South Park’s Scathing Critique of US Healthcare

Promo for new South Park episode, The End of Obesity

The End of Obesity, a new episode of the viciously satirical cartoon series, South Park, is a merciless excoriation of American healthcare, one that has some physicians commenting that the show is more documentary than parody.

Currently running exclusively on Paramount Plus, this latest installment of the long-running show centers on the rotund Eric Cartman, who’s diagnosed as obese and learns about the new GLP1 agonists. Problem is, his mom’s insurance doesn’t cover them, and the family can’t afford the out-of-pocket cost.

Obsessed with Ozempic, Cartman and his sometimes-friends, sometimes-rivals, Kyle and Butters, charge headlong into a maze of insanity called insurance-based healthcare—complete with fax machines, dot matrix printers, moribund claims reviewers, and endless bounces between doctors, imaging centers, labs, hospitals, and corporate offices.

A Maze of Insanity

Throughout the episode, South Park’s founder and main writer, Trey Parker, lambasts America’s obsession with quick pharmaceutical fixes; the pernicious influence of the Big Food industry; the arbitrary nature of insurance coverage; the stunning lack of care coordination; and the burdensome layers of bureaucracy that have made healthcare a cauldron of frustration for practitioners and patients alike.

The boys’ quest for coverage leads them to a dingy back office at an insurance company’s headquarters. It’s stacked to the ceiling with unprocessed paperwork, and manned by frazzled clerk using an ancient computer, a manual typewriter, and a rotary dial phone.

There, they learn a fundamental truth: “The medical director’s job is just to say ‘No.’”

As Cartman and his pals vainly attempt to navigate the system, the adults in South Park, Colorado, are having illicit Ozempic parties.

Randy, a local cannabis grower, asks his friend Towely (a talking towel): “Dude, have you ever done GLP1 peptides? They’re these new crazy drugs people are doing. It’s like Cocaine and Molly mixed together. They make women go crazy.” And indeed, the neighborhood “hot girls” are gleefully injecting black market Ozempic smuggled up from Mexico.

Claims Denials, Ozempic Parties

By the end of the episode, widespread shortages of legit GLP1 drugs—prompted by a federal crackdown to curb abuse—have led Ozempic-crazed citizens to rob pharmacies at gunpoint.

Meanwhile, Cartman and his friends, unable to convince Big Insurance to cover a prescription, resort making their own home-brew Ozempic (thanks to some TikTok tutorials). This prompts the fury of a mob of cereal mascots representing sugar manufacturers, who retaliate by creating a new “body-positive” drug that inhibits the wish for weight loss.

South Park has a long colorful history as an equal opportunity parodist that spares no one and nothing. In keeping with that tradition, The End of Obesity mirrors all that is absurd, ridiculous, and irrational in healthcare.

More Docu Than Satire

Medical professionals commenting on Reddit chat threads about the show, clearly recognize the reality that the episode reflects. As one physician posted: “It’s closer to a documentary rather than satire.”

Another clinician-commentator says the show’s sarcasm, caustic though it is, did not go nearly far enough:

“The medical system is so much worse than depicted in this clip. Here are just a few reasons:

  1. The boys here have unlimited time and energy. Imagine going to multiple appointments while sick and tired, or trying to get time off work again and again and again. People just give up and suffer quietly, or can’t get the time off work.
  2. Obesity is at least a fairly easy diagnosis based on an objective measure. Compare that to chronic fatigue or menopausal issues.
  3. Doesn’t show the boys paying for every appointment. Even $20 or $100 can be a non-trivial hurdle or disincentive.
  4. Doesn’t show delays between appointments caused by inaccessible providers…long waits for available appointments or restrictions on what providers can help them… though they did mention ‘in network’.
  5. Doesn’t show transportation issues of even getting to the proper doctor.”

The mind-numbing, time-sucking convolutions of the system so vividly portrayed by South Park, are “why so many of us in primary care are leaving insurance-based care to start cash-pay practices,” wrote another Reddit commentator.

Always edgy, often obnoxious, yet somehow endearing, South Park has never shied away from confrontational content and controversial topics.

South Park creators Trey Parker (L) and Matt Stone, in 2017. Photo by Gage Skidmore

The show has taken on a host of hot-button subjects since its launch in 1992: religious fanaticism, gender roles, ethnic and racial identity, suicide and mental illness, sexual orientation, political malfeasance, colonialism and slavery, terrorism, adulation of celebrities, corporate wrongdoing, substance abuse, climate issues, political correctness, and just about any other topic likely to get a rise out of the show’s vast and loyal audience.

South Park’s founders Trey Parker and Matt Stone have often drawn the ire of religious groups, clergy members, civil rights organizations, and political leaders for their reliance on crude stereotypes, puerile humor, and obscene language. Though the show has a massive fanbase, it also has plenty of detractors who contend that its snarky tone and deliberately provocative language are polarizing.

South Park is tragically a show that has done more harm than good almost solely because most of its viewers are too stupid to realize Matt and Trey are making fun of them,” stated one commentator on Reddit

30+ Years of Sarcasm

The End of Obesity is not the first time the show’s writers have wrangled with medical and public health issues. Weight Gain 4000, from the show’s very first season, lampoons fast-fix bodybuilding products and American health consumerism. Cherokee Hair Tampons, from Season 4, deals with bogus cancer cures, New Age gullibility, and meaningless virtue-signaling (free-range aspirin, anyone?).

A screen shot from South Park’s 1997 episode, Weight Gain 4000

More Crap, from 2007, lampoons celebrity obsession and vanity…I mean elective… medical procedures. Medicinal Fried Chicken (2010) blasts medical marijuana, online gaming, social media, and fast food.

Flip the Pyramid (2014) mocks federal government food policy. Turd Burglars (2019) dives into the wiggly world of C. difficile, the gut microbiome and fecal transplants. And not surprisingly, the 2020 season offered up a hefty dose of Covid-related content.

But The End of Obesity is the first time the show has taken on a full-scale critique of the insurance system itself. Beneath the sophomoric humor, it hits on important issues like the nation’s love-hate relationship with pharmaceuticals, the arbitrary nature of “disease” definitions, the financial motives of the insurance business, and the pernicious, entwined relationship of the food and drug industries.

It’s an ugly picture that South Park paints. But it’s one we as a nation need to confront.


Subscribe to Holistic Primary Care