Fat Load

Far be it from me to deny the undeniable, but the fact that obese people have higher annual health care costs, which is what this study found, does not mean they have higher lifetime costs. It therefore does not follow that reducing obesity would reduce total medical spending in the long run.

In fact, a study published last year in PLoS Medicine reached the opposite conclusion: Because obese people tend to die sooner than thin people do, the researchers found, eliminating obesity would increase spending on health care. "Although effective obesity prevention leads to a decrease in costs of obesity-related diseases," the authors wrote, "this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

In a December report, the Congressional Budget Office likewise warned that "any savings to the federal government" from discouraging unhealthy habits such as overeating or smoking "could be at least partially offset by additional expenditures as healthier individuals live longer." For example, "Medicare costs could rise for the treatment of other diseases and conditions during those extra years of life, and expenditures for programs that are not directly related to health (such as Social Security) could also increase as life spans are extended."

Overeating, like smoking, seems to be one of those risky habits that saves taxpayers money. If reducing demands on the public treasury is the aim, such habits should be encouraged.

Or maybe we should question the idea that every citizen is a cost to be minimized for the greater good, without regard to his own wishes. The bigger the government's role in health care, the stronger the rationale for such collectivist thinking.