A Weblog of Centrist Voices in American Politics
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A Weblog of Centrist Voices in American Politics | |
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June 27, 2005The High Cost of Only Counting Some of the CostsAccording to Obesity in U.S. carries hefty price tag, we can cut healthcare costs by tackling the problem of obesity.
I can accept people thinking we should tackle this problem for moral reasons, even if I don't agree with that. And I can accept a fiscal cost argument, but only if it counts everything. Don't obese people die younger? When was the last time you saw an 82 year old obese person? If we want to do the calculations to determine whether obesity is a net cost on society, don't we also need to count the following two numbers: --the number of healthcare dollars saved by not treating obese people after they die prematurely --the number of social security dollars not paid out to obese after they die prematurely Unless we count these numbers in making an economic cost argument for fighting obesity and find that, indeed, yes, obese people are more costly even factoring in premature death, then the only rational arguments are moral ones. My sense is that the economic argument may well be a trojan horse for lifestyle prohibitionists. If someone destroys their health and shortens their lifespan, that's troublesome. Troublesome enough to dictate behavior? Will we really save money by ridding the world of obesity? I have my doubts. Posted by Brian Keegan at June 27, 2005 03:23 PM Comments
Same reasoning applies to smokers. I think it's important to note that simply figuring out the relative costs is NOT the same as deciding to ration healthcare by such factors. For all that I knock the deficiencies of our health care system, we continue to pretty much provide major health care to all. And I actually do know some 80+ yr old fat people. I believe I read somewhere (meaning don't trust this info from my unreliable memory) that a certain amount of extra poundage picked up later in life is not nearly the health risk factor as obesity earlier in life. Being 20 or 30 pounds overweight in your 60's is not the same as being consistently overweight throughout your life. This is my guess, for whatever that's worth. But I imagine that, if you take the costs of health care for the average obese person over the course of his or her shortened life span, those costs would exceed the savings from said shortening. That's not to say that I don't agree with your point that the savings from pre-mature death should be factored into the monetary analysis. Indeed, they should. It is a strange thing to consider when such issues of health care are in question that everyone does ultimately die from something, regardless of his or her lifestyle. So what is the net effect of longevity? Do most people who live longer spend little time at the doctor's office or hospital and, in the end, keel over quickly with little muss or fuss? Do they spend more of their lives vigorously contributing to the expansion of the economy? Now, as is my tendancy of late, I must propose and absurdist and amoral question. If people who live longer healthier lives are actually more costly than the obese, alcoholic, smoking, etc., would we then be economically prudent to encourage smoking, drinking, over-eating, sloth, etc.? Posted by: WHQ at June 28, 2005 09:14 AMYes on fat, on smoking ... save Social Security, bring back Marlboro Man to TV! The real issue of health care is how much is consumption (in last 3, 6, 12 months of life?) vs. investment (where the treated live more than 1, 2, 5 years?). The other issue is Insurance -- can the insurance provider increase premiums for "more costly" behavior/ symptoms (fat, black lungs; gay sex for AIDs?). If not, then it's certainly unfair to make the "responsible" (less costly) pay for the "less responsible" (more costly) -- but full lifetime costs and taxes paid for health and retirement must be included. Posted by: Tom Grey - Liberty Dad at June 28, 2005 11:15 AMTop of my head from previous studies--30% of all health care costs are "end of life" care in the last 12 months of life. I have no further breakdowns handy on that, so don't start assigning too much meaning. Obviously, sick people use more health care, and really sick people tend to die. Posted by: Tully at June 28, 2005 11:41 AM |
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