Healthy people are too expensive for society?
February 5, 2008
As suggested by the story in today’s New York Times, we can expect to hear much fuss about a new study showing that obese people and smokers cost less to treat. Of course they do. They die sooner. Healthy people are expensive say some Dutch economists in this new study. Economists have an interesting way of looking at such things; all they care about is money. But what about quality of life? Shouldn’t that count as economic value?
[…] Healthy people are too expensive for society? […]
Pingback by What does Heart Healthy really mean? by Health Tips — February 5, 2008 @ 12:03 pm
I think every time one reads a study that finds nothing more than a correlation but tries to establish causation, one should practice flipping cause and effect. Otherwise, we are at risk of concluding things like, “Large pants cause obesity,” or “Flooding in the basement causes rain.”
Maybe this is another place where we might have the interpretation backwards. You, and the authors of the NYT article, suggest that healthy people cost more because they live longer. What if it’s the other way around - people live longer because they cost the health care system more? That is to say, if you’re going for routine physicals, having all those expensive tests the experts recommend, getting a lot of preventive care, and immediately, aggressively going for treatment when problems are found, you will live longer.
An unrelated thought - I wonder if the authors of the dreaded Mississippi bill read this. If overweight people do cost the health care system less than thin people, what does that do to the argument that legislators have a right to discriminate against fat people for the sake of public funds?
Comment by Migraineur — February 5, 2008 @ 5:12 pm
If changing one’s diet to an American style, high meat & dairy habit, to a plant based diet is a much more drastic change than switching from a vehicle that gets maybe 35mpg better– 15 mpg (1995 Ford Explorer) to 51mpg (Toyota Prius), I hardly see how this is likely. And if it is, what is their solution to this problem, we should all end life sooner? Ha.
Comment by Daniel Ithaca,NY — February 5, 2008 @ 6:36 pm
OK read the article. 1) All data is for the Netherlands, (countries with say radically different health care systems and costs might work quite differently) 2) Obese people are more expensive than smokers or “healthy-living” people, in lifetime cumulative numbers until age 56, but healthy-living folk are more expensive in lifetime totals, “because of differences in life expectancy” 3) This study only looks at “health-care costs” not at other costs or revenues created by the conditions. It is possible that, for example, the cost of actually buying the cigarettes, means that the lifetime total costs of smoking are more than that of healthy living. Likewise, smokers and obese people have higher death rates than healthy people long before retirement age (and work loss for days missed due too medical treatment). Thus, smokers and obese people probably contribute less to the economy per capita than healthy-living people on a lifetime basis. I would be totally unsurprised if a study that focused on overall costs, rather than just “health-care costs” found that healthy living people are less expensive, even though they live longer in aggregate. (Again the study itself points out this problem if you read the whole thing, not just the summary at teh beginning). 4) The study uses a simulation modelling strategy based on other studies that have found a causal link between BMI and health-care costs without specifiying that link, thus as the study it self points out it is extremely vulnerable to “confounding variables, eg socio-economic status” 5) the study argues that the proper goal of health-care is not cost-savings but being cost-effective; I’m quoting here “Bonneux et al. [9] made this very clear: “The aim of health care is not to save money but to save people from preventable suffering and death. Any potential savings on health care costs would be icing on the cake.”
-By Brian M. using his wife’s account
Comment by Robyn M. — February 5, 2008 @ 7:50 pm
I dunno, I think it’s got some bearing. After all, we live in a society where employers and HMOs openly discriminate against obese employees because of the supposed costs they rack up in terms of health insurance. If that’s not actually true, then a whole lot of people have been badly mistreated because of some faulty calculations.
It shouldn’t be an excuse for smokers or the obese to not take care of themselves, but I hope it’s a wake-up call to all the companies who have threatened to fire staff if they don’t lose weight or HMOs who threaten to cut off benefits to people who don’t achieve a specific BMI.
Comment by Sheryl — February 6, 2008 @ 8:20 am
“Economists have an interesting way of looking at such things; all they care about is money.” If you say so.
Parke
Comment by Parke — February 7, 2008 @ 11:59 am
Present company excepted, of course!
Comment by Marion — February 7, 2008 @ 1:38 pm
[…] again from Marion Nestle news of the Dutch economist study that shows that overweight people and people who smoke are less costly […]
Pingback by Curious Creature » Newsflash - Obese people and smokers less costly to society — January 2, 2009 @ 2:54 pm