics like me need to inject multiple times a day in order to survive had exploded, increasing more than 1000 percent between 1999 and 2019. In 2018 GoFundMe was full of campaigns for people who couldn’t afford insulin, while Twitter was full of politicians tweeting about how it should be more affordable. For years nothing else aside from a lot of hand wringing actually happened.

I felt entirely helpless until I eventually joined a wonderful mutual aid organization focused on getting supplies to diabetics in need. It was the only group actually taking action.

Without a government mandate to reduce prices, we are left with having to trust individual pharmaceutical companies to make ethical choices.

Finally, in 2022, Biden’s Inflation Reduction Act put a $35 cap on the out-of-pocket price of insulin for anyone insured via Medicare: adults 65 and older. Later, supposedly “under pressure from President Biden,” the three top insulin makers—Eli Lilly, Sanofi, and Novo Nordisk—who had lined their pockets for years with profits from a drug that only costs around $3.37 per vial to make, finally lowered list prices. But this may have more to do with separate settlements made by insulin makers with individual states rather than presidential influence.

Drug makers could have lowered prices years ago when diabetics were dying due to lack of access to insulin, and now we’re meant to accept their acquiescence as better late than never.

But it’s not so simple.

Without a government mandate to reduce prices, we are left with having to trust individual pharmaceutical companies to continually make ethical choices. Eli Lilly can essentially change its mind about insulin prices at any time, sort of like when a billionaire launches a startup and offers nice salaries and great benefits but then gets bored and fires everyone. This is no way to live.

So yes, of course let’s avoid the whims of billionaires and get out there and vote for Kamala Harris over Trump. But as long as we live in a country with for-profit healthcare where drugmakers have control of the pricing of all of the drugs they produce, no one is safe.

The recent lowering of insulin prices is a good first step, but that’s all it is. The fight is only just beginning for demanding more government regulation of pharmaceuticals. Other wealthy nations provide universal healthcare for its citizens, but as long as America refuses to join them, it’s the best we can do. I’ll keep donating to my mutual aid group in the meantime.