Overweight elderly Americans contribute to financial burdens of the US health care system

Jul 25, 2008

Being overweight or obese is not only a personal issue that affects one's health but is also a public health issue that impacts other people in society. A new study in the journal Health Services Research reveals that the extra Medicare cost associated with overweight elderly people could place a significant financial burden on tax payers, costing up to hundreds of billions of dollars across the entire current Medicare population.

The article's findings show that treating the health needs of an overweight or obese elderly person will cost Medicare 6 to 17 percent more over a lifetime than treating an elderly person with a healthy weight.

The authors used a measure of weight that takes into account a person's height, known as the body mass index and looked at total costs from Medicare alone for individuals covered from age 65 until death. The extra demands made of the healthcare system by overweight and obese elderly amounts to Medicare's spending on average an extra $15,000 on overweight elderly individuals and an extra $26,000 on obese individuals.

"Our research provides valuable information for why the public and health policy makers need to pay attention to the financial burden of health care for overweight Americans besides it's being just a health issue," Professor Zhou Yang at Emory University conclude. "More aggressive public health campaigns or early behavioral or policy intervention to stop the obesity epidemic could be cost-effective as well as otherwise beneficial for society."

Zhou Yang, Ph.D., MPH of Emory University and Allyson G. Hall of University of Florida used data from the longitudinal Medicare Current Beneficiary Survey from 1992 to 2001 to construct a model of the relationship between body weight and health care expenditures amongst different baseline weights at age 65 followed up to death.

Source: Wiley

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zbarlici
3.2 / 5 (9) Jul 25, 2008
You think your country has a problem with the obese? ... just wait and see the outcome of your federal government`s bailing out of Fannie Mae and Freddie Mac.
zbarlici
1.3 / 5 (14) Jul 25, 2008
Physorg - don`t post any more stories like this. It`s just wrong.

The fact that you are placing a monetary value on such things shows that you have little or no respect for those the article speak of. shame.

Is that word still in your vocabulary? "shame"?

This also goes for the general N. American population. All the way from the parents to the kids. Don`t resent your kids while they`re growing up or you WILL end up in a senior`s home. Show them your love, respect and teach them how to love their own kids in turn.
hydrik
5 / 5 (12) Jul 25, 2008
This article proves that government should NOT be involved in health care! Government shoved Medicare down taxpayers throats and now wants more control over the taxpayers lives in order to create the "perfect" citizen. A taxpayer who does not smoke, drink, eat too much, have too many children, pays more taxes, is subserviant to government officials, etc. etc. Let the citizens decide for themselves how they want to live. Less government equals a free society!
zbarlici
2.6 / 5 (9) Jul 25, 2008
Hydrik - let`s tackle one issue at a time.

Government is very critical to society well-being... but the society and its current ideals/ethics is what determines the course of the government in the years to come.

Let`s just stay on topic with the article pls.
zbarlici
1.2 / 5 (6) Jul 25, 2008
Really. While the bailout of the millenium is about to happen, the Govt has no right to bitch and whine about "peanuts". So whoever is trying to push that angle can quit it now.
k_m
2.9 / 5 (7) Jul 25, 2008
I see taxes going up!!!!
first it's raise taxes on tobacco products to help cover healthcare (thus making it your civic duty to smoke)...
next it'll be introducing taxes on food products (which are traditionally untaxed) to cover obesity costs.
social security- tax you
tobacco- tax you
obesity- tax you
Wasabi
4.5 / 5 (8) Jul 25, 2008
"The fact that you are placing a monetary value on such things shows that you have little or no respect for those the article speak of. shame."

Wow, just... wow. How about accepting some personal responsibility for individual actions and choices and the correlation between those choices and SELF respect? And while you're at it, accepting some parental/personal responsibility for the diets of your own children. The article's point however was about cause and effect and the burden it places on every one of us as the problem escalates without a fundamental public policy focal shift.
xen_uno
2.8 / 5 (8) Jul 25, 2008
I'm all for a "fat tax". Seeing some fat person wolf down a 10000 calorie happy meal makes me sick, therefore it's bad for my health and the government need to protect me. It's only justice since I can no longer smoke in my well ventilated bar where everyone puffed (including the employess), and the few non-smokers there didn't care.
Glis
1 / 5 (10) Jul 25, 2008
So by using the system they are a burden on it?

This makes no sense. We pay for healthcare to keep us healthy. The healthcare industry needs perpetually unhealthy people that depend on their service. Healthcare can never work as it should ideally if it's for profit. There is no money in healing people, but there is plenty of money in maintaining them. Fat unhealthy people are the reason you can find a doctor's office with 5 miles of your house.

Supply and demand along with margins are very scary things when they apply to your health.
gopher65
1.6 / 5 (7) Jul 26, 2008
I agree Glis. The fact is that there is a social evolutionary selection pressure against corporations that "fix" health problems. They tend to go bankrupt, or get swallowed by larger companies ("tend to" isn't quite right. "do" would be better). The reason for this is because by curing a disease a company eliminates its own customer base, which is a very anti-capitalist thing to do. So all "good" healthcare and pharma companies have been eliminated, leaving us with the dreg we have today.

This is just the way the free market works. This isn't to say that private corps shouldn't play a roll - even a big roll - in healthcare, just that they should not, and cannot, be primary providers, or research fund directors. If they are, they will *have* to choose the direction that is best for their shareholders, and that direction isn't in the best interests of the general population. This is why anti-biotic research has all but stopped; in a decade or two we're really going to start feeling the results of that decision:P.

There are just some sectors that can't be controlled by governments, and there are others that can't be controlled by corps. No one suggests that we should have privately controlled military forces, because that wouldn't be good for populous. Healthcare is the same way.
aussiecarter
2.7 / 5 (3) Jul 26, 2008
Measuring "fat" numbers are a positive step to managing them. Ultimately dollars saved are the same as dollars earned. It's no different the financial loss to society from a tax cheat compared with the medical expenses of someone who voluntarily becomes overweight, it's money lost and everyone pays. Many people lack mental resources needed to maintain healthy eating habits, especially when confronted with marketing campaigns run by high fat franchises. Marketing campaigns are proven historically to increase demand for things which reap profits and cause problems for society. Just take the case of big tobacco. The companies were never going to turn around say "hey, you know we should ban our products in bars because it may cause terminal disease". Never going to happen. More to the point the numbers suggest obesity causes medical problems and hence medical expenses for society, and remember everyone pays. I think in the end there will be some similarities develop between approach to tobacco with that of unhealthy eating. Only problem it's much more difficult to tax a cheeseburger than a packet of cigarettes. So we will have to wait and see what solutions present themselves.
Mayday
3 / 5 (3) Jul 26, 2008
I think the information in this article is an important start. When an individual chooses to live an unhealthy livestyle, they should be informed to and accept the fact that eventually, if they live long enough, their lifestyle choice will become an unfair burden on others.
This is a start.

The "shame" is really in the denial that these unhealthy folks live with.

As a person lives out a long life, chances are they will eventually accrue large medical costs. The article is just trying to point out that those who choose to be obese are likely to be eating a larger share of the healthcare pie.

The next step is for society to decide to either penalize the obese, or to spread the burden to everyone. And since obesity is an individual choice(along with the attendant denial), it makes sense to create some sort of "sin tax" for those who choose this lifestyle. An alternative would be some "reward" system for those of us who choose to maintain a healthier wieght.

We pressure smokers to quit, we make motorcyclists wear helmets, we require seatbelts to be buckled. There are countless safety laws, regulations and sin taxes. Including obesity would certainly make sense.

Personally, I would be supportive of penalizing parents of obese children and all obese adults. I'm just not sure how, as the "action" involved is so easy to hide.

One question, for both the group and the study: Does this higher than normal weight include people who carry extra muscle as opposed to extra fat?
Mayday
3.6 / 5 (5) Jul 26, 2008
It strikes me that the obesity issue is driven by two things. First, we accept that it's "okay" for responsible individuals to not have control over their own actions. From over-using credit to gambling to smoking to litering to over-using energy to over-eating. We openly accept that various "uncontrollable" and detrimental actions are okay when, in fact, they are, in the end, not.

And second, it is taboo to mention or point out or in any way openly attempt to help an obese person see the folly of their ways. You can point out that someone is wearing miss-matched socks, that their golf swing is in error and even ask them to not smoke. But there is utterly no accepted way to intervene for the benefit of an obese person.

These two factors combine to the extreme detriment of obese people. Solving the second would be a great starter. I just have no idea how to begin without risking personal injury. Any thoughts?
thku4grace
2.8 / 5 (4) Jul 26, 2008
I am generally opposed to governmental intervention into our lives. However, I'm also opposed to all those average Joes who are also intervening into my life with their requests for my tax dollars to subsidize their lifestyle. If it were so that the cost of our lifestyle choice was borne by ourselves only, to each his own. But that isn't the case at all. Medicare is only the most obvious example. The fact of the matter is that employer based health insurance uses the law of large numbers and with 33% of the general population obese, we all bear the burden of their lifestyle choice.
DoctorKnowledge
3 / 5 (3) Jul 26, 2008
With respect to thku4grace, I think people in society are linked now in ways that were not true 150 years ago. Then, you got drunk and fell off your horse -- it was your own damn fault. Now, if you get drunk in your car, you're liable to kill innocent people, put a burden on the police department, and run up insurance costs. Obesity is just a problem that's easily identified. But this is just part of a trend in our society -- count on any behavior that's an indisputable risk to come under scrutiny.

Frankly, I'm overweight. Of course, I feel I have legitimate reasons. I wouldn't mind being penalized quite so much -- if I thought smokers were also being penalized. And, I'm not trying to pretend this isn't subjective, but I bet most people have such subjective feelings -- I look at some sports activities -- where I know they have a high risk of breaking an arm or leg. In the context of this subject, I'm asking myself, if I'm penalized for being overweight, why aren't they, for their dangerous behavior? I guess I'm saying there isn't an easy place to draw the line.
Damon
5 / 5 (2) Jul 26, 2008
There is a tendency to jump on the tax bandwagon whenever there is a societal problem. I personally feel education is the best way to beat obesity, smoking, alcoholism, and other unhealthy lifestyles. It's not the quick fix of an added tax, but over the long run, if society can be patient, it will pay off.
superhuman
1 / 5 (1) Jul 26, 2008
I think medical insurance should be tailored to individuals as much as possible.
You should be able to choose what you want to cover in your policy, if you are overweight or want to be protected in case you will you should pay proportionally more. Same should go for all other health risks, including smoking and sport.

If you chose lower policy and you gain weight later then you will have to pay that extra percentage of the health costs yourself.

I believe that would be a fair system.
GrayMouser
3.7 / 5 (3) Jul 26, 2008
No one knows how much fat a person needs to have to remain healthy. My Grandmother was 94 when she died and she was at least 50 pounds over weight. It strikes me that the health Nazis are after the perfect race of healthy, tall, thin, young people.
Mayday
2.3 / 5 (4) Jul 27, 2008
Go outside. Walk around. Watch people congregate. It is clear we need incentives to get people to stop over-eating.

The simple added cost of eating excess food clearly does not work, though you'd think it might. It doesn't.

We, as a society of people who want a brighter future, need to slow down the eating. That's clear.

You. You there! Please, please, stop eating more than you should. It will end your life prematurely. It will cost the rest of us needlessly. How simple an idea. Yet so uncomprehensible to a growing number of otherwise apparently intelligent people.

If it were a victimless self-destruction that would be one thing. But it is not. The nature of health insurance is that we all pay, whether national-socialized medicine or not, it makes no difference. We all pay for each other. So, for a group of individuals to assume the priviledge of consuming excess healthcare due to their excessive behavior is unfair.

So, I ask you, please, eat intelligently. If you find you can not. Please seek help. We will help you.
fleem
3 / 5 (2) Jul 27, 2008
"Our research provides valuable information for why the public and health policy makers need to pay attention to the financial burden of health care for overweight Americans besides it's being just a health issue"

What the poor often don't understand is that every govt program increases taxes, and all taxes are pretty much a "poor tax". The poor want entitlements and assume the rich will pay. They won't. Take money from a rich citizen and he buys less services and luxury items made by the poor. Take money from corporations and those corps promptly take it out of blue collar benefits. Create money with printing presses (by lowering the prime rate) and (although it has the advantage of being a world-tax) it hurts the poor because most poor keep any savings they do have in banks rather than investments. Yes, the free market has fairly rare problems that sometimes need to be addressed by govt (like trusts & monopolies) but the free market is a far better band-aide for greed than govt regulations that are always poorly thought-out and administered, mainly because those responsible for it have little accountability.
Damon
3 / 5 (4) Jul 27, 2008
Fleem, sounds like the old "trickle down" theory of economics. Would you advocate privatising roads, schools, and parks? there are many things that are best left to the people, thru a participating democracy, than to the free market. Health care is one of those things that should not have for-profit capitalism involved.
fleem
5 / 5 (1) Jul 27, 2008
Fleem: "the free market has fairly rare problems that sometimes need to be addressed by govt (like trusts & monopolies)".

Damon: "Would you advocate privatising roads, schools, and parks?"

There are three separate talking points here.

First, in my post I confirm the govt's role in regulating monopolies, yet you respond as if I am condoning monopolies. From this I can only conclude you either don't know what a monopoly is, or you didn't read the post to which you are responding.

Second is the question of HOW subject to monopolization are those things you mention. That's a subject deserving of another thread I think! I will say that certainly roads and parks are VERY subject to monopolization because its hard for people to make a choice in what roads they will use (but not impossible--they can even change where they live, if they have to)--but there can be a ~little~ competition in that area, and there already is in the contractor bidding process (assuming its done ethically) and the freedom to move.

Third, you speak as if it has to be one way or the other. It doesn't. Private schools are the prime example. Note that prominent public health care proposals being put forth actually PROHIBIT private health care. Rather, let the govt compete with everybody else--the free market allows that.

Egnite
1 / 5 (1) Jul 28, 2008
I thought the US had a private healthcare system and you either had to pay for the hospital bills or have health insurance pay for them?
Glis
not rated yet Jul 28, 2008
Wow. What a bunch of selfish pricks. It's not like people choose to be fat. I was graced with a good metabolism and can outeat my fat friends and not gain a pound. Plus, this article is on ELDERLY OBESE, most likely diabetics who could eat a rice cake and put on half a pound.

Maybe I should give this whole 'bashing people for a condition that most can't help' a try though...why not give a big FU to cancer patients. They surely eat up a lot of resources, and if they would have stuck to an all organic diet, not lived under power lines and never used a cell phone they probably wouldn't have the tumor in their head. What about paralyzed people? They eat up a TON of resources! Let's give them the boot too. That'll teach them for skiing! Don't even get me started on sick children! Those little bastards never worked a day in their life and I gotta pay so that they get to live into their teens? God Damn these unhealthy people for using up my healthcare! What right do they have? Wow, that was easy! I can just alienate people that aren't like me if their well being costs me anything. Fantastic! Screw you fat grandma, you probably deserve to die!

Thank you all for showing me this amazing crutch! I can turn difficult moral choices into monetary ones, brilliant!
superhuman
not rated yet Jul 29, 2008
Wow. What a bunch of selfish pricks. It's not like people choose to be fat. I was graced with a good metabolism and can outeat my fat friends and not gain a pound. Plus, this article is on ELDERLY OBESE, most likely diabetics who could eat a rice cake and put on half a pound.

Maybe I should give this whole 'bashing people for a condition that most can't help' a try though...why not give a big FU to cancer patients. They surely eat up a lot of resources, and if they would have stuck to an all organic diet, not lived under power lines and never used a cell phone they probably wouldn't have the tumor in their head. What about paralyzed people? They eat up a TON of resources! Let's give them the boot too. That'll teach them for skiing! Don't even get me started on sick children! Those little bastards never worked a day in their life and I gotta pay so that they get to live into their teens? God Damn these unhealthy people for using up my healthcare! What right do they have? Wow, that was easy! I can just alienate people that aren't like me if their well being costs me anything. Fantastic! Screw you fat grandma, you probably deserve to die!

Thank you all for showing me this amazing crutch! I can turn difficult moral choices into monetary ones, brilliant!


So how do you know you can't help being fat?? Limit calorie intake and you WILL slim down there is NO doubt about that.

Do you think its fair to take the money from people who don't have enough to support themselves and their children and give them to someone else cause that person can't deny himself food?

You CAN eat less, it is YOUR choice if you don't, take responsibility for YOUR choices like we all do for OURS. The whole society is build around taking responsibility for your actions. If we accept that fat people don't have a choice to eat less then we have to accept that rapers don't have a choice not to rape and killers - not to kill.

Finally its not like we propose to lock overweight in concentration camps! All we propose it that they cover their extra insurance costs themselves!
Glis
1 / 5 (1) Jul 29, 2008
Haven't you noticed that most fat people in the country are lower working class? Why do you think that is? Maybe because, in our country, good healthy food is expensive, and crap food is cheap. Also, we don't do much labor, and most people working a crappy job 40 hours a week kids probably another odd job, don't really have time to hit the gym. Our whole system is based on minimal impact work and quick starchy foods.

Granted, there are land whales out there who could probably lose 100 lbs if they didn't get a handicapped sticker and had to walk a few hundred yards to their car.

For most poeple it's just not that simple though. If you could simply 'eat less' to lose weight we'd all look like supermodels.

If someone actually has a problem and is using the system I don't care about paying a little more for their well being. Saying that someone isn't taking care of themselves so they should pay more is a very dangerous statement. What if the next time you go to the doctor he notices you cholesterol is a little high, and that you have a sunburn, then he charges you more for the visit? What if they find traces of alcohol, nicotine or caffiene in your system, should they be allowed to charge you more?
Mayday
5 / 5 (1) Jul 31, 2008
Wow. This has been enlightening. I confess that it has been my impression that obesity was a lifestyle choice. But the fact that so many here clearly believe otherwise has led me to want more information on the subject.

Can anyone lead me to sources that can clarify this? And all due respect, please, and I'm sure you are well informed, but please, no rants, just sources, if you could. (Well, you can rant a little, I mean this is a comments blog.)

I'm also fascinated with the various notions of penalizing unsafe behavior and would offer this observation: obesity is a long-term on-going "behavior." And importantly, there is no safe way to practice it. This is an important distinction, as there are safe ways to mountain climb, bungee jump, and many of the other things people do when living life to the fullest. One can even drink alcohol safely, I think.

But there is no safe cigarette. And there is no safe obesity. So separating "wreckless" behavior from "risky" behavior is important if we're going to start penalizing people. There is a world of difference.

I'd go so far as to speculate that safe mountain climbers and safe sky divers probably consume LESS healthcare resources than the average person.

But I am looking forward to some links or recommendations on the obesity choice vs no choice subject.

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