Stephen Ubl, CEO of the nation's largest pharmaceutical lobbying group ("Drug makers are trying to help diabetes patients," July 22), takes great pains to place the blame for high health care costs anywhere but on the shoulders of those who sign his paychecks: drug manufacturers.

When we consider the future of health care and charting a path toward increasing the quality of care and affordability for patients, it's the patients we should put first. Our conversation must be driven by and centered around them, not Big Pharma CEOs. Yet pharmaceutical corporations have spent millions to drive the health care conversation right into their wallets.

Ubl suggests greater transparency for patients and asks insurance companies to pick up their share of the tab. At face value, both are excellent points. But Minnesotans deserve more than lip service from the pharmaceutical industry. One obvious solution that he missed?

Hold the drug manufacturers that he represents accountable.

If drug companies spent less money lobbying and paying their executives enormous sums (Ubl himself takes home more than $30 million a year, and his organization spent $128 million on lobbying in 2017), they could put more money toward lowering the actual costs of drugs. A vial of insulin, for example, costs between $2.28 and $3.42 to manufacture, according to a study in BMJ Global Health, while the cost to purchase it has surged to more than $500 per vial in some cases. We wouldn't be having this conversation if that low manufacturing cost was reflected in patients' pharmacy bills.

Ubl further argues that the Minnesota Legislature's effort this year to provide an emergency supply of insulin "would have largely duplicated existing programs." How can he explain that to the families of people who have died rationing their insulin? Those programs weren't there for Alec Smith, and they weren't there for Jesy Scherer-Radcliff, two young people who lost their lives after they were forced to ration the insulin they couldn't wait until payday for, because of corporate greed.

Insulin has been around since 1923. How long can pharmaceutical companies hide behind "research and development costs" before they have to admit that the reason they offer rebates and coupons is because the cost of medication is too high in the first place? Will they ever concede that for an industry that creates products people need to survive, 42% profit margins are too high?

No, Ubl prefers to kick the can farther down the road, asking insurance companies and patients to cover for his clients, rather than simply cutting the high cost of insulin at the source.

I have a solution: Instead of blaming the insulin's price tag on the policymakers and the insurance companies, I would urge Ubl and his colleagues to take a very long look in the mirror.

Dr. Alice Mann, DFL-Lakeville, is a member of the Minnesota House. She is a family-practice physician.