U.S. spending on healthcare hit a new record in 2024 – $5.3 trillion. That is a seven percent jump from the prior year, maintaining a longstanding pattern of health spends rising faster than spending on everything else in this economy. But how can it be that, despite all this spending, the burden of chronic diseases continues to rise?

The answer is not so hard to understand. It is all about failing to provide real care for chronic diseases at the root of the problem.

Diabetes, Bones & Joints

It is not a mystery where the money is going. A study last year in JAMA makes it clear that, far more than any other health issue, diabetes is driving healthcare spending. Next in line as a top driver was musculoskeletal disease. These two drivers have one thing in common. Obesity contributes greatly to them and treating obesity can prevent them.

Rigorous studies have shown that both metabolic surgery and advanced obesity medicines are remarkably effective in preventing diabetes. Both of these highly effective obesity treatments prevent and relieve pain from osteoarthritis.

In large part, the spiral of spending is being fueled by a reluctance to grant people access to care for obesity. Even worse, we now have health insurers taking obesity medicines away from people who had found relief from chronic diseases by taking them.

This comes from a very warped view of health economics.

Fix the Leaking Roof!

The metaphor of a leaking roof is apt for the situation in healthcare spending. We face a deluge of costs from chronic diseases that are, in large part, the consequence of untreated obesity. Historically, the options for treating obesity have been limited. Now they are multiplying, but still, health systems are reluctant to pay for treating the root cause of the chronic diseases that are bankrupting them. They are busy administering spends on diabetes and other diseases.

They cannot imagine redirecting the great sums of money that they are already spending on the consequences of neglect. In the midst of a downpour it is hard to imagine how to fix a neglected roof.

But as long as health systems neglect to treat obesity – the most prevalent chronic disease in America – health costs will continue to spiral out of control.

Click here for more from CMS analysts,  here, here, and here for further perspective.

Omaggio a Betuda Futurista, painting by Carlo Carra / WikiArt