Drive Down Healthcare Costs By Driving Down Obesity

In his remarks Tuesday night, President Obama repeatedly stressed the need to drive down healthcare costs to sustain economic growth and reduce the country's deficit. President Obama mentioned tackling the long-term problems that reside within Medicare and Medicaid and was questioned earlier as to why he has to this point not directly asked the American people for a particular sacrifice in order to improve the economy. While taking the time to outline ways in which the American people have already made and continue to make sacrifices, he missed out on the opportunity to ask for a sacrifice of time, energy, and our excess weight.

In 2007, the U.S. spent more on healthcare than any other nation in the world totaling $2.27 trillion, roughly 16% of our GDP. Healthcare costs in the U.S. are currently hovering around $7,000 per capita and by many estimates are expected to increase to $15,000 per capita by 2015. A majority of healthcare costs are related to preventable and reversible illnesses, many of which are related to weight and obesity: our weight isn't just slowing us down out on the track it's hurting our economy and our wallets. In 1994, the obesity percentage (people with a BMI of at least 30) by state in this country ranged between 10-19%, with 34 states below 15%, by 2007 only Colorado maintained an obesity percentage below 20%. Current statistics place the national obesity rate at 1/3 of the population. Slightly more than another 1/3 of the country is overweight (a BMI between 27-29) with little to no fluctuation across age groups. Being overweight or obese increases the risk of numerous costly illnesses and conditions such as coronary heart disease (which claims more lives per year in the U.S. than the next 7 leading causes of death combined), type-2 diabetes, cancer, heart attacks, and strokes.

Over the last two decades, the debate over who should pay for healthcare has raged, while as a society we have become more overweight and sedentary than we have ever been before. Remarkable research and progress has been made during this time in medicine, the human body, and health, and yet we are literally eating away at our wallets and our lives without a second thought. Rush Limbaugh rails against universal healthcare as socialism, but where is the money from the insurance company coming from when he inevitably has a heart attack? Michael Moore lambastes private health insurance as unaffordable, but does he realize he is driving up the cost? Insurance companies work based upon the principal that the premiums of the healthy fund the treatment of the sick, in the same way that the auto insurance premiums of drivers who have never been in an accident pay for the insurance claims when a car is totaled. The system is set up as a bet that there will be more premiums coming in from people that are unlikely to be sick than there is money being paid out in claims to care for the sick. Charging higher premiums for those that are most likely to get sick and rejecting applications based upon health exams are the means with which the insurance companies try to hedge their bets. As more and more amongst the population become unhealthy, a larger amount of the money from premiums is paid out at the same time as the pool of incoming, healthy premiums shrinks. This causes the insurance prices to rise for everybody including for blanket coverage at companies with health benefits. The pool is further drained by cases where the illness could have been stopped in its early stages, but the doctor's office was avoided for as long as possible. This does not excuse insurance companies from denying legitimate claims and there are serious institutional changes to make healthcare more affordable and accessible to all, which must be addressed. However, we have a responsibility, if not to each other, than to our families and ourselves to live healthier lives.

It is a long and hard battle that requires a lifestyle change. There is no quick fix, let alone one that comes in a pill that has not been approved by the FDA. We can remove transfats from within our borders and make a donut shop display calories alongside prices, but until we make a commitment to live healthier lives, we will only sink further into the deep fryer. I'm not asking you to drop everything and suddenly become Michael Phelps, instead, consider taking steps to become even slightly healthier: lose those five pounds you promised yourself you would at New Year's, take the stairs instead of the elevator on your way to work, go for a 30 minute bike ride with the kids, don't use as much ranch dressing on your salad. After that, see if you feel better, chances are you will, and you will want to keep at it, and in the long run, we will all save some money.

Over the last year, I co-produced a half-hour documentary, entitled SickCare, that elaborates on this issue and the benefits that leading a healthier life brings. For more information or to receive a copy of the documentary, please email [e-mail], website coming soon.

Comments

[historymatters]

I think environmental influences on weight gain or obesity is poorly understood. Obesity and overweight cross all socioeconomic lines, although lower income and less educated people have been identified as having a higher proportion of people with these health issues. But we don't really know if it's just overeating & lack of exercise that causes all obesity. Environmental factors play a big role - everything from the effects of hormones and antibiotics in the food and water supply, to air pollution, to living in dangerous neighborhoods or in neighborhoods without sidewalks. A lot of people also have to work two jobs to make ends meet, and that doesn't leave a lot of time for exercise or healthy eating.

It is not as simple as people just overeating out of laziness or whatever. But isn't it so much more fun to find a group of people to target, demonize them, and make society's problems all their fault?

[Duncan Quirk - Huffpost Blogger]

There are multiple factors and influences regarding obesity, and environment does play a role. It is imperative that we tackle all of them, however, there are many ones that can be taken on at the individual level to improve health. It is much easier for one person to start watching what he eats than to limit and reduce the effects of hormones and additives in foods. I agree that people working multiple jobs and long hours on one job, makes it harder to stay healthy and eat properly, and steps must be taken to promote, amongst the workplace, initiatives that stress and allow for proper diet and exercise. If there is a demand for faster and cheaper, healthier food, it will be supplied, but since there is only a demand for fast and cheap food, I witnessed, a few years ago as a camp counselor, a brother and sister who complained to their mother about the McDonald's she had brought them for lunch (a startlingly regular action) how they had already had McDonald's for breakfast. Her response, "It's okay we'll have Burger King for dinner." My goal is not to demonize people, my goal is to help people and convince them to find small ways that will improve their lives and ours.

[PlaceboStudman]

When are people going to realize that weight, and resulting health effects are not always a matter of poor diet and lack of exercise. There are many millions of people who have real genetic and metabolic issues that prevent them from losing weight, and there are medications that force people to gain weight when they don't want to, no matter how they change their diet/ exercise habits. And, the truth of the matter is, when you're walking down the street and see someone who is overweight, you can not possibly tell me that you know FOR SURE that the overweight person is just lazy and has a bad diet. let's be a bit more compassionate, and realize that guilting people into losing weight isn't going to work, when there are millions of us who truly have no control over weight.

I also take issue with your contention that it is the high cost of premiums that fund the care for the sick. WRONG WRONG WRONG. It is the millions of people who are disabled and critically and chronically ill, who pay tens or hundreds of thousands of dollars a year for their (sub standard) medical care which holds down the prices of those with lesser medical needs. Can you imagine how much it would cost to put a cast on a broken arm if it weren't for the tens or hundreds of thousands of dollars the guy in the next bed is paying for his cancer chemo and radiation?

[Duncan Quirk - Huffpost Blogger]

While I agree that there are people who are genetically disposed towards being overweight and obese, and there are other causes, however, as you have said, one can not predetermine the cause of a person's obesity simply by looking at him/her, therefore you or I can not know for sure that the overweight person is suffering from a genetic issue. While there may be many millions of people that are predisposed to these problems and have tried hard to combat them to no avail, there are roughly 100 million obese people in the U.S. and another 100 million that are overweight. While there might even be as many as 10 million people who are either genetically or through medications predisposed to being overweight, that still leaves 190 million people that are not. There are also people who are genetically disposed and adhere to a poor diet and sedentary lifestyle. There are also people that are genetically predisposed to more fit body frames, that were once healthy and athletic, that became unhealthy and sedentary. For those amidst all categories that have tried to become healthier, I commend you, for those that haven't, I ask you to try. For those that have tried and failed, do not be discouraged, it's a tough road, my cousin was once obese and has since lost 80 lbs through diet, exercise, and determination: every little bit helps even if it isn't drastically lowering your BMI, maybe it's just limiting your fast food intake.

[Duncan Quirk - Huffpost Blogger]

I standby the fact that the premiums of those who are not currently having insurance money being used for their treatment supply the money that the insurance companies distribute. That is how insurance companies work: a life insurance company could not fulfill a $100,000 life insurance claim if the money only came from the premiums of the deceased, otherwise the money could have just as easily been put into a bank. There are millions of people who are paying too much for both healthcare premiums and for healthcare. It should be our goal to reduce both, and by reducing the probability that the more expensive treatments will be necessary, we will reduce the number of people who need them and further drive down costs for all. Addressing the scenario which you have put forth, any first year medical student should by all means be able to set a cast, if not the most appealing to the eye it will be effective on a simple fracture, but chemotherapy and radiation are far more complex and require a lot more.

[PlaceboStudman]

How do you propose "reducing the probability that the more expensive treatments will be necessary" when there are millions of people BORN with congenital defects, MD, CP, and Spina Bifida that I have, that will not kill us, but will cost tens or hundreds of thousands of dollars out of pocket after insurance?

And I take fault with comparing LIFE insurance with HEALTH insurance. Life insurance is a one time pay out by an insurance company upon a person's death. Health insurance is paid out every time a patient who owns health insurance goes to the doctor, has a medocal test, or has surgery. And many of those things simply can not be avoided, as in the case above where a person is born with a congenital disease.

Yes, it would be nice to live in a world where everyone is generally healthy, and preventative care, diet and exercise is the only thing needed to maintain a person's health. But, this just simply isn't the case. And those of us who pay tens or hundreds of thousands of dollars a year ARE paying to make sure that the person who only needs a cast can get that cast (and all the other ammenities associated with a doctor visit) at a relatively lower price

[Diogenis]

Does President Obama have to spoon feed you?