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Research Article

Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

  • Pieter H. M van Baal mail,

    To whom correspondence should be addressed. E-mail: pieter.van.baal@rivm.nl

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Johan J Polder,

    Affiliations: National Institute for Public Health and the Environment, Centre for Public Health Forecasting, Bilthoven, The Netherlands, Tilburg University, Department Tranzo, Tilburg, The Netherlands

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  • G. Ardine de Wit,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Rudolf T Hoogenveen,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Talitha L Feenstra,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Hendriek C Boshuizen,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Peter M Engelfriet,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Werner B. F Brouwer

    Affiliation: Erasmus University, Medical Center, Rotterdam, The Netherlands

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  • Published: February 05, 2008
  • DOI: 10.1371/journal.pmed.0050029

Reader Comments (8)

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Additional Considerations and Logical Alternatives.

Posted by plosmedicine on 31 Mar 2009 at 00:19 GMT

Author: Phillip Nelson
Position: Ph.D., Retired
Institution: home
E-mail: penelson@belf.org
Submitted Date: February 05, 2008
Published Date: February 7, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Additional Considerations
Somewhere in the statistics on health care is the surprising data that for the average person, over half a person's health care costs occur during their last 9 months of life, as our medical systems goes to extraordinary lengths to extend and increasingly painful life.
Also, in US state of Oregon or Washington, when people could choose to end their life when faced with a certain oncoming painful death from cancer or similar causes, most continued to choose to extend their life.
Other research shows a huge increase in the quality of life when a person remains "at choice," even when they do not choose an alternative.
Logical Alternative: Allow people approaching a painful end of life to be able to choose to end it earlier, with a quarter or so of the statistically projected savings going to their heirs. This adds a stressful choice, but allows a dignified, caring farewell. I'm getting old and would like this choice.

No competing interests declared.