So far, there is less than meets the eye to last month’s announcement that obesity is now regarded as a disease by federal health officials.
The decision does not mean millions of Americans can suddenly begin dunning Uncle Sam for Jenny Craig cuisine and gym memberships. What it means, in the words of Health and Human Services Secretary Tommy Thompson, is that “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.”
Those “interventions,” according to The New York Times, could include surgery, dietary counseling and behavior therapies. Currently, Medicare covers bariatric surgery but only if the patient has health problems above and beyond the obesity itself. If the sole purpose is to lose weight, the government doesn’t pay.
That now may change, and the consequences could be expensive, adding billions of dollars to the government’s health-care tab every year.
One troubling implication is that this change came at the behest of bureaucrats rather than as a result of congressional consideration. A decision that opens the way to possible massive new entitlements deserves public review by the people charged with controlling the nation’s pursestrings.
Another is that obesity, if it truly is a disease, is often a self-inflicted one, and it’s fair to ask why millions of Americans who do watch their weight (sometimes at considerable personal expense in time, money and sweat) should have to pay the piper for those who don’t.
On the other hand, it’s clear that obesity is not the only self-inflicted health problem for which the public winds up paying. Smoking, overdrinking, failure to use seat belts — society picks up much of the tab for those poor personal decisions as well. The price is paid in the form of higher insurance premiums and higher tax bills.
So we can quibble all we want about personal responsibility, but as a matter of public policy the issue may boil down to dollars and cents. Paying up-front to treat obesity may save money in the long run. Millions of hefty Americans are likely to suffer further medical complications such as heart disease and diabetes if they don’t take the weight off. Treating them now, before the complications set in, may be a good investment, reducing the need for more expensive long-term care.
Still, it wouldn’t hurt if more of us started our exercise routines with a simple but under-used maneuver: Shoving ourselves away from the table.