Course on "Obesity Economics"

[Cynthia]

Whenever we assert that our bodies are no one else's business, someone pulls out the old, familiar economic bomb -- noting that obesity raises healthcare spending and thus affects all consumers. It's an argument that I've been repeatedly unable to counter, and I believe that it hurts our ability to advance the size diversity movement more than any other factor.

A Johns Hopkins online course, "Principles of Obesity Economics," is being offered free on "Coursera." Learning how the economics-based argument is constructed may help advocates counter it more effectively. I won't be taking it, but perhaps some of you will. If you do, please share your experiences.

Course Description

[Azrael]

And now with a single link I counter that age old argument...

BAM! New York Times


Basically, a study found that obesity is apparently a middle cost.

It's not as cheap as smokers but not as expensive as normal people.

Oh and the shocker here is that since normal people apparently live the longest, they cost the most and smokers cost the least.

Ofcourse, we'll never have people going on about getting rid of healthy people because they cost us money nope.

[Cynthia]

Thanks for posting that. (It gives a whole new meaning to the term "economy-sized.")

[portapotty102]

Too bad I didnt see this soon but let me explain how they are in fact wrong, very wrong economically.

The general argument that for how obesity costs more is this:

Pretty darn close to all health care spending is done through insurance companies. These companies essentially set up something called a "risk pool". These pools attempt to limit the risk associated the probability of expense paid out through diversification. Imagine that i hold one insurance policy. If I just hold this one policy and no others then I am taking a huge risk because if that person ever gets very sick im screwed. Now if I hold 100 policies then and one gets sick then I can easily pay out the expenses. Now if someone is continually sick/seeking medical treatment (they claim be the obese ppl) and causes my expenses to rise, then I will in turn rise the costs of all policy members to cover the costs. That is how they see obese ppl raising the general costs of insurance premiums of "healthy" others. At this point you get people crying "market failure" and 24 oz soft drinks are banned in NYC.

The Problem with this argument.

Health care is THE worst industry as far as operating on a common sense, business mind basis. Let me ask you a question; how much was your last doctors visit? Now I am not talking about co-payment, I am talking about the complete cost. I am sure that right now you are finding yourself unable to guess a price with 95% confidence. Now how much was a gallon (or liter) of gas? Chances are you can probably guess the price of gasoline within $.10. This is because energy is a fully functional market, health care is not. When you dont know prices you dont shop around. When you dont shop around, businesses dont compete. When businesses dont compete, they have NO incentive to lower prices. It is this problem that is the major contributor to rising healthcare costs NOT obese people. Fix the market and health care will become cheap again.

Let me put it another way. Do we yell at a TV lover for buying a lot of tvs? Do we yell at a apple lover for buying every new apple product? Do people yell at Jay Leno for buying many cars? No because that sounds complete ridiculous. Healthcare is just like any other good, so why would it make sense to yell at someone for using more healthcare than another?

The next time someone talks about this to you tell them "Don't hate the player, hate the game"

[vardon_grip]

"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."

I don't think the NYT article helps things. Fat people cost less because we die sooner? Not exactly a feel good message.

[Dr. Feelgood]

Originally Posted by vardon_grip

I don't think the NYT article helps things. Fat people cost less because we die sooner? Not exactly a feel good message.

If it'll make you feel better, think of it this way: thin people aren't necessarily healthier than fat people, they just take slightly longer to die.

[vardon_grip]

Originally Posted by Dr. Feelgood

If it'll make you feel better, think of it this way: thin people aren't necessarily healthier than fat people, they just take slightly longer to die.

I like your thinking! First to go in the ground. WINNING!

[moore2me]

Originally Posted by portapotty102

Too bad I didnt see this soon but let me explain how they are in fact wrong, very wrong economically.

The general argument that for how obesity costs more is this:

Pretty darn close to all health care spending is done through insurance companies. These companies essentially set up something called a "risk pool". These pools attempt to limit the risk associated the probability of expense paid out through diversification. Imagine that i hold one insurance policy. If I just hold this one policy and no others then I am taking a huge risk because if that person ever gets very sick im screwed. Now if I hold 100 policies then and one gets sick then I can easily pay out the expenses. Now if someone is continually sick/seeking medical treatment (they claim be the obese ppl) and causes my expenses to rise, then I will in turn rise the costs of all policy members to cover the costs. That is how they see obese ppl raising the general costs of insurance premiums of "healthy" others. At this point you get people crying "market failure" and 24 oz soft drinks are banned in NYC.

The Problem with this argument.

Health care is THE worst industry as far as operating on a common sense, business mind basis. Let me ask you a question; how much was your last doctors visit? Now I am not talking about co-payment, I am talking about the complete cost. I am sure that right now you are finding yourself unable to guess a price with 95% confidence. Now how much was a gallon (or liter) of gas? Chances are you can probably guess the price of gasoline within $.10. This is because energy is a fully functional market, health care is not. When you dont know prices you dont shop around. When you dont shop around, businesses dont compete. When businesses dont compete, they have NO incentive to lower prices. It is this problem that is the major contributor to rising healthcare costs NOT obese people. Fix the market and health care will become cheap again.

Let me put it another way. Do we yell at a TV lover for buying a lot of tvs? Do we yell at a apple lover for buying every new apple product? Do people yell at Jay Leno for buying many cars? No because that sounds complete ridiculous. Healthcare is just like any other good, so why would it make sense to yell at someone for using more healthcare than another?

The next time someone talks about this to you tell them "Don't hate the player, hate the game"

Dear portapotty,

I enjoyed reading your explanation and think you did a very good job explaining a complicated issue. You also write very well too. Bravo, I give you two thumbs up and snaps. You may well become a lawyer, teacher, or politician if you're not there already.

I have some additional material you might want to weave into your next piece of persuasive writing - I call it the Wal-Mart factor. I think you already understand what I mean. Can the average shopper at Wal-Mart understand your article and summarize it? (Notice I did not say "read the article".) I am judging that your target audience was college level folks. Could you write to a junior high level of comprehension? You probably could.


Second comment for argument's sake - Many of us really don't want or seek cheap health care. I might if I just need a flu shot, urine test, or hearing test. But, a few of us have a very complicated set of co-morbidities. What I need are the best experts I can find and who will accept me as a patient. I currently have five doctors (I have a lot of baggage). However, most of these men & women are keeping me out of more trouble (for the time being). What I mean by trouble is excessive health care costs.


Third argument for the presidential debate - Both candidates have said doctors should be rewarded for keeping their patients healthy and in good shape. My questions - How about a doctor that specializes in geriatric patients? How about doctors that specialize in caring for cancer patients? or nursing home patients? or AIDs patients? How about doctors that care for the homeless, etc?

Fourth and final argument (my theory) - I think the average person who dislikes fat people is not thinking about insurance economics. I think that teenage girls, teenage boys, and other fat bashers could care less about cheap medical costs. I think these bashers just hate fat people. We are on the same shelf as snakes, spiders, doggie poo, and people that clean out septic tanks (or untouchables). Too many people were hiding behind the door when they were giving out human kindness, grace, and compassion.

[Zoom]

Instead of bothering trying to read and understand the arguments, and wasting time developing a counterargument, I simply shrug and say "They're probably lying because they want money".

Obviously they have a motive-- either to get rid of people's flab or to get them to buy into someone else's philosophy or routine.

Look at all the time we saved! Now we can get back to living life.

[Azrael]

Originally Posted by vardon_grip

"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."

I don't think the NYT article helps things. Fat people cost less because we die sooner? Not exactly a feel good message.

It's not supposed to be a feel good message really, it's supposed to counter the "we should get rid of fat people because of costs to the state" argument.

Which is what it counters, that's the point.

[vardon_grip]

Originally Posted by Azrael

It's not supposed to be a feel good message really, it's supposed to counter the "we should get rid of fat people because of costs to the state" argument.

Which is what it counters, that's the point.

No, it doesn't counter that argument. (as far as the NYT article states) The highlighted portions show that fat people cost more between the ages of 20-56. (the prime years!) It is messed up logic to say that fat people (and smokers) cost less because they die sooner than thin people. Poor health and dying sooner than the average are nothing to cheer about (HAES?) and the NYT article will not do much to change the minds of thin people who believe that fat people are costing them money.

[EMH1701]

I would like to know how I cost everyone more simply by existing if I have no serious health issues because of my body weight. The argument does not seem to hold water for everyone. In fact recently, there was a news article that admitted such a thing as "benign obesity" exists. Clearly not everyone who is a fat person has health issues related to their weight, and assuming such is discriminatory. I contend it's not the body weight, but other factors are involved, such as what a person eats and how much one exercises. Fat vegans do exist, despite the fact that people don't want to believe it.

[Azrael]

Originally Posted by EMH1701

I would like to know how I cost everyone more simply by existing if I have no serious health issues because of my body weight. The argument does not seem to hold water for everyone. In fact recently, there was a news article that admitted such a thing as "benign obesity" exists. Clearly not everyone who is a fat person has health issues related to their weight, and assuming such is discriminatory. I contend it's not the body weight, but other factors are involved, such as what a person eats and how much one exercises. Fat vegans do exist, despite the fact that people don't want to believe it.

It's basically a game of averages really...

You could have a bunch of people who have absolutely nothing wrong with them and you could have a certain amount of people who die very early. The ones which die early bring the average down to something lower than normal. So even if it's not all around people will love to use generalisations.

I would also agree that the simplifying that the media tends to do when it comes to health is bunk.

I mean a doctor will look at blood pressure, cholesterol levels, heart rate, respiratory rate, blood sugar levels, and body fat percentage.

The assumption that one automatically means an individual is unhealthy is a very simple and incorrect view of things.

Originally Posted by Vardon_Grip

No, it doesn't counter that argument. (as far as the NYT article states) The highlighted portions show that fat people cost more between the ages of 20-56. (the prime years!) It is messed up logic to say that fat people (and smokers) cost less because they die sooner than thin people. Poor health and dying sooner than the average are nothing to cheer about (HAES?) and the NYT article will not do much to change the minds of thin people who believe that fat people are costing them money.

Depends entirely on the system.

In most of the Western world it isn't private healthcare so from cradle to grave (IE the long run) overall it costs less (because of state healthcare).

In a system like say The American system (the minority in the West) an Insurance company will have to pay for those costs so there's an increased risk for taking on the obese (thus the obese will have to pay more).

Also, the average mentioned in there (if I recall) was 80 as opposed to 84.
A 4 year difference.
Woohoo, based on the wonderful game of averages fat people will live on average 4 years less than normal people.

Nothing to panic/cheer about but nothing that the media could scare you with (such as the lovely "you're going to die in your 40s if you get fat type of thing).