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EducateWorthington.org

The 912 Project - Glenn Beck

912 Group of Central Ohio

Please let me know if you'd like your link added

[Edmund Burke]

Not sure how I feel about this...obesity is something that transcends simple willpower, and yet do I want the treatment of same subsidized by skinny people?  

Since even private insurance is a form of socialism, it's a hard call.

______________________________________________________-
Medicare Scraps Old Policy on Obesity

Thu Jul 15,11:15 PM ET
   
   Add White House - AP Cabinet & State to My Yahoo!

By ELIZABETH WOLFE, Associated Press Writer

WASHINGTON - Medicare is discarding its policy that obesity is not a disease, potentially throwing open the door for millions of overweight Americans to make medical claims for treatments such as stomach surgery and diet programs.

   

"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely," Health and Human Services (news - web sites) Secretary Tommy Thompson told a Senate panel Thursday. Treating obesity-related illnesses results in billions of dollars in health care costs, he said.

"With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese," Thompson said.

With the removal of language in Medicare policy that said obesity is not an illness, beneficiaries will be able to request a government review of medical evidence to determine whether certain treatments for obesity can be covered.

Though Medicare and Medicaid programs cover sicknesses caused by obesity — including type 2 diabetes, cardiovascular disease, several types of cancer and gallbladder disease — the previous policy meant that weight-loss therapies have often been denied coverage.

"The medical science will now determine whether we provide coverage for the treatments that reduce complications and improve quality of life for the millions of Medicare beneficiaries who are obese," said Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services, which oversees health insurance programs for the elderly, disabled and poor.

Some detractors of the change said it is based on unsound science.

"We have a tremendously exaggerated fear of higher than average weight in this culture," said University of Colorado law professor Paul Campos, author of "The Obesity Myth."

"What's partly baseless is this notion that the government needs to intervene to make Americans thinner," Campos said.

HHS said the policy change is not expected to immediately alter Medicare coverage, and no figures were provided on potential costs to taxpayers. The Medicare agency said it may meet this fall to review scientific evidence on various surgical procedures related to obesity.  

["The only thing necessary for the triumph of evil is for good men to do nothing."]

Speaking as someone who has fought this fight for decades, I'll chime in.  There are those who can eat more than Godzilla and never put on a pound.  That ain't this kid.  My own weight has fluctuated up and down all my life.  I seem, in my mind, to be genetically predisposed to easily putting on weight, just as others seem to have a genetic predisposition towards a consistently slender physique.  I've learned over the years that they only way I've found to stay on top of this is exercise.  Thus I spend time in the gym lifting weights and running most mornings to start my day, and that works fine in my case.  If I do that for some years, then take a more lethargic approach to my existence for a few years, I put the weight back on, finally get sick of it, and start working out again.  Diets suck, as I love to eat whatever I want and when I want it.  So I indulge myself frequently, while trying to eat intelligently a lot of the time as well, but put in the exercise necessary to stay in control of the end result.

There may be cases that do involve a set of circumstances where obesity is totally outside the potential realm of control of the individual, though for the most part that's not the case.  Perhaps not in all, but in the majority of cases, this can be controlled by lifestyle and determination.  A high percentage of our population is just so busy being busy that they rationalize it that they have no time for exercise, and many amongst them simultaneously are not able, for whatever combination of reasons, to control their caloric intake.  I posit that in general, we'd better individually and collectively re-think this, put our health and longevity in perspective, and as individuals make the internal, commited decision to take personal responsibility for how the battle of the bulge turns out in our own case.

In the overwhelming majority of cases, this obesity phenomenon is not a disease-related issue, but the unfortunate cumulative result of years of day to day, seemingly unimportant decisions that in the end wreak havoc on our bodies.  In most cases it was preventable, and also in most cases it can be successfully addressed if someone can find the strength to make the necessary decisions about what they need to do about it, and then follow through with determination.  Nothing easy about it, to be sure, but it can be done, and we need to do it, both as individuals and as a nation.  A universal jacking up of insurance rates to start covering obesity treatments on a more widespread basis is not only an injustice to those who are not part of the problem, it is a disservice to the patients in my mind.  Similarly, getting the government involved through their programs, perhaps creating new entitlements, would be a bad move.  In general, it's not an issue that should even involve the medical community.  Stomach stapling, liposuction, and other such treatments are pretty daggone radical moves in my mind, when a reasonable amount of exercise, combined with the exercise of some willpower, will in most cases suffice.

The reality is that we make time for what is, in our perception, important to us.  I happen to think, that at this point in my life, controlling my weight and conditioning is important to me, so I make the time to deal with it.  For periods in my life I have not, and will probably find myself there again at some point.  So, if I relax the effort, should others be obliged to underwrite my weakness?  I think not.  On the other hand, there are folks whose physical condition do not permit themselves the luxury of being able to work out, and perhaps that's a different story.

I'm a smoker as well, damn things are enjoyable.  Again a conscious decision, repeatedly made every time I fire one up.  Well aware of the potential hazard, I have not as yet suffered any ill effects.  Am I genetically predisposed to contracting cancer or having a heart attack?  I don't honestly know.  But if I do, I'll not be expecting anyone else to share the financial burden of treating conditions I should have had the sense to avoid.

[Edmund Burke]

I generally agree that obesity is related to poor habits, but that's not the whole story.  The fact is, the tendency to be obese runs in families and, as you note, some people can eat with impunity and others can't -- differences in genetic metabolism, in part.  So, my guess is that some people find it relatively easy to maintain their weight, and others finds themselves in a vicious cycle...weight gain, which makes exercise painful, with more eating...and eventually it takes a crane to lift you out of bed.

I guess my point is that expecting heroic efforts from people (and blaming some of them for failing at that heroism) isn't reasonable...any more than expected EVERYONE to overcome economic and social disadvantage.  My real question is, given human frailty and the tendency of MOST fat people to give up after repeated failures, is there a role for medicine and the government in stopping the obesity epidemic?  

I honestly don't know the correct answer (maybe there isn't one).  I wouldn't want this to turn into (yet another) windfall for trail lawyers, but I do hope that successful medicines and treatments can provide some hope.  If the government could supercharge the development of same, I'd be OK with that.

[The consequences of treating obesity as a disease]

From Townhall.com today:

The consequences of treating obesity as a disease[/size]

Jacob Sullum
July 23, 2004

This month's decision by the Medicare program to begin paying for obesity treatments has prompted complaints that the government is forcing thin people to subsidize fat people. But the winners and losers from this policy shift are not as obvious as they might seem.

 To begin with, the government says two-thirds of us are overweight, so this is not so much the thin subsidizing the fat as the fat subsidizing the obese. And if all the taxpayer-financed surgeries, diet programs and counseling sessions actually work (a big if , the upshot could be lower taxpayer costs.

 A study published last year in the journal Health Affairs estimated that the health care costs associated with excessive weight amount to something like $93 billion a year, half of it covered by Medicare and Medicaid. On average, medical treatments cost $732 more per year for the obese and $247 more for the merely overweight.

 The increases in Medicare and Medicaid costs were statistically significant only for the obese -- a fact that widens the divide between the plump and the corpulent. If the big expenses don't kick in until you get really fat, I guess even the overweight have a right to object when their fellow Americans eat too much.

 So maybe it's not so strange to see George Washington University law professor John Banzhaf, a promoter of fast food lawsuits, complain that "obese patients are contributing to skyrocketing Medicare and Medicaid outlays and costing thin taxpayers tens of billions of dollars a year." Although Banzhaf is tubby, perhaps he's not fat enough to be a drain on the Treasury.

 For those who are, spending money on weight loss now could, in theory, avoid bigger costs down the road -- money that would be spent to treat diabetes, heart disease or other obesity-related illnesses. That's the fiscal justification for covering obesity treatments under taxpayer-financed health insurance (although it makes more sense with the younger population covered by Medicaid than with the retirees covered by Medicare).

 But there's a complication. We don't really know whether taxpayer costs are higher, on balance, than they would be if everyone were thin

Link to complete article:  

Treating Obesity As A Disease

[Edmund Burke]

I agree with that assessment...medical subsidies should be modest and focus on prevention, behavior modification, and pharmaceuticals.  We shouldn't subsidize heroic measures like intestinal bypass or lyposuction.  And I emphasize the word "modest."  Indeed, I think the copays should be quite high depending on the illness being treated.

Still, I have no idea how to bring this about politically.  When you are talking about Medicare or Medicaid, everyone wants to talks about "rights" to this and "rights" to that.  Before you know it, you have Federal money subsidizing fat farms for the rich and famous.

["The only thing necessary for the triumph of evil is for good men to do nothing."]

Do they serve alcohol at fat farms?  We could get Teddy Kennedy registered.

Obesity is a disease of the mind not the body, making most treatment's an excersise in futility.  You must want to lose weight to lose weight.  Treating the obese as victims is rediculous.  The obese must be showed that they can lose weight, until you seee it its almost unbelieveable.  I weighed 286 lbs at one point, I had a surgery and lost 30 lbs.  After that first 30 I had hope and proof that there was another me under all that fat.  I believed and that gave me strength.  Obesity is a disease of hopelessness and disbelief in the possibility of change.  Change mind states of the chronically obese, save lives.  

Kerry supporters have disguised fat farms into Wendys.  Its the roach motel premise.  Bring em in with tasty smelling treats, shackle them to hampster wheels to power his amazing contradiction machine.   :rolleyes:  

[Edmund Burke]

Mr. James...you oversimplify.  If what you say is true, then obesity is a mental illness, and yet there are many accomplished fat people who are success in most aspects of their lives.  This has as much to do with biology as with the mind, and the science is bearing that out almost on a daily basis.

If you lost lots of weight and have kept it off (without ganja), then congrats.  My thinking is that perhaps you have substituted one addiction for another...but I could be wrong.  I don't know you or your life history.