2013
Now that obesity is a “disease” will health benefit plans be able to deny any treatment or procedure related to weight loss? If you use the track record of Obamacare rules and regulations as a benchmark, the answer may be the new sneakers you just bought so you can exercise will be covered by health insurance. Given many obese people are currently healthy, is obesity really a disease … or just a new strategy.
This article is an interesting read, check out the full article.
Last week’s announcement by the American Medical Association’s (AMA’s) council on science and public health cheered me. It said that the AMA should not designate obesity a disease, because doing so was unlikely to improve health outcomes and because the most widely utilized obesity metric — the body mass index or BMI — was simplistic and flawed. It’s a reasonable and principled stance, which should have been the first clue that it was doomed.
The AMA’s board and delegates proceeded to snatch defeat from the jaws of victory by ignoring their own scientific council and labeling obesity as a disease. To be clear, the decision is almost purely symbolic; it has no legal force or authority, but it does up the ante in the debate with insurers and employers over what care elements should be covered and reimbursed. In other words, this is about money. Obesity: the new ATM for the health care system.
I’m just curious about where physicians have been for the past, oh, thirty years. Since 1980, as Americans have morphed into the fattest culture in the history of Western civilization, physician supply per 100,000 population has increased about 50%. Per capita medical care spending has increased from roughly $1,100 to over $8,400. 1980 was also the last time that roughly half of US adults were normal weight. Now, only about a quarter of American adults have a normal BMI.
Were US physicians blindfolded as they encountered patients growing incrementally larger with each visit? Were they keeping their mouths shut about the obvious — gee, I really think you should get out for some walking and limit the snacks — because they were awaiting a chance to make more creative use of ICD and CPT codes?


Dick, that pales in comparison to the new definitions of mental illness – including something called an “unspecified mental disorder” … Apparently we are all a little crazy, just at different points on something called the “continuum of normalcy”.
Stranger than fiction… I guess chocolate will be a 213 expense soon, to improve our moods…
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You are right about that. By the way what do you know about pre-certification of mental health care? As I read the regs it’s banned except to the extent it also applies to medical, but I know of plans that still apply pre-cert requirements for an outpatient MH visit.
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I think medical management practices are permitted, so long as they are not, based on an after the fact determination, found to
be a subterfuge. More guidance needed, unfortunately, more guidance under PPACA often means more limitations on plans. … As all employers are evil in the eyes of this administration.
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