Wegovy could be covered for at least 3.6M people under new Medicare rules
kff.org
kff.org
Of course, would be nice if they would negotiate a lower price as it’s really expensive.
But Medicare covers other chronic preventative meds, PReP coming to mind and that’s like $10k/year. But still way cheaper than HIV treatment that it prevents.
Fen-phen reduced obesity for some, but the heart damage it caused made it more expensive than no intervention. [1]
[1] https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine
Use for weight loss is relatively new as well. Approvals for that use are more recent, but off label use preceeds approval.
I’m assuming the tests were done on people with diabetes then.
Were there tests done on non diabetic people as well?
Beyond the sarcasm, it is concerning that most comments read here are raving about how much of a positive effect this cure could have. From a quick scroll, I haven't seen any addressing the fact that a new pill is not helping solve the cause of the problem.
We, as a society, have absolutely no reason to be obese. Yet, we choose to ignore the root of the problem, and cheer on the palliative chemical solutions. These solutions inevitably come we serious health side effects that we accept without blinking, as the most natural thing. And the industry also cheers as they can now also sell a second cure to address the side effects of the fist cure.
It shouldn't be forgotten that the pharmaceutical industry is, fist of all, a business.
https://arstechnica.com/tech-policy/2018/04/curing-disease-n...
It seems plausible that the introduction of evolutionarily novel ultraprocessed foods, designed by scientists in labs to be as tasty as possible, could increase a lot of people's appetites.
The processed foods however is what we’d want to get rid of. Otherwise all we do is slow down the loop, and add in more side effects.
Bravo. So we also know what we should go after instead of simply compensating the issue with new pills. Because we also know how well the pill approach worked in the US when handling pain..
So yeah, we could improve the future, but there's also lots of people who need help today and bringing up "but we failed in that one specific case" while being silent about everything else in medicine is silly.
Pros and cons not withstanding, any intervention which reduces obesity is a solution. Think of it like having a flat and thinking that taking the nail out of the tire is the only way to fix it. Replacing the tire also works.
The problem with analogies like this is that they make no sense. A medication that suppresses appetite isn't replacing the tire.
Second, replacing the tire is worthless if the road ahead has another million nails on it.
This applies to lots of conditions, right? I mean, society has absolutely no reason to have HIV. Just wear condoms and/or be obstinate. Easy peasy, right?
Fortunately, we have medication to treat and prevent HIV. Quite expensive, but they save lives.
When 50% of your population is obese, and a further 33% is overweight, you have a major health crisis at play. And maybe, instead of trying to find better ways of soaking up the leaking water, we should focus on fixing the leak, not matter how great the cleaning products are that are being sold to us.
We've heavily regulated cigarettes, we've heavily regulated (some) life-threatening chemicals, it's time to focus on the rubbish being sold to us as food, and it's time to educate our populations without being too soft on the sensibilities of some, or too lenient towards the commercial interests of others.
I don't think obstinance only works. Being a curmudgeon doesn't prevent one from having unprotected sex. :)
And I say this as someone who just says no to everything ;)
We know from behavioral genetics that, for people in the same environment, individual differences in obesity are about 70% heritable. And there's loads of evidence that the standard "diet and exercise" approach does not lead to long-term weight loss in the vast majority of people who attempt it. (It does lead to shorter-term weight loss, but then people regain the weight, for biological reasons.)
So, short of massive regulation of modern "food products", the only options are either bariatric surgery (which does produce long-term weight loss) or some new intervention. The GLP drugs are the most promising candidates in that category.
I agree that there's too much triumphalism about these drugs at the moment. We don't really know yet whether they will produce long-term weight loss without serious side effects.
https://www.cms.gov/files/document/fact-sheet-medicare-selec...
> For the first time, the law provides Medicare the ability to directly negotiate the prices of certain high expenditure, single source drugs without generic or biosimilar competition. Below is the list of 10 drugs covered under Medicare Part D selected for negotiation for initial price applicability year 2026, based on total gross covered prescription drug costs under Medicare Part D and other criteria as required by the law.
https://www.medicare.gov/about-us/prescription-drug-law
> For the first time, Medicare will be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don’t have competition.
https://www.kff.org/affordable-care-act/press-release/3-char...
> The Congressional Budget Office has estimated that negotiated prices will reduce Medicare spending on drugs subject to negotiation, translating into nearly $100 billion in federal savings between 2026 and 2031.
There is absolutely no reason for it to cost $10K per year in the US.
I’m more worried about the long term effects of it, we had plenty of “miracle drugs” in the past that resulted in significant damage long term to either those who took them or to their children.
If there's a major unseen gotcha lurking, it hasn't showed up in the first two decades. (Plus however long prior to that the clinical trials were going on for.)
Is it "off label" use of Ozempic? Yes. Are the FDA and medical patents in the US broken? Yes.
The only way to make it cheaper in the US is to make your pay more.
I think this is very unimaginative to claim that the developer/manufacturer costs are fixed in stone and THE ONLY WAY is for customers to zero-sum it amongst themselves.
Most of the cost was in development/trials, the marginal cost of manufacture is probably in the single digits per month. With such an enormous market demand the development costs can be recouped faster and there is a possibility to lower the prices in the states as well.
Also 10x difference points to more systematic differences in the healthcare systems not just altruism of the US citizens.
Heart disease, diabetes, and fatty liver disease are some of the most common killers and the reduction in excess body fat will causally and significantly lower the risks for all of them.
Personally, just adjusting lifestyle (reducing intake of sugary and artificially sweetened foods; exercise; and intermittent fasting) over a sustained period of time (3-4 months) helped me drop 40 lbs. OTC supplements like vitamin d, and omega fish oil added to regimen (as recommended by doctor).
We should keep looking for better options, we can and should always keep an eye on potential consequences down the line — and we can always elongate that line — but the very real, proven consequences of being overweight/having high blood pressure can be calculated like those that are attached to burning coal and they are worth tackling without prejudice, within the guidelines of what good science deems safe.
Anything we can do to help with cardiovascular issues needs to be explored. Doing otherwise would simply be immoral and irresponsible. We have tried eating salads and going for quick walks. It's always great when that's enough to change one person for the better. When it's not, we should help with empathy. Currently, there simply is no clearer, quicker path to doing more than these drugs, on a societal level.
It's "masking" the issue as much as chemotherapy is "masking" the issue. People are dying. We have tried appeals to salads and quick walks.
Unless you got anything up your sleeve, I recommend we stick to the ol' "keep more people alive with the best stuff we currently got" plan, until information pops up, that makes this look like the morally worse option.
But in that regard preventing death is fairly hard to beat as a baseline.
This bit made me laugh, as if public health initiatives have been taken remotely seriously by the past few decades. It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication.
Did that happen with tobacco? Alcohol?
It's a hyperbole, meaning to say: The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach.
What makes it fairly obvious to me is that despite clear and long standing conflicting beauty ideals, the massive societal advantages beauty affords, and an industry build around weight loss (not even drugs, stuff like Weight Watchers), people still struggle.
If you have good insight into why informing about tobacco worked to the degree it did (although lung cancer is still the leading cause of cancer death) other than claiming vague un-seriousness, I am all ears. Otherwise I have a hard time understanding this as an information problem.
My point here was that we seemed to approach tobacco/alcohol a bit more methodically - taxes (i.e., increasing costs for cigarettes), regulations (i.e., where alcohol can be sold), education (i.e., scary cigarette packaging) - whereas we seem to be saying, "Well, we did very little and got no results, so let's go nuclear!" when it comes to obesity
It seems to me that, if obesity is so harmful to society, places like McDonalds and other (provably) unhealthy food shouldn't be as cheap or as easy to get as it is.
> The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach.
It certainly is frustrating, and I feel that more than I probably should. Probably something to reflect on.
Incorrect.
You patch that by altering the environment OR the body OR or the impulses.
To fix that you need to alter all 3
We have tons of evidence to the contrary in multiple disciplines. Like, have you never made a conscious dietary change?
In any case, yes I have, but the only time it has worked was when I changed my environment (stopped slouching at home bored with a full pantry) and my impulses (filled my days with activities so that boredom hunger wouldn't strike). Only changing one would make me last a couple of weeks max
Different people struggle with different impulses. I don’t have much trouble permanently modifying my diet. I struggle, on the other hand, with keeping a normal sleep schedule.
Which isn't to say that the overall idea of trying to find other ways to make obesity less common is bad, it just isn't a coherent argument for that.
To me, that suggests that maybe that simplistic (and frequently repeated) mental model is inaccurate or insufficient in some way.
My working theory is that most Americans’ gut microbiome is massively screwed up due to some combination of genetic, dietary, and environmental factors, and it changes what they crave, and how their body reacts to the food they eat. But I’m very much a layman on this topic.
People putting it down to eating less are parroting the food equivalent of abstinence-based sex education, and we’ve been drumming on that for like the last 30 years. We have to find what’s making people want to eat to excess, not just tell people to eat less and exercise more. That obviously doesn’t work.
If you think that there's something else going on, then let's see some hard data.
Personally, my "satiated" level is very low. When trying to gain weight while weightlifting, it was difficult to eat the amount of calories needed. I know others who can easily eat twice as much as me in a sitting and not feel full. Something different in happening in our bodies to signal "stop".
Eating less and exercising more does work. Talk to dedicated lifters about their cutting/bulking, where they want to be, and talk to them about it again in six months if you want to see how effective it is. It doesn't work for a lot of people because in the short, medium, and arguably even long term, it doesn't make you feel good.
There are a handful of people that can struggle to gain or lose weight on a diet appropriate for the amount of exercise they do. You may be one of them. If you are one of those people, asking why other people struggle with it is like being a 6'6" basketball player and wondering why somebody who is 5'9" struggles to dunk like you can.
There is a massive difference between being at a calorie deficit and starving yourself. I don't even know what to say -- this horse has been beaten to death by countless thousands of people and it's wild that anecdotal evidence with a sample size of you is enough to justify theorizing an alternative to an incredibly simple idea that until a few generations ago, there was absolutely no evolutionary pressure to not want to eat everything you can.
I suppose you'd say that some areas experienced more evolutionary pressure to eat as much as possible than others due to differences in food security?
But being hungry/unsatiated is distracting and can decrease your performance on every other task you do, so I don't really agree that there's no counterpressure. And I doubt that people in even those less food secure regions are just hungry all the time, like some obese people here describe being. It really seems like something just gets messed up in the signalling, which makes it seem more like a health problem/malfunction than some built-in evolutionary drive that doesn't fit the modern world.
> Snack companies take advantage.
I'm uncomfortable with these new drugs but they seem to be a net positive so this is a good thing. But we should also look into legislating junk food companies that hijack people's appetite for a quick buck.
Chile banned sugary food TV advertising to children and saw a roughly 10% drop in purchases high in sugar. An unleashed free market in food has been shown to be harmful and the drugs alone are insufficient. Regulation is necessary.
https://healthpolicy-watch.news/chiles-comprehensive-food-po...
At the very base this is mostly true but it's like saying the reason people die is because they stop living. Framing it as people behaving "in this self-destructive way" also isn't helpful because being obese isn't a moral failing.
The true answer is more complex. At least in the US, consumers have been fighting deceptive marketing/branding for things that have been claimed to be healthy choices but are full of sugar and unrealistic serving sizes. Combine that with unhealthy foods generally being cheaper and/or easier to cook and now more accessible/easier healthy eating also has class issues. Exercise does too as most of the places where obesity is most concentrated in the US (the Southeast) doesn't have walkable cities or sidewalks at all.
This has been a common comment left on HN of "it's just move more, eat less" and yeah, at a fundamental level, sure, but really doesn't take into account how difficult it can be for a person that's in that situation.
For example, many people around me gained weight after they became parents. Especially women after birth. It is just insanely difficult to work hard in an office job, take care of young kids and exercise etc all at the same time. As you age things get very difficult as well. I eat significantly less than what I used to just few years ago but still have 5-10lbs extra.
Obviously meds don’t work for everyone, but the aim is to have population level effects.
It’s about effective interventions. Obviously major interventions are needed as there is a huge amount of obese and overweight in the US and many other methods have been attempted.
It’s not about theoretically possible (ie, a bodybuilder can do it) but effective population interventions that result in people successfully losing weight.
Think about people going to medical school and becoming a doctor. It’s obviously possible but if you said the solution to income inequality was for everyone to go to medical school and be doctors that would not be a very effective intervention.
Not being obese is not being wealthy. It’s simple what to do, but difficult to stick to a successful plan.
Etc etc
Life is full of things that are supposedly easy, but yet people don’t do them. I think it’s reductive to just stick with ineffectual interventions that aren’t being used because they seem simple and people should just adjust.
Saying “Japan (4.5%) can do it so Germany (19%) should stop being so fat” isn’t very helpful. [0]
The goal is to reduce obesity. It’s not like we can’t also attempt systemic changes while also using ozempic.
If you’re saying we shouldn’t use ozempic because other methods should work (but haven’t in many countries), then that’s a pretty simplistic argument. And one that will likely result in greater obesity and societal harm.
[0] https://en.wikipedia.org/wiki/List_of_countries_by_obesity_r...
One of the reasons I referenced other countries was because it provides very strong evidence that culture is a factor. In America, we presently have a culture of telling ourselves that it's really hard to keep excessive amounts of weight off. We betray ourselves every time we tell that lie.
And like the majority of people who lost weight, I gained it back.
Why? I don’t know. My body just wants to eat more. I have to be constantly vigilant or else I’ll fall into my old habits of what my body demands that I eat. I’ll eat dinner and then still be hungry.
I think you’re getting this backwards. I already have an eating disorder.
I'd take the odds that you eat too fast. Slow down and carefully chew every single bite. Put the cutlery down in-between bites.
All the people who have never been fat have the best advice that us fatties totally appreciate and want to hear even when we never asked for it. In fact, it’s extra awesome when people bring up obvious advice when we don’t ask for it because fat people like me are actually less smart than you! So it’s really helpful to have a helping hand and I thank you for it.
Thank you for downplaying a disease that almost half of the population has and for blaming it on me as an individual. Because obviously if half the country has the exact same ailment as me, it’s really a sign of the dangerous virality of the fast paced chewing lifestyle.
Since most people who lost weight gain it back at some point statistically, it really makes logical sense that it’s all about how fast we are all chewing our food. All the celebrities and pundits on TV and in social media talk about how we need to chew our food faster, so it’s hard to escape that perverse influence.
If you're interested, I do have a recommendation for you. For my money, Joel Greene is the best scientific thinker on the topic of diet and health, and his recent book "The Way" does a lot to replace frustration and confusion on the topic with sense and helpful advice. I recommend it if you've had success with a diet, and then regained the weight, and now nothing works - that's the exact problem he's focused on. Above and beyond whether you like his suggested solution, he does a lot to uncover mechanisms and explain the complexity of the problem.
For what it's worth, I think your experience is completely normal. Nearly universal, even.
I. Am. Not. Looking. For. Advice.
Especailly not some stupid fucking self help book from a quack selling $100+ supplements.
If you'd rather see the bibliography without the boomer, here's what's directly relevant to what you were writing about - one of the (several) mechanisms for weight regain and why losing weight is so much more difficult the second time around: https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(... (TLDR: Control of hunger by the hypothalmus responds to dieting by becoming more aggressive, and it stays that way after the diet stops.)
It's not in your head and it's not a character flaw. Purely physiologically speaking, naive, restrictive dieting really does become much harder, if not impossible, the more you do it.
Of course you’re still hungry - you have a pantry of delicious food right at your fingertips. One Oreo couldn’t hurt, right?
That’s not somehow unique to fat people, though I know some other skinny people will pop in and say “I’m basically never hungry!” Humans didn’t evolve to have delicious food constantly available, and to need to do no exercise to get it.
I wouldn’t say those that are overweight have an eating disorder. They’re (obviously, going by statistics) “normal.” Then there’s those of us that have the will power or specific motivation to not stuff food down our throat. The few that are left are probably the real ones with something biologically unique.
https://glp1.guide/content/senior-citizens-and-glp1-receptor...
Also as some other people have noted, those costs seem high now, but they're certain to go down over time (due to competition and other companies entering the market along with other countries), and almost certainly worth the cost -- type 2 diabetes can be very expensive, along with all the other effects from complications of obesity.
For example, Wegovy has actually been FDA approved for reducing heart disease risk:
https://glp1.guide/content/news-fda-approves-wegovy-for-redu...
See https://www.ncoa.org/article/get-the-facts-on-falls-preventi....
This is not to say the drug is bad, simply to encourage education so we dont trade one problem for another.
This isn't true in the sense that it's because of GLP1 RAs in particular -- it's just that GLP1 RAs are effective at rapid weight loss, and that's what happens when you undergo rapid weight loss REGARDLESS of method.
It's a trade-off -- do you want to manage muscle loss and bone density issues (with an easily modifiable dosage/etc) or manage type 2 diabetes or heart disease for the same patient?
Not sure where you get "everyone" from, but look at the average car cost, plus insurance and fuel and maintenance; $800 is nothing.
The average monthly car payment is $738 for new cars and $532 for used. Several factors determine your payment.
The data source is Experian, so I give it some credence.
If you think it’s high, consider that all the low payments you know of need an ‘equivalently’ high payment to balance out the average. People spend huge amounts of money on cars.
The average amount of a car payment and the average amount an American pays in car payments in an average month are vastly different stats.
Contrived example: I buy a $20k car. $500/month payments, 0% interest for simplicity of the math. I keep it for 20 years.
It cost me $83/month on average to purchase. My car payment was $500.
https://www.nerdwallet.com/article/loans/auto-loans/average-...
That might not be wise from a personal finance standpoint but buyers seem to prefer longer loans now.
What $20k car are you talking about exactly?
A new Toyota Camry base model costs nearly $30k.
And that is basically the most sensible no-frills vehicle you can buy.
In my area a $20,000 example of a Camry already has 80,000 miles on it and is a full 5 years old.
You are not keeping a $20k car for 20 years for a total lifespan of 25 years. That isn’t realistic at all.
It’s a far more realistic example than the pricey BMW SUVs people are linking with five-year cost summaries here.
The point is “average monthly car payment” and “average money spent per month purchasing cars” aren’t the same stats, just like the cost of a heart transplant doesn’t translate to how much I pay this month for one.
If we just dive down the rabbit hole of cheaper economy cars all we are saying is that the standard of living is declining when we compare to the past.
A 1987 Dodge Caravan cost between $25k and $38k in today's money. You can't even get a base model Chrysler Pacifica for that much.
I agree on the fact that most people are buying used cars...but used car prices are based on the benchmark of new car prices, and they're higher APR loans as well. So really both categories are getting less and less affordable.
By getting in? It has five seats, just like the Camry. It's ~2" narrower.
It wouldn't be my primary car of choice for triplets, but plenty of families of five don't have three in the bulky kind of car seats simultaneously.
https://www.deserttoyota.com/toyota-camry-vs-toyota-corolla/ says the Camry is 72.4 inches wide, the Corolla 70.1 inches.
But even then, assuming they somehow capture every resale of every vehicle, most people who can barely afford a car are not buying another car as soon as their payments end. Many, such as myself, drive a car until it dies. We tend to also learn a good deal about vehicle mechanics/maintenance to keep it going 'on the cheap' until either the engine or the transmission fails catastrophically and it becomes cheaper to get another used vehicle.
Also - you can't really go buy this OTC anyway so it's not really a substitutable good.
A bit aside, I am bullish on these compounds. Tirzepatide is a discovery on the same order of magnitude as any - even potentially bigger than all the recent ML stuff. It's not even close to it's full potential. The data shows it's the only thing we have that really squashes diabetes and obesity with minimal side effects, but also has big positive effects on addiction, heart, bones, liver, brain, and immune system.
The addiction effects alone could change the world tremendously for the better if it's made easier to get and easier to ingest. I gave one of my Mounjaro shots I wasn't going to use to someone who had been trying to quit cigarettes for a decade and they were basically in tears a few days later telling me they went two full days without smoking, the first time they'd ever even gone a few hours since they were young.
https://www.coxautoinc.com/market-insights/kbb-atp-january-2...
So the actual average purchase price is closer to 34.
The average purchase price for a car is about $33.5k in the US. That BMW starts at 47.
You may need to recalibrate your intuition. Average payment on a new car purchase in the US is almost $9,000/year. Average used car payment is >$6,000/year. This is before taxes, insurance, gas, etc. It is common to spend $10,000/year on owning a car in the US.
The Americans who don't spend a lot of money on car-related expenses are the outliers. Despite this, the median American household still has $12,000 per year leftover after all of their ordinary expenses like paying for cars. Average Americans have high incomes, profligate spending patterns, and poor savings behavior.
There is a rule of thumb that the purchase price of the car is 1/3 of the cost over its lifetime. That's pretty generous in 2024 since cars now have better mileage, better reliability and cost more, but it's almost certainly more than half the cost.
That's over $10,000 a year
And new is appropriate, since used price is payment from one owner to another. IOW, if one side of the transaction gets a good deal the other gets a bad one, leaving average unchanged.
Average annual capital cost is new price divided by lifetime.
Second - every one of your numbers is rounded up quite a bit, especially mileage as the average mileage would be 135k by year 10.
Third - You left out selling your 50k car in year 10 given 135k miles.
Fourth - EAC, one way to get to the truth, not the only.
The average new car buyer. The average payment on a new car is now $726 per this source (some sources have even higher numbers). That's about $8700 per year. That plus insurance, fuel, and maintenance puts you well over $10k.
https://finance.yahoo.com/news/average-auto-loan-payments-ex...
The insurance, fuel and maintenance are correct though.
Seriously, I don't mean to be rude, but god damn this is out of touch for people who are struggling.
https://www.coxautoinc.com/market-insights/kbb-atp-january-2...
To clarify further, my response is primarily aimed at the idea that the op couldn't even understand why people would need the government to help pay for things and pre-supposes the idea that all of us can afford $10k per year on a car.
One counterpoint is that in my country we’ve successfully reduced prices for medicines a lot by strong negotiations in the last decade. We are last in line among western nations for medicines now. Shortages all around.
And the US isn't paying for the R&D (that sounds like a regurgitated line from somewhere?) so much as paying for the pharma company's profits, due to the US's totally screwed-up healthcare system and situation.
I'd rather my taxes go to preventing obesity in the first place then paying for a pill that helps relieve its symptoms (but does not fix the underlying cause), is expensive, and has side effects. Make it harder to life an unhealthy lifestyle, just as we've made it a lot harder to smoke over the past 40 years. Start by taxing sodas and processed foods for one and use the money to subsidize healthier foods and prevention of "food deserts" in lower income areas (given that obesity is highly correlated with low income which is highly correlated with unhealthy diet -- it's hard to stay healthy when all you have nearby are corner stores stuffed with Frito Lay and Coke.
To me it's another example of how we really have our priorities backwards.
Not if your priority is to maximize shareholder value
If taxing sodas had the effect of reducing body weight by 1/3, then I’d be all for it.
But behavioral interventions are really hard to stick. The reason ozempic is taking off is that it works given the systemic issues we have.
It’s the equivalent of saying people shouldn’t take anti-depressant meds because we can just change systemic factors they cause depression.
We can do both, but it’s not like we’d discourage food deserts instead of ozempic. We need to do both. And cynically, I think ozempic will work to reduce obesity.
Fair point, but the systemic factors that cause depression are much more diverse, harder to identify, and much more difficult to rectify. (Also, I would argue that we have become a highly over-medicated society.)
Edit: Also, we did successfully change social behavior when it comes to smoking (younger people don't realize just how prevalent smoking was in 60s and 70s, perhaps as prevalent as drinking Coke and being overweight is today), though it did take massive class-action law suits. Maybe that's what it will take, though smoking -> lung cancer was perhaps a particularly easy link to prove.
Well, and that's exactly what these drugs do: they either make you uninterested in processed foods or make you ill if you consume them. Considering how many people's dietary habits are formed in childhood, and considering how many people learn dietary habits from their parents, I could see GLP-1 agonists having a generational effect where the children of people who take them never get hooked on bad food to begin with.
Although for what it's worth, you're absolutely right about food deserts and income, I sadly just don't see those things getting tackled head-on unless political winds in the US shift dramatically. On the other hand, making junk food less profitable to its creators might actually force some change, as backwards as that is.
That’s probably the only long term solution our hyper-capitalistic society
Trying to get support for changes to what food is available etc. may well be better in the long term, but in the short term you're doing the equivalent of asking a bunch of addicts (me included) to voluntarily vote to banish our dealers.
Many of us will, but the measures will remain weak enough that we'll still find ways of satisfying the addictions anyway.
A few have brought it to court and said “as long as there is a shortage this should be legal” and the court agreed.
But the FDA really dislikes compounding because of the safety risks.
https://www.fractyl.com/fractyl-health-demonstrates-signific...
(no affiliation, just very interested in a permanent fix that scales vs chronic mgmt with a pharma product)
Treating refined sugar as the addictive substance it is, and keeping those products in a separate part of the store rather than at the checkout line. Removing subsidies for unhealthy ingredients, subsidising healthier ones. More education in schools. Better funding and requiring school districts to meet certain quality standards for the food they provide to children. Ensuring all children have the right to a healthy meal. Where previous initiatives have fallen short, critically evaluate why and make them better. Thinking about social psychological factors for our collective mental health and thinking about how this influences our dietary and exercise choices.
There are lots of actions that could be taken that are not just pharmaceutical.
"Hi, can I get a ... snickers please?"
"Ye but i'll have to see some ID first!"
Just look at American portion sizes at any restaurant -- they're huge! The common mantra is that we want to ensure we get our money's worth. I was astounded on my trips to France. The dinners were still filling, but were much smaller than most American restaurants I've dealt with on the East Coast, Southeast, and Midwest.
Plus we put sugar/HFCS in literally everything. If you wanted to save a few calories and eat a ham sandwich at home, the basic loaf of white bread you're yanking off the shelf has HFCS, and for what?
This isn't even getting to the usual punching bag of fast food/fast casual, where you're easily set back 1000-1500kcals on the default menu selection.
Not to be had at any price in Australia.
Should now insurance not cover heart attacks or diabetes or other illnesses strongly correlated with weight for obese people ?
Where does that stop ? When is it not fault ? Should insurance not cover if you injured in sports(been careful) Or work place injuries (choosen a different job ) ?
[1] this is the same dumb deserving argument for uninsured, they are still getting treated in ER usually repeatedly when it would be cheaper to cover them
This is a myth. Insurance is low-cost or usually free for all low income people in the US.
Since the emergency over Covid was declared over last year, the number of people and kids being kicked out of Medicare and Medicaid ostensibly because of procedural issues or some imaginary fraud has been constantly in the news.
The forever argument on the right is link coverage to employment or some other ridiculous reason deserving reason invoking the welfare queen caricature, just last week John Oliver did a segment on this .
I’m sure you can dig up some exceptions where someone was denied coverage for some reason or bureaucratic screw up, but my above statement is broadly true.
Also, I wouldn’t consider John Oliver a good source for anything. His show is biased infotainment pandering to a specific group.
Medicare should easily be able to negotiate some volume pricing, now that they’re legally permitted to finally.