Let's just blame the fat people
I was among friends the other night, listening to a doctor go off about how health care in this country costs so much because Americans are fat. If she had to see one more obese mother feed her already-overweight eight-year-old child Cheetos for breakfast, this doctor said, she was going to scream. Want to know why we're a nation of arthritis- and diabetes-prone heart-attack and stroke victims? she asked. Just think about all that extra weight our bodies were never meant to carry around.
I was attracted to this concept of fat-as-the-problem; I like simple explanations. So I was quite happy—well, maybe happy isn't exactly the right word—to come across some data to back up that doctor's claim.
The Agency for Healthcare Research and Quality (AHRQ), a division of U.S. Department of Health and Human Services, recently put out this research note (PDF), demonstrating that in recent years health care costs for overweight and obese people have escalated much faster than for the rest of us. This is something to think about, considering that out of 216.8 million American adults, 58.9 million of us are obese (that's 27%) and 75.7 million of us are overweight (another 35%). Oh, and we're quickly getting fatter. We added 10 million more obese people just between 2001 and 2006.
The numbers the AHRQ gives are these:
- Between 2001 and 2006, average health care expenditure for normal weight people increased from $2,607 to $3,315—a 27% gain.
- For overweight people, the average cost rose from $2,792 to $3,636—an increase of 30%.
- And for obese people, the average amount paid increased from $3,458 to $5,148—a gain of 49%.
The AHRQ defines all those "weight" categories in terms of body-mass index, but I won't get into that here. We all probably have an intuitive understanding of normal, overweight and obese.
And now we also all have an understanding of how much those various conditions cost in terms of health care. Though I should point out that the AHRQ's expenditure amounts are in nominal dollars. The relationship between normal, overweight and obese holds either way, but if you want to know how much more expensive health care is in terms of what else you might buy with that money, you should adjust for inflation. I did that, putting everything into 2006 dollars: costs for normal-weight people have jumped by 11%, for overweight people by 14% and for the obese by 31%.
Barbara!
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The numbers are slightly overstated because medical evaluations of obesity and overweight are based solely on BMI, and BMI absolutely ignores the fact that the Gym was invented back in the 1970's. It's a minor effect, probably just a few % points, but it is worth noting when looking at these kinds of statistics.
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The other big thing to note with this is if you want to blame "fat people" you also have to look at the corn subsidy industry and all the ways that we've managed to inject what is essentially hog feed (high fructose corn syrup) into literally every single piece of food we produce. -
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Following up on what Sean said... the food industry has also crammed as many calories into the cheapest foods possible and, as a result, the most overweight people also tend to be the poorest (who also are the least likely to have health insurance).
There are a million reasons why health care costs so much (overly expensive schooling and a limit on the number of people allowed to become doctors stand out in my mind. Both of which create an artificially low supply). Should we also remember that doctors try to milk insurance companies for as much money as possible (a moral hazard that might not be present if they knew they were taking their patient's money) while the insurance companies spend a ton of money on administrative fees trying to pass off the bills to others?
In the end, I think your doctor friend should go back to being the incurious specialist she is and leave the economics and socio-economic analysis to others.
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The problem is that the poor are also undereducated and don't really understand that cheeto's or fried chicken leftovers is not a good breakfast.
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Hmmm, I just ate leftover fried chicken (locally raised heritage chicken fried insufferably in lard rendered from local pigs, but still) and I have on occasion put Cheetos ("natural" white cheddar cheetos, but still) in my kid's lunchbox. Does this mean my health care costs are going up?
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All probably true. However, there is a fair amount of evidence that single payer systems (Finland is a notable example) do a much better job of educating and providing incentives to the public tochange behavior than is the case in America.
Number 1: Private insurance companies don't really care hwat public health statistics are --as long as they don't have to pay more than they can profitably charge premiums for.
Number 2: Single payer health care systems have the kind of clout that no one in America has today.
So if you belive these things, you should probably support single payer. Maybe we could begin by getting corn syrup out of everything in sight.
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A morbid question but I'll ask it anyway. Do you have any idea if these studies adjust for the earlier death rate of obese patients? Is it akin to smoking where net-net the smoker generally uses fewer health care dollars over their entire life due to decreased life expectancy and death from relatively quickly fatal diseases?
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I'm fat and live in a deep shell of emotional self loathing every day. Maybe its the mustache, maybe the bacon, either way -- I'm just gross.
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Oh, I don't think the *only* reason health care costs a lot is because of obesity. I get that there are many screwed up parts of the system. Here's another example: http://www.nytimes.com/2009/07/01/business/01meddebt.html. Good point about the corn lobby; that was the topic of conversation a different night.
@tomlind: The research note is pretty slim (technically, it's only a "statistical brief"). The methodology is to look at health care expenditures for each group of people during two discrete years—2001 and 2006. So, no, it doesn't take your point into account, through it is an interesting one.
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I had a similar theme this week. http://snipurl.com/miy83 [livefitezine_wordpress_com] It's amazing to think that so many Americans spend all that time and money being obese - and don't get off the couch.
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[...] Let’s just blame the fat people I was among friends the other night, listening to a doctor go off about how health care in this country costs so much [...] [...]
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[...] have a nation in which 27% of us are obese. The airlines have a tough enough time charging an extra carrying penalty for our most rotund [...]
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[...] her Surgeon General. After all, obesity in America is a serious problem in America that results in higher healthcare costs and global warming so what kind of a message does Benjamin’s presence [...]
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I hate your title. "Blaming"!?!
warpedopinion.wordpress.com
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13.1
I agree. The title was in extremely poor taste. Well, along with the rest of the article, but at least it was more tactful.
Assigning "blame" to what amounts to a 3% difference in cost of care seems....... unnecessary, and certainly the "simple explanation"/easy way out for such a complex problem as health care costs. This is a pretty awful jump in logic.
And yeah - I bet the doctor sees a lot of that kind of thing, BECAUSE SHE'S A DOCTOR, and it's her job to see people with problems. Lots of fat people eat responsibly, raise their children responsibly, etc.
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