If you’ve done any traveling lately, like I have, you’ve probably spent a lot of time in airports. If you look around an airport, you’re struck by an undeniable fact – many Americans are obese. What can be done about this?
Grace-Marie Turner, writing for Galen.org, says obesity is a serious health problem for millions of Americans. In fact, about 42% of Americans are living with obesity. The association with other chronic conditions including heart disease, Type 2 diabetes, and stroke is incontrovertible.
Obesity also has been identified as one of the greatest risk factors for severe COVID-19 infection and death, and its burden does not fall equally on all communities. It is a particularly significant concern for communities of color. A newer generation of innovative anti-obesity medications (AOMs) is emerging that can provide another treatment option for those living with obesity. But not all health plans cover these drugs, and under current law, few seniors have access to them through Medicare.
Medicare doesn’t currently pay for many of these drugs in an effort to save money. Medicare already is going broke, but its bankruptcy will be accelerated if it continues to pay for care only to treat diseases instead of allowing a broader range of treatment options to help get and keep people healthy. Both political parties stress their commitment to Medicare, and it is important to identify ways to improve the health of the Medicare population to reduce overall medical costs. Covering AOMs would be an important step in that direction.
When former President George W. Bush promoted creation of the Medicare drug benefit in 2003, he argued Medicare needed to be reformed “because it did not provide prescription drug coverage.” “Medicare would pay for a surgery, say, like ulcer surgery, for $28,000,” he said, “but wouldn’t pay $500 for the prescription drugs that would have prevented the ulcer in the first place.” Mr. Bush argued that “medicine had changed with the advent of prescription drugs, but Medicare hadn’t.”
This was a step forward to getting badly needed prescription drugs into the hands of seniors who needed them most. But not all drugs were eligible. The Medicare Modernization Act (MMA) passed in 2003, and the Medicare Prescription Drug Benefit (Part D) program it created began covering seniors in 2006. But the legislation banned coverage for medicines or classes of medicines “when used for anorexia, weight loss, or weight gain.” And the ban still stands. And the results speak for themselves – just look around the airport!
In a classic example of Medicare policy gone awry, today Medicare will pay for expensive bariatric surgery – the last-resort of treatment for the morbidly obese – as well as treatments for more than 200 comorbidities linked to obesity such as certain cancers, dementia, and Alzheimer’s disease, but not for new treatments that scientists have developed that can address the disease itself. Only the government could come up with such utterly ridiculous healthcare policy.
This policy is costing American lives and money. A study by Harvard University researchers found that annual medical costs for adults living with obesity were $1,861 higher than medical costs for people of healthy weight and $11,481 higher for people with severe obesity. A study by Brookings Institution scholars found that people living with obesity have nearly 36% higher average annual health costs compared to healthy-weight individuals.
An unlikely alliance of groups is coming together to urge Congress to allow coverage of anti-obesity medications in Medicare. “It’s not every day that the pharmaceutical industry, the NAACP, a cancer center, and a nonpartisan think tank are all lobbying to achieve the same policy goal,” an article in STAT reads. “But an effort to expand Medicare coverage for obesity drugs has managed to unite them all, and many more groups across the health care industry, too.”
It’s time America woke up to the alarming obesity problem in our population. The problem threatens the lives of many Americans, the healthcare budget of the nation, not to mention the availability of many of our youth for military service. There is some indication, however, that Americans are aware of the problem. They rated obesity as the second greatest threat to public health, after opioids and fentanyl in a recent Axios-Ipsos American Health Index survey.
Turner summarizes, “Prevention saves money and lives. As the obesity problem grows, patients should be able to choose for themselves, in consultation with their physicians, from a full range of treatment options, including innovative anti-obesity medications.”
That would be a healthcare policy that actually makes sense!
