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Last week, The Los Angeles Times health blog reported on the obesity epidiemic:

Spending on healthcare for obese American adults increased 82% between 2001 and 2006, according to a new government report. In 2001, expenditures for obese Americans totaled $167 billion compared with $303 billion in 2006. Costs for adults who were overweight rose 36% during that time period while costs for normal-weight adults increased 25%….

Obesity being a massive problem in America is no great shock, nor is the plain truth that the overweight are more susceptible to chronic ailments. If you have low back pain, excess weight can often make it worse; if you need a bone marrow biopsy the more flesh, the riskier the procedure becomes. Generally, the more obese the patient, the harder the patient is to treat effectively.

The United States knows all to well, losing weight is hard, and becoming harder. There are the commercial reasons, the demographic reasons, the emotional reasons. It cannot be denied that progress over any of these obstacles falls hard on the overweight person, and their actions. But the healthcare industry can help, and drop costs at the same time.

An obese patient who presents with a long history of low back pain, can benefit more from a detailed action plan (diet, exercise, therapies) than costly, often repetitive, injections with no long term guarantee. The problem is doctors don’t get compensated nearly as well for keeping a patient healthy as they do for performing a procedure or ordering a test.  The system must morph into an ”incentive for preventive” system and leave the fee-for-service model behind. Reform has it’s obstacles; most doctors, after all that expensive schooling, are expecting a big paycheck.  Doctors will have to lower compensation expectations—a two week vacation rather than the two beach houses.  Medical schools will  also need to adjust, getting an undergraduate degree is expensive enough, another $100,000 plus is pushing absurdity. Finally, insurance companies will have to reimburse for preventive measures, and reimburse fairly.

It’s important to note the above statisitics state, normal-weight adults have also seen a drastic increase in healthcare costs—a good indication that this is not solely a cohort problem, rather a systemic problem. Being healthy and fit is a great goal for every person and for America as a whole—a way for each individual to help lower the cost of healthcare in total. But a healthy, slimmer America is not the silver bullet, rather just one of the rounds in the chamber. Should all people try to remain at a healthy weight? Absolutely. Will it alone fix all our heathcare problems? Hardly.

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