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Tuesday, December 6, 2016

You Now Pay for Your Neighbor’s Weight Problem: Thanks, Obamacare

Health-conscious people have to subsidize healthcare costs for people that make poor choices.

Everyone should have the right to do whatever he wants so long as it doesn’t harm person or property.  If you want to smoke a pack a day, drink a fifth of vodka before bed every night, or indulge in gluttonous habits, by god, that should be your right.

Unfortunately, lifestyle choices that have resulted in a 50-inch waist are now affecting people’s property because of something known as the Affordable Care Act. When I say property, I mean money.

The Affordable Care Act was a bill passed by Congress to expand health coverage to all Americans. This was to be instituted at no cost to any citizen. Well, anyone who has been paying attention to his health-insurance premiums over the past couple years knows this is simply not true. Health insurance premiums have increased dramatically in most instances.

You Will Pay for All

This occurs because details within the Affordable Care Act mandate that everyone is now required to have health insurance. It seems like a noble idea, except that along with everyone being required to have health insurance, health insurance providers were also forced to cover pre-existing health conditions.

Health-conscious people have to subsidize healthcare costs for people who make poor choices.Anyone with diabetes, coronary artery disease, cancer, obesity, etc. were all guaranteed to be covered under the ACA. You can see the problem with this. Coverage of pre-existing health conditions greatly increased the cost that health insurance providers were forced to pay out for treatment. This was supposed to be offset by young, healthy adults joining the health insurance pool. Due to already expensive premiums, young people have been deciding not to buy health insurance and instead pay a mandatory fine. This further compounds the problem and increases health insurance premiums even more.   

There is also a phenomenon where individuals are less likely to make wise health choices if it is perceived that they will not have to bear the economic consequences of those choices because insurance covers the majority of the costs.

Combine this with the ability of health insurance holders to seek out healthcare services without the cost being a major deterrent. You end  up with lots of people going to the hospital for very minor things. While at the hospital, doctors are motivated to extract the maximum amount of payment, via prescription of expensive and maybe even unnecessary treatments because insurance is covering the cost.

In defense of hospitals, they are often at the mercy of insurance companies and what gets approved for coverage, so they use a shotgun approach toward billing. At the same time, patients often seek out more expensive treatments when cost is not an obstacle. This completely undermines the doctor/patient relationship goal of not only choosing the best treatment option but also the most sensible treatment option from a cost/benefit standpoint.

These are just a few of the many examples that have led to the increase in health insurance costs. While providing healthcare coverage to everyone is certainly seen as humanitarian, it comes with the unfortunate consequence of health-conscious people having to subsidize healthcare costs for people that make poor choices.

Freedom Is Better

In a perfect world, meaning a free world, everyone would be able to live their life however they want and be accountable for the personal and economic impact of their choices. But, with the ACA we are all in this mess together. I can’t think of anything more humanitarian than trying to be a healthier person for yourself, all while simultaneously reducing the economic burden of your fellow human citizens.

I used the example of obesity to demonstrate a condition that causes an increased burden on the cost of administering healthcare to people. Some of you may be thinking to yourself “That’s wrong! Being overweight or obese is not unhealthy, nor does it have an impact on the cost of the healthcare.”

Well, you would be wrong. Research demonstrates that obesity and overweight are the second leading causes of preventable death, right behind tobacco usage.

Here are some alarming economic implications for obesity:

  • Obese adults spend 42 percent more on direct healthcare costs than adults who are a healthy weight.
  • Per capita, healthcare costs for severely or morbidly obese adults (BMI >40) are 81 percent higher than for healthy weight adults. In 2000, around $11 billion was spent on medical expenditures for morbidly obese U.S. adults.
  • Moderately obese (BMI between 30 and 35) individuals are more than twice as likely as healthy weight individuals to be prescribed prescription pharmaceuticals to manage medical conditions.

Now factor in that 68.8% of the US citizens are considered overweight and obese and you can see the dramatic impact overweight and obesity are having on our healthcare system.

I am not trying to single out overweight and obese people. There are plenty of other preventable health conditions that contribute to the cost of healthcare insurance. But obesity and being overweight are the most widespread.

While being overweight or obese are major issues to address, most all of us would be well served to quit smoking, drink less alcohol, exercise more, make better food choices, supplement wisely, and sleep adequately. Not only will that have a direct positive impact on yourself, it will have a direct positive impact on everyone forced to bear the cost of our nation’s health.   

What you do not gain from getting healthy is the one thing that would most benefit you from doing so: lower premiums on your monthly payments. Because of Obamacare, that pressing advantage has been taken from you. And everyone. Who can be surprised that the result is a less healthy population?

  • Austin Schanzenbach is a Health Administrator on a Native American Reservation in the Midwest.