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Severe Obesity Costs Medicaid $8 Billion Annually, Study Finds
Severe obesity is putting a huge financial strain on both the U.S. Medicaid system and severely obese patients themselves, new research suggests.
The study pegs the national bill for providing obesity-related health services for the severely obese at $69 billion a year, according to HealthDay. Severely obese is defined as a body mass index (BMI) of 35 or higher, the study authors said.
Medicaid pays just over 10% of the annual cost of treating the severely obese. That works out to about $8 billion a year, the researchers said. And that figure is likely to rise as Medicaid expands under the Affordable Care Act.
"Severe obesity affects one in seven adults," said study co-author Michael Long, an assistant professor at the Milken Institute School of Public Health at George Washington University in Washington, D.C. "And it increases the risk of disease and death at a much higher rate than moderate obesity."
Moderate obesity is a BMI of between 30 and 35, the study authors noted. "So although severe obesity accounts for only 41% of the 81.5 million Americans who are obese, the costs associated with treating it are actually 60% of all obesity-related costs combined," Long explained. "And Medicaid patients, who have low resources and a high burden of disease and obesity, are not covered completely. So severe obesity is a big burden on both Medicaid and patients."
Long and his colleagues reported their findings in the November issue of Health Affairs.
Obesity has tripled over the last 30 years in the United States, according to the study authors.
Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Connecticut, said that "obesity is, inevitably, enormously expensive, because it is on the causal pathway to every major chronic disease that plagues modern societies, diabetes most indelibly." He explained that "the costs of obesity extend out to the costs of all such conditions: heart disease, cancer, diabetes, stroke, arthritis, dementia, and more."
Those disease risks and costs are even higher for the 33 million Americans now considered severely obese.
To get a better idea of the costs of obesity, the team crunched data from two national studies conducted between 2007 and 2013. The studies included more than a half million people.
The researchers found that the moderately obese pay $941 more per year for health care, compared with someone of normal weight. By contrast, people who are severely obese pay $1,980 more, the findings showed. Private insurance covered more than one-quarter of these expenses, while Medicare covered about 30%. State-run Medicaid programs footed 11% of those bills, the investigators found, and patients were left to cover 30% out of their own pockets.
Some state Medicaid programs pay more than others. For example, Wyoming's program covers 58,000 severely obese adults at a cost of $64 million per year (at the low end of the scale). Meanwhile, California spends about $9.1 billion for 3.2 million adults (at the high end), the study reported. Regardless, the study authors concluded that severe obesity appears to be "disproportionately responsible" for a lion's share of the whole nation's health care bill.
Any solution, Long suggested, will have to address two issues: identifying cheaper but effective clinical interventions while also expanding treatment access for the severely obese. "That might actually cost more money in the short run," he acknowledged. "But it will have long-term payoffs, for both the patients and Medicaid. And we have to do something, because this problem is just the tip of the iceberg. If we just let this continue as is, the costs will only grow over time," Long said.
Katz added, "The only hope for the future of public health and the economy alike is to change the trajectory we are on, and put out this fire." But he said that, in his opinion, "the answer is not more drugs and surgery, but a culture-wide commitment to better use of feet and forks." In other words, exercise more and eat healthier.
Source: HealthDay, November 3, 2015.