This Worries Me Not One Whit

It turns out that people are using GLP-1 drugs to game insurers, and all I feel is schadenfreude. 

Basically, if you go on GLP-1 drugs like Ozempic for a few months, you can mask a whole bunch of comorbidities, like type 2 diabetes, obesity, cholesterol levels, etc. for a few months.

You can get the drugs more or less anonymously online, and when you go to your insurance exam, you are svelte, your cholesterol and A1C levels, and your sugar levels are good.

So, the underwriters look at the numbers, and you pay less for insurance, and you "win" when you die young.

Anything that hurts insurance companies, and in so doing reduces the money that they have for creating political influence, is OK by me:

I've just got back from HLTH in Amsterdam, nursing what might be the worst three-day hangover of my adult life. Worth it, though. It's one of the best health tech events in Europe, and I made some genuinely great connections.

………

Now, while everyone else obsessed over AI (shocking, I know), I was laser-focused on GLP-1s. One throwaway comment during a private equity panel sent me down a rabbit hole on insurance companies grappling with the weight-loss drug explosion.

The downstream effects are completely fascinating and completely overlooked. I spent the rest of the conference hunting down insurance people who were all asking the same question: how the hell do we deal with this?

Turns out, they have good reason to panic.

Life insurers can predict when you'll die with about 98% accuracy.

This ruthless precision comes from from decades and decades of mortality data they use to figure out how much to charge you every year, so that the money they earn (from you and by investing your premiums) will easily cover what they'll need to pay out later.

………

Typically, underwriters- suspiciously sounds like undertakers-rely on a handful of key health metrics like HbA1c, cholesterol, blood pressure, and BMI to calculate your risk of dying earlier than expected (and thus costing them money).

Those eagle-eyed readers among you have probably noticed something interesting already. Those same four metrics are exactly what GLP‑1s improve. Not just a little, but enough to entirely shift someone's risk profile within at least 6 months of using them.

………

Let’s say a 42-year-old applies for life insurance:

• They self-report a BMI of 25 (healthy)
• No visible co-morbidities in claims data
• No prescription record shows Sema/Tirzepatide
• Labs within normal range

The insurer sees a ‘mirage’ of good health and approves them as low-risk.

But in reality:

• They were obese a year ago (BMI 32)
• Lost around 14kg using GLP-1s from a D2C provider (no detail on their electronic health record)
• Still have underlying metabolic syndrome

………

Insurers call this type of screw-up "mortality slippage."  

Basically, people are pretty good about giving themselves an injection for a few months, but over a 109 year period, most of them drop off the proverbial wagon, which means that their risks go up.

Oops.