5 ms·

I de facto require semaglutide due to the side-effects of the only anti-depressant I'm able to tolerate (I've titrated up and down on 17+). Unfortunately, I cu

I de facto require semaglutide due to the side-effects of the only anti-depressant I'm able to tolerate (I've titrated up and down on 17+). Unfortunately, I currently don't have health insurance and hovering at 35% excess weight. There's no point in my going to a doctor when all of their recommendations are "window shopping". The only way this shit stops is not Medicare for all, which is a red herring with third-class coverage, surprise costs, and still run by for-profit corporations. The ultimate solution is universal healthcare for all and making for-profit health insurance illegal. This can only happen when (low-information) voters stop shouting FUD like "Communism", "rationing", "waiting lists", "big gubberment reg-u-lation", and "death panels". Every other free country in the world has better outcomes, healthier citizens, and lower costs. The root cause is unregulated profiteering that cannot be changed at present because of regulatory capture, corrupt politicians, and the lack of people organized and protesting about it.

hippich 3y ago
While it is not the answer to the problem you stated, just in case, there are companies selling "research only" peptides including semaglutide. And depending on you risk tolerance, are viable alternative.
- mynameisnoone 3y ago
  I'm not going to go to some crack dealer to get a medication that requires refrigeration. This is a systemic problem. Also, semaglutide will be soon available in pill form. Semaglutide and metformin are the most revolutionary medications to prevent the most common and expensive diseases and improve life quality. One issue is that there is also a lack of longitudinal, evidence-based prophylaxis policy even in Medicare (the budget, third-rate health insurance for disabled and poor people) that waits until someone has suffered irreparable harm to then intervene with expensive care reactively. America is all about waiting until people are in the ER to do anything, and then drive them into bankruptcy while they're dying. I wonder how many people outside of Americans have met people with terminal cancer in the midst of bankruptcy proceedings with the hospitals pounding at the door to take everything they have while they're dying.
SnorkelTan 3y ago
Gastric bypass? Has the benefit of being a onetime payment instead of in perpetuity.
- frumper 3y ago
  I’m sure some people have, but of the half dozen people I know to have gotten a gastric bypass, all of them were about where they started no more than 5 years later.
  - jonex 3y ago
    Weight gain does often happen a few years post treatment. Even then it's beneficial compared to no intervention, which would most likely have them be even worse off five years later. Long term health outcomes are better for those who get treatment than those who don't.
  - SnorkelTan 3y ago
    Are you sure they got gastric bypass and not lap band? All the people I know that got the bypass has lost significant quantities of weight. The bypass surgery essentially greatly reduces/removes the stomach from the digestion equation and greatly reduces the efficiency of digestion. The lap band is a rubber band around the stomach which makes it harder to consume large quantities of food, but has a higher chance of being ineffective. I’m overweight myself but it’s not medication related. I’ve been using behavior modification using cbt paired with diet and exercise. The cbt was a recent addition since I’ve regressed several times with just diet and exercise alone.
- mynameisnoone 3y ago
  Fuck no. You first.
kube-system 3y ago
> The ultimate solution is [...] making for-profit health insurance illegal. > Every other free country in the world has [...] ... and most also have private health insurance too. Some have a higher percentage of people with private health insurance than even the US does, often in a supplementary role.
- wharvle 3y ago
  Yep. The single thing they all seem to do that the US doesn’t isn’t eliminate private health insurance, but institute price controls—one way or another. Some with literal price sheets (Japan), others by creating a government-controlled monopsony of some sort (Canada), others by taking over healthcare providers themselves so the government can set prices (er, well… compensation) directly (the UK). Well, and I’m not sure any others have a problem like we do with the AMA.
- dmos62 3y ago
  Private or public doesn't really matter as long as the prices are sensible. I recently learned that you can pay as much as 1k dollars a month (not a typo) for regular health insurance in US, whereas I pay ~55 euros a month for mine. Median salary here is around 1k euros a month. I pay around 15-25% taxes.
- nielsbot 3y ago
  (Not sure if you're arguing for or against a privatized health insurance system) I guess that countries that provide public health insurance don't have people skipping doctor visits because of costs, even if the majority of residence also have private insurance.
  - kube-system 3y ago
    I’m not arguing for either. I’m just pointing out that the “other countries” the parent commenter is referring to as a benchmark didn’t eliminate private health insurance.
- otikik 3y ago
  Well we do know how much we are going to get charged by private hospitals, at least.
s3p 3y ago
100% agree. Also, just wanted to say that having used semaglutide myself I really empathize with your situation. I had struggled with an eating disorder to varying degrees of success for about 5 years before I found semaglutide. Suddenly my mental fixation on food was gone and I finally felt what it’s like to have a normal relationship with food. The medical landscape in the US is fucked and I hope it changes. Drugs like these would be much better if they weren’t governed by profit seeking companies.
freddie_mercury 3y ago
Wait, do you think every other free country in the world has made private health insurance illegal?
- mynameisnoone 3y ago
  Don't be silly. The smart ones have for good reason.
rolisz 3y ago
FYI, you might be out of luck in other countries: in Romania (where I live) semaglutide is made available for free only for diabetics. If you want it for off label usage, you'll pay for it. In Hungary, it's illegal for doctors to prescribe it to non diabetics, so good luck getting it off label.
ars 3y ago
Absolutely none of the insults you wrote have any connection with healthcare issues. The actual issue is way way simpler: Doctors and other healthcare works make too much money for it to be affordable for everyone. That's it, it's as simple as that. Compare Dr salaries to other countries. Doctors in the US make 2 to 10 times as much as other counties. (Google it if you don't believe me.) And they make so much because there is not enough supply. And colleges take advantage of that and charge insane tuition. Want to actually change things? Start educating way way way more Doctors, and encourage people to go to low cost universities (which do exist - but everyone wants "the best"). See: https://www.advisory.com/daily-briefing/2022/02/16/physician-shortage https://www.advisory.com/daily-briefing/2022/02/16/physician...
- genocidicbunny 3y ago
  > Compare Dr salaries to other countries. Doctors in the US make 2 to 10 times as much as other counties. This is slightly unfair if you don't consider the cost and time of becoming a doctor. That is not to say that the AMA doesn't purposely enforce a shortage as an attempt to drive up wages, but many doctors spend the better part of a decade (or more) before they're really earning any reasonable amount, and they have large debts from paying for school. > Start educating way way way more Doctors Yes. But that will hurt those who are already doctors somewhat, so there's a strong incentive to limit the pool. > encourage people to go to low cost universities (which do exist - but everyone wants "the best"). These don't really exist in any reasonable amounts. You also have to consider how much of a doctor's education is outside of a university. And it does make a difference which hospitals you have your rotations and residency at. If you want to be doing EM, you're not going to want to end up in some sleepy town in the midwest where the most that happens is some drunk dude needing his stomach pumped. If you want to end up being in a specific field, your choices tend to be relatively limited in where you can actually get the education and experience you need for that specialty. Anyways, all that is mostly to say that the healthcare 'system' in the US is a clusterfuck for many interconnected (and entangled) reasons and there is no one simple issue to address.
slipandafall 3y ago
I think it's the over regulation of the industry that's causing the issues. A medical degree AND at least 1 year of residency are required to be licensed to practice, which is fine. But congress capped the amount of residency slots in 1997 due to fears of having to many doctors and hasn't raised it pretty much since. So yes, "big government regulation" and central planning aka communism has caused this issue. Those companies and individuals that are profiteering off of this situation are also to blame, but not nearly as much blame as the whole of congress.
- mynameisnoone 3y ago
  This is a really sophomoric, conspiratorial, uninformed take. Doctors aren't the problem. It's the for-profit engines of corporate hospitals, insurance, and big pharma.
  - slipandafall 3y ago
    I never said doctors were the problem, I said congress was the major cause of the problem by limiting the amount of residency slots based on incorrect predictions. Those for-profit engines do have an effect but they're just playing by the rules established by congress. Not sure where you got conspiratorial or uninformed, here's the study that guided the decision making [1]. I will take sophomoric since I don't know a damn thing about this industry, but both left and right are recognizing the problem and trying to get something done about it which is what we need more of[2]. [1] - https://eric.ed.gov/?id=ED210990 https://eric.ed.gov/?id=ED210990 [2] - https://www.ualrpublicradio.org/local-regional-news/2023-05-03/u-s-sen-john-boozman-introduces-bill-aiming-to-address-physician-shortage https://www.ualrpublicradio.org/local-regional-news/2023-05-...

hippich 3y ago

While it is not the answer to the problem you stated, just in case, there are companies selling "research only" peptides including semaglutide. And depending on you risk tolerance, are viable alternative.

mynameisnoone 3y ago
I'm not going to go to some crack dealer to get a medication that requires refrigeration. This is a systemic problem. Also, semaglutide will be soon available in pill form. Semaglutide and metformin are the most revolutionary medications to prevent the most common and expensive diseases and improve life quality. One issue is that there is also a lack of longitudinal, evidence-based prophylaxis policy even in Medicare (the budget, third-rate health insurance for disabled and poor people) that waits until someone has suffered irreparable harm to then intervene with expensive care reactively. America is all about waiting until people are in the ER to do anything, and then drive them into bankruptcy while they're dying. I wonder how many people outside of Americans have met people with terminal cancer in the midst of bankruptcy proceedings with the hospitals pounding at the door to take everything they have while they're dying.

SnorkelTan 3y ago

Gastric bypass? Has the benefit of being a onetime payment instead of in perpetuity.

frumper 3y ago
I’m sure some people have, but of the half dozen people I know to have gotten a gastric bypass, all of them were about where they started no more than 5 years later.
- jonex 3y ago
  Weight gain does often happen a few years post treatment. Even then it's beneficial compared to no intervention, which would most likely have them be even worse off five years later. Long term health outcomes are better for those who get treatment than those who don't.
- SnorkelTan 3y ago
  Are you sure they got gastric bypass and not lap band? All the people I know that got the bypass has lost significant quantities of weight. The bypass surgery essentially greatly reduces/removes the stomach from the digestion equation and greatly reduces the efficiency of digestion. The lap band is a rubber band around the stomach which makes it harder to consume large quantities of food, but has a higher chance of being ineffective. I’m overweight myself but it’s not medication related. I’ve been using behavior modification using cbt paired with diet and exercise. The cbt was a recent addition since I’ve regressed several times with just diet and exercise alone.
mynameisnoone 3y ago
Fuck no. You first.

kube-system 3y ago

> The ultimate solution is [...] making for-profit health insurance illegal. > Every other free country in the world has [...] ... and most also have private health insurance too. Some have a higher percentage of people with private health insurance than even the US does, often in a supplementary role.

wharvle 3y ago
Yep. The single thing they all seem to do that the US doesn’t isn’t eliminate private health insurance, but institute price controls—one way or another. Some with literal price sheets (Japan), others by creating a government-controlled monopsony of some sort (Canada), others by taking over healthcare providers themselves so the government can set prices (er, well… compensation) directly (the UK). Well, and I’m not sure any others have a problem like we do with the AMA.
dmos62 3y ago
Private or public doesn't really matter as long as the prices are sensible. I recently learned that you can pay as much as 1k dollars a month (not a typo) for regular health insurance in US, whereas I pay ~55 euros a month for mine. Median salary here is around 1k euros a month. I pay around 15-25% taxes.
nielsbot 3y ago
(Not sure if you're arguing for or against a privatized health insurance system) I guess that countries that provide public health insurance don't have people skipping doctor visits because of costs, even if the majority of residence also have private insurance.
- kube-system 3y ago
  I’m not arguing for either. I’m just pointing out that the “other countries” the parent commenter is referring to as a benchmark didn’t eliminate private health insurance.
otikik 3y ago
Well we do know how much we are going to get charged by private hospitals, at least.

s3p 3y ago

100% agree. Also, just wanted to say that having used semaglutide myself I really empathize with your situation. I had struggled with an eating disorder to varying degrees of success for about 5 years before I found semaglutide. Suddenly my mental fixation on food was gone and I finally felt what it’s like to have a normal relationship with food. The medical landscape in the US is fucked and I hope it changes. Drugs like these would be much better if they weren’t governed by profit seeking companies.

freddie_mercury 3y ago

Wait, do you think every other free country in the world has made private health insurance illegal?

mynameisnoone 3y ago
Don't be silly. The smart ones have for good reason.

rolisz 3y ago

FYI, you might be out of luck in other countries: in Romania (where I live) semaglutide is made available for free only for diabetics. If you want it for off label usage, you'll pay for it. In Hungary, it's illegal for doctors to prescribe it to non diabetics, so good luck getting it off label.

ars 3y ago

Absolutely none of the insults you wrote have any connection with healthcare issues. The actual issue is way way simpler: Doctors and other healthcare works make too much money for it to be affordable for everyone. That's it, it's as simple as that. Compare Dr salaries to other countries. Doctors in the US make 2 to 10 times as much as other counties. (Google it if you don't believe me.) And they make so much because there is not enough supply. And colleges take advantage of that and charge insane tuition. Want to actually change things? Start educating way way way more Doctors, and encourage people to go to low cost universities (which do exist - but everyone wants "the best"). See: https://www.advisory.com/daily-briefing/2022/02/16/physician-shortage https://www.advisory.com/daily-briefing/2022/02/16/physician...

genocidicbunny 3y ago
> Compare Dr salaries to other countries. Doctors in the US make 2 to 10 times as much as other counties. This is slightly unfair if you don't consider the cost and time of becoming a doctor. That is not to say that the AMA doesn't purposely enforce a shortage as an attempt to drive up wages, but many doctors spend the better part of a decade (or more) before they're really earning any reasonable amount, and they have large debts from paying for school. > Start educating way way way more Doctors Yes. But that will hurt those who are already doctors somewhat, so there's a strong incentive to limit the pool. > encourage people to go to low cost universities (which do exist - but everyone wants "the best"). These don't really exist in any reasonable amounts. You also have to consider how much of a doctor's education is outside of a university. And it does make a difference which hospitals you have your rotations and residency at. If you want to be doing EM, you're not going to want to end up in some sleepy town in the midwest where the most that happens is some drunk dude needing his stomach pumped. If you want to end up being in a specific field, your choices tend to be relatively limited in where you can actually get the education and experience you need for that specialty. Anyways, all that is mostly to say that the healthcare 'system' in the US is a clusterfuck for many interconnected (and entangled) reasons and there is no one simple issue to address.

slipandafall 3y ago

I think it's the over regulation of the industry that's causing the issues. A medical degree AND at least 1 year of residency are required to be licensed to practice, which is fine. But congress capped the amount of residency slots in 1997 due to fears of having to many doctors and hasn't raised it pretty much since. So yes, "big government regulation" and central planning aka communism has caused this issue. Those companies and individuals that are profiteering off of this situation are also to blame, but not nearly as much blame as the whole of congress.

mynameisnoone 3y ago
This is a really sophomoric, conspiratorial, uninformed take. Doctors aren't the problem. It's the for-profit engines of corporate hospitals, insurance, and big pharma.
- slipandafall 3y ago
  I never said doctors were the problem, I said congress was the major cause of the problem by limiting the amount of residency slots based on incorrect predictions. Those for-profit engines do have an effect but they're just playing by the rules established by congress. Not sure where you got conspiratorial or uninformed, here's the study that guided the decision making [1]. I will take sophomoric since I don't know a damn thing about this industry, but both left and right are recognizing the problem and trying to get something done about it which is what we need more of[2]. [1] - https://eric.ed.gov/?id=ED210990 https://eric.ed.gov/?id=ED210990 [2] - https://www.ualrpublicradio.org/local-regional-news/2023-05-03/u-s-sen-john-boozman-introduces-bill-aiming-to-address-physician-shortage https://www.ualrpublicradio.org/local-regional-news/2023-05-...