Sunday, August 16, 2009

insurance makes you fat

July 27, 2009, 3:13 PM ET
Does Health Insurance Make You Fat?
A recent economics paper may give skeptics of President Barack Obama’s push for near-universal health care new ammunition. The argument? Health insurance makes you fat.
Is it the health insurance or the hot dogs? (Getty Images)
Americans who have health insurance, either private or public, are more likely to gain weight or become obese, wrote authors Jay Bhattacharya and Kate Bundorf from Stanford University, Noemi Pace from University College London and Neeraj Sood from the RAND Corporation. According to the paper, which estimates weight gain in terms of body mass index, a measure of weight related to height, “private insurance increases BMI by 1.3 points and public insurance increases BMI by 2.1 points.”
Economists have long been saying that fat people weigh on taxpayers’ finances. A 2005 study estimated that the federal government pays for roughly half the total annual medical costs associated with obesity, resulting in an average annual $175 in per-capita taxpayers’ costs to pay for obesity expenditures among Medicaid and Medicare recipients.
And a study released today revealed that the overall cost of obesity-related health-care treatment doubled in a decade to $147 billion, growing faster than obesity rates, which went up 37% during the same time period.
The new evidence fits well with what Bhattacharya, Bundorf, Pace and Sood argue: Health insurance isn’t simply a transfer of wealth from thin taxpayers to overweight ones, but a “true economic subsidy for obesity.” According to the study, health-care coverage literally encourages obesity, because people tend to become less careful about weight-gain when they know that insurance will cover at least some of the weight-related health costs in which they may incur.
Though the study found weak evidence that more generous insurance encourages greater weight gain, or that risk-adjusted premiums discourage it, there was “strong” statistical evidence that being insured increases body mass index and obesity. So, will expanding health-care coverage to drive up U.S. obesity rates to new record-setting heights?
For those defending a U.S. health overhaul, France, the poster child of universal health care, offers handy counter-evidence.
The French have long enjoyed both some of the world’s most generous public health-care benefits and a global fame for legendary thinness. Universal health care, it seems, needs not come with a rising tide of fat.
Still, even in France obesity and generous state insurance make a toxic mix for fiscal budgets. Processed foods and sedentary lifestyle, in fact, have long been eroding the “skinny French woman’s” immunity to chubby tights, NPR reported. And rising obesity rates have added sizeable costs to the state’s health-care budget, the New York Times wrote in 2006.
With adult obesity growing at 6% annually in 2006 “the French could be — quelle horreur — as fat as Americans by 2020,” the New York Times writes. Already in 2002, obesity-related health-care costs in France amounted to between two to six billion euros (between $2.8 and $8.5 in today’s dollars), a French-language study estimated.