Obesity, Business and Public Policy
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Obesity, Business and Public Policy

Edited by Zoltán J. Ács and Alan Lyles

The effects of obesity have become practically ubiquitous in the US. This book aims to provide an alternative framework through which to explore the important and controversial obesity debate that has spilled over from the medical community. This book is not about obesity as a medical condition, nor does it offer a wide-ranging discussion on the health effects of obesity or the role of the ‘right’ diet.
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Chapter 7: Weight Control, Private Health Insurance and Public Policies

Alan Lyles and Ann Cotten


Alan Lyles and Ann Cotten American social life, in and out of the house, is often built around eating. J.E. Tillotson (2004) OVERVIEW Given the critical function that employment-based health insurance has on the provision of health care in the USA, this chapter focuses on employers in their role as primary providers of private health insurance, the public sector’s role as regulator of insurers and employers, and the options available to both groups for preventing and treating obesity. To understand how public policy can influence obesity prevention and treatment through the health care system, the factors that shaped the evolution of the current private insurance system will also be discussed. While the public policies that influence the availability and content of private health insurance are considered, the public programs that provide health benefits to poor, disadvantaged and elderly populations, such as the Medicare and Medicaid programs, are beyond the scope of this chapter. Obesity represents a major cost to insurers and to the public. Fiftythree percent of adults in private insurance plans are overweight or obese – a level comparable to that of other insurance categories (Finkelstein et al., 2003). Medicaid, however, has the largest percentage of obese enrollees, at 27.4 percent (versus a range of 17.0–18.8 percent for others). The aggregate financial impact of excess weight varied by insurer – costing private insurers 8.2 percent of their spending – for obesity alone was recently estimated at $9.5–16.1 billion. Public payors had a similar experience: Medicaid at 8.8...

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