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I now do what is sure to be very controversial.
We talk a lot about the cost of obesity on the American health care system obesity rates have doubled even tripled in decades the United States causing health.
Cost to go up for everybody but.
Just simply having more access to health insurance.
Add to the obesity problem and not make it better Stanford University associate professor medicine gate -- Sharia is one of the authors of the -- yes.
Just that and he joins us now -- Brian Day in thank you for joining us.
I I did you assume the concept is pretty simple -- people feel that they have cheap or free access to something.
They will abuse it more and they will care less about what it takes to get them there.
That that's the basic idea what one way to think about it is -- when you buy jelly -- You're not you've been EP 99 cents for the doughnut but actually that's not the full price of the -- That the price of the -- also includes the price of all of the increase health care costs associated with getting sick and so on from from or beat you're getting fatter from eating jelly -- you people when they buy the -- don't see that price and if they have insurance that extra price is paid for by somebody else.
So you ignore it.
Are you more likely to -- the -- -- or avoid the jog or that you might otherwise do.
Our insurance basically subsidizes.
Those kinds of habits.
Just pilot doesn't mean -- -- that day go ahead minister now.
Yeah that is -- any assurances that thing it's -- -- on many other on other other dimensions but -- that is certainly one effective insurance.
But do -- risk adjusted premiums.
Discourage this kind of weight gain assuming that we have continue that.
In for in Medicare and Medicaid and then private insurance.
What can those insurers do to fix this.
That that's a really good point if you -- in -- health insurance pool with lots of other people and you share the cost that's called -- insurance then.
Other people are paying the cost of that jelly -- On the other hand if you -- -- adjusted premiums that if you're paying your your higher health care costs of -- buy you lots of jelly doughnuts and my health have my I get I get fatter.
And up my health.
And if I have a risky just supreme -- the repaying those costs in that case I'll take that into I'll probably more likely to take into account.
The the higher cost of that -- don't know what the other one.
You -- to bring it up no offense I mean it seems pretty basic most other if you build a house on the coast.
That's prone to hurricanes are gonna pay a lot more if -- bad for -- than last year you can get insurance you're gonna pay a lot more.
Why does the medical insurance what does health insurance seem to operate outside the realm of other types of insurance and the way -- -- price for risk.
There are a lot of restrictions on how Bob medical insurance to price risk of the private market.
There -- now up what in other research I found is that.
The obese workers actually earned less than -- workers at firms where there is health insurance.
In other words obese workers pay for their health insurance to lower wages.
Now that mechanism in private insurance doesn't exist at all and public interest doesn't exist at all so for instance if you are on Medicare you're gonna be paying the same price for it.
Whether -- -- obese no matter what there's no risk adjustment at all really in terms of the price paid for by consumers in public insurance.
In private -- there are other mechanisms by which.
The costs of higher risk of passed on to people.
In I think mainly through the wage system.
Now there are restrictions in private insurance having to do with anti discrimination.
Provisions in the in the Americans with disabilities act for instance the reduce the ability of private insurance insurers to to risk -- in that way but they still.
It's still get it's more likely to get passed on then in in the case of public insurance where there's basically no mechanism.
To pass on the higher costs associated with higher risk to people.
All right -- had to charge of Stanford University who has been no -- controversial topic and -- I guarantee it will be now some people saying hey.
Don't penalize us because were overweight.
But it sounds like Everett it's it's costing the pool mores wells we have to discuss the.
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