Real Talk | Insurance Companies


Real Talk | Insurance Companies

Dr. Murphy address insurance coverage when it comes to weight loss.

Yeah, we haven’t really even discussed this yet. Why do insurance companies not pay for people to lose weight? You would think they would. It’s the right thing to do. I mean, these people don’t understand why they’re doing the things they’re doing. They just know they’re gaining weight, but their insurance company, they won’t pay for a visit to my office. None of them hardly ever will. They’ll fight tooth and nail to pay for bariatric surgery. But the question becomes why? It would seem to almost make sense to the average lay person that paying for this would stave off a bunch of problems. And that’s true. The problem is when do these problems occur? Okay, so let’s walk this through the medical economics of our society. Well, we live to be roughly 77 years of age. And when you look at economics of healthcare, two-thirds of our healthcare dollars are spent in the last two to three months of life. So I’m 77 years old. I got two, three months to live. All, pretty much two-thirds of my healthcare dollars are going to be spent right there. I’m going to have a heart attack, wind up in a nursing home, have a stroke, need home health care, get cancer, need hospice. But this is where all the healthcare dollars are concentrated, two-thirds. So, if we knew when people were going to die, the exact date had little digital signatures on their wrist and we wanted to save, gosh, $700 billion a year. I say we start killing these people three months before they’re supposed to die. Well, we’ll save a lot of money doing that. But it stops, stands to reason then, well, let’s look at when your problems are occurring from chronic diabetes. I’ve lost my kidneys. Now I’m on dialysis. I’ve had high blood pressure because I’m overweight. Now I have heart attacks and strokes. Oh, I’ve got to have my knees replaced. Okay. And I’m in my seventies then that’s because I’ve been overweight all my life. And now my knees are breaking down. But none of these problems really happened before the age of 65. Well, before the age of 65, guess what? You’re not on Medicare. After 65, you are. And these insurance companies know this. You are no longer going to be their problem. You’re going to be a Medicare problem. And if you think the federal government’s going to pay for weight loss, they don’t have any money left. It’s over. So no. Do I think the insurance companies should pay for people to lose weight? Absolutely. The federal government should step in and demand this. And the reason why they should demand it is they’re going to be saving money on the long term to where it’s not going to cost them money when they turn, get to be age 77, 78. They’re going to be dying of old age. Great. There was no healthcare expenditure. Why can they not see this? And the reason why? That insurance lobby in Washington, DC. Ain’t nobody going to be changing those rules. These babies are making money. Insurance companies, profit margins, 10, 20%. Unbelievable. In healthcare, we’re lucky to make 1%, 2%. These guys are making money hand over fist. And when healthcare insurance, when they passed the Affordable Healthcare Act, I always thought this thing was going to be a joke. Well, it kind of turned out to be a joke. And I loved it when the federal government stepped in and said, oh, if you make more than 20, 30% profit, well, you got to give that money back. Well, I did get a check back that year for $1,800. That was back in 2010. So first and last time I got that check, I haven’t seen one since. And the only thing I do know is my insurance rates, they’ve been going up about $1 to $200 a month for the past 10 years. So I don’t see this slowing down anytime soon. Insurance companies are still making 20 to 30% profit. They keep saying it’s the rising cost of healthcare. I don’t know where it’s being risen at because the insurance companies sure are not paying me and reimburse me those rates. And I don’t think they’re reimbursing the hospital rates. But I think they have some creative accounting going on. I think they managed to not ever generate much more than 20% profit. Otherwise, they’d have to pay me back and they don’t want to pay old doc back any money. But that’s the reason why I think insurance companies don’t want to pay for it. It’s pure economic sense. It is a financial reason. If there was a financial benefit to losing weight, they would certainly implement that policy. They do penalize you for being overweight, but it won’t ever be their problem. They look at it, oh, you’re overweight, we’re going to charge you more insurance. Why? I’m not going to be a problem to you. I’ll be a government problem. Why are you charging me more? Oh, because they can. They like to. They get back to using that body mass index as a weapon. Oh yeah. Well, the guy that invented it is a Swedish epidemiologist 200 years ago and said, you know what? This really doesn’t work well for people. Works good for populations, but not good for people. Well, he’s apparently smarter than the insurance companies, but he’s been dead for 200 years now. So we can’t really dig him up and get his advice on this. But that’s why we’re not ever going to pay for weight loss. Not in my lifetime, I don’t think the insurance companies will ever be forced to do this. They should, but they won’t. I don’t understand it though. I mean, you lose weight, you’re taking off your diabetes medicine, you’re taking off your blood pressure medicine. This is good for you. It’s good for society. Bad for pharmaceutical companies. Great for the federal government. We can win here if we just do this.

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