Medicare Adds Preventive Services for Obesity

Today the Centers for Medicare and Medicaid Services announced today that it will begin covering payment of screening for obesity, a nutritional assessment for those who qualify and counseling services through primary care providers.

Obesity is a large problem in the United States (no pun intended) and unabated can lead to many chronic illnesses, not the least of which are heart attack, stroke and diabetes. This preventive program is another measure via the Affordable Care Act and is a good weapon to have in the preventive services arsenal.

Like so many things in life, prevention of illness or disability is preferred to treatment of the same. Motivated obese Medicare recipients will likely reap the most health benefit from these newly covered services.

What I think is unfortunate is that the medical aspect of obesity treatment is not being linked to the mental health aspect of it. The way the system is currently designed, payment for these services will only be provided when a person goes through a primary care practitioner, which means a physician, nurse practitioner, physician assistant or clinical nurse specialist in a family medicine, internal medicine, or geriatric medicine.

I entrust my health care to practitioners in these specialties. In fact, I have always chosen a family practitioner because of their broad knowledge base. But I think counseling, even for obesity, belongs in the realm of mental health. The problem of obesity is a complicated one and, it seems to me, to call for the integrated services of a medical practitioner and a mental health practitioner for the most positive outcome for the individual.

As a taxpayer, I understand that the cost of mental health services in some areas may be cost prohibitive at this time. As an individual who understand you don't change a lifetime of habits overnight, I lament this well-meaning but inadequate decision.

How do you feel about these newly covered services?

Parental Custody of Obese Children in Jeopardy?

There's no denying that obesity and general conditions of being overweight are plaguing the United States and other countries who model the American lifestyle. Facts and research bear out that obesity leads to other chronic and sometimes life-threatening health conditions such as Type 2 diabetes and cardiovascular disease--among others.

So then, does it logically follow that severely obese children should be taken from their parents, as Harvard pediatric professor and obesity expert David Ludwig, contends in the July 13, 2011 article published in the Journal of the American Medical Association contends?

Or is the American family already a casualty of a government that is overstepping its bounds into the personal lives of its citizenry?

There has to be other solutions to this problem other than yanking children from their homes--and placing them where? Would foster families be the answer? Already there are too few foster families available for children taken from homes where abuse or neglect is suspected. What training would foster families be required to undergo that their care would be superior to the care morbidly obese children could receive at home?

Surely the public health care system could--and should--be updated to address the needs of not only children with obesity, but also parents and adults with the same health issue. Supervision could be provided by local health departments, with the responsibility of care for the child remaining where it should be--at home.

Education and community resources need to be available to families of all income levels and physical abilities. If the government needs to step in at all, let it be to ensure that all school systems have physical education classes.

It's true that childhood obesity is an issue that needs to be addressed, but let's do so within the family system. The family unit has endured throughout time, whereas governments come and go. We must say "No!" to Big Brother making any more intrusions into the family.



Sources: Time; "Should Parents Lose Custody of Their Extremely Obese Kids?"; Bonnie Rochman; July 13, 2011
              Journal of the American Medical Association; "State Intervention in Life-Threatening Childhood Obesity"; Lindsey Murtagh, JD, MPH and David Ludwig, MD, PhD; July 13, 2011

Technology Presses on, but at What Price?

I'm not the first to think or speak about how advances in technology have changed life--some for the better and some for the worse. I'd be a hypocrite if I didn't confess that I enjoy many of the things about which I speak, but moderation is the key.

Television, video games and computers enhance our lives, but at what cost to the generation beginning now to take the helm and their children? Even cell phones, many of which are now mini-computers, take their toll on developing social skills and face-to-face interpersonal relationships.

Take a look at play parks and family lawns. Do you see kids out doing the things you used to enjoy as a child? Many family neighborhoods look like ghost towns from a street view. There's not many kids outside running, jumping, or tossing balls--the simple things that built imaginations and kept today's breakfast from developing into a new extra pound on an increasingly obese generation.

I want to tell them to turn off the gadgets and experience living. A skinned knee or elbow is a small price to pay for play time in the outdoors. Moderation is the key; it's truly common sense.