The twisted path from farm subsidies to health care expenditures

Stephanie Bernell

School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, USA.

DOI: 10.4236/health.2012.412A216                

Abstract

Overweight and obese individuals are at increased risk for many diseases and health conditions, including but not limited to the following: hypertension; osteoarthritis; dyslipidemia; type 2 diabetes; coronary heart disease and stroke. Consequently, individuals who are obese are more likely to use health services and are more likely to use costly health services than non-obese individuals. Between 1987 and 2001, growth in obesity related health expenditures accounted for 27 percent of the growth in inflation-adjusted per capita health care spending. Researchers, popular press and the television news media have paid considerable attention to the effect that farm subsidies have on dietary habits and obesity. Prominent researchers in the field have concluded that US farm subsidies have had a negligible impact on obesity. However, even small increases in obesity rates are associated with higher health care expenditures. The primary intent of this study is to break down the linkages from farm subsidy to health expenditure and shed light on the unintended implications of the farm subsidy program. We find that agricultural subsidies have the potential to influence health care expenditures.

Keywords

Obesity; Farm Subsidy; Health Expenditure; Cost; Medicare; Medicaid

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Health Organization Fact Sheet (2010) Overweight and obese. http://www.who.int/mediacentre/factsheets/fs311/en/index.html
[2]	Centers for Disease Control and Prevention (2004) Prevalence of overweight and obesity among adults: United States, 2003-2004. http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese03_04/overwght_adult_03.htm
[3]	Bray, G.A., Nielsen, S.J. and Popkin, B.M. (2004) Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. American Journal of Clinical Nutrition, 79, 537-543.
[4]	Pi-Sunyer, F. (2002) Medical complications of obesity in adults. In: Fairburn, C.G. and Brownell, K.D., Eds. Eating Disorders and Obesity: A Comprehensive Handbook. 2nd Edition, Guilford Press, New York.
[5]	Quesenberry, P., Caan, B. and Jacobson, A. (1998) Obe- sity, health services use, and health care costs among members of a health maintenance organization. Archives of Internal Medicine, 158, 466-472. doi:10.1001/archinte.158.5.466
[6]	Raebel, M.A., Malone, D.C., Conner, D.A., Xu, S., Porter, J.A. and Lanty, F.A. (2004) Health services use and health care costs of obese and nonobese individuals. Archives of Internal Medicine, 164, 2135-2140. doi:10.1001/archinte.164.19.2135
[7]	Organization for Eco-nomic Co-operation and Develop- ment (OECD) Health Data (2006) How does the United States compare. http://docs.google.com/gview?a=v&q=cache:Gly4VVgc4pYJ:www.oecd.org/dataoecd/29/52/36960035.pdf+health+spending+oecd+2006&hl=en&gl=us&sig=AFQjCNGONhHiBbeh_kDRb5-A14JYaSTASg.
[8]	Thorpe, K.E., Florence, C.S., Howard, D.H. and Joski, P. (2004) The impact of obesity on rising med-ical spending. Health Affairs, 23, W4-480.
[9]	Wolf, A. and Colditz, G. (2007) The cost of obesity: The US perspective. Pharmacoeconomic, 5, 35-37.
[10]	Wolf, A. and Colditz, G. (1998) Current estimates of the economic cost of obesity in the United States. Obesity Research, 6, 97-106. doi:10.1002/j.1550-8528.1998.tb00322.x
[11]	Finkelstein, E.A., Fiebelkorn, I.C. and Wang, G. (2003) National medical spending attributable to overweight and obesity: How much and who’s paying? Health Affairs, 22. doi:10.1377/hlthaff.w3.219
[12]	Finkelstein, E.A., Fiebelkorn, I.C. and Wang, G.J. (2004) State-level estimates of annual medical expenditures attributable to obesity. Obesity Research, 12, 18-24. doi:10.1038/oby.2004.4
[13]	Thompson, D. and Wolf, A. (2001) The medical-care cost burden of obesity. Obesity Review, 2, 189-197. doi:10.1046/j.1467-789x.2001.00037.x
[14]	Alston, A., Rick-ard, B. and Okrent, M. (2010) Farm pol- icy and obesity in the United States. Choices, 25.
[15]	Effland, A.U.S. (2000) Farm policy: The first 200 Years. Agricultural Outlook, 21-24.
[16]	Bundy, W. (1998) Tangled web: The making of foreign policy in the Nixon presidency. Hill and Wang, New York.
[17]	Alston, J.M., Sumner, D.A. and Vosti, S.A. (2008) Farm subsidies and obesity in the United States: National evidence and international comparisons. Food Policy, 33, 470-479. doi:10.1016/j.foodpol.2008.05.008
[18]	Park, Y.K. and Yetley, E. (1993) Intakes and food sources of fructose in the United States. American Journal of Clinical Nutrition, 58, 73S-47S.
[19]	Smith, S.M. (1998) High fructose corn syrup replaces su- gar in processed food, Environmental Nutrition, 11, 7-8.
[20]	Bray, G., Bouchard, C., James, W., Eds. (1998) Hand- book of obesity. Marcel Dekker, New York.
[21]	Engemann, K. (2008) US farm subsidies Liber8. Econo- mic information newsletter. Federal Reserve Bank of St. Louis.
[22]	United States Department of Agriculture (2008) 2008 farm bill. http://www.usda.gov/wps/portal/usda/farmbill2008?navid=FARMBILL2008.
[23]	Gardner, B. (2002) US agricultural policies since 1995, with a focus on market effects in grains and oilseeds. working paper 02-17, Department of Agricultural Economics, University of Maryland.
[24]	Westcott, P. and Price, J. (2001) Analysis of the US commodity loan program with marketing loan provisions. Agricultural Economic Report 801, United States Department of Agriculture.
[25]	Goodwin, G. and Mishra, A. (2005) Are decoupled farm payments really decoupled? An empirical evaluation. American Journal of Agricultural Economics, 88. 73-79. doi:10.1111/j.1467-8276.2006.00839.x
[26]	Morrison, P. and MacDonald, J. (2003) Tracing the ef- fects of agricultural commodity prices and food costs. American Journal of Agri-cultural Economics, 85, 633- 646. doi:10.1111/1467-8276.00461
[27]	Cawley, J. and Kirwan, B. (2005) Pour some sugar on me: The contribution of US agricultural policy to obesity. Unpublished manuscript.
[28]	Chou, S., Grossman, M. and Saffer, H. (2004) An economic analysis of adult obesity: Results from the behavioral risk factor sur-veillance system. Journal of Health Economics, 23, 565-587. doi:10.1016/j.jhealeco.2003.10.003
[29]	Cawley, J. (1999) Rational addiction, the consumption of calories and body weight. Dissertation, University of Chicago, Chicago.
[30]	Lakdawalla, D. and Philipson, T. (2002) The growth of obesity and technological change: A theoretical and em- pirical investigation. Research working paper 8965, Na- tional Bureau of Economic.
[31]	Pronk, N.P., Goodman, M.J., O’Connor, P.J. and Martinson, B.C. (1999) Relationship between modifiable health risks and short-term health care charges. JAMA, 282, 2235- 2239. doi:10.1001/jama.282.23.2235
[32]	Wang, F.F., McDonald, T., Bender, J., Reffitt, B., Miller, A. and Edington, D.W. (2006) Association of healthcare costs with per unit body mass index increase. Journal of Occupational and Environmental Medicine, 48, 668-674. doi:10.1097/01.jom.0000225045.77734.f4
[33]	Centers for Medicare and Medicaid Services (2009) Fact sheet, national health expenditures. http://www.cms.hhs.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp#TopOfPage.
[34]	European Commission (2009) Financial programming and budget. http://ec.europa.eu/budget/index_en.htm
[35]	Pollan, M. (2007)You are what you grow. New York Times. http://www.nytimes.com/2007/04/22/magazine/22wwlnlede.t.html.
[36]	Fox, M. (2009) US states to get significant obesity money. Reuters.