I’m not going to disect all your points. I’m just going to point out who Medicare insures. By the time people get on Medicare, their lifestyle consequences have mostly been locked in for decades. At that point they simply arent going to be around long enough to realize any long term benefits. Those CBO estimates apply specifically to Medicare for specific reasons, not to the drug category in general.
Saying we should wait a couple decades before covering it uses the same argument as when people questioned the COVID vaccine. But coverage was mandated, and it was pushed on everyone despite not having long term data. Even pushed on the demographics who’s most likely consequence of catching COVID was not even knowing they had it, for whom the benefits were barely marginal at best.
I hear that the GLP-1 drugs inhibit appetite and stop cravings. So they correct a huge part of an “unhealthy” lifestyle – overeating. Also since it’s more difficult for overweight people to exercise, losing some weight could help. These drugs can get people out of unhealthy lifestyles.
The X factor here is that for someone like me in their 50s, the impact of the shitty lifestyle diseases aren’t going to hit till I’m on Medicare. The private insurers don’t want to cover it because they won’t be on the hook when the heart attack or stroke actually manifests. The taxpayers will. surely there’s some point at which glp1 break even.
It will be interesting to see how countries with national health systems that essentially eat the cost of care over an entire lifetime treat it.
I’ve gotten good results on them and it’s improved my health dramatically. I’m not happy about an unreimbursed $300 a month though. I do spend a lot less on food and booze though.
Assuming these drugs don’t have long term side effects. The long term gains are not that great for the cost. Study found that after taking Ozempic for 68 wks (cost of ~$20k), then stopping 120 wks later, they had regained most of the weight lost and only down about 5% in body weight. That doesn’t sound cost effective to me for society to socialize the costs.
This reminds me of some study conducted on The Biggest Loser’s participants. Yes, they lost a lot of weight during the time they participated in the show but regained most of it in a few years. Even worse, their body metabolism might have changed, making it more difficult to lose weight.
BTW, there will be a strong incentive for patients to continue on the GLP-1 medication indefinitely, the dream of pharmaceutical companies.
$300/month for life, or $100k treating a heart attack plus whatever else comes after that if you happen to survive the first one.
It isnt a perfect equation, there are tons of variables, but the potential value is there. Especially when the cost of the medication is only going to come down, while treatment costs [usually] only go up.
I’m not trying to put a price on human life or being healthy. However, if I understood what TravelerMSY wrote, he pays $300/month for his GLP-1 but his insurance pays the balance. So monthly total is much more than $300/month?
Asked and answered. Who is covered by Medicare? Most Medicare patients do not have a long term outlook to produce much long term benefit.
The question to ask is, what is the benefit to Medicare when private insurers start covering such drugs? The presumption is healther serior citizens will result in lower Medicare costs.
Cost and potential impact were not on the same scale though. Many people were dying in a very short time span from COVID and we had to shutdown the economy to slow the initial spread. The cost to vaccinate for COVID was incomparably smaller compared to lifetime of GLP-1 drugs so I disagree that the cost vs. benefits analysis were similar.
There were not a lot of cheap alternatives to control the COVID pandemic, outside of masks. Letting it run its course had hospitals unable to cope, medications to treat COVID patients were very costly, and lockdown was very bad for the economy. By contrast, obesity has relatively cheap solutions: get off the couch and stop pigging out. But it’s just more convenient to not change lifestyle, medicate the issue away, and have society pick up your bill.
Anyway, I understand that this won’t be a popular opinion to refuse socializing the cost of obesity treatment considering over 2/3rd of the US population is overweight or obese. But then why not subsidize the cost of gym memberships? Isn’t that also helping keep healthcare costs lower and would pay for itself over the long run?
I’m not really disagreeing. Just pointing out that the question isnt to cover or not to cover, it’s cover the obesity drugs now or cover the obesity consequences later. There is value potential in covering these drugs, that could lower the total “socialized” costs that would otherwise be incurred.
Issue is that historically, gains have almost always been privatized, not as ubiquitously socialized as costs. When have health insurance premiums not exceeded rate of inflation despite medical advances that have added to costs, say over the last 30 years? So color me a pessimist if somehow I don’t see insurers passing these potential future savings on back to us, even IF they eventually materialize.
Subsidizing poor decisions unfortunately is the foundation of most of the social programs in this country. Welfare, WIC, Section 8, Medicaid etc. all probably have a root in most cases to a set of bad decisions made in that persons life. We socialize the cost of all of those.
