More evidence has emerged that obesity could become a bigger health problem than smoking ever was. Earlier this year researchers announced that obesity added more to U.S. health care costs than smoking. And a new Canadian study found that obese people tend to visit the doctor more than smokers of normal weight.
The costly obesity epidemic
In April a Cornell University study published in the Journal of Health Economics found that obesity accounts for nearly 21 percent of U.S. health care costs—more than twice that of smoking and more than twice that of government estimates. Now researchers at Concordia University in Montreal are saying they see a Canadian parallel in terms of doctor visits.
“The fact that obesity is more serious than smoking helps people understand the gravity of the problem,” said James McIntosh, a professor in the Department of Economics at Concordia University, “because they already have some kind of intuitive understanding of how bad smoking is.”
Obesity and doctor visits
To learn whether lose weight could help people visit the doctor less frequently, McIntosh built a model using data from the 2010 Community Health Survey, a study including health information on more than 60,000 Canadians. He estimated that doctor visits would decrease by 10 percent if health problems related to obesity were not a factor.
If the estimates in the Concordia study were to apply to U.S. health care costs, a person losing weight could personally subtract thousands of dollars from the total. The Cornell study found that medical expenses for an obese person were $2,741 higher (in 2005 dollars) than if they were not obese. Nationwide, that pencils out to $190.2 billion per year, or 20.6 percent of U.S. health expenditures.
Could be worse?
The Concordia model could be a conservative estimate of the money saved by losing weight because it didn’t take into account visits to the doctor for problems related to type 2 diabetes, an inevitable consequence of obesity. Plus, the survey data McIntosh used didn’t include information about a participant’s weight history. To wit, for those who have recently crossed the line into obesity, the full effect of the health consequences on doctor visits is yet unknown.
A fat tax?
McIntosh suggests using economic incentives to cut obesity related medical costs by charging obese people more for health insurance. In the U.S., more companies are penalizing employees who smoke by charging them higher health insurance premiums. Now that obesity puts a greater strain on the health care system than smoking, could it be time for similar measures?
Up to now, government health care reform has focused on changing the way insurers, drug companies and doctors do business, rather than promoting more personal responsibility for one’s health.
A 2009 article in Health Affairs estimated the annual cost of obesity at $147 billion and growing—about $1,250 per U.S. household, mostly in taxes and insurance premiums. Legislators have proposed taxing sugary drinks to help curb the obesity epidemic. Perhaps a “fat tax” in the form of higher insurance premiums based on body mass index would be more effective.
Meantime, the best way to avoid costly to the doctor tomorrow is to lose weight today.