Sitting Around, Chewing the Fat

Whether you look at Medicare statistics or at individual state healthcare plans (such as Hawaii’s), the reality is that being overweight places a profound burden on the cost of providing such benefits. Think about it, coronary disease, stroke, excessive wear and tear on joints, diabetes and even some forms of cancer can create amazing long-term complications, treatment costs and are problems that tend to get worse with age, not better. Yet there are strong links between being overweight and each of these diseases (and a whole host of additional ailments). Add being overweight to the health-decimating damage of “demon tobacco” and you have the two most massive contributors to chronic and often fatal disease.

Just look at the cost of diabetes, most of which falls into the category of type 2 (late onset), which typically arises later in life, particularly among those with weight issues. Hawaii’s numbers are most illustrative. According to the HonoluluAdvertiser.com (September 10, 2008) notes that 19% of state plan was paid out for the treatment of diabetes. And 40% of those being treated for diabetes were also under treatment for coronary disease.

They noted a study by the American Diabetes Association that this statistic is very reflective of national costs as well: “Average annual medical expenditures for a person with diabetes are $11,744, more than two times greater than the cost for someone without diabetes, the report said… Diabetes costs the country $174 billion annually, a 32 percent increase over the past five years. The costs include $116 billion in diabetes-related medical expenditures and $58 billion in indirect costs of absenteeism, lost productivity and early death… Medicare, the federal health insurance program for people 65 or older, reported $234.5 million in fee-for-service spending for people with diabetes in Hawaii in 2005. That's close to half of total spending of $532.8 million, and a higher percentage than on the national level, where 30 percent Medicare spending is for people with diabetes.” Wow!

We see the federal government and various states trying desperately to eliminate saturated foods (usually so-called fast food) from school cafeteria menus with new movements focused heavily on requiring chain restaurants to provide caloric and saturated fats information directly on the menu (not just posted “somewhere” in the restaurant). We see the television commercials showing celebrities battling weight problems, but able to triumph with one marvelous diet plan or food supplement or some “drug” that will “curb your appetite.” Articles on weight control abound, people suffer with volatile weight loss plans followed by a return to weight gain, a push-pull of alarming proportions on the human heart. Lap-band surgery is even advertised on billboards!

But, ladies and gentlemen, we are fat and getting fatter! Obese, actually. According to Wikipedia, “Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy.” The July 1^st Science and Technology section of BusinessWeek.com reported: “Adult obesity rates increased in 23 U.S. states last year and did not fall in a single state, an annual survey released on July 1 found. Adult obesity rates now exceed 25% in 31 states, up from 28 states last year and 19 the year before that… The problem appears destined to continue worsening, too, the report indicates. Among children 10-17, about 30% are overweight or obese in 30 states, says the survey, which also examined youth this time around. Study after study has found that overweight children are more likely to become obese as adults, and obese children are almost certain to remain that way.”

If we are to afford the massive healthcare plan that, sooner or later, will be a reality in the United States, we simply have to eliminate the greatest contributors to out-of-control increases in medical care by administering a very heavy dose of preventive medicine. We have to stop smoking and lose weight! BusinessWeek.com notes the magnitude of that effort: “[T]wo-thirds of U.S. adults are now considered overweight or obese, as determined by their body-mass index, a measure of weight in relation to a person's height. The survey also found that four states have obesity rates above 30%: Mississippi (32.5%), West Virginia (31.2%), Alabama (31.1%), and Tennessee (30.2%).”

Funny how many people eat (“comfort food”) when they get depressed or are stressed out, and with this unemployment numbers rising and home prices plunging, people with that proclivity have an open invitation to escalating the “fat wars.” But if we really want to increase productivity and reduce the huge anticipated burden of a national healthcare system, there is a clear path of individual choice. Perhaps there needs to be a specific “pound-for-pound” “healthcare surcharge” on those who are placing the greatest voluntary strain on medical costs. Heavy taxes on tobacco products, routed directly to support the new national system of healthcare, are equally appropriate.

As high healthcare costs really undermine our nation’s financial strength, her productivity and competitive abilities, maybe we should start looking at physical fitness and healthy lifestyle choices as patriotic. A “little” effort for a “big” problem.

I’m Peter Dekom, and I approve this message.