Doubling Obesity Has Tripled Medicare Costs

Dr. Thorpe says "primary prevention" needed for Medicare recipients

This Asbury Park Press story about a new study reveals the disturbing fact that obesity among Medicare beneficiaries has more than doubled while Medicare costs to treat the obesity-related diseases of these patients has tripled.

Lead researcher Dr. Kenneth E. Thorpe, chair of the Department of Health Policy Management at Atlanta, Georgia-based Emory University, looked at Medicare data from 1987 through 2002 to analyze spending on healthcare for Medicare beneficiaries as well as rates of obesity.

In the 15-year period, Dr. Thorpe found that the number of Medicare beneficiaries who were considered obese rose from 11.7 percent in 1987 to 22.5% in 2002--NEARLY DOUBLE! Additionally, healthcare spending over that same time period for those specific Medicare recipients jumped from 9.4 percent to a whopping 24.8 percent--NEARLY TRIPLE!

Dr. Thorpe's intial reaction to his study results was one of immediate and effective action.

"What this study tells us is that we need to aggressively put in place interventions to deal with obesity and chronic disease prevalence among the elderly to control spending," Dr. Thorpe concluded.

Yes indeed, Dr. Thorpe, but that's a lot easier said than done. When you have such poor dietary advice being given to patients about what they need to do to lose weight and get healthy, it makes the ultimate goal of bringing costs down that much more difficult. Sadly, this problem will NOT be going away anytime soon as obesity rates keep going up and up.

Additionally, Dr. Thorpe found that our senior citizens who are entering the Medicare program are already carrying around excessive weight and have developed problems, such as obesity, diabetes, and metabolic syndrome. This is a point that policymakers have neglected as they seek to reduce spending on Medicare costs.

Dr. Thorpe notes that most of the increases in the Medicare costs from 1987 to 2002 were a direct result of new Medicare recipients entering the program with pre-existing obesity-related diseases.

The results of this study appear in the August 22, 2006 issue of the health policy journal Health Affairs.

One of the scariest statistics in Dr. Thorpe study was the revelation that the number of Medicare patients being treated for FIVE OR MORE medical conditions went up from about a third (31 percent) in 1987 to OVER HALF of the recipients in 2002! Even more startling is the realization that payments for these Medicare patients accounts for more than three-fourths of all the spending on Medicare in the year 2002, up sharply from the 52 percent in 1987.

Suggesting a plan of action is needed to not only improve the health of these Medicare patients, but also to relieve the financial pressure being placed on the Medicare system, Dr. Thorpe suggested an immediate change or else the integrity of Medicare could be permanently compromised.

"We need to recognize that we need to do much more in terms of primary prevention - diet, exercise and nutrition - not only among the existing Medicare beneficiaries, but among the near-elderly, those 55 to 64," he said. "These people will be entering Medicare with rates of chronic disease disability that we have never seen."

You know, that sounds all well and good, Dr. Thorpe. But why do you think anything will change if we keep giving the same lifestyle advice that has been hammered down the collective throats of the American people for decades. Obviously, something is not working or we would be in this big mess we are in. The answer may not necessarily lie in more of the same, but rather new approaches to educating the public about what constitutes a healthy diet and fitness program.

As someone who used to weigh over 400 pounds, I know how frustrating it is to feel like weight loss and health issues only come in one box. Generally, this has been the low-fat, low-calorie, portion control line of thinking that has ALWAYS been considered the only real healthy way to eat. Unfortunately, that way of eating does NOT work for everyone which is why many people are bucking the advice they get from their government and doctor to try the low-carb lifestyle.

That was the best decision I ever made regarding the future of my health and now I am 180 pounds lighter as a result. If you genuinely want to bring about effective change in the hearts and minds of the American people regarding healthy living so they don't come into the Medicare system a ticking timebomb just waiting to explode and suck every last dollar out of the Medicare budget, Dr. Thorpe, then you will begin to urge government and medical leaders to begin educating people about other alternatives to the failed low-fat diet approach as soon as possible.

It will anger some of the hardnosed bureaucrats who don't want to hear the truth, but our current dietary recommendations have done nothing but exascerbate the obesity problem and make it worse than it has ever been. The downward spiral we are currently experiencing shows no sign of stopping unless serious and meaningful changes are implemented to allow a variety of obesity-treatment options to be given unabeted access to the American people.

Do we REALLY care about the health and wellbeing of the overweight and obese in this nation? That's two out of every three people these days who need to find the hope that permanent weight loss is within their grasp. They may find it outside of the traditional means someday, but why not open the door of opportunity NOW so we can bring those obesity numbers and the associated healthcare costs back within a reasonable range.

The government and special interest groups need to stop protecting the interests of their friends in the food manufacturing industry who stand to take a hit if livin' la vida low-carb goes mainstream. Is it more important to keep the wallets of these big companies fattened while the nation's obesity rate quickly approaches 100 percent?!

Enough with the talk about helping people change because it is way past time for petty chatter about this serious issue. Are we ready to FINALLY take the next step forward or will we continue to allow the old way of thinking rule the day? Dr. Thorpe, we need leaders on this issue to stand boldly in the face of critics and declare, "This is the right thing to do."

Will you be that brave and honorable leader? How about members of Congress? Medical professionals? Is there anyone ready to take me up on my recommendation that Americans be armed with the facts about many different weight loss plans so they can decide which one is best for them? I promise you we will see a meaningful turnaround in obesity in America as we set the example for the rest of the world to follow. Can we make this a reality in the United States?

E-mail Dr. Kenneth E. Thorpe with your comments at kthorpe@sph.emory.edu.

8-29-06 UPDATE: Dr. Kenneth Thorpe kindly responded to my concerns about this very important issue with Medicare in an e-mail today:

"Congrats to you on your leadership in this. I am doing several talks on this in DC this month to drive home the message. Key here is absent a clear understanding of what is driving up the growth in spending, it becomes impossible to effect meaningful change in Medicare or the growth in private insurance...

Dr. Thorpe was also kind enough to pass along a link to this post to the Health Affairs journal where I was asked to submit a response letter for posting. I will be doing that and will post a link to it here when it is online.

WE MUST HELP DR. THORPE DRIVE HOME THIS POINT. Change is not just an option, but it MANDATORY if we are going to recapture control spiraling obesity rates and the costs associated with obesity-related diseases on a crippled Medicare system.

8-30-06 UPDATE: Health Affairs linked my letter in response to this study at their web site today.