Last week the announcement that GLP-1’s would have price caps in 2026 was no surprise. Anyone following the GLP-1 industry knows that these meds are a phenomenon, a capitalist, not medical, breakthrough. With lowered prices and pill versions fast tracked, Ozempic et al. changed the landscape of the profitability of health care and the entire medical/diet/exercise complexes.
Rest assured, these changes are not related to the overall health of Americans. All signs point to a market too large for the current system to handle. Compounding pharmacies and online GLP-1 bodegas swept up the leftover profit with only a faint whisper of medical attention. The online companies have more in common with a smoke shop than a medical office.
No one knew what these meds were going to do to our society. Anyone and everyone feels drawn to the miracle shot and the fantasy, not reality, of a perfect body. From people who were minimally affected by media and thinness to those with lifelong eating disorders, people can’t escape the lure of the magic injectables.
Not only are the medications here to stay, but they also have changed medicine for good. After years of blaming patients for their various maladies due to being overweight, doctors now have a supposed cure at their disposal which is reinforced to patients every minute on social media, pressed upon clinicians by big pharma and suddenly available to most people by the government.
The next step is clear for medicine, even if the goal is a stretch for the zombie-like approach to medical care these days. Rather than follow the pharma company’s and health insurance juggernaut’s recommendations, doctors need to figure out how to use these medications wisely and simultaneously phase out the reliance on blame and shame about weight as an excuse not to practice medicine.
These medications help a large number of people by treating diabetes, regulating the gastrointestinal system, managing metabolism, decreasing inflammation and aiding in sobriety. Many people benefit from much lower doses than recommended, and the benefits of the GLP-1’s can buoy people to look to other ways to improve health. No doctor should treat the medications as a magic fix and absolve them of the responsibility for improved health.
These medications are likely to be the truest test to see if medicine can function with some autonomy from the capitalist system. Health care is a the fastest growing part of the economy. Financial firms are aware of the amount of money available in this industry, as evidenced by the investment in eating disorder treatment, for example. Doctors often work for large conglomerates now and find themselves drowning in bureaucracy and overwhelmed by messages from industries with ulterior motives.
Can GLP-1’s be an entree into practicing better medicine? Can doctors use this intervention to help patients see the benefit of preventative medicine? Can the lure of weight loss, the unabashed panacea of the medical establishment, help doctors speak more openly to patents about their actual health, not just weight?
Perhaps it’s an overreach to imagine such a sea change in health care, but access to these injectables will bring patients into the office and give doctors a captive audience to listen to broader ideas about health. Even more importantly, patents can start to trust doctors and the health care system again.
There is no point questioning the utility of these meds. They are here to stay. Instead, we need to accept the change and consider how medicine can improve from here.
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