There are two interesting posts that I will comment upon today. The first is a CDC post on Childhood Obesity. The second is a cost analysis of obesity in Health Affairs.
First the one on childhood obesity. I present the data in a somewhat different form than the CDC as below.
(i) CDC presents the 1998 stats on percent of 2-4 year olds in 1998. Note the variation between the states.
(ii) Now the percent of 2-4 year olds ion 2008. Now not the sudden upward explosion and the growth in certain states. New Jersey and Virginia have the largest prevalence in this data set.
(iii) Now the change in actual prevalence from 1998 to 2008. This is instructive but we use the following chart for better resolution.
(iv) Finally the percent change in prevalence in the same time period. This shows the explosive growth, appearing at 20% over this period. This is for 2-4 year olds! Not teenagers of older people. They will never get rid of this problem and this is the ticking time bomb of health care.
The CDC study states:
"The findings indicated that obesity prevalence among low-income, preschool-aged children increased steadily from 12.4% in 1998 to 14.5% in 2003, but subsequently remained essentially the same, with a 14.6% prevalence in 2008. Reducing childhood obesity will require effective prevention strategies that focus on environments and policies promoting physical activity and a healthy diet for families, child care centers, and communities."
Now for the Health Affairs report. It is by Finkelstein et al and it reports:
"In 1998 the medical costs of obesity were estimated to be as high as $78.5 billion, with roughly half financed by Medicare and Medicaid. This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending. We found that the increased prevalence of obesity is responsible for almost $40 billion of increased medical spending through 2006, including $7 billion in Medicare prescription drug costs. We estimate that the medical costs of obesity could have risen to $147 billion per year by 2008..."
Their approach is dramatically different than our, in our Diabetes White Paper, where we stated:
"... demonstrates the potential impact an economic control of behavior can have in reducing a major health care cost. Type 2 Diabetes is caused by obesity in almost all cases. It currently, in 2008 costs, accounts for almost $275 billion annually or 12% of all health care costs. We estimate that by 2020 it will account for 25% of health care costs and is growing at 10-11% per annum. It is possible to control this at the source by taxing "carbs" as we have taxed tobacco. This paper presents the case from the perspective of the medical evidence, costs factors and economic control models."
In our approach we did a bottom up analysis based upon prevalence and incidence of disease states and costs per year per disease state. The Finklestein approach was performed by a statistical study of patients. Although they are half of our value they we fell justify the numbers we have arrived at. Clearly Type 2 Diabetes is and will explode as a major driver for health care costs. The Medical Home approach just institutionalizes this. We still firmly believe that the solution is via some form of controlling taxation as was done with tobacco.
First the one on childhood obesity. I present the data in a somewhat different form than the CDC as below.
(i) CDC presents the 1998 stats on percent of 2-4 year olds in 1998. Note the variation between the states.
(ii) Now the percent of 2-4 year olds ion 2008. Now not the sudden upward explosion and the growth in certain states. New Jersey and Virginia have the largest prevalence in this data set.
(iii) Now the change in actual prevalence from 1998 to 2008. This is instructive but we use the following chart for better resolution.
(iv) Finally the percent change in prevalence in the same time period. This shows the explosive growth, appearing at 20% over this period. This is for 2-4 year olds! Not teenagers of older people. They will never get rid of this problem and this is the ticking time bomb of health care.
The CDC study states:
"The findings indicated that obesity prevalence among low-income, preschool-aged children increased steadily from 12.4% in 1998 to 14.5% in 2003, but subsequently remained essentially the same, with a 14.6% prevalence in 2008. Reducing childhood obesity will require effective prevention strategies that focus on environments and policies promoting physical activity and a healthy diet for families, child care centers, and communities."
Now for the Health Affairs report. It is by Finkelstein et al and it reports:
"In 1998 the medical costs of obesity were estimated to be as high as $78.5 billion, with roughly half financed by Medicare and Medicaid. This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending. We found that the increased prevalence of obesity is responsible for almost $40 billion of increased medical spending through 2006, including $7 billion in Medicare prescription drug costs. We estimate that the medical costs of obesity could have risen to $147 billion per year by 2008..."
Their approach is dramatically different than our, in our Diabetes White Paper, where we stated:
"... demonstrates the potential impact an economic control of behavior can have in reducing a major health care cost. Type 2 Diabetes is caused by obesity in almost all cases. It currently, in 2008 costs, accounts for almost $275 billion annually or 12% of all health care costs. We estimate that by 2020 it will account for 25% of health care costs and is growing at 10-11% per annum. It is possible to control this at the source by taxing "carbs" as we have taxed tobacco. This paper presents the case from the perspective of the medical evidence, costs factors and economic control models."
In our approach we did a bottom up analysis based upon prevalence and incidence of disease states and costs per year per disease state. The Finklestein approach was performed by a statistical study of patients. Although they are half of our value they we fell justify the numbers we have arrived at. Clearly Type 2 Diabetes is and will explode as a major driver for health care costs. The Medical Home approach just institutionalizes this. We still firmly believe that the solution is via some form of controlling taxation as was done with tobacco.
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