On 28-Jul-09, at 4:34 PM, Doug Henwood wrote:
> [from the WSJ's daily Real Time Economics]
>
> 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.
>
> 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.
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