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The Incidence of the Healthcare Costs of Obesity

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Author Info
Jay Bhattacharya
M. Kate Bundorf
Abstract

The incidence of obesity has increased dramatically in the U.S. Obese individuals tend to be sicker and spend more on health care, raising the question of who bears the incidence of obesity-related health care costs. This question is particularly interesting among those with group coverage through an employer given the lack of explicit risk adjustment of individual health insurance premiums in the group market. In this paper, we examine the incidence of the healthcare costs of obesity among full time workers. We find that the incremental healthcare costs associated with obesity are passed on to obese workers with employer-sponsored health insurance in the form of lower cash wages. Obese workers in firms without employer-sponsored insurance do not have a wage offset relative to their non-obese counterparts. Our estimate of the wage offset exceeds estimates of the expected incremental health care costs of these individuals for obese women, but not for men. We find that a substantial part of the lower wages among obese women attributed to labor market discrimination can be explained by the higher health insurance premiums required to cover them.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 11303.

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Date of creation: May 2005
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Handle: RePEc:nbr:nberwo:11303

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I1 - Health, Education, and Welfare - - Health
J7 - Labor and Demographic Economics - - Labor Discrimination

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-48, July-Aug.. [Downloadable!] (restricted)
  2. Woodbury, Stephen A, 1983. "Substitution between Wage and Nonwage Benefits," American Economic Review, American Economic Association, vol. 73(1), pages 166-82, March. [Downloadable!] (restricted)
  3. Patricia M. Anderson & Kristin F. Butcher & Phillip B. Levine, 2003. "Economic perspectives on childhood obesity," Economic Perspectives, Federal Reserve Bank of Chicago, issue Q III, pages 30-48. [Downloadable!]
  4. Summers, Lawrence H, 1989. "Some Simple Economics of Mandated Benefits," American Economic Review, American Economic Association, vol. 79(2), pages 177-83, May. [Downloadable!] (restricted)
  5. Gruber, Jonathan, 2000. "Health insurance and the labor market," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 12, pages 645-706 Elsevier. [Downloadable!] (restricted)
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  1. Lopez-Pablos, Rodrigo A., 2007. "Health Econometric: Uncovering the Anthropometric Behavior on the Women's Labor Market," MPRA Paper 5961, University Library of Munich, Germany, revised 02 Feb 2008. [Downloadable!]
  2. Fabrice Etilé, 2007. "Social norms, ideal body weight and food attitudes," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 945-966. [Downloadable!]
  3. Lopez-Pablos, Rodrigo A., 2008. "Notas sobre Descomposiciones Microeconométricas: Un Análisis Antropométrico
    [Notes on Microeconometric Decompositions: An Anthropometric Analysis]
    ," MPRA Paper 8222, University Library of Munich, Germany. [Downloadable!]
  4. Naci H. Mocan & Erdal Tekin, 2009. "Obesity, Self-esteem and Wages," NBER Working Papers 15101, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. Andrew J. Oswald & Nattavudh Powdthavee, 2007. "Obesity, Unhappiness, and The Challenge of Affluence: Theory and Evidence," IZA Discussion Papers 2717, Institute for the Study of Labor (IZA). [Downloadable!]
    Other versions:
  6. Jay Bhattacharya & Mikko Packalen, 2008. "The Other Ex-Ante Moral Hazard in Health," NBER Working Papers 13863, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Vincenzo Atella & Noemi Pace & Daniela Vuri, 2008. "Are employers discriminating with respect to weight? European Evidence using Quantile Regression," CEIS Research Paper 123, Tor Vergata University, CEIS, revised 14 Jul 2008. [Downloadable!]
    Other versions:
  8. David Lempert, 2007. "Women's Increasing Wage Penalties from Being Overweight and Obese," Working Papers 414, U.S. Bureau of Labor Statistics. [Downloadable!]
  9. A. Spithoven, 2009. "Why U.S. health care expenditure and ranking on health care indicators are so different from Canada’s," International Journal of Health Care Finance and Economics, Springer, vol. 9(1), pages 1-24, March. [Downloadable!] (restricted)
  10. David G. Blanchflower & Andrew J. Oswald & Bert Van Landeghem, 2008. "Imitative Obesity and Relative Utility," NBER Working Papers 14337, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  11. Euna Han & Edward C. Norton & Sally C. Stearns, 2009. "Weight and wages: fat versus lean paychecks," Health Economics, John Wiley & Sons, Ltd., vol. 18(5), pages 535-548. [Downloadable!]
  12. Tomas Philipson & Richard Posner, 2008. "Is the Obesity Epidemic a Public Health Problem? A Decade of Research on the Economics of Obesity," NBER Working Papers 14010, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  13. Euna Han & Edward C. Norton & Lisa M. Powell, 2009. "Direct and Indirect Effects of Teenage Body Weight on Adult Wages," NBER Working Papers 15027, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  14. Christian A. Gregory & Christopher J. Ruhm, 2009. "Where Does the Wage Penalty Bite?," NBER Working Papers 14984, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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