The reigning Biden administration, on Tuesday, took yet another questionable step. They proposed to modify existing guidelines to obligate Medicare and Medicaid programs to bear the expense of Ozempic, Mounjaro, and Wegovy for those insured under such schemes. Currently, these initiatives do not facilitate coverage for weight loss drugs, and Biden’s team seems to be going out on a limb to change that.
Their proposed changes would supposedly grant access to prescription drugs to an estimated 3.4 million Medicare enrollees and an additional 4 million people using Medicaid. The supporters of this change argue that the alterations could trim down out-of-pocket costs related to weight loss drugs by an astounding 95% for some Medicare enrollees. However, could this just be smoke and mirrors?
The proposed changes will concentrate solely on those suffering from obesity, rather unfairly leaving out those who are simply overweight. They will only be able to benefit from this coverage if they are suffering from another medical condition such as diabetes. This selective approach is concerning.
This development arises in the wake of a study conducted earlier this month which revealed that about 75% of adult Americans are either obese or overweight. Seemingly using this study as a platform, Biden’s Department of Health and Human Services (HHS) made this contentious decision.
Their decision also conveniently aligns with recent criticisms about Ozempic and other weight loss medications. Last month, during a congressional hearing, it was noted that leading figures in the medical community along with lawmakers are backing Ozempic due to Novo Nordisk, the enterprise manufacturing the drug, being a massive contributor to medical research.
The dire situation was expressed perfectly with the statement that the stricken are a boon for the pharmaceutical industry because they are tied to medications for their entire lifetime. The speaker, Kennedy, added, ‘Picture the scenario when Medicaid commences payment for Ozempic, which charges a whopping $1,500 per month, and is now advised for children as youthful as six.’
This is all for obesity, a condition that is entirely avoidable and was almost non-existent a century back. The fact that they’re pushing this onto children as young as six is particularly worrying. Are we setting our younger generations up to become a lifetime income source for the pharmaceutical industry?
Kennedy posed an alternative approach where, instead of Biden’s current strategy of pushing for the use of weight loss medications to handle obesity, he turns towards a solution involving organic food. As he steps into the position of the head of HHS, he plans on laying great emphasis on organic diets.
Kennedy further stated, ‘Given that 74% of Americans are obese, the costs could potentially escalate to a shocking $3 trillion annually for Medicaid covering Ozempic. We could use just a fraction of that money to provide all Americans with organic food and entirely eradicate diabetes.’ His point seems to indicate an alternative solution which is far more reasonable and sustainable.
Interestingly, a majority of state Medicaid programs, as of now, do not cover weight loss drugs for obesity alone. Meanwhile, Medicare only extends coverage for these drugs for those who are obese or overweight and have been diagnosed with diabetes or cardiovascular disease.
These medications currently leave enrollees significantly out of pocket, forcing them to shell out as much as $1,000 a month. With added pressure on users, it’s no wonder that the Biden administration’s controversial proposal is causing more than a few eyebrows to raise.
A topic of fervent discussion has been the Treat and Reduce Obesity Act of 2023, which has been fervently discussed amongst lawmakers for over a year. This act would mandate insurance firms to cover Ozempic’s cost, an alarming move under the current context.
The administration’s move to adjust the rules to support medication coverage for obese individuals immediately brings to question the motives behind this and whether there might be underlying industry influences. It seems easy to promote medication use when the pharmaceutical industry is playing a major factor.
One must carefully consider whether providing easy access and coverage for weight loss drugs is the right way to address a problem which would be better tackled by lifestyle and dietary regulation. If this rule change goes through, it could set a dangerous precedent for treating symptoms over root causes.
Moreover, the significant potential costs associated with this decision, combined with the selective criteria for eligibility, present a model that critics may argue is not the most sustainable or fair in the long haul. It appears that the decision could have significant financial implications and may inadvertently neglect a large portion of the population.
While the intentions of the Biden administration might be to improve public health, the potential impacts and implications of their recently proposed rule changes prompt serious questions about appropriateness, efficacy, and long-term impacts. As always, the promise of quick-fix solutions should be viewed with a healthy dose of skepticism.