The debate over health care costs often deals with systemic matters - redundant administration, competition for expensive high-tech diagnostic devices, fees for quantity of services rather than quality of care, unnecessary procedures, excessive drug prescriptions and so on. Often missing from the health care debate is a fundamental issue - health.
"'F' as in Fat: How Obesity Threatens America's Future 2012," a report by the Trust for America's Health and the Robert Wood Johnson Foundation, demonstrates why it is crucial not only for the health of individuals, but for the health of the economy and the nation, for Americans to slow the obesity epidemic.
If obesity rates continue on their current trajectories, according to the report, 13 states could have adult obesity rates above 60 percent by 2030, 39 states could have rates above 50 percent, and all 50 states could have rates above 44 percent.
Mississippi would have the highest rate at 66.7 percent and Colorado would be lowest at 44.8 percent. Pennsylvania's rate would climb from the 28.6 percent recorded by the Centers for Disease Control and Prevention in 2011, to 56.7 percent by 2030.
Obesity already has passed smoking as the nation's leading driver of disease and attendant health care costs. The direct cost of obesity-related diseases already is more than $150 billion a year nationally, not counting lost productivity and other indirect costs. If the study's projections were to prove accurate, the direct costs by 2030 could increase by as much as $68 billion per year.
Obesity is a direct driver of type 2 diabetes, heart disease, hypertension, stroke, arthritis and several types of cancer.
The study also posed a scenario in which states' residents reduced their average body mass index - a measure of obesity based on height and weight - by 5 percent. In Pennsylvania, that would result in 366,995 fewer cases of type 2 diabetes, 312,456 cases of heart disease, 284,931 fewer hypertension cases, 163,746 fewer arthritis cases, and 28,162 fewer cases of obesity-related cancer. Instead of a 9.1 increase in health care costs, the state would realize a 7.1 percent savings.
But education and some policy can make a difference. Nutrition education and physical education should be protected in school budgets and the effort to improve school lunch nutrition should continue. The government can and should regulate food advertising aimed at children.
And as federal law makes health insurance available to more Americans, it also should make preventive care an even higher priority.