Thanks to bad habits ranging from eating super-sized portions to playing couch potato, Americans are getting fatter. And obesity-related illnesses are reaching epidemic proportions, even in kids.
Now the government proposes a dramatic stand against the problem - at least for seniors. Last week, it reclassified obesity from a personal failing to a medical problem under Medicare. That opens the door to covering treatments for seniors from fitness programs to stomach-shrinking surgery.
As health policy, the move makes sense. Obesity - typically caused by poor diet and lack of exercise - is closing in on smoking as the leading preventable cause of death in the USA, according to a recent study in the Journal of the American Medical Association. And the nation's top dietitians predict Americans' average weight will continue to balloon over the next decade, USA TODAY reports Monday. So by treating some of the 7 million obese seniors, the government hopes to save money treating obesity-linked illnesses, such as diabetes and heart disease.
But in striving to slim down elders, Washington risks adding to its own bloat by failing to consider the potential tab to taxpayers. The Department of Health and Human Services is not sure what treatments would be authorized and whether the expense might be offset by preventing other diseases.
The fact that no one asked a basic question - "How much will it cost?" - is particularly disconcerting given Medicare's long history of uncontrollable spending. Just last year Congress approved a Medicare prescription drug benefit whose 10-year price has already been revised upward by 35% to $535 billion - $13,000 per senior.
In fact, Medicare has been on a decades-long spending binge with no sign of slowing down. This year, it will eat through some $270 billion, about nine times the budget of the Department of Homeland Security. It comprises 12% of all federal spending and has grown fivefold in the past 20 years.
Its spending growth has been driven by the very problem the obesity decision highlights: a lack of thought to the long-term implications of expanded health coverage. Funding weight-loss surgery, for instance, might curb obesity-related illnesses. But it also might remove incentives for seniors to diet and exercise if they can opt for a Medicare-funded operation instead.
The government may mean well in tackling obesity as a medical problem. But as economists are quick to note, there's no such thing as a free lunch, even a low-calorie one.