Health care costs: The big, fat truth

Three things about health care are universally true: It ranks near the top of “important” issues.

It’s really expensive.

Damn near no one understands it.

The combination of ignorance and health care’s ever-expanding complexities has resulted in a history of bad policy, where premiums have skyrocketed and coverage has declined. Obamacare, passed in 2009 and upheld by the Supreme Court, was supposed to change that by providing affordable care to every American. It didn’t. Despite promises to the contrary, many were unable to retain their preferred physician, experienced unacceptable wait times, and often did not receive the medical care to which they had been accustomed. And instead of physicians primarily focusing on patients – the very reason they chose the medical profession – too many were forced to deal with mountains of bureaucratic paperwork, decimating the personal doctor-patient relationship. Salt in the wound was watching premiums and deductibles continue to climb while health care became ever more labyrinthine.

Despite the broken system, Obamacare ruled the day and reform wasn’t an option. But all that changed with Donald Trump’s surprise victory. Now, repealing Obamacare is legitimately on the table. Or is it?

Let’s address the white elephant that no one else is: There is no true solution to reforming health care so that it’s affordable for all Americans. None. There are many reasons for this, from our entitlement mentality to costs that simply cannot be controlled. But like our nation’s $20 trillion debt, it is a house of cards that will eventually implode. The best we can hope to achieve is slowing the inevitable and preparing a better system for when the current one collapses.

Two plus two always equals four – whether people choose to believe it. And the hard truth is that America simply cannot afford its astronomical health care costs. That said, there are reforms that would inject market forces into the system to improve care and slow the meteoric rise in costs.

By far, the number one issue that must be on the table is addressing the obesity epidemic. And “epidemic” is exactly what it is, as 36 percent of Americans are obese, and an additional 34 percent are categorized as overweight. It is the largest factor in the spiraling costs that continue to devour ever larger slices of the health care pie. To get our arms around this, consider that more than $200 billion per year – yes, staggeringly, that’s per year – is spent on obesity-related, preventable chronic diseases.

In other words, by the next presidential election, we will have spent a trillion dollars just on obesity costs alone. Chew the fat on that, because not even America’s economy can absorb such a monstrosity. And it will get considerably worse as more Baby Boomers – the most overweight generation on record – enters the period where health issues are most prevalent.

Taxing foods and sugary drinks is not the answer, as that hurts manufacturers, businesses and employees, while penalizing healthy consumers.

So how do we cut the fat from these massive obesity outlays? For starters, since obese individuals incur 42 percent more health care costs than healthier people, they should bear the bulk of those costs.

A mandate that insurers must screen every individual, every year, to gain health assessments and establish baselines, makes sense. With that information, premiums can be adjusted so that those with self-induced obesity conditions pay more.

And that is only fair, since healthier Americans are now mandated to subsidize the unhealthy behavior of the obese. Some will call this a bigoted “fat tax,” while accusing this author of fat shaming. Wrong.

The obese can have their cake and eat it, too. They’d just pay more to do so.

How is that any different from life insurers making smokers pay more?

Or auto insurers charging young drivers higher rates? Higher risk behavior begets higher premiums.

Those who become healthier by hitting reasonable benchmarks would earn a premium decrease, while those who choose to continue an obese lifestyle would be forced to put more skin in the game.

Take a bite out of the trilliondollar obesity epidemic, and the rest is gravy.