Blue Cross tells us why wellness matters — or not

I wrote a post recently about how wellness and prevention are not the most important aspects of health reform — and there is little evidence that prevention is going to contain costs.

Blue Cross and Blue Shield of North Carolina loves to talk about prevention because the company wants to guide the national conversation away from access and consumer choice. After I wrote about prevention, Blue Cross and its public relations firm Capstrat posted a note on its health reform website on “why wellness matters.”

Wellness matters, Blue Cross tells us, because a recent study in Health Affairs estimates that medical costs related to childhood obesity reached $237.6 billion in 2005. Pretty shocking, huh? Apparently, Blue Cross doesn’t find anything fishy about a study that says $237.6 billion of our $2 trillion health system is spent on childhood obesity.

When you link to the study cited by Blue Cross you can see in the executive summary that the cost is actually $237.6 million, not billion.

Now $200 million isn’t pocket change — but in the context of our health system, that’s not much. Blue Cross gets more than $100 million to administer the State Health Plan. And our state’s Medicaid program is between $8 billion and $10 billion in state and federal spending. There is also this sentence in the study:

Obesity as a diagnosis is different from the AMA definitions of overweight and obese. Diagnosis is a product of clinical judgment and reimbursement by hospital payers and is subject to inaccuracy. The trends described are to be interpreted with caution because they could represent trends in diagnosis rather than an increase in patients in which obesity is causing other medical conditions.

Again, we all recognize that obesity is a problem. It will most likely take reforms to our food system, not just our health care system, to fight obesity in the United States. But anyone discussing health reform who mentions prevention as the top priority for controlling costs is misleading you. And, like Blue Cross and Capstrat, they are probably just making up numbers.


  1. IBXer

    July 14, 2009 at 3:36 pm

    Give me liberty or give me death.

    I would rather live free without health insurance than have government ran healthcare and bureaucrats dictating how much I am allowed or required to eat, sleep, or engage in physical activity.

  2. Adam Linker

    July 14, 2009 at 3:51 pm

    I linked to the original cached Blue Cross post — before it changed the post to the much less impressive $237 million.

  3. Adam Searing

    July 14, 2009 at 4:05 pm

    Here’s a link to a copy of the original Blue Cross post, just in case the cache Adam links to doesn’t work:


  4. Misty

    July 15, 2009 at 8:27 am

    I think that prevention is very important because prevention of certain diseases will very obviously cut prices because then you wont have to treat it- and therefore pay for said treatment. And also, not just for a matter of dollars and cents, prevention and wellness will lead to happier, healthier, more productive lives.

  5. AdamL

    July 15, 2009 at 10:05 am

    Great observation Misty — it’s exactly my point that wellness is great for improving lives. It’s not the most important way to cut costs, which is what some would have us believe.

    It does seem intuitive that prevention will “very obviously” cut costs, but a great deal of research shows that some types of prevention cuts costs and some types do not.

    If, for example, you screen for childhood obesity, how much does the screening cost? What are you going to do if a child is obese? How much will the counseling and whatever else you do cost? On how many children will the screening and counseling work?

    It will most likely end up not saving the health system money. Of course, the screening and counseling might still be worthwhile if it leads to better lives — even if it doesn’t save money.

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