Medical professionals, public policy experts and scientists converged on Atlanta for Obesity Week recently for a very simple reason: The rate of obesity in the United States simply is not sustainable. Not for our country, not for our communities and certainly not for individuals.
How bad is it? In the past 30 years, the percentage of American adults who are obese has doubled, driving a sharp rise in such chronic conditions as diabetes, heart disease and hypertension.
The ramifications for health spending are significant. Annual health costs for obese individuals are more than $2,700 higher than for non-obese people. That adds up to about $190 billion every year. And many of these costs are borne by Medicare, which will spend a half-trillion dollars over the next decade on preventable hospital readmissions alone.
We cannot afford to wait until patients are on Medicare to fight obesity. We need personal solutions — and policy solutions — to get obesity under control.
First, we must take personal responsibility by eating less, eating healthier and exercising more. That is the basic formula for losing weight. We all know that. But, for a wide variety of reasons, that doesn’t work for everyone. We can lecture, cajole and plead all we like, but we still have an obesity problem. More than one in three American adults are obese, and experts say it’s only going to get worse.
That’s where the policy solution comes in. The American Medical Association recently, and rightly, classified obesity as a disease. That has sparked an important conversation about treatments and coverage of obesity under Medicare and other insurance plans.
Medicare must begin covering obesity treatments because chronic diseases are a primary driver of higher costs in the Medicare system and, as we know, obesity is a primary cause of chronic disease. As it stands now, however, Medicare is specifically prohibited from covering obesity treatments. That’s a mistake, and Congress must pass the Treat and Reduce Obesity Act, which will permit Medicare to provide the care people need — and remove costs from the system.
If Medicare begins covering obesity treatments, it will significantly reduce the long-term costs associated with obesity-related chronic diseases.
An example can be found in the Medicare prescription drug benefit. During the Medicare Part D debate, actuaries came in with astronomical costs, because they were only looking at the price per prescription and multiplying.
They were wrong.
Not only did the Part D program come in under budget because of competition, it actually reduced costs elsewhere in the Medicare system. In fact, the Medicare prescription drug program lowered hospital and nursing home bills for patients because access to affordable medicines kept patients healthier longer, and out of the more expensive hospitals and care facilities.
Instead of paying $100,000 for a hospital stay, Medicare was paying, say, $100 a month for prescription drugs. Which is the better deal?
Now, we must do the same with obesity treatments under Medicare and the health exchanges under the Affordable Care Act.
Obesity is a condition that we would be wise to cover and treat early and often, because the tidal wave of diseases that come in its wake are much more costly in dollars and lives. We simply must stop waiting for people to get sick and then spend infinitely more trying to make them well again. It’s just silly.
Covering obesity is a no-brainer. We must begin behaving rationally if we are going to come to grips with rising health costs and a population that is getting sicker.
Tommy G. Thompson is a former Wisconsin governor and U.S. Health and Human Services Secretary. Dr. Kenneth Thorpe is chairman of the Rollins School of Public Health at Emory University.
