Americans have lower life expectancy, higher infant mortality, and are generally sicker than citizens of other countries despite spending twice as much on healthcare. Confronted with this fact some of us, observing that all other countries have universal healthcare, start thinking that universal healthcare might help this country too.
Not so fast says Greg Mankiw, economic adviser to Mitt Romney. The other day he blamed the relatively poor health care numbers in the US on, among other things, obesity. The US doesn’t really have an overall lower life expectancy, he says, if you adjust for how fat Americans are. So don’t blame the healthcare system.
He may be right. But if so, it strongly argues for charging fat people (or as Mankiw puts it, people who have made that “lifestyle choice”) more for their healthcare.
Being a fuzzy headed liberal I tend to favor community rating, charging everyone the same premium regardless—but I can see a case for “risk adjusting” premiums for, say, obesity and smoking.
But, politically, I’m not sure Mankiw and Romney really want to make this their campaign theme: “don’t worry about healthcare because we will just charge higher premiums to fat people until they slim down and get healthier”. Particularly when you take a look at the map. Here is a ranking of states with the highest percentage of obese people. Kind of matches a certain political map I’m thinking of.
3: West Virginia
8 (tie): Indiana*, South Carolina*
15 (tie): Ohio*, Alaska
17: North Carolina*
18: North Dakota
22: South Dakota*
31 (tie): Idaho*, Washington*
36 (tie): Wyoming*, New Hampshire*, New York
40 (tie): New Jersey*, New Mexico*
43 (tie): Arizona, Utah*
47 (tie): Rhode Island*, Vermont