We have a problem. Right now, roughly 100 million people in the U.S. have obesity. This is a chronic disease that leads to diabetes, heart disease, certain forms of cancer, liver disease, osteoarthritis, and a host of other conditions. But for the most part, people receive no medical care for obesity.
A new report in the Journal of Medical Economics tells us that this is foolish. It’s costing Medicare billions of dollars because obesity care saves money.
Limited Medicare Coverage for Chronic Obesity Care
Medicare will cover bariatric surgery, but relatively few people opt for that. It also provides nominal coverage for behavioral therapy. But that coverage is so restricted that less than one percent of those who could benefit are getting that care. In the case of anti-obesity meds, Medicare excludes them. The authors of a recent GAO report noted that Medicare beneficiaries are far more likely to get drugs for erectile dysfunction than for obesity.
A Costly Mistake
The report in the Journal of Medical Economics estimates the costs and benefits of better access to obesity care in Medicare. ConscienHealth’s Ted Kyle is a co-author, alongside a diverse team led by Fang Chen. The bottom line is quite simple. Behavioral support and anti-obesity meds can save money. Over ten years, the savings add up – 20 to 23 billion dollars.
The reasons are straightforward. Obesity care saves money because it prevents some of the complications of obesity. Behavioral therapy can prevent people from developing diabetes. So, too, can anti-obesity meds. Obesity care can help people maintain a lower, healthier weight. As a result they need less care for other conditions over time.
The savings add up. Into the billions.
Looking Forward to Passing TROA
Bad habits – even if they’re costly – are hard to break. Private health plans are only slowly changing their ways. Insurance companies have no incentive themselves. But employers are catching on to the fact that obesity care can give them a healthier workforce.
For Medicare to catch up, Congress will have to pass the Treat and Reduce Obesity Act (TROA). It would ease Medicare restrictions on obesity care in two ways. First, it would eliminate restrictions that prevent skilled professionals (like dietitians) from providing behavioral therapy for obesity. Second, it would eliminate the exclusion of obesity meds.
TROA is gaining support rapidly. And these data are certainly good news for the prospects of passing it. But actually getting it done will require support from a broad coalition of people who understand the issue. Building that support will be a key focus for National Obesity Care Week, coming up September 15-21. ConscienHealth is proud to be a champion for this cause.
Click Here for the new paper in the Journal of Medical Economics.