Right now, we are witnessing a great withdrawal from healthcare, especially for people living with obesity. Many people are losing health insurance coverage altogether because it has become unaffordable. Many others are finding that their insurance will no longer pay for the care they need – if they want the care, they must have the cash. For many people living with obesity, this became an overwhelming problem with the beginning of the new year.

Living a Nightmare

Joseph Zucchi is a physician associate in New Hampshire specializing in obesity medicine. He explains the nightmare he is living:

“We are witnessing a system-wide ‘rug pull.’ I have patients who have lost over 100 pounds, resolved their sleep apnea, and have no more joint pain. They were doing amazing! Then, coverage was cut on January 1. No weaning, no grandfathering, not a slight price increase … just a hard stop.

“If we did this to a patient with cancer or diabetes, cutting off a therapy that was clearly working, it would be considered unethical. Yet because it is obesity, insurers pull the plug with no hesitation.

“For the plans that actually do cover these medications, the prior authorization process has become a nightmare. I have been in the office till 9 pm many nights trying to keep up.”

Money Talks

The idea that money talks may go all the way back to Euripides in the 5th century BC. But it is certainly getting new life in 21st century American healthcare. As health insurance becomes unaffordable, providers are dealing with an influx of self-pay patients. Lilly and Novo Nordisk are dealing with price and insurance pressures with new offers to patients who have the financial resources to pay $200 or $350 per month out of pocket for a GLP-1 to treat obesity.

But that leaves many working class people out in the cold. Increasingly, money talks in healthcare and everyone else walks – if they don’t have the cash to pay for healthcare.

Economic Failure

This is not working. A new scientific statement from the American Heart Association provides great detail on the social, economic, and structural barriers that keep communities most affected by obesity from getting care and effective prevention for this, America’s most prevalent chronic disease.

Letting money talk is not a strategy for a healthy population or a healthy economy. Because without healthy people, we cannot have a healthy economy. Some things really are simple and this is one of them.

People need good care for good health. It should be within reach for all.

Click here to read more of Zucchi’s observations of what’s unfolding in obesity care. For more on self-pay trends, click here. For the AHA statement on social and economic barriers to addressing obesity, click here.

Satirical Bryan Money, photograph by Steve27K, licensed under CC BY-SA 4.0