Two Generations

Growing Old with Obesity, Blowing Up Healthcare Budgets

Adult Prevalence of Obesity by Age GroupsIf you’re looking for good economic news, avert your eyes from healthcare. Trustees told us yesterday that Medicare will be insolvent only eight years from now. That’s three years sooner than the last estimate. One reason is that healthcare spending is growing faster now. Healthcare spending is up by 5.3% this year. Why? A new study in Health Affairs tells us that growing obesity in an aging population is blowing up healthcare budgets.

People are growing old with more obesity than ever before. And of course, the complications of untreated obesity are piling up. Diabetes is near the top of the list of a few conditions driving nearly half of the growth in health spending.

Aging, Obesity, Technology, and Preventive Care

Economist Abe Dunn and colleagues found that merely 30 conditions accounted for 42% of healthcare spending growth between 2000 and 2014. Those conditions were only one tenth of the conditions the researchers analyzed. But they drove an outsized portion of the growth in healthcare spending.

Costs for diabetes, kidney disease, and arthritis are growing rapidly.  We are employing better technologies for dealing with these and other costly conditions. So people are living longer with more chronic diseases. The authors explain:

Population aging in combination with the rising obesity rate likely has a unique and growing impact on the prevalence and treatment of many conditions.

And yet, healthcare is slow to respond. Most doctors do little to treat obesity in routine clinical care. They’re better equipped to treat its complications. About all a patient can expect from most doctors is advice to lose weight. (Duh!) So patients take the blame. The condition progresses and complications multiply.

But we find reasons for hope. More effort is going into prevention. Programs modeled after the Diabetes Prevention Programs are taking root and spreading. These programs offer very basic, evidence-based obesity care. It’s not enough. But it’s a start.

Click here for the study in Health Affairs. You can find further perspective here and here.

Two Generations, photograph © OAC Image Gallery / Obesity Action Coalition

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June 6, 2018