Health care in the United States is provided by a variety of governmental and business organizations (Himmelstein & Woolhandler, 2016). However, the government funds the bulk of the health care expenditures. According to the estimation of the Centers for Medicare and Medical Services, the government covers 64.3% of total costs (Himmelstein & Woolhandler, 2016). The rest of health care provision and spending comes from private payers.
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The United States spends on the health care more than any other nation (Himmelstein & Woolhandler, 2016). The share of national health expenditures in 2013 amounted to 11.2% of gross domestic product (Himmelstein & Woolhandler, 2016). It is estimated that by 2024, tax-funded health expenditures will rise to the two-thirds of all health-related spending and will reach the Canadian level of 70.7 % (Himmelstein & Woolhandler, 2016). As costs of health care grew over the last 50 years, the share of tax-funded spending also increased from 30% in 1965 to 64.4 % in 2013 (Himmelstein & Woolhandler, 2016). The growth of funding can be attributed to the aging population and the increase of chronic disease occurrences. The percentage of the population that is receiving subsidies, Medicare or Medicaid coverage is expected to grow from 36,9% in 2013 to 44,6% in 2024 (Himmelstein & Woolhandler, 2016).
Obesity is responsible for the uptick in the rates of preventable chronic diseases and health care expenditures. It is also related to the job absenteeism and lower productivity. If the problem of obesity is not properly addressed, it might put an additional burden on the US economy. Moreover, this generation might become the first one that has shorter life expectancy than that of a couple of previous generations (Himmelstein & Woolhandler, 2016).
Summary of the Issue
Obesity is the source of significant worry amongst health care professionals. It is usually associated with a wide range of health problems such as hypertension, diabetes type 2, obstructive sleep apnea, several types of cancer, cardiovascular disease and dyslipidemia (Hofmann, 2015). Obese people also suffer from negative social attitudes, structural disadvantages and have a shorter life expectancy (Hofmann, 2015). The correlation between obesity and chronic diseases indicates that the obese part of the USA population would need a higher use of healthcare. A recent study conducted in the United States shows that obesity would cost additional $US1270 for a man and $US 2530 for a woman in additional annual spending (Cecchini & Sassi, 2015). Economic ramifications of the obesity include direct costs (preventive, diagnostic , treatment services) and indirect costs in reduced productivity and lost time due to premature mortality (Abdel-Hamid, 2009). Hence it should be regarded as a serious health problem that causes a heavy burden on the national economy.
Obesity is usually defined by the body mass index (BMI) that is more than 30 (Hofmann, 2015). The people with BMI over 40 are characterized as morbidly or extremely obese (Hofmann, 2015). According to a recent study, nearly 70 percent of the United States population are currently overweight (Cecchini & Sassi, 2015). This number also includes children: every third kid in the US is overweight (Cecchini & Sassi, 2015). As a result, this generation might become the first one that has shorter life expectancy than that of a couple of previous generations. The dynamic model developed by Thompson explores the relationship between BMI and the risks of hypertension, hypercholesterolemia, CHD, type 2 diabetes and stroke (Hammond & Levine, 2010). His study indicates that future risks of these diseases are significantly higher for people with BMI of 32.5 and BMI of 37.5. With the adjustment of other risk factors, results from the Thompson’s model show a considerable increase in the disease occurrence rates among individual with high BMI (Hammond & Levine, 2010). The hypertension risk for the individuals with BMI of 32.5 is twice as high than for those with BMI of 22.5 (Hammond & Levine, 2010). The risk of CHD for obese people is 41.8%, while for the individuals with normal BMI it is only 34.9 % (Hammond & Levine, 2010).
According to the National Institute of Health (NIH), the most effective model for obesity treatment should include dietary, behavioral, pharmacological and surgical components among others for the successful intervention (Kazaks & Stern, 2003). It should be more concentrated on the overall health improvement rather than on the body weight reduction (Kazaks & Stern, 2003). Currently, there are many controversies surrounding the issue. The main of them is that physical exercise rarely if ever leads to even a short-term weight reduction. There are several dozens of studies conducted between 1971 and 1996 that can confirm this popular assumption (Kazaks & Stern, 2003). The data presented in them suggest that a regular exercise along with a diet usually brings only marginal weight loss benefits in comparison with the diet alone (Kazaks & Stern, 2003).
The recommendations of the American Medical Association’s Expert Committee insist on the assessment, prevention, and treatment of both child and adolescent obesity (Hammond & Levine, 2010). Prevention is arguably the best strategy for overcoming obesity epidemic. It must include regular clinic visits, periodical BMI assessment, counseling aimed at the increase of physical activity and improvement of diet, school and state level surveillance of nation’s BMI (Hammond & Levine, 2010). According to the US Preventive Services Task Force, behavioral intervention is an effective tool for lowering BMI (Hammond & Levine, 2010). A potential approach to solving the health care issue of obesity might include implementation of the policies that would provide an opportunity for people to make healthier lifestyle and diet choices. The creation of new recreational facilities that encourage people to be more active might result in the decrease of the nation’s BMI. The long-term effect of intervention policies depends on a number of different factors. The most essential among them would be the ability of new policies to generate long-term changes in people’s behavior. According to Cecchini, only 50 percent of the children would retain healthy habits throughout their life (Cecchini & Sassi, 2015). Another important factor associated with the effectiveness of the intervention program is the population coverage. The policies aimed at sustainable improvement of nation’s health must be designed to reach significant portions of the public (Cecchini & Sassi, 2015).
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In the last several decades, obesity has become one of the most pressing health issues in the United States. Currently, more than 75 % of adults are overweight and 30 % are considered to be obese (Hammond & Levine, 2010). Those suffering from excessive weight problems are also more likely to have other diseases such as hypertension, diabetes type 2, obstructive sleep apnea, various types of cancer, dyslipidemia and cardiovascular disease (Hofmann, 2015). Health aspects of the issue are not the only ones that must be considered while exploring the issue of obesity. Various direct and indirect costs in reduced productivity and increased use of healthcare place an additional burden on the US economy. Prevention strategy for overcoming an epidemic includes regular clinic visits, periodical BMI assessment and counseling aimed at diet improvement.
Abdel-Hamid, T. (2009). Thinking in circles about obesity. New York, NY: Springer.
Cecchini, M., & Sassi, F. (2015). Preventing Obesity in the USA: Impact on Health Service Utilization and Costs. Pharmacoeconomics, 33(7), 765-776.
Hammond, R. A., & Levine, R. (2010). The economic impact of obesity in the United States. Diabetes, Metabolic Syndrome and Obesity 3, 285-295.
Himmelstein, D., & Woolhandler, S. (2016). The Current and Projected Taxpayer Shares of US Health Costs. American Journal of Public Health, 106(3), 449-452.
Hofmann, B. (2015). Obesity as a Socially Defined Disease: Philosophical Considerations and Implications for Policy and Care. Health Care Anal, 24(1), 86-100.
Kazaks, A., & Stern, J. (2003). Obesity Treatments and Controversies. Diabetes Spectrum, 16(4), 231-235.