Semaglutide is the microcosm for the failed American insurance system

Well, since he is taking phentermine, apparently he got something covered.

 

This is what is wrong with this country. Instead of people saying "Sorry I was wrong" when proven wrong, they want to double down and say even more when they don't have all the facts again. Facts like he is paying for the drug out of pocket because the vast majority of insurance companies do not pay for FDA approved weight loss drugs. Now would you like to triple down and be wrong a 3rd time or finally be an adult and say "Sorry I was wrong I didn't have all the information." ?

 

So you have no problem paying out of pocket for the cheap drug, but you do have a problem with the expensive drug. Understandable, but the insurance company doesn't set the prices.

Are you old enough to remember the world before drug ads on TV?

There is ample evidence that people going to doctors and asking for specific drugs, based on word of mouth and TV advertising, is terrible for patient outcomes. There is evidence that most of the time doctors prescribe whatever is being asked for with very little reason. It's why drug advertising has become such big business. Most of the big drug companies spend multiple times as much on marketing as research.

Any time you go to the doctor and say, "I want this drug because I heard about it on the internet/saw it on TV", that is not a clinically valid reason to chose one drug over another, but it happens all the time.

None of this is the insurance company's fault.

Again, this is a drug APPROVED BY THE FDA FOR USE IN TREATING DIABETES.

Get it approved for weight loss, and you have a case.

 

Ahhhh there is the Triple down. You have moved the goal posts. Now doctors suck because they are prescribing a drug which is FDA approved for the condition and has been shown to work. Funny how you don't say anything about the retail cost of heart medication, cancer medication, etc. Just a weight loss drug, when obesity is the largest cause of other medical issues. Reduce obesity and you reduce other health issues. So either you are a shill for the insurance industry or you have an issue with overweight people. Wanna go for four now?

 

I sent you the link. You chose not to read it. Wegovy is approved for weight loss.

https://www.fda.gov/news-events/pre...reatment-chronic-weight-management-first-2014

 

My insurance company pays for all the on label drugs I've been prescribed. Never had a problem. If you want to talk about pharma bro Martin Shkreli jacking prices, again not an insurance issue - a drug company issue. Most of the heart medications people take are old and cheap as dirt. Same with cholesterol and blood pressure medications. That's one of the big reasons they prescribe them. There are newer, shinier drugs, but people dont go into their doctors offices and demand the newest drugs. Or someimes they do but it there is plenty of literature about the issues with that.

https://www.health.harvard.edu/medications/do-not-get-sold-on-drug-advertising

 

How did you "send it to me"? I have never received anything from you as far as I know.

 

Sorry I meant in a previous reply. Post # 60, which you replied to but completely ignored the link.Have you ever been prescribed a weight loss drug? We aren't talking about jacking up the price. Most insurance companies exclude weight loss drugs. Go on you your insurance company's website and price Wegovy. 9 times out of 10 it will not be covered even though it is approved for weight loss by the FDA. Also insurance formularies are well known for not covering certain drugs. If there are 2 competing drugs they will cover one and not the other. Back before indigestion medications were OTC my coverage would change every year based upon which drug gave the best price.

 

You're right I know people with asthma who get their prescriptions denied all the time because the insurance company wants to go with the cheaper drug not the better on.

 

There are multiple problems here. Yea insurance companies want to save money and will rather cover cheaper medications than more expensive ones even if they are prescribed by doctors.

Doctors are in many cases over prescribing drugs because there is a lot of advertising and marketing for prescription drugs both to doctors and consumers.

Because many drugs address related or different conditions we’ve been seeing drugs meant for one use being prescribed and even over prescribed for another condition leading to higher costs and shortages of the medication for the original condition it was created for.

Our healthcare system and society in general is very poor at dealing with basic health and prevention as such we’re seeing preventable conditions getting worse. By the time people seek treatment these conditions are often harder and more expensive to treat.

 

I still haven't fully understood the health insurance system in the US.

Like, I could afford the best health insurance available - but I don't understand which one that would be. We are currently on some stupid expat insurance which costs like 100k a year for my family, and it basically just uses random US plans where you have to call to get their ok to visit certain doctors, and it is never really clear if a doctor is "in network" or not, just a dumbass process. If someone could tell me, this is the gold standard, best, most expensive plan in the US, but hassle-free, I'd appreciate it.

As to the weight loss drugs - I recently spoke with the Chief Medical Officer of a very large health system in the US, and he was very concerned that these weight loss drugs would bankrupt the US health system.

My wife is a doctor, and she says that the way they work is basically just to suppress your appetite, so you end up eating less.

To me, that kind of begs the question, why should society pay for you to take a drug to suppress your appetite and eat less, when you should really be able to achieve that on your own?

I'm 6'6, 220 lbs now. During the pandemic, I somehow went up to 235 lbs. Due to professional interest in it, I played around with continuous glucose monitors (Abbot Freestyle Libre). Realized that my glucose levels were a bit too high. Now, I'm half German, half Korean, and love Italian food. So, basically, I like potatoes, rice, bread, pasta - almost like a "carb only diet" I have been on all my life. So anyway, out of professional interest, I slapped on a continuous glucose monitor for a few weeks in a row, and tried to cut out carbs almost completely. Ate a lot of stuff I like anyway, like berries, red peppers, tomatoes, etc., and a bit more salad. Drank "bulletproof coffee" in the morning (coffee with butter in it, kind of fills you up and you won't want to eat all that much).

Went from 235 to 205 lbs in like 4 weeks. Was totally easy, and kind of fascinating to see how big the impact of a change in diet was.

Of course, once I stopped measuring my glucose levels, I went back to a lot of my old eating habits, and having permanent access to huge country club buffets in the US hasn't necessarily helped lol, so I am back to about 215-220 (varies a bit). But I have been playing tennis so much (when I was not traveling) that when I used a CGM again for 14 days, my base glucose levels seemed to be down by about 10, and I seemed to have much lower/fewer spikes even when eating the stuff that used to give me very large spikes previously. So I think it is all connected. More exercise, more sleep, less carbs.

The "less carbs" is the most important part, in my opinion, if you want to lose weight.

I am not affiliated with this startup, but I would recommend looking into it: https://www.levelshealth.com/ - basically, I think that you need a prescription to get a CGM in the US, and they make that really easy to get. They then kind of coach you into monitoring your glucose and looking at what foods cause you glucose spikes.

Try that for a month?

There are also other companies which offer some kind of overall health coaching/diet coaching, like https://gyrosco.pe/ - again, I am not affiliated, but I tried this and thought it was interesting.

I understand that different people have different genetic predispositions to gaining weight (my wife has a much healthier diet than I do (eats almost no carbs or sweets) and eats a lot less, yet, I look lean and she looks "feminine").

But if you think about it - you already know what needs to be done - cutting out sweets, processed foods, carbs, sodas will have a big impact rather quickly - but rather than owning it and taking action yourself, you are blaming "the system".

Of all the different health tracking things I have tried (Oura Ring, Apple Watch, Withings Watch, Withings Sleep Mattress, Samsung Galaxy Watch, Whoop, Fitbit, Withings Scales, Withings Blood Pressure Monitor, etc. etc.), I found the Abbott Freestyle Libre continuous glucose monitor by far the most insightful thing. Looking past glucose tracking/supporting weight loss, people are now using it also to look into the connection of glucose to athletic performance, see https://www.supersapiens.com/.

Anyway, good luck - I know it seems hard - but it's definitely possible to lose weight without the weight loss pills. As far as I know, they are like the perfect recurring business model for the pharma companies (no wonder Novo Nordisk's market cap is larger than the GDP of Denmark...), because once you stop taking them, you just put the weight back on again, so you are basically on a never ending subscription. So it seems much more reasonable to try other ways to lose weight first.

P.S.: These drugs are often also not without side effects...little anecdote, a friend of mine, a doctor in Germany who is very active on Raya and constantly dating hot chicks, not obese at all, self-prescribed Ozempic for whatever dumbass reason, gave himself an injection just before a date with a super hot Swedish chick, then started feeling extremely nauseous during the date and threw up all over the place LMAO. Well-deserved.

 

The Dexcom is better than the Libre

 

What makes it better? (I haven't tried it.)

 

It is more accurate. It gives you alerts if you are trending low before you hit a low. Honestly though for your purposes it doesn't matter. You aren't diabetic so the little differences don't matter as much.