Thursday, September 30, 2004

Government snacking on taxpayers once again

Posted by Craig Westover | 1:57 PM |  

In my column "Government obesity can be prevented" I wrote with what I thought was hyperbole --
When it's one's own money being consumed for health care, not the government's, not the employer's and not the neighbor's, one is less likely to drive to the doctor for a Jenny Craig prescription and more likely to eat well and exercise.
But I guess you can't make it up fast enough. From today's New York Times:

At a meeting in November, Medicare's advisers will assess the safety, efficacy and cost of one increasingly popular method of weight loss - surgery - as a first step in a new policy that could lead to the use of federal money to cover a range of other obesity treatments.

At the moment, Medicare will pay for surgery for obesity when patients suffer other problems associated the condition, like diabetes. Now, Medicare says it may decide to cover treatment for those who are simply obese, meaning their body mass index, a measure of body fat, is at least 30.

The immediate question is whether to cover so-called bariatric surgery, which costs $30,000 to $40,000 if there are no complications, and greatly reduces how much food can be consumed and the calories that can be absorbed. But commercial diet programs as well as many obesity doctors, including members of the American Obesity Association, whose sponsors include makers of weight loss drugs as well as companies like Weight Watchers and Jenny Craig, say they want coverage for other programs, too.

The obesity association said that it planned to use Medicare as a wedge to open the door for broader coverage for the obese and then, possibly, for overweight Americans.

And they are laying the ground work. Consider this from the AOA website:
Obesity is not a simple condition of eating too much. It is now recognized that obesity is a serious, chronic disease. No human condition — not race, religion, gender, ethnicity or disease state — compares to obesity in prevalence and prejudice, mortality and morbidity, sickness and stigma.
As I note in my column, deciding whether or not a "widespread" health concern is a "public" health/government intervention issue is a matter of objective criteria, not an emotional appeal to pity and sympathy. As I wrote:

Here's some food for thought — a simmering widespread health concern, like obesity, is not automatically a "public health" problem that will boil over unless government puts a lid on it.

Main course "public health" is government activity that protects citizens from risks to which they have not consented — dangers posed to the community at large, dangers from which individuals cannot realistically protect themselves. The legitimate menu of public health includes ensuring clean air and water, maintaining adequate sanitation and controlling contagious diseases. . . .

Thus the limited portion government that produced such spectacular fare as eradicating killer diseases has been supplanted by an "all-you-can-eat" smorgasbord of behavior modifying communications and regulatory programs that equate a Big Mac and a 64-ounce "Bladder Buster" with the Ebola virus.

Obesity is not caused by polluted air, dirty water or inadequate sanitation. It is not contagious. No individual person's obesity reduces any other person's health. Individual health is not public property or public responsibility.

I suppose the silver lining in this billowing cloud of an increased nanny state is that once taxpayers start footing the bill for diet programs, there won't be enough discrestionary income left to supersize a fast food meal.

Read the column . . . .