If health care is a “right, than personal responsibility is a must

KEY TAKEAWAY: As the debate around a single payer health care initiative continues to rage on more and more people are saying that health care is a “right”.  But where does the personal responsibility of taking care of ourselves fall within this “right”?   One-third of American adults and one in six children are now obese, although an annual report released Thursday by two nonprofit groups found that rates could be stabilizing.

Unhealthy behaviors such as smoking, poor eating habits, and lack of exercise are costing the United States billions of dollars in the treatment of preventable diseases. The United States spends more per capita than any other nation on health care, including $1.5 trillion in medical costs associated with chronic diseases such as diabetes, heart disease, and cancer — diseases that have a direct link to smoking and obesity, the nation’s two largest national risk factors.

Obesity is growing faster than any previous public health issue in the United States . Today, 31 percent of Americans are considered obese and if current trends continue, more than 100 million U.S. adults — or 43 percent of the population — will be considered obese by 2018. Over the same period, obesity could add $344 billion to the nation’s annual health care costs and account for more than 21 percent of health care spending.

The United States spends signi cantly more on health care than any other nation. In 2006, our health care expenditure was over $7,000 per person, more than twice the average of 29 other developed countries. We also have one of the fastest growth rates in health spending, tripling our expenditures since 1990. Yet the average life expectancy in the United States is far below many other nations that spend less on health care each year.

As a nation, more than 75% of our health care spending is on people with chronic conditions

Hospitalizations are also expensive — in 2006, they made up about $1 for every $10 spent nationwide on hospital-based care.

The Cost of Chronic Diseases and Health Risk Behaviors

In the United States, chronic diseases and conditions and the health risk behaviors that cause them account for most health care costs.

  • Eighty-six percent of the nation’s $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions. These costs can be reduced.


  • Total annual cardiovascular disease costs to the nation averaged $316.1 billion in 2012–2013.  Of this amount, $189.7 billion was for direct medical expenses and $126.4 billion was for lost productivity costs (from premature death).


  • Cancer care cost $157 billion in 2010 dollars.


  • The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. Decreased productivity includes costs associated with people being absent from work, being less productive while at work, or not being able to work at all because of diabetes.


  • The total cost of arthritis and related conditions was about $128 billion in 2003. Of this amount, nearly $81 billion was for direct medical costs and $47 billion was for indirect costs associated with lost earnings.




Addressing the problem..

1ne: Employers need to work with insurers and health organizations to develop ways for employees to adopt healthy lifestyles.

2wo: A bigger emphasis on prevention needs to be integrated at every point of contact along the health care transaction model.

3hree: Financial incentives should be tested to determine the outcome of changing unhealthy lifestyles such as higher premiums associated with weight and lack of exercise.

4our: Insurers should mandate that overweight customers meet with a licensed dietician to learn about eating healthy.

5ive: Employers need to allow employees time off to visit health clubs or build on campus gyms so employees can take the time they need to “get in shape”.

Even with my busy schedule, I fond the time to ride my bike 100 miles a week.  I do it because I feel better after I ride, to help control stress and weight and because I love cycling.  Can we ignite these healthy passions in people that will cause our health system a lot of money?

1 thought on “If health care is a “right, than personal responsibility is a must

  1. Richard,
    I lecture on this topic several times per year and during the process of tweaking my PowerPoint prior to a presentation in a few weeks I came across your blog posts. Great stuff. However, I think that you are fairly conservative on your estimates for the cost of obesity. The direct health costs are likely much more than you state and the indirect costs are even greater than the direct costs. If we put the total costs of the two biggest patient controlled factors, obesity and smoking, together and look at the direct and indirect costs combined, then I would guess that we are talking about a $1 trillion bill due to behavior.

Leave a Reply

Your email address will not be published. Required fields are marked *