Weight Loss therapy being considered by Medicare

[Guest Guest]

With over 60% of Americans overweight, this is better late than never. Obesity is rampant in children, so perhaps we should be addressing this at the beginning of life, rather than at the end. America has always been more treatment oriented, instead of prevention oriented, like Canada.

 

http://seattletimes.nwsource.com/html/nati...39_obese16.html

 

Medicare moves closer to covering obesity therapies

 

By Rob Stein and Ceci Connolly

The Washington Post

 

WASHINGTON The federal Medicare program yesterday abandoned a long-standing policy that obesity is not a disease, removing what has been a major roadblock for many people trying to get treatment for the burgeoning health problem.

 

After years of review, the Centers for Medicare & Medicaid Services, which runs the health program for elderly and disabled Americans, announced it was dropping language that had led the agency to routinely deny coverage for a host of weight-loss therapies.

 

While the decision does not automatically mean any specific treatment will be covered, the move opens the door to an expected flood of applications from individuals, doctors and companies for Medicare to begin paying for therapies.

 

These include stomach surgery, diet programs and behavioral and psychological counseling.

 

"Obesity is a critical public-health problem in our country that causes millions of Americans to suffer unnecessary health problems and die prematurely," Health and Human Services Secretary Tommy Thompson said in announcing the long-awaited decision.

 

"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."

 

The move, the latest the federal government has taken to fight the rising obesity problem, was hailed as a major step forward by public-health experts, anti-obesity advocates and doctors.

 

"Conceptually, this is a huge change, for the medical profession, for insurers and for employers, to treat this just like any other disease," said Morgan Downey, executive director of the American Obesity Association, an advocacy group.

 

Because private insurers often pattern their coverage after Medicare, the decision is expected to put strong pressure on them to expand coverage for weight-loss treatments.

 

Insurers welcome move

 

Representatives from the insurance industry, which has begun scaling back payments for stomach surgery, welcomed the decision and signaled companies would take their cues from Medicare.

 

"We're going to be watching this very closely," said Karen Ignagni, president of America's Health Insurance Plans, the industry's primary trade group. "We're going to be looking at what they are evaluating and what their results are."

 

In addition to the practical implications of getting insurance to pay for more treatment, experts said the move would help counter the stigma that overweight and obese people often face, encouraging more doctors to treat the problem like other medical conditions and overweight individuals to seek help.

 

"The lack of recognition of obesity as disease has cast a pall over the field. Now Medicare is saying obesity deserves treatment like any other disease," said Louis Aronne, president elect of the North American Association for the Study of Obesity.

 

Critics who denounced the decision said the health consequences of being overweight have been exaggerated and that any real problem is one of individual responsibility.

 

"This is truly a dumbing down of the term 'disease.' This is the only disease that I'm familiar with that you can solve by regularly taking long walks and keeping your mouth shut," said Rick Berman, executive director of the Center for Consumer Freedom, a food-industry-funded advocacy group.

 

"It's terrible to start using taxpayer money like this when there are other legitimate diseases that need to be addressed."

 

Many elderly too thin

 

The decision is irrational, given that being underweight is more of a health problem for the elderly than being overweight, said Paul Campos of the University of Colorado, author of the "The Obesity Myth."

 

"It's not just a bad idea, it's completely unscientific," Campos said. "We're in the grip of a kind of out-of-control cultural hysteria on this issue that leads to really irrational social decisions, such as making obesity a disease among the elderly."

 

Sen. Tom Harkin, D-Iowa, called the decision a "partial" improvement.

 

"This is illustrative of the problem we have with Medicare," he said. "If you've got a problem, we'll fix you. Medicare should have programs to prevent obesity."

 

Harkin is pushing comprehensive legislation that would promote exercise in schools, require nutritional labeling on chain-restaurant menus, provide Medicare coverage for screening and prevention services and give the Federal Trade Commission power to restrict food advertising that targets children.

 

Because it was unclear exactly what Medicare would eventually pay for, there were no estimates of what the policy change would cost the government.

 

The decision reverses a policy put in place decades ago by the Centers for Medicare and Medicaid's predecessor, which had declared that "obesity itself cannot be considered an illness."

 

The policy made it difficult for obese people to obtain coverage for surgery, nutritional counseling, diet drugs and other treatment unless they were suffering from other recognized diseases, such as diabetes or high blood pressure.

 

Yesterday's decision stopped short of declaring obesity a disease, instead simply dropping the original language.

 

"I think that's virtually identical to saying it is a disease," Downey said. "They don't have any reason now to deny coverage on the basis of it not being a disease."

 

The decision will not affect weight-loss drugs.

 

But Downey said his group planned to press Congress to address that when it reconsiders Medicare's new prescription-drug benefit.

 

Copyright © 2004 The Seattle Times Company

 

[redhenfarm]

Hmmmm. I have mixed feelings about this. It makes sense there should be coverage for people whose doctors advise to lose weight for health reasons. But why limit it to the elderly? I am also skeptical of anything that pushes us any more towards the trend of discriminating against the overweight person. I became "chubby" at 8 and have been at various degrees of average weight to fat. I have seen doctors who (especially years ago) cranked at you if you were 5 lbs. off the "chart". It will be interesting to see how this goes. When I worked for a psychologist a law passed that looked like insurances wouldn't be able to cut needed therapy for patients but by golly they found a way to get around that, too.