Fat people cheaper to treat

ForceD · Feb 7, 2008

Did anyone happen to see this article about the cost to treat skinny, healthy people compared to treating smokers and/or fat people? The researchers say it came as no surprise but I have to say that I have never thought of it this way. What they’re saying is that the skinny, healthy people (like us) cost the healthcare system more because we live longer. What the article doesn’t mention (because the study probably doesn’t) is the comparative quality of life in the later years. To me that’s important. I’d bet that when we’re in our 80s and seeking treatment for a simple arthritic knee or a vision problem, they’re only in their 70s, lugging oxygen tanks to their doctor’s office looking for a complete heart and lung transplant. Dan Study: Fat people cheaper to treat <a href="http://www.usatoday.com/news/health/2008-02-05-obese-cost_N.htm" target="_blank">http://www.usatoday.com/news/health/2008-02-05-obese-cost_N.htm</a> LONDON (AP) — Preventing obesity and smoking can save lives, but it doesn't save money, researchers reported Monday. It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars. "It was a small surprise," said Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more." In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers. Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the "healthy-living" group (thin and non-smoking), obese people, and smokers. The model relied on "cost of illness" data and disease prevalence in the Netherlands in 2003. The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run. On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than the healthy people. Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on. The cost of care for obese people was $371,000, and for smokers, about $326,000. The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars. "This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," said Patrick Basham, a professor of health politics at JohnsHopkinsUniversity who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas, and changing science. "If we're going to worry about the future of obesity, we should stop worrying about its financial impact," he said. Obesity experts said that fighting the epidemic is about more than just saving money. "The benefits of obesity prevention may not be seen immediately in terms of cost savings in tomorrow's budget, but there are long-term gains," said Neville Rigby, spokesman for the International Association for the Study of Obesity. "These are often immeasurable when it comes to people living longer and healthier lives." Van Baal described the paper as "a book-keeping exercise," and said that governments should recognize that successful smoking and obesity prevention programs mean that people will have a higher chance of dying of something more expensive later in life. "Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more." The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs. "We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons." Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed

pete_72 · Feb 7, 2008

only focuses on cost, not contribution. If you're fit and healthy and work a full career you will (on average) contribute 10-15 years more to social Security (or the insurance company in a private health care model) than the person who checks out at 50.

pete_72 · Feb 7, 2008

*on average implies there's numbers behind my statement. There aren't. 
should have maybe used the word "typically". If you work to 65 you typically contribute more than the person who doesn't. (The money for health doesn't just materialise, it comes from the people who use the healthcare).

jroden · Feb 7, 2008

I'm a little suspicious that the costs associated with terminal stage diabetes related to to obesity may not be fully reflected in these data. My understanding is this affliction is one of the major costs to the healthcare system is a substantially related to lifestyle in adults.

bcc594 · Feb 7, 2008

On the surface, the argument seems to make sense. But, as Pete points out, if you take into account worker-days lost to illness, lost productivity, and extra contributions to either state or private care providers, things more than likely pan out. Besides, I want to enjoy my life.

teacherjen · Feb 7, 2008

"The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs." 
Yep, that's exactly what I was thinking as I read it.... there's a whole portion of financial contribution not accounted for here. But it is interesting.

ForceD · Feb 7, 2008

Yeah, there are lots of questions that are evidently not confronted. For example, if you take us healthy people out of the equation and we’re neither contributing $$ to the system nor using the services…do the fat smokers contribute enough to take care of themselves? 
Dan

LeftRightRepeat · Feb 7, 2008

I'm just doing my part to keep health care costs down. Hey, you gnna finish that jelly stick?? <img alt="" src="http://bestsmileys.com/eating1/6.gif" style="border:0px solid;">

melistic · Feb 7, 2008

I just don't even see how this can be true. Granted math is never my friend. 
I go to the doc. once a year because they make me. Mostly no test are run. Takes about 15 min. 
I have many clients who see the doctor at least once a month. I have been there for hours with some folk. I bet prescriptions are not included in those figures. As well, the day to day cost of diabetes. Or obesity. The sticks and papers and insulin. The orthodics, the wheelchair the home blood pressure testing. Home health aid. I bet turn over time for doc.s wasn't figured either. Takes me a whole lot less time to take off my shoes, jump on a scale, walk down the hall, hop on the table than it does someone clinically obese. Not to mention I have less issues to deal with from the outset. (Now if doctors actually knew anything about wonky knees or creaking shoulders) 
I have been to more than one doctor with more than one client. There are lots of test. Lots of blood-work. How about what insurance covers. Stop smoking patches are expensive. Nutritionist at multiple visits. What about the girl laying next to me at the chiro who's there 3x/ week to my occasional wrenched whatever. She's there because she sits in an armchair all day everyday. Of course it hurts. 
According to your study WE are going to live, on average, only 4 years longer than the obese. This in itself points out some faults to the data. That is not necessarily healthy people, more likely it is a study of people who's BMI is not in an unhealthy range. Which, in my opinion is a useless measure. Janis, Jimmy & Jim were probably in a healthy BMI range but healthy? NO 
*concerned about the healthy people having more strokes..

pete_72 · Feb 7, 2008

I just don't even see how this can be true. Granted math is never my friend. 
I think the likelihood is that if you grow old you're gonna be eligible for the old-people-only treatments (hip replacements, that kind of thing) that them that die young never need. at $417K versus $371K you might cost 12% more as an absolute figure, but it's going to be largely back-end loaded (ie. once you are actually old). 
I wouldn't worry 'bout it. A quick scan of this board says we're all gunna get flattened by SUVs. <img alt="uhoh2.gif" src="http://files.kickrunners.com/smilies/uhoh2.gif">

Tithers · Feb 7, 2008

Allz I know is TG for GROUP INSURANCE! 
This hawt chick is totally UNISURABLE for private plans.

4boysmom · Feb 7, 2008

There was a raging debate in another forum about this. This gal that's twice my size claiming that there's nothing wrong with her, that she can be as big as she wants and it's not going to affect her health. Okay... After being shouted down, I gave up. 
Here's the thing. My husband is obese. His prescriptions are all lined up on the counter. I don't even know what all he's on these days. And, he uses a breathing machine at night. He doesn't have any of the biggies yet--high blood pressure, heart disease, diabetes--but it's only a matter of time. Both his parents died of heart disease in their 60's. He's 45. 
Now, I probably do go to the doctor more than he does. You know, all those silly running injuries... But, now which to you think is easier to treat--someone with a sports related injury or someone with a chronic illness due to obesity? 
edit to add--Grandpa was a runner way back when running was "unhealthy". He had his jewelry business, which was quite active until he had a stroke at age 89. He died of pneumonia at age 90. Grandma used to s/b/r, and now still walks. She's 92. ALthough she's currently in a nursing home after a nasty fall last week (fell into the corner of a dresser and broke several ribs and ruptured her spleen) her health is very good, and expects to return home in a couple weeks.

rottensquirrel · Feb 7, 2008

As someone pointed out skinny people live longer so they have years of cost associated with their increased lifespan. In addition living longer puts them at higher risk for costly problems (Alzheimers) that can be long term issues. Overweight people and smokers tend to die quicker than skinny folks. 
I think other studies have been done to show the health costs associated with smoking do not exceed for the money brought in (taxes etc.) I have been told the same is not true for alcohol perhaps alcoholics live longer than smokers. 
From my pespective it can be incredibly difficult to treat obese pts. Oftentimes their joints fail early and surgically the procedures are more difficult to perform and the complication rates are higher.

jroden · Feb 8, 2008

If the study was comparing the dutch system, perhaps it's apples and oranges. End of life is far and away the largest cost in America, but other countries have health systems that ration things like dialisis and ICU beds, so it's difficult to compare.

ForceD · Feb 8, 2008

What I’d like to see the study further look into is a comparison of physically fit people and the “skinny, healthy” people used in the study. Skinny doesn’t necessarily mean healthy, and neither necessarily means physically fit (and vice versa). In other words, does someone who remains physically fit through their life draw as much from the healthcare system as someone who is “healthy” but not necessarily physically fit? Further, what is the comparative impact on the healthcare system between the shorter living fat smokers and the longer living physically fit? 
Dan

mmoonptdeux · Feb 8, 2008

That what I was thinking myself. There are some skinny people who couldn't walk a mile without getting exhausted and there are some obese people who can do an Ironman (like the guy they briefly touched upon in the last NBC broadcast.)

Fat people cheaper to treat

Top Contributors this Month