Unbiased Analysis of Today's Healthcare Issues

Will giving weight-loss prizes to the obese save the NHS money?

Written By: Jason Shafrin - Feb• 12•08

According to the Daily Mail (…obesity epidemic…) the NHS could give “vouchers to the overweight to spend on healthy food in supermarkets” or cash prizes to those who manage to lose weight. The UK could also mandate cooking classes in school and more time for physical education classes.

The UK report on obesity states: “We need to rework the incentives for individuals and public bodies to encourage actions now, thereby avoiding much larger costs in later years.”

But will decreasing obesity save the government money? Not according to a recent paper in the PLoS Medicine titled “Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure.” The paper finds that healthy people have more lifetime medical costs that either obese individuals or smokers. How can this be the case? It is true, that each year an obese individual lives they will incur more medical costs than a healthy person. In particular, spending on heart disease, diabetes, and musculoskeletal diseases. Since a healthy person lives longer, however, the healthy person has more years of medical expenditures which will accumulate compared to an obese individual. Similarly, smokers have higher medical costs per year but since they have a shorter life expectancy, smokers actually incur fewer medical costs over their lifetime than healthy individuals.

It seems that giving prizes to obese individuals for losing weight will not only be costly in terms of the tax revenue needed to fund the project, but will also increase medical expenditures if people do in fact lose weight. The Healthcare Economist is proposing a revolutionary concept: let each individual choose their own weight make their own lifestyle choices without any government interference.

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  1. Vieng says:

    I haven’t read the article yet, so maybe this posting is premature.
    Did they look at the benefit to society/government in having healthier citizens? Sure, healthier people live longer and will probably incur more medical debt over their entire life time, but doesn’t that also mean that they will have more productive working days etc than the average ‘sickly’ person (obese person with severe complications from diabetes or smoker that is out at least a week a month with severe pneumonia only to die of lung cancer).

    It seems a little cold and calloused to say that we should just let people choose their own early death. I understand that we have to take personal responsibility for our actions, but if ‘vices’ can be incentivized (burger is cheaper than an apple) why not healthcare?

  2. […] Lower obesity rates likely would decrease disease rates. But just because there is a correlation between obesity and disease rates, doesn’t mean that obesity is the causal factor. It could be that individuals who are obese are also more disease-prone and this would be the case even if they lose weight. Still, on an annual basis, healthier living of course does decrease medical costs. Over a lifetime, however, healthier lifestyles and reduced obesity may actually increase medical costs (see 12 Feb 2008 post). […]

  3. There is no fast or simple answer to obesity however with current rising health care cost governments need to promote a variety of programs in hopes to reach some of the population. Sometimes more money will be spent then saved by some of the programs but it’s the trickle effect that will spread along the path of some of the masses.

  4. […] costs each year, those who are extremely overweight also have lower life expectancy. According to a PLoS study, obese individuals actually cost the NHS less money due to their lower life […]

  5. […] More evidence that although preventive may improve patient health, it may also increase costs.¬† (See also my post from 12 Feb 2008). […]

  6. […] at the cost of individual liberty to choose what to eat and how much to exercise. ¬†Further, reducing obesity may actually increase health care costs (since obese people die […]

  7. […] but it is a cost effective way of living a longer, more productive life. But Jason Shafrin at the Healthcare Economist read that PLoS study and had a different view, while the Medical Humanities blog by Daniel Goldberg […]