Celebrity magazines are full of stories about the rich and famous losing weight quickly thanks to expensive weekly injections. Oprah, Kelly Clarkson and Elon Musk have said they have taken weight-loss drugs, and rumors of the Kardashians and Adele taking such drugs have made headlines.
But what about the rest of us? While new FDA-approved weight-loss drugs may give some of us a red carpet, they could save lives and improve the quality of life for people with Medicare insurance.
The Treat and Reduce Obesity Act of 2023 is currently before Congress (HR 4818, S.2407). At issue is whether drugs like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound will be included in Medicare Part D, the list of covered prescription drugs.
There is no debate about whether these drugs help people lose weight. Between 15 and 25 percent of body mass can be lost in just a few months. Oprah proves it. And there is agreement that significant weight loss in our older population increases life expectancy and mobility.
Obesity is a leading cause of heart disease, high blood pressure, type 2 diabetes and other serious illnesses. If we reduce obesity, the cost of open-heart surgery, home care for stroke patients, medical equipment and rehabilitation will also go down. If someone 65 or older can lose 30 pounds in three months and avoid expensive treatments, why not help them do so? Once the weight is off, older Americans will try to keep it off.
Let’s be cynical. Unless you’re an heir, you want this for your elderly relatives. Medicare pays for bariatric surgery. But instead of focusing on prevention, Medicare’s default position is “take care of it when it happens.” Seniors want to live long and productive lives while saving money. They’ve paid into a system their whole lives and deserve treatment that reduces avoidable Medicare costs. The debate in Congress is centered around the cost of drugs. (Unfortunately, it doesn’t address the needs of our seniors.)
Will more money be spent or saved if weight-loss drugs are included in Medicare coverage? The Congressional Budget Office looks at only half of the equation. It estimates the cost of providing weight-loss drugs, but makes no attempt to determine how much it might save. How can the CBO know if it is cost-effective without considering the cost of the savings? It can’t.
Two things are certain: Congress has money for some people, but not for our own elderly population. And Congress would rather pay for emergencies than help seniors avoid disability, death, and long-term care. It’s all about the money.
Obesity affects 42% of all adults in the U.S. and costs Medicare $92.1 billion a year (the total cost for those not covered by Medicare is estimated at $200 billion to $500 billion). The potential savings offered by the new drugs are staggering. The Schaefer Center for Health Policy & Economics at the University of Southern California estimates that $245 billion could be saved over the next decade. (The Schaefer Center receives funding from pharmaceutical companies.) Costs go down as weight goes down.
Over 10 years ago, the FDA declared obesity a disease, yet current law does not reflect that classification or attempt to address this American epidemic. The outdated Medicare Modernization Act of 2003 should be amended to cover obesity treatment, and weight loss drugs should be added to Medicare Part D. Ask Congress to pass the Treat and Reduce Obesity Act. Tell them you want to live healthier and longer. You’ll pay taxes even in retirement and you’ve earned the help that’s available now. And say you want it now.
