Minimal, but minimal progress in the US was/is still progress.
Doesn't disagree with your original claim that there is low incentive for any private insurance to care regarding longevity, but figured I could add some color
If you know a "customer" of yours (an individual employee) is only going to be with you until they either change jobs or go on Medicare, then it seems the name of the game then is to make sure that nothing catastrophic happens to them until you can hand them off to someone else.
In which case, they should definitely go on ozempic. Even if the effects of ozempic immediately come off after usage, it's a short-term enough solution that benefits the insurance company, no?
The problem is, prediabetic and folks who may have crossed 7.0 A1C once, and just overweight folks with docs who are willing to play fast and loose are demanding it. Skipping metformin and other first line treatment options that are way cheaper. For those folks, complications might be the next guys problem.
I don't think this is completely true right? Rather, it's more accurate to say that customers that are seen as healthier get to pay less premiums, but customers that are seen as unhealthy have to pay more.
In both scenarios, you, as the insurance company, still want to be minimizing the amount of care you actually pay for.
In other words, to maximize profits, it seems like the best customer is one that's high risk (high premiums), but less likely to require a catastrophic payout. In which case, it feels like an obese high risk patient on ozempic seems like a pretty solid deal.
> In the simplest terms, the 80/20 rule requires that insurance companies spend at least 80 percent of the premiums they collect on medical claims, effectively capping their profit margins. If insurers fall under this threshold, they must rebate the difference to policyholders.
Source: https://www.aeaweb.org/research/regulating-health-insurers-a....
So that would mean that the only way to increase the profit is to reduce over head and keep more of the 20% or increase the amount of claims. Paying out less in claims would mean they have to give rebates back to the customers.
As with everything health care related I'm sure it's more complicated than that and I'm missing something. For instance my health care plan is through my employer so everyone pays the same premium and the provider doesn't get to set it based on how healthy each employee is (although certainly the whole group is negotiated when the contract comes up for renewal).
Most people don’t change jobs or insurance companies every few years. When they do, it’s often within similar regions and industries so the chances of ending up right back under the same insurance company are significant.
Regardless, the issue is more complicated than your line of thinking. Insurance companies have very small profit margins. Current GLP-1 drugs are expensive, around $1,000 per month.
So each patient on GLP-1 drugs costs an extra $12K per year (roughly) or $120K per decade. That would have to offset a lot of other expenditures to break even from a pure cost perspective, which isn’t supported by the math. So the only alternative would be to raise everyone’s rates.
I know the insurance industry is the favorite target for explaining everything people dislike about healthcare right now, but at the end of the day they can’t conjure money out of nothing to cover everything at any cost demanded by drug makers. These drugs are super expensive and honestly it’s kind of amazing that so many people are getting them covered at all.
People with chronic health conditions spend an inordinate amount of time at the doctor and in hospitals. That could save a significant amount of money if that’s reduced or eliminated. Not to mention the time savings.
I could be wrong, but all things being equal doesn’t it make sense to spend $12k/year on medication than $12/year on doctor and specialist visits in addition to medication?
To put the this in perspective, where I live spends about $10,000/yr/person on health. That's all kinds of health. I'm not sure $5,000/yr (which is about the price here) of GLP-1 would be a generate proportionate decline, but I would not write it off. The $10K is paid by everybody, the $5k would only be for the obese.
I don't think that's too much of a factor?
I mean, check how much (or rather how little) people learn of the stuff that _is_ covered in school. Tweaking the curriculum would just mean that instead of not paying attention in algebra, students would not pay attention in 'health education class'.
I mean the education system is its own mess for other reasons, but it's not a complete failure