The Consequences of Obesity for the External Costs of Public Health Insurance in the United States

作者：MacEwan Joanna P; Alston Julian M; Okrent Abigail M

来源：Applied Economic Perspectives and Policy, 2014, 36(4): 696-716.

DOI：10.1093/aepp/ppu014

• Obesity
• Externality
• Health-care cost

Over the past five decades in the United States, total medical expenditures and the proportion of medical expenditures financed with public funds have both increased significantly. A substantial increase in the prevalence of obesity has contributed to this growth. In this study we measure the external cost of obesity in the form of publicly funded health-care expenditures, and how this cost changes when the distribution of obesity in the population changes. We use a continuous measure of obesity, Body Mass Index (BMI), rather than discrete BMI categories to represent the distribution of obesity and changes in it. We predict that a one-unit increase in BMI for every adult in the United States would increase annual public medical expenditures by $6.0 billion. This estimated public cost equates to an average marginal cost of $27 per year, per adult for a one-unit increase in BMI for each adult in the U.S. population-or $4.35 per pound. Separately, we estimate that if every U.S. adult who is now obese (BMI a parts per thousand yen30) had a BMI of 25 instead, annual public medical expenditures would decline by $166.2 billion (in constant 2009 dollars), or 15.2% of annual public medical expenditures in 2009. Assuming a socially optimal BMI of no more than 25, we estimate that the prevalence of obesity in 2009 resulted in a deadweight loss of $148.2 billion in 2009.

• 出版日期2014-12