[Obesity Discussion]

Health Care Cost Obesity- Americans to Weigh In

BY JED GRAHAM
INVESTOR'S BUSINESS DAILY
Posted 5/29/2007
Wary of tackling Social Security or Medicare reform, members of Congress are pitching a new prescription for the nation's coming fiscal woes: fresh fruit and exercise.
Healthy diets won't pay the trillions of dollars in unaffordable health benefits promises. But politicians and policy advocates are arguing that heavier Americans — not just older Americans — pose an urgent fiscal threat.
The two challenges are not unrelated. A doubling of obesity rates among the Medicare population has been a big force behind the program's spiraling cost, concluded a 2006 study by Emory University health economists.
Emory's Kenneth Thorpe and David Howard found that spending on obese patients accounted for 25% of total Medicare spending in 2002, up from 9.4% in 1987.
An earlier Emory study traced 27% of the overall growth in health spending from 1987 to 2001 to treatment costs for obesity-related conditions such as diabetes and heart disease.
Growing waistlines also hold implications for Social Security. While there is speculation that obesity might slow or stop longevity gains, experts are much more sure of its link to disability. Higher disability rates are a double negative, driving up Social Security costs while shrinking the potential payroll-tax base.
A failure to address the obesity epidemic would "explode the federal budget," Sen. Tom Harkin, D-Iowa, said at the May 8-9 National Summit on Obesity Policy.
Harkin outlined his legislative efforts to trim obesity rates. Much of the focus is on combating childhood obesity.
The Child Nutrition Promotion and School Lunch Protection Act would authorize the secretary of agriculture to update the nutritional standards schools must meet to receive federal reimbursements.
The current definition of "foods of minimal nutritional value" lets schools offer candy bars, soda and potato chips. The new bill would expand the guidelines to cover not just food in the cafeteria but in school vending machines.
Harkin's measure has 11 co-sponsors, including four Republicans. But it might face opposition from snack food companies and possibly even schools that count on revenue from vending machine contracts. A 2005 Government Accountability Office report found that 75% of high schools and 65% of middle schools have contracts with soda companies.
Harkin is also pushing nutritional measures as part of the broader farm bill. He wants to expand a program he created that now provides free morning snacks of fruits and vegetables at some 500 schools. And he wants to provide incentives for the poor who rely on food stamps to purchase fruits and vegetables.
"The cheapest calories are starches and sugars" that lead to obesity, Harkin said.
Food of higher nutritional content tends to cost much more, making the fight against obesity "an uphill battle," said Peter Orszag, director of the Congressional Budget Office.
Harkin also is fighting to require restaurant chains to provide nutritional information on their menus.
Recent studies show that a focus on nutrition can pay off. A study of 10 schools in Sweden that banned sweets and sodas found that the number of overweight children dropped from 22% to 16%. Over that same span, another group of schools that didn't make changes saw the number of overweight children rise from 18% to 21%.
A study from Tufts University published this month in the journal Obesity found that a communitywide effort to battle obesity in Somerville, Mass., also produced significant gains.
The town's schools offered healthier foods, after-school activities and nutrition lessons. Even local restaurants participated. After just eight months, the average 8-year-old had gained one pound less than children in two similar communities.
While experts blame America's obesity problem mostly on diet, some legislative proposals aim to get people to burn more calories.
Rep. Zach Wamp, R-Tenn., wants physical education to be classified as a core subject under the reauthorization of the No Child Left Behind Act. Another measure would give employers a tax deduction for providing workers access to off-site fitness clubs.
The obesity epidemic has exposed the failings of a health care system that is short on prevention and "still focused on paying for intensive interventions," said Mark McClellan, former head of the Centers for Medicare and Medicaid Services.
A doctor's practice that focuses on prevention isn't rewarded in our current health system, McClellan said at the Obesity Summit.
In a 2006 study published in the journal Health Affairs, Emory's Thorpe reported that virtually all of Medicare's spending growth has come from an increase in patients with 5 chronic conditions, including obesity-related ailments.
McClellan and Thorpe joined with business, labor and health care groups to launch the Partnership to Fight Chronic Disease. The group hopes to make the prevention and better management of chronic disease a top health issue.

Health Care Cost Obesity