Overweight but won’t exercise. Who should pay?

A new study says that the overweight live longer. Economists say that may be true, but the overweight have higher health costs.


A higher body mass index — a standard measure for determining whether people are overweight or obese — is associated with a number of chronic illnesses, including diabetes, heart disease and hypertension. These chronic illnesses are expensive to treat. If, as it now turns out, overweight people are living longer in addition to racking up more chronic illnesses, that means Medicare is on the hook for paying for more expensive people for more years….

In other words, your spare tire might help you live longer, but it is also accelerating the country’s debt problems.

[Prof. Goldman] gave as an example a doctor he knows who has an obese patient taking expensive drugs for various health problems related to being overweight. The doctor told Professor Goldman: “The best thing I could do for this patient would be to take him for a walk. But I don’t get paid for that.”

Across the pond, Savitri Hensman writing at Ekklesia, points to a proposal in the UK to cut benefits for people who don’t exercise:

As the NHS Choices website explains, GPs can help people to lose weight in various ways, including “exercise on prescription” and other physical activity opportunities. In addition “Many GP surgeries across the country prescribe exercise as a treatment for a range of conditions, including depression”. People with a family history of heart disease, at risk of osteoporosis, with diabetes, high blood pressure, arthritis or who have had a stroke are among those who can benefit.

A Dose of Localism recommends punishing those on such schemes who do not turn up to exercise sessions: “Relocalisation of council tax benefit and housing benefit combined with new technologies provide an opportunity for councils to embed financial incentives for behaviours that promote public health. The increasing use of smart cards for access to leisure facilities, for instance, provides councils with a significant amount of data on usage patterns. Where an exercise package is prescribed to a resident, housing and council tax benefit payments could be varied to reward or incentivise residents.”

Is it wrong to require those on Medicare to pay for their healthcare if there is a cheaper and superior alternative, i.e. exercise? If we can ban supersized sodas or kids meals with toys (as some cities do) why not mandate exercise by taxing your Medicare benefits if exercise is prescribed and you don’t do it?

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