The obesity wrinkle (heh)...

The debate over health care reform is producing some odd arguments. The WSJ jumps in with this valid point.

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? [More]

After offering this as a counterargument to expanding health insurance access, the writers conveniently pull their train of thought to a halt on a siding.  But the next step in this line of thought is clear: if obesity is a rapidly growing problem right now, we need to cutback current levels of insurance coverage, or at least charge fat people enough more to recover such expenses.

Yeah - that might happen. But it may also be pointing out that our current health care system doesn't seem to be up to the real health care challenges facing us - and I think obesity is one. 

Check the picture in the article.  One carefully unspoken - but subtly alluded to - concern among many who fear changes in a system they have already successfully gamed (gotten more services than premiums paid) is adding obese minorities (blacks and Hispanics have higher obesity rates; MS is the fattest state, etc.) will allow health costs to really go wild.

This may well be right. But it doesn't have to be that outcome. Obesity, despite some claims to the contrary is a real health problem.  Suggesting access to health care  - which will be the way we address this issue - is counterproductive on obesity strikes me as a strange approach, and a potentially explosive precedent.