The Common Good

Missouri's Health-Care Dilemma

Yesterday, by a 3-to-1 margin, Missouri voters passed Proposition C: "No law or rule shall compel, directly or indirectly, any person, employer, or health care provider to participate in any health care system."

From The New York Times:

"This really wasn't an effort to poke the president in the eye," said State Senator Jim Lembke, a Republican. "First and foremost, this was about defining the role of state government and the role of federal government."

Good luck, Missouri, if you end up having to take care of your residents all on your own because the Center for Disease Control just released a study saying you are among the fattest states in the union.

From The Wall Street Journal:

"No state had an obesity rate above 30 percent in 2000, whereas nine states are above that threshold today, the report said. Those states are Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia."

Those extra pounds are going to affect Missouri's budget, and the budgets of those Missourians who opt out of health insurance coverage. From a June 2010 report, "F as in Fat: How Obesity Threatens America's Future 2010," page 107:

  • Obesity-related medical costs total $147 billion a year, or nearly 10 percent of all annual medical spending (based on 2006 data).
  • Of the $147 billion, Medicare and Medicaid are responsible for $61.8 billion. Medicare and Medicaid spending would be 8.5 percent and 11.8 percent lower, respectively, in the absence of obesity.
  • Obese people spend 42 percent more on health care costs than healthy-weight people.

Ironically, when you compare obesity rates by state with how states voted in the 2008 presidential election, you discover that all nine states with over 30 percent obesity rates voted Republican. By contrast, eight of the nine states or districts with the lowest obesity rates (Colorado, District of Columbia, Connecticut, Massachusetts, Hawaii, Vermont, Oregon, Montana, New Jersey) voted Democratic.

Does this mean that if all the red states opt out of the federal health-care program, costs will dramatically drop for the blue states?

Well, they might drop a bit (or at least they might increase less). But this is no time for people in blue states to crow. Here's the really grim news. The CDC report says that "in 2000, [alarmed by our nation's obesity rate of 19.8%,] a Healthy People 2010 objective was established to reduce the prevalence of obesity among adults in the United States to 15%." Instead, we got fatter. Lots fatter.

Not one state achieved the goal of less than 15 percent obesity rate by 2010. Whereas in 2000, 28 states had an obesity rate of less than 20 percent, in 2009 only Colorado and the District of Columbia had a rate that low. In 2000, no states had an obesity rate of greater than 30 percent; in 2009, nine states do.

When all the states are put together, our average obesity rate is 26.7 percent -- almost 7 percentage points higher (and about 27 million more people) than nine years earlier. And since weight and height were self-reported in the study, many analysts believe our true obesity rate is even higher than the study indicates. (Be honest now: Is the weight on your driver's license entirely accurate?)

With or without federal insurance mandates, we are seriously weighing down our nation's health-care system. If Missouri successfully challenges parts of the Patient Protection and Affordable Health Care Act -- and it may not, because federal courts are likely to disagree with their election results -- then Missouri lawmakers had better start thinking about what to do with their rotund citizens who are too rich for Medicaid but too poor, too optimistic, too negligent, or too stubborn to pay for health-care insurance.

portrait-lavonne-neffLaVonne Neff is an amateur theologian and cook; lover of language and travel; wife, mother, grandmother, godmother, dogmother; perpetual student, constant reader, and Christian contrarian. She blogs at Lively Dust.

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