Medicare, the nation’s medical safety net for seniors, on Wednesday announced it would extend its coverage forobesity screening and “intensive behavioral therapy,” ensuring that roughly 30% of the 42 million people insured by the program can undertake a weight-loss program supervised by their doctor.
The decision by the federal government to cover face-to-face doctor visits as an aid to weight loss is likely to prod private insurers, many of whom have been reluctant to cover medically supervised obesity treatments, to follow suit.
Medicare‘s decision will permit beneficiaries — typically those 65 and older — to see a physician once a week for a month for obesity counseling, then once every other week for an additional five months if they have a body mass index above 30 — the standard definition of obesity. If the beneficiary loses three kilograms or more — 6.6 pounds — in that period, Medicare will approve an additional six monthly doctor visits for further counseling.
This is insane. Sam MacDonald reported this in another combox thread, commenting sarcastically:
Because they cannot lose weight without intensive counseling.
Guess who’s all for it?
“I think it’s fantastic,” says Dr. Marijane Hynes, a primary care physician at George Washington Medical Faculty Associates Weight Loss Clinic.
How are we going to pay for this? Medicare is already well along the trajectory to insolvency within this decade, and now we’ve just added another benefit for 1/3 of its recipients. Because, as Sam — who lost well over 100 pounds by making his mind up to do it — points out, there’s this idea that people are helpless over their own appetites without expert guidance.
And what a crock this BMI is. I am about 15 pounds overweight, but it’s hard to see that because I have a big frame. But when I recently had my BMI taken, it said that I was right on the borderline between being overweight and obese. Ridiculous. If a slender-framed person of my height (5′ 11″) was carrying my poundage (197), he might be obese. Me, not. I bet that many of those “obese” Medicare patients are not obese at all.
This whole thing is deeply frustrating to me. Obesity, and the complications that go with it — diabetes, heart disease, etc. — is a huge medical problem in this country. Nobody can deny that. But do we really need to have the government pay experts to tell people to stop shoving food in their faces, to eat healthier, and to get off the couch and move around some? Is this really so hard to figure out?