Many Americans in Denial Over Weight Gain: Study --Doctors Lounge

Many Americans in Denial Over Weight Gain: Study --Doctors Lounge:

Study finds that Americans routinely underestimate the amount of extra pounds they pack on.

The Obesity Epidemic and its Cost

More than one-third of U.S. adults (over 72 million people) and 17% of U.S. children are obese. During 1980–2008, obesity rates doubled for adults and tripled for children. During the past several decades, obesity rates for all population groups—regardless of age, sex, race, ethnicity, socioeconomic status, education level, or geographic region—have increased markedly. The U.S. Centers for Disease Control and Prevention released a new report in which they indicated that an estimated 42% of Americans will be obese by the year 2030.

 Obesity and Florida

In the fall 2003, Governor Jeb Bush formed the Governor's Task Force on the Obesity to make recommendations regarding the problem of overweight and obesity in Florida. In the executive summary for the task force’s final report, Zachariah P. Zachariah, M.D. Chair of the Task Force, states, "Obesity is second only to tobacco use as a threat to public health. Its implications include serious health consequences such as diabetes, coronary heart disease, high blood pressure, and certain cancers. A recent study published in The New England Journal of Medicine indicates that one out of four children who are overweight have early signs of type 2 diabetes. Additionally a recent study by the RAND Corporation, a research and development institution concludes that obesity is linked to higher rates of chronic health conditions than smoking, drinking or poverty."

That statement was made in 2004, and eight years later the increase in the rate of overweight and obesity Floridians has gone unabated. The recommendations of the task force can be found at: http://www.doh.state.fl.us/family/GTFOE/report.pdf

Financial Consequences of Obesity

Obesity takes a toll on physical health, but it also places a financial burden o the health care delivery system to treat increased illness as a result of obesity-related health challenges. Erik Finklestein, PH.D and others have estimated that as much as $75 billion dollars of our public health cost bill as attributable to obesity in 2003, about half of which was publically financed.

Obesity, its impact on medical cost in Florida and on state budget dollars is problematic in light of growing number of citizen eligible for and utilizing Medicaid. Since 2000 the percent of the entire state budget allocated to Medicaid has grown from 20.3% to 30.7% in 2012. The burden of obesity-related medical costs falls disproportionately on public health care in the U.S., draining resources from public programs like Medicare and Medicaid. Obesity accounted for 27 percent of the growth in real U.S. health care spending between 1987 and 2001.

In a unique study that departed from looking at historical costs of obesity, Kenneth E. Thorpe, Ph.D., and colleagues from Emory University developed an econometric model to estimate the growth of health care costs over time that are attributable to changes in obesity rates. This report provides projections of future health care costs directly attributable to obesity for each state and for the nation.

Major Findings

• Obesity is growing faster than any previous public health issue our nation has faced. If current trends continue, 103 million American adults will be considered obese by 2018.
• The U.S. is expected to spend $344 billion on health care costs attributable to obesity in 2018 if rates continue to increase at their current levels. Obesity‐related direct expenditures are expected to account for more than 21 percent of the nation’s direct health care spending in 2018.
• If obesity levels were held at their current rates, the U.S. could save an estimated $820 per adult in health care costs by 2018 ‐ a savings of almost $200 billion dollars.
• In the study the obesity level in Florida is projected to increase from 29.4% in 2008 to 35.8% in 2013 and  to 43.9%in 2018
• Health care spending (millions of dollars) in Florida attributable to obesity and obesity-related diseases is projected to increase from $4,873 in 2008, to $9,389 in 2013, and to $25,804 in 2018
• If obesity-attributable health caring spending remained constant the state of Florida could realize a medical care saving of $2.6 billion for 2013 and $15.7 billion for 2018

Who Opposed Obamacare - The Most Obesity States

The Supreme Court upheld the Affordable Care Act of 2010, otherwise known as Obamacare.  Judging from the polls, American public opinion appears to be very sharply divided over the legislation.  Some view it as socialism, others as the first success in a half-century of efforts to achieve a sensible national policy on health care.

Those who have the most to gain from President Obama’s health care legislation are those who have a pre-existing condition or are pre-disposed to illness, and that obviously applies to overweight and obesity Americans.  They are more likely to need medical care in the future, but can be charged higher rates if they try to buy private insurance, by virtue of their condition.  Or without a change in policy they can be excluded completely.  Each obese American currently incurs medical costs 42% higher than those of normal weight, that insurers can have been able to avoid that risk.

One of the interesting things about opposition to the ACA, was that some of the most obesity states voted against their own best interest. The chart below shows how Congressmen from each state voted on the Affordable Care Act on the vertical axis of Figure 1, with the state rates of obesity on the horizontal axis.   There is a statistically significant relationship.  But the relationship goes the other way:    states where more people are overweight, such as Mississippi, Alabama, South Carolina and Texas, are more likely to oppose Obamacare.   In those parts of the country where people are slimmer, such as New England, New York and Colorado, there is strong support for health care reform.  For every one percentage point increase in obesity, support for Obamacare declines by an estimated four percentage points on average.

      Figure 1:  States with higher obesity rates tend to oppose the Affordable Care Act 
   

Exercise and eating habits obviously relate to be overweight or obesity.  The states where residents get the most physical exercise are Minnesota, Utah, Oregon, Washington and Vermont; the states that get the least are Mississippi,  Tennessee,  Kentucky,  Lousiana and Alabama. And which states do data  data sources indicate has bad eating habits:  the five worst-ranking are Mississippi, Alabama, Missouri, Kansas and Oklahoma.

In addition to obesity, what the data reveal about how states rank on the overall health index.  The states that rank the best on an overall health index are Vermont, New Hampshire, Massachusetts, Minnesota, and Maine and Iowa.  The states where people are the least healthy overall are Louisiana, Mississippi, New Mexico, Nevada, Oklahoma and Texas.  The weight of the evidence is fairly clear: the states where people are most in need of help getting private insurance (and obesity related illness) are the states opposing the legislation that helps them do that.
 
It seems that the economists’ view of the world is wrong.  People are not voting in their self interest.
  
 Most people don’t know what Obama’s bill does.  Broadcast media has contribute to the view that it reduces personal responsibility for health care.  But the truth is the opposite.  In our current system, hospitals are required to treat patients who show up at the emergency entrance with a heart attack - even if their condition is partly their fault, due to habits of overeating and under-exercising.  This uncompensated care is passes on as a cost to insurers and other payors, and the rest of us end up footing the bill.   The universal mandate is designed to fix that, by making everyone pay for the health care they get (and perhaps even encouraging them to see a doctor who will advise them to adopt a healthy life style).  Establishing personal responsibility, not socialized medicine, is the reason why conservative think tanks proposed the idea of the universal mandate in the first place, and why Mitt Romney enacted it in Massachusettts.   But most people seem still unaware of this.