NCPA - National Center for Policy Analysis


August 21, 2009

This is how President Obama should start a speech on health care --"My fellow Americans: We are old.  We are fat.  We are afraid of lawyers."  Of course, the president would never begin a speech like that, but maybe he should, says Rich Karlgaard, publisher of Forbes magazine.

We are old.  Here are the facts about so-called mandatory entitlement spending in the United States:

  • Out of a typical year's federal budget about half goes to transfer payments of various sorts--Social Security, Medicare, Medicaid, unemployment compensation, disability programs, etc.
  • Together Social Security and Medicare suck up nearly $1 trillion annually and, because of the country's aging boomer population, are the fastest-growing part of the entitlement pie.

We are fat.  Here are the alarming facts about obesity in the United States:

  • Nearly one-third (31 percent) of Americans are clinically obese (Body Mass Index of 30 or more).
  • According to American Sports Data, "3.8 million people are over 300 pounds, over 400,000 people (mostly males) carry over 400 pounds, and the average adult female weighs an unprecedented 163 pounds!"
  • Obesity leads to a legion of ills, from heart attacks and strokes to gut cancers and diabetes; the annual cost of treating diabetes and its effects exceeds $200 billion.

We are afraid of lawyers.  Here are the facts:

  • The biggest cost is not malpractice awards, which annually drive up U.S. health care costs by 1 percent to 2 percent -- $20 billion to $40 billion a year -- although that's bad enough.
  • Most costly is the individual doctor's perceived threat of a career-ending malpractice award and his or her incentive, therefore, to practice defensive medicine; this occurs when a doctor, fearing a lawsuit, orders a battery of costly diagnostic tests to rule out the highly improbable, even when the obvious cause of sickness or injury is staring him in the face.
  • According to a Massachusetts Medical Society study, in one year Massachusetts wasted $1.4 billion on defensive medicine; prorated for the entire U.S. population, the cost would be about $66 billion a year.
  • Another study cited by the American Academy of Orthopaedic Surgeons puts the cost of defensive medicine much higher--$100 billion to $178 billion per year.

Source: Rich Karlgaard, "Our Health Care Crisis: Age, Obesity, Lawyers," Forbes, August 20, 2009.

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