Comment by doctorpangloss
2 months ago
another POV is he was extremely lucky
Pfizer decided to NOT commercialize its GLP-1 drug (https://www.statnews.com/2024/09/09/glp-1-history-pfizer-joh...) in 1992.
What if it had commercialized GLP1s?
The law that prevented Medicare from paying for weight loss drugs like GLP1s, the MMA, was passed in 2003. So Medicare would have to pay.
YEAR NOM. ADJ 23 NET NET ($B) ($B) 10% 100%
1998 69.2 129.4 102.6 -138.6
1999 125.6 229.7 202.9 -38.3
2000 236.2 417.9 391.1 149.9
2001 128.2 220.6 193.8 -47.4
Okay, only 4 surplus years. 10% uptake of GLP1s, okay, they'd be in surplus. 100% uptake, it would be a deficit.
Any number of things could have happened. This was just one thing that definitely was completely in control of people - it was in the control of Pfizer's commercialization team - it wasn't some unforeseeable crisis.
My point is, the little HN takes here and there like yours, better to not make them, because frankly you don't know anything about the budgeting process or governance, so why say anything at all?
I don't doubt he was lucky which is why I parenthetical referred to the dot com boom. I don't quite understand the relevancy of GLP1s to his luck. I think obesity wasn't what it is today back in the 90's.
I think the saying is Luck rewards the prepared.
I mean, luck is always a part of it, but you need responsible policy too. The US was lucky from 2010 to 2020, with the the economy growing basically that whole stretch, and we still ran a massively growing deficit the entire time because we decided to try and reform the middle east while lowering taxes.
A really important detail that I don't think gets enough mention is that the second gulf war was paid for off the books. The war was not part of the federal budget.
would his policy have been to pay for GLP1s? Yes. And is that a little more than a hypothetical? yes. People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college).
I'm unable to follow the point of the significance of GLP1s. I also wouldn't describe the expense as biotech I think healthcare is a better description.
Finally the US's current healthcare system is truly broken. Our elected officials choose to ignore the issue and act as if we are fortunate to have this system. Which must be the least efficent way to deliver healthcare.
> People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college).
That's just wrong. Social Security, Medicare, debt interest, and the military eclipse everything else. Discretionary spending outside the military is only like 15% of the budget.
Also, why are you even connecting GLP1 drugs and the 90s federal budget surplus? The drugs didn't exist back then, and the government isn't paying for everyone to take them now, so I have no idea why you'd even draw a connection there.
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