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Obesity and Health-Care Costs

For quite some time, I thought the "Barbara!" at the bottom of posts on Time's Curious Capitalist blog were Justin Fox exhorting his colleague Barbara Kivat to weigh in. Not true! It's Barbara Kivat noting that she, and not Fox, wrote the post. Good to know. And this information in this post Barbara wrote, comparing the rise in health expenditures from 2001 to 2006 for for people in different weight groups, is also very good to know. But it needs a graph:

percentage_rise_in_health_expenditures_between_2001_and_2006_for_people_categorized_as_.png

That data, which comes from the Agency for Healthcare Research and Quality, looks a bit more straightforward than it necessarily is. You're not just seeing sicker individuals in there. You're also seeing the financial incentives of overtreatment, the advance of medical technology, a lot of wasteful interventions, a system that overspends for every unit of care purchased, and so on and so forth. You're also seeing demographic correlations: Obesity is a particular problem among poor and minority communities, both of whom tend to be sicker.

But for all those caveats, you're also seeing sicker individuals in there. This is, after all, what the health-care system was built so to do: Find sick people and do expensive stuff to make them less sick. Which is a good reminder that not all of the health-care spending's problems can be solved by changing the ways hospitals do business. Some of them will have to be solved by making us less sick. Go here for more on that.

By Ezra Klein  |  July 10, 2009; 10:38 AM ET
Categories:  Health Economics  
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Comments

You know Insurance companies have a financial incentive to not pay for unneeded procedures, but the hatred engendered by their refusal to cover these procedures is a large part of the reason why people like you push for Government Insurance options? But you want the Goveernment option to employ metrics to reduce unneeded procedures as well, so don't you think everyone is going to hate them too? People hate insurance companies mostly because of claim denials. If the Government denies claims they will hate them too.

If insurance companies can't effectively root out unneeded procedures when they have a financial incentive to do so then what makes you think the Government can do it when they don't?

Posted by: fallsmeadjc | July 10, 2009 11:28 AM | Report abuse

Your point in the post is valid, but that is an unbelievably misleading graph.

Posted by: devpsychsmith | July 10, 2009 12:27 PM | Report abuse

I've got two words for you: Actos and Januvia.
If you figure a major health problem among obese people is diabetes, you can assume that the two patented drugs mentioned above will be prescribed for many of them. At around $150 per month each, these useful drugs aren't cheap.

Posted by: dave89 | July 10, 2009 1:10 PM | Report abuse

This is another of the ongoing discussions of the issue of wellness and health costs.

All "slice of bread" studies (like this one) show that obese people (and smokers, and the sendentary, and heavy drinkers) cost more at any given time than people with good health habits.

All "whole loaf" studies with any statistical power show that over a whole lifetime, the people with good habits cost the system more than people with bad habits because they live longer, suffer illnesses and conditions that are age related and cost money to manage, and then die, running up the usual expensive end of life bill.

This is especially true right now, since the baby boomers who have poor health habits are reaching ages when they can expect to cost a lot of money because their health will deteriorate.

There are some interesting preliminary observations that suggest that medical innovations occuring since the main body of whole loaf studies were done in the late 80's and early 90's have allowed some people with poor health habits, especially obese people, to live longer and thus cost more, perhaps changing the dynamic. It may be time to revisit the issue by doing new "whole loaf" studies to evaluate the situation right now.

However, I tend to think that that is a waste of money. We know that everyone should have good health habits. No one argues otherwise. The evidence suggests that in the long run that will cost the health care system -- not to mention the pension and social security system -- more money. But that makes a difference only if you are trying to make the argument that good health habits change the dynamics of health care reform. They don't. We need to take care of everyone, regardless of whether one or the other group is cheaper.

All this is a distraction proceding from the argument that bad health habits is the major, or at least a major, problem with the American health care system. It isn't. End of story.

Posted by: PatS2 | July 10, 2009 3:16 PM | Report abuse

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