Brief Summary: Effect Of Obesity On Health Insurance Rates

Effect of Obesity on Health Insurance Rates
By

Khalida Willoughby

American Public University

Abstract
Health insurance rates continue to rise partly due to the unhealthy lifestyles that millions of Americans choose to live. Among the leading reasons why insurance rates continue to climb is due to the rates of obesity in the nation. Unhealthy life styles of Americans such as increased consumption of fast foods, lack of exercise and lack or preventive care are mainly responsible for spike in insurance rates. Those who are obese have a higher incidence of chronic diseases to include stoke, cancer, heart disease and high cholesterol. This paper will define obesity and laid forth by health professional.
This paper will also establish and discusses those lifestyle behaviors that cause an increase in health insurance rates. The paper will also discuss costs incurred by the insurance companies, specifically due to obesity as well as steps that are being taken by health insurance companies to reduce such costs.

Obesity is the main factor responsible for the increasing costs of health insurance in the United States. Billions of dollars in costs are incurred each year by insurance companies due to the increasing numbers of those members who are obese. Obesity also has a great effect on the American economy because companies are finding it necessary to move jobs overseas where workers are more fit with lower health insurance premiums. Obesity is a risk factor for chronic conditions such as diabetes, strokes, cardiovascular disease, and hypertension. Costs related to treating obesity can be extremely high therefore insurance companies can deny coverage to those who are obese or charge extremely high premiums. The costs of providing insurance to those who are obese are high, leading to increase in premium costs for those individuals who are of healthy weight. Obesity is described as having an excess amount of body fat. In order to be obese, a person must have an excess of twenty percent body fat. If a persons body mass index is over 30, a person is described as morbidly obese if a person is fifty to one hundred percent over normal weight or their body mass index is over forty. When a person is significantly overweight, normal body functions are difficult to perform leading severe health consequences. Lack of a balanced diet and consumptions of calories in excess lead to obesity. Lack of exercise is also a major contributing factor for obesity. Eating too much and no or little exercise leads to obesity. In some cases, obesity is can be the cause of genetic disposition or a chemical imbalance. According to the Centers for Disease Control (CDC), in 2011, 33% of Americans or 72 million people in all age groups were obese. The rates of obesity in men was 33%, and women 35.5%. The rate of obese children is at an alarming 30.1% . The obesity rates are greatly effected by socio- economic status. Obesity rates are higher among Black and Hispanics and more prevalent in poorer communities. “ Long and healthy lives are tied to where people live, to income, wealth, education, race/ethnicity, immigration status, and the degree of inequality in society, as well as to other physical and social determinants of health.” ( Ashe et Al, 2009) In 2008, heath care costs associated with obesity were estimated to be over $147 billion with private insurers paying for most of the cost. (Health Affairs, 2009). “Since the early 1970s, adult obesity rates have doubled and childhood obesity rates have more than tripled, while health expenditures have risen two percentage points faster than the Gross Domestic Product (GDP), burgeoning from 8.8 percent in 1980 to a projected 17.9 percent in 2011.4” (Yang & Nichols, 2011). Two thirds of the rise in cost of healthcare can be directly linked to diseases whose risk factors are obesity. If obesity rates are not tackled now, estimates project that by 2018, health care spending due to obesity will rise to over $344 by 2018. In a study conducted by Jean Bearnheart, the relationship between weight status and health insurance premiums were examined. Study participants were between aged 19-26. Body mass index was used as the unit of measure. The hypothesis of the study stated that having health insurance meant lower body mass indexes. The study concluded that being overweight did mean little or no insurance coverage. Pediatric obesity is a social and economic issue that needs to be immediately combated.
According to the CDC, being overweight as a child is the number one risk factor for being overweight as an adult. In recent years, the effect of obesity on society has been brought to light due to the efforts of First Lady Michelle Obama. As part of her platform as first lady, she had dedicated her time to bringing attention to the dangers of childhood obesity in our society. Overweight prevalence is higher in boys (32.7 percent) than girls (27.8 percent). In adolescents, overweight prevalence is about the same for females (30.2 percent) and males (30.5 percent). The prevalence of obesity quadrupled over 25 years among boys and girls (Get Fit Foundation,
2011) The Get Fit foundation estimates that obesity is the number two cause of preventable death in the United States. Diseases that were once limited to adults are now more prevalent in children and young adults. According to the get fit foundation, todays youth are the unhealthiest in the history of America. Parents are focused on having a job and providing for their families that they do not take the time to properly monitor what their children are eating. The cost of food has steadily risen over the past couple of years. It is easier and cheaper for a parent to stop by a fast food chain for dinner than to go to the grocery store and purchase healthy and nutritiously sound foods. Technology has also impacted the level of obesity in our nation. Rather than go outside an play, kids are stuck on the couch playing video games, surfing the internet or watching television programs. Companies and Corporations also incur the costs of obesity associated with employees in the workplace. Kenneth Thorpe and colleagues calculate that obesity is culpable for 27% of the increase in inflation- adjusted health care costs among the working-age population that took place between 1987 and 2001. Thorpe also noted that as a result of obesity, employees incur an extra cost of $170 per year per employee, for a total of about $11.7 billion per year. Obesity also leads to loss of productivity and revenue due to time taken off because of illness. Health problems attributed to obesity have a significant impact on the US healthcare system in terms of direct and indirect medical costs. Direct medical costs include preventive, diagnostic, and treatment services,whereas indirect costs relate to morbidity and mortality. It is estimated that by 2016, companies will pass on healthcare costs to employees. If the problem of obesity gets worse, companies may even fail to to hire obese employees due to the rising cost of healthcare. This is called weight discrimination. Employers also view obesity as detrimental to the image of a company. Obese individuals are also seen as a financial liability to a company because obese people might be seen as lazy and unproductive. Medicare and Medicaid spending has increased due to the increased rates of obesity in America. The burden of these increases has caused an increase in tax rates that is directly paid for by the American people. Medicare spending is 8.5% higher and Medicaid almost 12% higher than it would otherwise be in the absence of obesity.” ( Frankstein & DiBenoaventura) the absence of obesity. There is indeed a shared social interest in reducing the incidence, prevalence, and excess health care costs associated with obesity. In order to cut costs and hopefully curtail the rising costs of obesity in 2011, Medicare introduced a program that will pay for behavioral counseling for adults who are obese.
In the past, Medicare did not recognize obesity as a disease. In 2004, Medicare changed its perspective on obesity, making it easier for weight-loss programs to be covered. (Stein & Connolly, 2004). This move was considered a big move by the federal government in helping to combat the obesity problem in our nation. “In addition to the practical implications of getting insurance to pay for more treatment, many experts said the move would help counter the stigma that is often associated with people who are overweight and obese. That might encourage more doctors to treat the problem like other medical conditions and overweight individuals to seek help” (Stein & Connolly,
2004). The recent changes included in President Obama’s health care reform act seeks to address the problem of obesity. The law is titled the Patient Protection and Affordable Care Act (PPACA). The law contains provisions that are meant to address and combat obesity within our society. Several of the provisions in the bill that tackle obesity are the following: improved nutrition labeling in fast food restaurants, which will list calories and provide information on other nutrients 18 the Childhood Obesity Demonstration Project, which gives grants to community-based obesity intervention programs and Community Transformation Grants, which funds community-based efforts to prevent chronic diseases to reduce obesity because they are focused on prevention (Yang, 2011). Contained in the new law are also programs that are directly in place to combat obesity. The PPACA also mandates that insurance companies provide screening services that wold help prevent obesity. The PPHA prevents insurance companies from charging a co-pay or coinsurance cost to individuals for services such as nutritional counseling and behavioral modification services. “ In addition, employers are allowed to reward employees, in the form of a discount or rebate of a premium or contribution waiver of all or part of a cost sharing mechanism, or the absence of a sub charge (an extra fee), for participating in a wellness program that is reasonably designed to promote health or prevent disease”. (Yang, 2011). Employers offering such incentives that are financial may motivate an employer to actively participate in their health. Although great emphasis is placed on lack of payment, there also needs to be just as much emphasis placed on the lack of willingness of insurance companies to pay for programs that help treat those who are obese. Health insurance plans often times do not pay for weight loss medications. Plans avoid offering such options to its members, or if they do cover weight loss programs, the premiums are significantly higher than those plans that do not offer such options. New technologies are offering new weight loss treatment options such as gastric bypass, or Lap band surgeries. Insurance companies are often reluctant to provide coverage for such surgeries because of the cost of the surgery and as well as the cost of post operative care. Therefore those overweight individuals are stuck in limbo, unable to pay for the treatment programs needed to help combat obesity. Americas obesity problem is one that is an epidemic and one that requires that lawmakers implement policies that will be effective in combating the problem of obesity. “America’s increasing obesity problem requires federal, state, and local lawyers, policy makers, and public health practitioners to consider legal strategies to encourage healthy eating and physical activity. The complexity of the legal landscape as it affects obesity requires an analysis of coordination across multiple sectors an discipline.” (Ashe et al, 2009). Combating the problem of obesity is one that is going to be challenging to citizens as well as health policy makers. “ Complex public health challenges, such as obesity, demand trans-disciplinary and multi-sectoral strategies, resource sharing, and political support. However, coordination between and within government agencies is hindered by several factors.” (Ashe et al, 2009). These factors include budget constraints, lack of resources, and the inability of government agencies to work together and of course willingness of the public to participate. Some policy makers have argued that those who are obese should bear the brunt of increased health care costs due to obesity. Members of society who are of normal or a healthy weight would be in support of such plans but those who are obese are at an unfair disadvantage. Some people have even gone as far as suggesting a tax that would be charged to those who are obese. In order to combat the obesity problem the issue has to be tackled from a variety of angles. Behavior modification is the most important factor in solving the epidemic of obesity in America. Insurance companies should provide fair and equal coverage for those who are obese with particular attention paid to lifestyle changes that would eventually lead to lower medical costs.

References

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