Weighty Arguments

Insuring our waistlines


Does having health insurance make people fat? A July working paper from the National Bureau of Economic Research found "strong evidence that being insured increases body mass index and obesity." Not only that, but public insurance seemed to have a substantially stronger effect than private insurance: It was associated with an average body mass increase of 2.1 points, vs. a 1.3-point increase for privately insured patients.

As Congress debates health insurance reform, one of the key arguments for government-mandated universal health insurance in general, and a new public insurance option in particular, is that a better insured population would mean lower costs in the long term. In a health care address on July 22, President Barack Obama warned that without reform "we will not be able to control our deficit."

But if more insurance means more obesity, we may be in a bind. A July study published by the journal Health Affairs claims that obesity is responsible for almost 10 percent of medical spending in the U.S. each year. While many argue those figures are overstated, it's undeniable that diabetes and other expensive obesity-related conditions are on the rise.

So why would a more insured population also be a fatter, pricier population? Simple behavioral economics. According to the Health Affairs study, "by insulating people from the costs of obesity-related medical care expenditures, insurance coverage creates moral hazard in behaviors related to body weight." An ounce of insurance might be worth a pound of, well, you know.