Feds Mull
Obesity as 'Disease' � You'll Pay Billions
Phil Brennan,
NewsMax.com
Tuesday, Jan. 22, 2002
Medicare officials, egged on by members of the
anti-obesity industry, are considering adding being overweight to
the list of diseases covered by insurance and Medicare � a move that
could cost Americans billions.
The nation's leading obesity organizations are pushing for such a
step, claiming that obesity is a disease that requires medical
attention and should be covered by insurance, HMOs, Medicare and
Medicaid, USA Today reported Monday.
More overweight people would seek medical assistance if obesity
were covered, the groups insist, and losing as little as 5 percent
of one's weight reduces blood pressure, blood sugar and cholesterol
levels. This, they claim, might well save health care costs in the
long run.
Medicare officials are "expected to announce within the next
couple of weeks whether to classify obesity as a disease for the
program," the newspaper revealed. Current regulations state that
"obesity itself cannot be considered an illness," and as a result,
Medicare usually doesn't cover treatments for it.
Adding obesity to the list of covered disorders would not
automatically mean that Medicare will start paying for treatments,
but it does leave an opening for more discussions at national and
state levels, experts say.
Being overweight is a health risk that can cause heart disease
and a host of other disorders and should be regarded as a disease
requiring medical treatment, advocates of the new classification
say.
If obesity isn't covered, "people will continue to get bigger and
sicker," Charles Billington, associate director of the Minnesota
Obesity Center in Minneapolis, told USA Today.
But classifying obesity as a disease would mean that the cost of
medical care and insurance � and the taxes that pay for such federal
programs as Medicare � would also get bigger and bigger, experts
say.
About 26 percent, or about 54 million adults, are obese: at least
30 pounds over what is considered healthy. About 300,000 deaths a
year are attributed to obesity.
The Voluntary 'Disease'
But some experts wonder if those facts justify ballooning
medical, insurance and tax costs. They argue that being overweight
is a matter of choice due to poor exercise and eating habits that
can't be blamed on a disease. And, they add, treating obesity as a
disease would be incredibly expensive and boost insurance premiums
and other health costs for companies and individuals.
Moreover, even if people do lose weight under costly medical
supervision, experience shows there is no guarantee they'll keep it
off.
"Historically, insurance companies have looked at obesity as a
condition that an individual should be able to manage through
modifying their own eating habits and increased exercise," Frank
Apgar, senior medical director of care management for Blue Shield of
California, told USA Today.
"Does one really need a doctor to accomplish these goals?" If so,
"should the individual pay for this, or is it something your
insurance company should pay for, i.e., all of us?" he told USA
Today's Nanci Hellmich.
According to advocates of the new classification, the answer is
clearly "yes."
"Obesity is the engine that is driving a lot of diseases - heart
disease, diabetes, hypertension, arthritis," said Morgan Downey,
executive director of the American Obesity Association. "We're
paying for those diseases, but not contributing nearly enough to
deal with the underlying cause, and that just doesn't make sense."
How much would adding obesity to the list of covered diseases
cost? USA Today estimated part of the price tag:
Diagnosis: Overeating, Underexercising
Just one physician visit a year by 25 percent of the 54 million
obese Americans would cost more than $810 million, based on a doctor
visit charge of $60.
If those same people took a year-long basic nutrition/behavior
modification treatment program at an estimated cost of $450 a
person, it would tally $6.1 billion.
Prescription diet medication could cost as much as $5.2 billion
if just 10 percent of obese people went on a weight-loss drug for a
year, at a cost of $80 a month.
If 100,000 severely obese people had gastric bypass surgery,
which creates a much smaller stomach and rearranges the intestine,
at a cost of about $24,000 a surgery, it would tally $2.4 billion.
(There are already an estimated 56,000 surgeries a year; some are
covered by insurance.)
Would all this increased spending really help solve America's
obesity problem? "Numerous studies on everything from prescription
diet medication to behavior modification show that dedicated dieters
lose about 10% of their weight in three to six months," the
newspaper explained.
"For many people, that translates to about 20 pounds or so. Then
the weight loss seems to slow down or halt. Some people are able to
lose and keep off more, but not everybody loses weight, and a number
who do are unable to keep it off."
Given those uncertainties, would it be wise to go on a new
spending binge to deal with obesity? Would such a program be worth
the multibillion-dollar price tag?
Reporter Hellmich wrote that studies are looking at whether
treating obesity is cost-effective, that is, would it reduce the
cost of treating the illnesses associated with being overweight.
In the final analysis, Apgar said, "it's a matter of allocating
how you are going to use your health care resources."
As always, "The cost is going to come back to the consumer," he
said.
That's you and me.
As a regular reader wrote to NewsMax: "Well, years ago we said
'Guns cause crime like large spoons cause Rosie O'Donnells.' Now we
have the 'out-of-control spoon in the pie-hole' syndrome. It was
preordained. We're not surprised."
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