Essay on Economic Impact of Obesity on the US Healthcare System

Look at obesity rates in Northern CA vs. Midwest Productivity would increase, as people would take fewer sick days. Also, the presence of food deserts, or neighborhoods that don’t have easy access to healthy and nutritious foods, makes socioeconomic status a factor in obesity. Perhaps helping fund community gardens and farmer’s markets where EBT and WIC could be used would help individuals in these areas consume healthy, fresh, and unprocessed food.

Kaiser Permanente is one of the leading non-profit healthcare organizations. They serve Americans along the West Coast of the United States as well as Washington, DC, and other states. Their state-of-the-art technology helps differentiate them from other healthcare organizations. They invest billions into research, technological advancement, and health information management. Not only do they strive to make their patients happy and healthy, but they also find the health of their employees just as critical. According to the case study, Kaiser Permanente takes measures to offer employees access to HIM technology, healthy food choices, and the chance to be more active despite having an office job. Kaiser Permanente has been putting a great emphasis on long-term weight management for both their patients and employees. By taking a holistic approach that focuses on a patient’s mental health, physical health, and resources, they aim to not only decrease BMI but to avoid already normal BMIs from increasing. The obesity epidemic, being one of the largest crises facing the American public today, has become a priority for Kaiser Permanente.

Kaiser Permanente considers obesity as a strategic challenge. There is no ‘quick fix’ in curbing the obesity epidemic, but rather a conglomerate of strategies and ideals. Physicians, psychologists, and researchers must take into account the complex social, economic, and health structures obesity is based upon. When treating an obese patient, not only does an individual’s physical and dietary routine need to be revised, but also their self-confidence level, social abilities, and emotional state. Weight is a sensitive topic for many Americans. Many who are overweight lose confidence in themselves, feel embarrassed or ashamed, and may lack a sense of belonging. An obese patient needs to feel supported but also inspired, to decrease their BMI and live a healthier lifestyle.

Kaiser Permanente is a large healthcare organization, treating 11.8 million, or 3.61% of the US population. Kaiser Permanente sustained approximately $131.4b in costs for the year 2018. However, Kaiser Permanente’s obese population of their patient base makes up a smaller portion of the population than the United States as a whole. Alas, obesity will still cost Kaiser Permanente billions. Assuming inflation rates will continue to increase steadily, Kaiser Permanente should prepare to have total healthcare costs as high as $221b by 2028, $7.08b (3.2%) of which will be obesity-related. As with every other healthcare organization, the continued prevalence of obesity will take up an increasing amount of Kaiser Permanente’s resources. Each year, more and more healthcare expenditures are going toward treating obesity-related co-morbidities such as type II diabetes, heart disease, and sleep apnea. In fact, the rate of obesity-related expenditures is increasing at a rate of 134.0% each decade in the United States, compared to total healthcare costs, which have increased between 2008 & 2018 at a rate of 58.7%. Projections based on the increase in spending seen in the last decade (2008-2018) show that annual obesity-related costs may reach a staggering $461b, while total healthcare costs maybe $5.8t. Obesity-related costs would account for 7.9% of total healthcare expenditures.

Kaiser Permanente has invested time, energy, and money in medicinal innovations and community health sustainability. HEAL, one of KP’s initiatives is a community outreach program that helped establish farmer’s markets and promote exercise and activity in communities with limited access to such resources. Kaiser’s technological initiative, HealthConnect, grants greater accessibility to healthcare services through telemedicine. This is beneficial because it makes it possible for those living in rural areas to get the state-of-the-art technology KP has to offer. In addition, patients are able to take control of their own health by utilizing some of the app’s features. The United States is already seeing results (plateauing obesity rates) because of programs such as HealthConnect. With high patient retention rates, low patient turnover, a good amount of money already invested, and the foothold they have due to the research and work already done by KP’s HealthConnect and HEAL, it is only logical that Kaiser Permanente continue to invest money in weight management and promote long-term care and management to ensure patients don’t regain weight lost. The case study states that KP has spent $50 million on HEAL since 2007 (10). The price of this program is only a portion of the billions in obesity-related healthcare costs KP incurs each year. Continued investment in programs such as HEAL could not only save KP billions of dollars, as calculated below but also help other industries thrive. A greater demand for organic foods may give farmers (who have recently been impoverished due to erratic weather and processed foods) an incentive to grow more crops. It would also help compensate for the trees burnt or cut down due to wildfires and demand for fattier meats. Farmers would be planting more fruit trees that could produce peaches, apples, avocados, etc.

As stated earlier, the incidence of obesity continues to increase, but the rate at which it is increasing is declining. These results should bring hope to those involved in public health, as it appears that fewer people are becoming obese each year. This in part can be credited to a higher accessibility of weight-loss programs. There are not only diet programs, but also smartphone apps, blogs, forums, weight-loss specialists, and a better understanding of using an osteopathic approach to weight loss. Several of these measures have already been implemented into Kaiser Permanente’s treatment plan. It would perhaps be beneficial for KP to look into the others listed, as well as discover the other causes of obesity and successful weight management. For example, greater comprehension of the genetic aspects of obesity could lead to being able to remove the ‘obese’ genes or revise the genes POMC and MC4R (obese individuals tend to have a deficiency in these genes) using technology such as CRISPR as well as administer synthetic Leptin, a ‘hunger-control’ hormone.

In addition to weight-loss treatment, Kaiser Permanente should continue to place a large emphasis on preventive care. It is easier (e.g. takes less time and resources) to manage someone’s weight when they are already at a healthy BMI than to decrease someone’s BMI and then sustain their ideal BMI. Each of these processes takes a lifetime to maintain, but it is more beneficial to teach someone to have healthy habits before they get unhealthy and cause damage to their bodies.

While not as important to their business model as it would be to the rest of the country (e.g. smaller obese population), it is vital from a public health standpoint for Kaiser Permanente to continue to invest in programs such as KP HealthConnect and HEAL. Obesity is an epidemic that, while slowing down [Exhibits 1,2], is still spreading. Every year, more and more Americans (children included) become obese. Excess body weight can be detrimental to a patient’s health, ultimately decreasing their well-being and increasing total healthcare costs (mostly being paid by insurance companies and the government). A decrease in the obesity rate would result in a decrease in chronic illness, healthcare costs, and weight-related fatalities. Kaiser Permanente, a major healthcare non-profit organization, should strive to offer comprehensive healthcare for all of its patients, as well as the rest of the world’s population. The obesity epidemic has been detrimental to the US population, workforce (more people are unable to work and use more healthcare coverage in employee-based insurance systems), the healthcare system, and the economy. By continuing to create innovative, well-researched, and effective weight management programs, Kaiser Permanente would bring one of the largest struggles of the United States and other obese countries to light. Obesity is a sensitive topic, and it can be rather difficult to communicate the potential lethality of this illness. However, facing the problem head-on by investing in obesity-related treatments could ultimately save healthcare organizations, insurance companies, and the government hundreds of billions of dollars, as well as increase the life spans of millions. Finding a cure for obesity should be a priority. A worldwide collaboration (that perhaps KP could initiate) would not only increase financing (for start-ups, other organizations’ research, and KP initiatives) and manpower to hasten the time it will take to stop obesity, but would also allow all physicians to voice their opinions, research, and procedures. No idea should go unheard. After all, innovation can sometimes only be accomplished through inspiration.

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According to data obtained from Kaiser Permanente and the American Medical Association, the rate of obesity in the United States has soared from 11.1% in 1990 to 39.6% in 2019. The presence of obesity has continued to increase in the United States, but there appears to be a trend of a lesser incline.

Illustrates the declining increase in obesity rates in the United States. Between 1990 & 2000, the rate of obese Americans increased by 174.8%. Between 2000 & 2010, the obesity rate increase was 19.7%. The rate increase between 2010 & 2019 was 8.5%. These results show that, while still having an increase in obesity presence in the United States, the number of new cases has been steadily declining.

Shows obesity-related healthcare spending in relation to total US healthcare costs. Total US healthcare costs have increased from $2.3t in 2008 to $3.65t in 2018, a 58.7% increase. Obesity-related costs have increased from $147b in 2008 to, as previously projected by a report cited by Partnership to Fight Chronic Illness, $344b, a 134.0% increase. Having obesity costs rising faster than total healthcare expenditures takes a large toll on the American healthcare system. Healthcare costs will continue to increase to compensate for the obesity-related costs.

Shows the portion of US healthcare costs spent on obesity-related co-morbidities. In 2008, 6.4% of US healthcare costs were attributed to obesity. This portion increased to 9.4% in 2018. Obesity continues to take up a large amount of American health resources.

Shows the American obesity rate compared to the obesity rate of Kaiser Permanente’s patient base. As cited by the AMA, approximately 39.6% of Americans suffer from obesity. This is significantly higher than Kaiser Permanente’s patient base, where 16.9% are obese.

Approximately 3.61% of Americans are patients in the KP network.

Projected US Healthcare Costs under the assumption that obesity-related costs will continue to increase at a rate of 134.01% each decade, and total costs will increase by 58.7%. Projected total annual healthcare costs for 1 year (2019), 5 years (2023), and 10 years (2028) will be $3.86t, $4.72t, and $5.79t respectively. Projected annual obesity-related healthcare costs will be $390b in 2019, $450b by 2023, and $546b by 2028. Obesity-related costs will make up 10.1% of 2019 costs, 9.5% of 2023 costs, and 9.43% of 2028 healthcare expenditures.

Based on calculations, 1.65 million (13.9%) KP patients have a BMI of 30-40kg/m^2 and 350,000 (2.96%) patients are morbidly obese. According to the case study, morbidly obese patients spend 1.78x that of a patient with a normal BMI and those with a BMI of 30-40kg/m^2 spend 1.25x more. Based on this information, it can be determined that a normal weighted patient’s costs average $11,264.56, a person with a BMI of 30-40kg/m^2 costs $14,080.70, and a morbidly obese patient’s average cost would be $20,050.92 annually. Assuming obesity-related costs will continue to increase at a rate of 134.01% each decade, and total costs will increase by 58.7%, projected total annual costs for 2019, 2023, and 2028 will total $139b, $147b, and $221b respectively. Projected obesity-related costs to be incurred by Kaiser Permanente will total $3.43b (2.47% of the total) in 2019, $5.05b (3.44% of the total) in 2023, and $7.08b (3.2% of the total) in 2028.

Since they serve about 3.61% of the population, it can be assumed that 3.61% of US Health Costs are incurred by Kaiser Permanente, totaling approximately $131.4b for the year 2018.

1. https://www.ama-assn.org/delivering-care/public-health/adult-obesity-rates-rise-6-states-exceed-35-7
2. https://healthy.kaiserpermanente.org/static/health/annual_reports/kp_annualreport_2017/
3. https://www.nytimes.com/2010/01/05/health/policy/05health.html
4. https://fortune.com/2019/02/21/us-health-care-costs-2/
5. https://www.leadforrareobesity.com/understanding-insatiable-hunger?gclid=Cj0KCQjw2efrBRD3ARIsAEnt0ejOciLFKiErkMs8fI5kMPlMxlF6_plUUyRBu0laUebGWDSyVl2CCKYaArTBEALw_wcB&gclsrc=aw.ds
6. https://ghr.nlm.nih.gov/gene/MC4R
7. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/leptin