Medical Care for Obese $1400 extra per year

Conventional Wisdom: I can’t believe it!  Obese individuals are causing the collapse of our healthcare system.  According to a report I saw in the AP, obese individuals cost us $1400 more per year in additional medical costs.  Let’s get them on the biggest loser and save our health care system!

The question is, does obesity cause sickness.  The original article from which the report is based claims that the cost to treat obese individuals has not changed between 1998 and 2006.  What has changed over this period is that a higher proportion of individuals are obese.

According to the article, “across all payers, obese people had medical spending that was $1,429 greater than spending for normal-weight people in 2006.” This figure was calculate by examining the differences between probability an obese person received a certain treatment compared to a healthy weighted person.  Then the average spending difference for that type of treatment was multiplied by this difference.  Thus, $1400, may be an underestimate if obese individuals have more serious hospital stays.

On the other hand, this study does not prove that obesity is the cause of these additional health care costs.  Let us think of the following thought experiment.  Assume the world is made up of 100 healthy people in year 2.  In year 2, half the people get sick, cannot exercise and gain weight.  Assume sick people incur $2000 in health care costs.  Now in this scenario, we would observe that sick people have higher health care costs.  Similarly, obese individuals have higher health care costs.  However, in this simple example, no one is innately obese; they only become obese from lack of exercise specifically due to their illness.  Thus, finding a correlation between obesity and medical costs does not prove that obesity causes increased medical costs. 

Further, obesity is only a problem when health insurance plans are community rated.  If obese individuals paid higher health insurance cost, then obese individuals would pay for their higher probability of becoming ill. Without community rating, however, any cost for additional medical costs to care for the obese will be shared among taxpayers.  This may unfortunately vilify the obese just as smokers have been villified in the U.S.


  1. You say that as if we haven’t already successfully vilified the obese.

  2. There’s no doubt that being obese causes health problems. It would be great to have a healthier and thinner nation. Yet, how can you point out over-eating and under-exercising when there are plenty of other things that cause health problems and cost us money? We still treat people who get sick due to cigarette smoking. We treat people who get sick due to things we deem illegal, like drugs. People get sick from lowered immune systems from working too much or not getting enough sleep or running their bodies down via any kind of stress (mental or physical). People pass on genetic conditions which cause severe health problems and cost us money. We treat people who decide to do stupid things causing themselves and others injury. I’m just wondering what the point is at pointing out a particular cause? Sure, people can start eating better and exercising more in this country (and they should!), but I guess they should also stop smoking, taking drugs, having babies, and attempting home improvment projects! We all want to be covered for what ails us, but then don’t want to take on the cost of what ails others (because it’s their fault?) Collecting this information should only be used as a means to realize we need to promote healthier lifestyles through education, etc. But wait….that will cost money too!

  3. Oh please… why do people have to find scapegoats.. I know a lot of overweight even obese people who are perfectly healthy. The AMA is lowering the limits every year what is acceptable as blood pressure, weight, glucose level etc so that more people have to take medication to correct it.
    Instead of making sure that the food we eat is healthy (obesity skyrocketed since high fructose corn syrup is used instead of sugar) they try to medicate everyone.

  4. Anna, you’re correct that many are healthy but they are unlikely to stay that way throughout their lifetime. You hit on an excellent point that gripes me about treatment of many conditions, the treating of symptoms rather than the root problem. Much (most) type II diabetes is caused by obesity, heart disease and many other issues can be linked to the diabetes, than as you say, most people want to be treated with a pill rather than pursue the cure (loosing weight in a healthy manner).

    Side note: high fructose corn syrup, sucrose (table sugar), glucose, they are all simple sugars and are bad for you when consumed in excess (like most things).

  5. Individual insurance policies typically add a surcharge for obesity and smoking. Life insurers do as well. Makes sense that people pay for potentially fixable health issues.

  6. I can’t believe this blog isn’t more popular … Great site!

    One note on this post: While it’s true (and obvious) that rising obesity has contributed to rising average health care costs on a per annum basis, recent studies have suggested that obese people do not spend more on health care over their lifetimes than non-obese people. This is due to their shortened average lifespans. I would say that the government should disincentivize obesity to improve health outcomes, but not necessarily to save money. Thus, a tax on unhealthy food seems a more sensible policy than asking obese people to pay higher premiums.

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