Address causes of health care costs, not just high prices

Published 8:09 pm Wednesday, September 18, 2019




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Health care costs are a major source of stress for millions of Americans. Even if you have a good job that pays well and comes with benefits, you still probably sink a substantial chunk of each paycheck into health insurance premiums, while still worrying a single major health care need could all but bankrupt you.

The cost for health care is increasing faster than inflation — it rose by 4.4 percent between 2017 and 2018, according to Fortune, which also reported Americans spent $3.65 trillion on health care in 2018.

Nearly every politician seeking election or re-election to federal office says they have a plan to fix health care so it’s more affordable, more understandable or both.

Those plans always seem to focus exclusively on changing how government regulates or pays for health care. There’s no doubt the U.S. health care system could be run more efficiently and with more transparency about costs. But it’s also true that health care costs would go down if Americans didn’t need so much of it.

Health care is a cause-and-effect industry. There are plenty of plans out there for how we could reduce the effects of health care prices; there aren’t many that talk about what causes a lot of health care needs in the first place: poor health.

Kentucky’s adult obesity rate last year was 36.6%, according to the most recent annual report from the Trust for America’s Health and the Robert Wood Johnson Foundation. The Bluegrass State is one of nine with obesity rates above 35% and one of 48 with obesity rates above 25% (Colorado and Hawaii were the only states where fewer than one in four residents were obese).

Kentucky’s obesity rate is up 2.3 percentage points from a year earlier, when it was 34.3%. And the study, which asks participants to self-report their heights and weights, likely underestimates the actual obesity rate because people tend to report they are taller and weigh less than they actually do.

Obesity is hardly the only indicator of poor health in Kentucky and the nation, but it is a significant one that correlates with a lot of expensive health problems.

Obesity increases the risk for type 2 diabetes, high blood pressure, heart disease, stroke, arthritis, depression, sleep apnea, liver disease, kidney disease, gallbladder disease, pregnancy complications and many types of cancer, according to the annual report. The report cites a 2016 study that found obesity increased medical expenses in the U.S. by $149 billion. That’s about 4.5% of all health care costs in 2016.

It’s significantly harder to develop good solutions that help Americans make healthier choices about exercising and, more importantly, their diets. But finding those solutions are essentially to actually solving this country’s massive health care costs problem.

Because we’re not addressing the problem, it’s only getting worse — obesity rates and bad health are not holding steady; they are on the rise.

Because of that, we could fix our health care system perfectly tomorrow, and costs would keep climbing anyway. If we really want more affordable health care, we have to take some of the responsibility on ourselves and address the causes, not just the effects.