Friday, December 2, 2011

Observations on Obesity and New Medicare Policy to Cover It

We are digging our graves with our own teeth.

Thomas Moffett (1820-1908), Irish Poet and Educator

December 2, 2011 – Medicare has announced it will cover obesity screening and counseling as a free preventive service.

Under the new rules, physicians will be paid to screen and counsel beneficiaries with a Body Mass Index (BMI) of 30 or more. The counseling can take place once a week for a month, then every month for 5 more months. Patients who lose 6.6 pounds or more at the end of 6 months will be eligible for 6 more counseling sessions. This is Medicare's 6-6-6-6 plan.

As things now stand, 30% of Medicare patients have BMIs of 30 or more. Many private plans cover bariatric surgery for the morbidly obese (BMIs of 40 or more), which is found in 2% of men and 4% of women, but they do not pay for screening or counseling.

Will the new CMS policy bring down obesity rates and slim waistlines?

The answer is unknowable at this point. But politically, it may not matter. Government success is measured in good intentions, not results. It is a good thing to pay doctors to advise on obesity, which leads to diabetes, heart disease, hypertension, sleep apnea, and high health costs. And it is a good thing always to offer “free” preventive services.

Who knows? An ounce of preventive counseling may be worth a pound of flesh and ward off a future disease. Given the scale of the obesity epidemic, it’s worth a government try.

I suspect, however, CMS has bitten off more than it can chew. Its good intentions remind me of the maxim: seek simplicity but distrust it.

Everybody knows these simple obesity rules.

• Eat less, move more, weigh less.

• More calories in, less calories out, more weight on.

• Choose veggies, eschew salt,carbs, sweets, red meat, and fats.

• Obey the law of small portions.

Besides, everybody knows inside every fat person there is a thin person wildly waving to get out. And , of course, everybody knows obesity is a mental state brought on by bad habits, boredom, low self-esteem, and disappointment.

But what few say, not often enough, is that obesity is a complex multidimensional cultural problem brought on by:

• Ubiquitous marketing of fast foods and sugary drinks.

• Poverty and distance from stores selling convenient fresh foods.

• Sedentary life styles accompanying video games, TV, on-line computer sitting.

• 2-3 automobiles per American family.

• Lack of sidewalks and walking paths.

• No more recess and time for outdoor games.

• Habits of the human heart which celebrate and congregate around tables of food.

• Sheer pleasures of tastey foods, beautifully served, and accompanied by animal spirits.

As H.L. Mencken (1880-1956) sagely observed, “For every complex problem there is an answer that is clear, simple, and wrong,” which may be why the Center of Disease Control reports that 98% of all attempts to lose weight fail.

Still, as the French say C’est quoi l’expression,, loosely translated as "It is worth a try."

Tweet: Medicare has announced it will cover screening and counseling for obesity as a free preventive service.

229 comments:

1 – 200 of 229   Newer›   Newest»
PeerMurphy said...

Gastric bypass is a type of surgery where the stomach is reduced in size by one of several methods. This small stomach is then reconnected or bypassed to the small intestine.

bariatric surgery

Richard L. Reece, MD said...

Everybody knows you can bypass the stomach and lose weight, but can you bypass American culture and do the same.

Anonymous said...

buy valium cheap online drug interactions valium seroquel - valium pills color

Anonymous said...

purchase tramadol buy tramadol online us pharmacy - tramadol online health solutions

Anonymous said...

buy ativan online no prescription buy lorazepam online cheap - ativan and alcohol overdose

Anonymous said...

order tramadol online mastercard legal order tramadol online - tramadol 50 mg for humans

Anonymous said...

buy tramadol tablets tramadol for pain - tramadol ibuprofen

Anonymous said...

buy ativan online 90 mg ativan - ativan and alcohol death

Anonymous said...

buy tramadol overnight tramadol online uk - tramadol online fedex

Anonymous said...

cheapest ativan ativan dosage kids - signs of ativan withdrawal

Anonymous said...

order tramadol no prescription tramadol interactions - tramadol hcl sleep aid

Anonymous said...

buy tramadol without a script tramadol withdrawal schedule - can you buy tramadol in usa

Anonymous said...

buy cheap tramadol tramadol 50 mg dog dosage - tramadol 93 58 pill

Anonymous said...

buy tramadol overnight shipping buy tramadol 200 - can you buy tramadol over counter

Anonymous said...

generic tramadol tramadol hcl 50 mg cost - tramadol hcl 100mg side effects

Anonymous said...

buy ambien zolpidem ambien urine urinalysis - retail price for ambien

Anonymous said...

order klonopin sublingual klonopin high - overdose clonazepam klonopin

Anonymous said...

ambien for sale online generic for ambien side effects - buy cheap ambien no prescription

Anonymous said...

where to buy tramadol tramadol daily dosage limit - tramadol hcl urine drug test

Anonymous said...

lorazepam online how long does ativan high last - buy lorazepam free shipping

Anonymous said...

order klonopin online klonopin long term use - much does 2mg klonopin cost

Anonymous said...

buy tramadol tramadol dosage levels - ultram vs tramadol generic

Anonymous said...

purchase ambien taking 10mg ambien - ambien side effects itching

Anonymous said...

generic ambien buy ambien online overnight delivery no prescription - ambien side effects addiction

Anonymous said...

buy cheap tramadol tramadol dosages humans - buy tramadol er

Anonymous said...

soma 350 mg buy soma visa - buy soma online us pharmacy

Anonymous said...

buy lorazepam online lorazepam 1 mg buy - ativan or xanax better

Anonymous said...

order tramadol online without prescription buy tramadol overnight delivery - tramadol generic for ultracet

Anonymous said...

buy cheap ambien zolpidem ambien cr side effects - does army drug test ambien

Anonymous said...

buy tramadol without prescriptions buy tramadol online pay with cod - order tramadol with saturday delivery

Anonymous said...

generic carisoprodol buy soma online usa - generic for soma

Anonymous said...

order ambien online online pharmacy review ambien - what is ambien cr used for

Anonymous said...

buy generic tramadol online tramadol hcl 50mg narcotic - tramadol online pharmacy

Anonymous said...

buy tramadol online buy tramadol australia - tramadol purchase no prescription

Anonymous said...

can you buy ambien online ambien accidental overdose - ambien cr 7 day trial coupon

Anonymous said...

order soma online san francisco soma apartments for sale - soma san diego website

Anonymous said...

tramadol online buy tramadol online no prescription usa - tramadol hcl 50mg online

Anonymous said...

buy klonopin online klonopin overdose pregnancy - klonopin generalized anxiety

Anonymous said...

ativan online ativan for anxiety - ativan withdrawal .5 mg

Anonymous said...

soma online buy generic somatropin - taking 2 350 mg soma

Anonymous said...

buy tramadol legal buy tramadol usa - tramadol or 100 mg side effects

Anonymous said...

order ambien without prescriptions side effects overdose ambien cr - generic ambien zolpidem side effects

Anonymous said...

buy viagra generic online buy viagra online singapore - order real viagra

Anonymous said...

buy ambien online purchase ambien online overnight - buy cheap ambien online

Anonymous said...

soma online buy discount soma online - buy generic soma online no prescription

Anonymous said...

generic viagra 50mg purchase viagra in australia - viagra canadian pharmacy no prescription

Anonymous said...

viagra online cheap viagra gel - viagra buy canada

Anonymous said...

viagra online cheap-generic-viagra forum - viagra online 50mg

Anonymous said...

order tramadol online overnight tramadol 627 side effects - buy tramadol online by cod

Anonymous said...

buy generic ambien ambien cr xanax interaction - buy ambien online no prescription

Anonymous said...

buy tramadol cheap tramadol 50mg caps - tramadol qt interval

Anonymous said...

soma without prescription cost of soma - soma generic 350 mg

Anonymous said...

buy klonopin online overnight safe buy klonopin online - buy clonazepam australia

Anonymous said...

ambien 5 ambien side effects heart - ambien side effects short term memory loss

Anonymous said...

soma online soma online ticketing - soma bras discount code

Anonymous said...

order generic viagra generic viagra cialis - generic viagra cvs

Anonymous said...

buy ambien online where to buy ambien cr online - ambien insomnia

Anonymous said...

cheap viagra 100mg viagra cialis - buy viagra costa rica

Anonymous said...

generic ambien ambien hair drug screen - buy ambien online fast shipping

Anonymous said...

viagra online buy viagra turkey - buy viagra online pakistan

Anonymous said...

ambien medication ambien not working - ambien zolpidem ingredients

Anonymous said...

buy generic viagra online overnight order viagra boots - how to purchase viagra

Anonymous said...

order tadalafil cialis 800 black - cialis generic vs brand

Anonymous said...

cialis online cialis daily treatment - cialis price walmart

Anonymous said...

viagra without prescription generic viagra safe - order viagra australia

Anonymous said...

cialis online cialis online 2.5mg - buy cheap generic cialis online

Anonymous said...

generic viagra online buy brand viagra online - buy viagra with paypal uk

Anonymous said...

buy tramadol overnight tramadol dosage equivalent to morphine - tramadol hcl 50 mg and tylenol

Anonymous said...

buy viagra from canada buy viagra online fast delivery - lloyds pharmacy online viagra

Anonymous said...

buy cheap tramadol buy tramadol online us - tramadol for dogs with pancreatitis

Anonymous said...

buy viagra online cheap viagra 50mg - does viagra work better than levitra

Anonymous said...

how to order viagra online safely female viagra buy online uk - cheap viagra overnight shipping

Anonymous said...

viagra medication buy herbal viagra uk - dosage does viagra come

Anonymous said...

buy soma online soma bras retailers - buy soma online usa

Anonymous said...

order tramadol overnight buy 200 mg tramadol online - tramadol 50 mg hcl

Anonymous said...

buy viagra online paypal viagra online nhs - cheap viagra for sale online

Anonymous said...

viagra online generic viagra brand - can i buy viagra at rite aid

Anonymous said...

generic cialis lloyds pharmacy cialis price - generic cialis united states

Anonymous said...

sildenafil citrate tablets buy viagra no prescription usa - equivalent of viagra for women

Anonymous said...

buy cialis without doctor prescription cialis 40 mg tablets - cialis price philippines

Anonymous said...

cheap tramadol online tramadol for dogs vs people - methocarbamol and tramadol for dogs

Anonymous said...

buy tramadol online buy tramadol online without rx - xanax tramadol overdose

Anonymous said...

buy viagra los angeles buy viagra london uk - buy viagra online without

Anonymous said...

order viagra online without script buy 1 viagra pill - reputable viagra online pharmacy

Anonymous said...

cheap cialis online cialis reviews forum - buy cialis using paypal

Anonymous said...

buy tramadol mastercard tramadol vs percocet - buy tramadol online in usa

Anonymous said...

cheap propecia buy generic propecia online uk - where to buy generic propecia forum

Anonymous said...

tramadol online buy cheap tramadol online cod - tramadol no prescription usa

Anonymous said...

buy tramadol online ordertramadolonline.org - tramadol ratiopharm 100mg nebenwirkungen

Anonymous said...

cheap sildenafil should i order viagra online - where to buy viagra online in canada

Anonymous said...

order viagra online india viagra in canada for sale - viagra time

Anonymous said...

order cialis online no prescription cialis daily mail - cialis half life

Anonymous said...

buy viagra online canada order viagra paypal - generic viagra 25mg

Anonymous said...

buy viagra generic online viagra online in canada - viagra dosage wikipedia

Anonymous said...

buy propecia online propecia side effects liver - buy cheap propecia online

Anonymous said...

order tadalafil cipla cialis reviews - cialis online satis

Anonymous said...

buy propecia propecia side effects blood pressure - buy propecia canada

Anonymous said...

buy tramadol online where to buy tramadol online safely - buy tramadol online prescription

Anonymous said...

order strattera strattera how long to work - strattera maoi drug

Anonymous said...

order viagra cheap want order viagra online - cheap viagra 100

Anonymous said...

order tramadol no prescription generic brand of tramadol - buy tramadol online tennessee

Anonymous said...

buy tramadol 180 buy tramadol in australia - tramadol addiction suboxone

Anonymous said...

buy retin-a online retin a for purchase - retin a cream 0.025

Anonymous said...

buy strattera strattera vs adderall weight loss - strattera make you high

Anonymous said...

buy viagra generic viagra canada online - buy viagra online australia no prescription

Anonymous said...

buy strattera online purchase strattera - strattera buy online no prescription

Anonymous said...

buy tramadol online tramadol overdose usa - tramadol dosage 50 mg

Anonymous said...

tramadol online no prescription 3 tramadol high - tramadol quitting cold turkey

Anonymous said...

tramadol online ultram side effects withdrawal - tramadol hcl doses

Anonymous said...

buy tramadol online tramadol online from usa - buy tramadol online no prescription cod

Anonymous said...

buy propecia online buy propecia france - buy generic propecia online

Anonymous said...

buy tramadol online no prescription overnight tramadol to buy online in usa - tramadol addiction while pregnant

Anonymous said...

buy retin a without a prescription retin a micro coupon 2012 - retin a micro tretinoin gel

Anonymous said...

buy strattera strattera drug interactions - strattera 60 mg effects

Anonymous said...

buy generic tramadol no prescription tramadol addiction in gaza - tramadol 50 mg cost

Anonymous said...

can you buy tramadol online legally tramadol 50 mg once a day - tramadol withdrawal wellbutrin

Anonymous said...

tramadol online overnight tramadol addiction stories - buy tramadol with credit card

Anonymous said...

buy retin-a retin a cream wrinkle treatment - retin a cream vs accutane

Anonymous said...

tramadol online tramadol hcl xl 150 mg - buy tramadol online no prescription overnight

Anonymous said...

where to buy tramadol online tramadol hcl 50 mg mylan - buy tramadol online next day delivery

Anonymous said...

tramadol 50mg tramadol contraindications - tramadol from usa no prescription

Anonymous said...

buy tramadol tramadol 750 mg - tramadol 50mg or 100mg

Anonymous said...

tramadol 50mg tramadol for dogs high - tramadol hcl buzz

Anonymous said...

buy tramadol online dosage for tramadol for dogs - tramadol hcl tab 50mg side effects

Anonymous said...

tramadol 50mg long does 100mg tramadol last - order tramadol for dog

Anonymous said...

tramadol online tramadol ibuprofen - order tramadol online from usa

Anonymous said...

tramadol 50 mg buy tramadol online no prescription next day delivery - buying tramadol online illegal

Anonymous said...

tramadol 50mg tramadol discount card - order tramadol online mastercard

Anonymous said...

tramadol 50 mg legal buy tramadol online united states - buy cheap tramadol no prescription

Anonymous said...

cheap viagra viagra online pharmacy - viagra buy us

Anonymous said...

buy viagra cheap viagra online from us - where can you buy viagra in stores

Anonymous said...

generic cialis no prescription cialis online legal - buy cialis paypal payment

Anonymous said...

tramadol 50 mg buy tramadol online no prescription mastercard - buy tramadol hydrochloride

Anonymous said...

discount viagra buy viagra online us no prescription - buy viagra online cheap with no prescription

Anonymous said...

order viagra buy viagra online us - cheap brand viagra online

Anonymous said...

generic viagra online buy viagra boots - purchase generic viagra us

Anonymous said...

cheap viagra cheap viagra us pharmacy - cheap viagra online ireland

Anonymous said...

viagra online without prescription viagra for women what does it do - is it legal to order viagra online in australia

Anonymous said...

cheap viagra buy generic viagra us - what dosage viagra works best

Anonymous said...

generic cialis cialis price reviews - buy cialis online uk no prescription

Anonymous said...

generic tadalafil cialis 5mg online australia - cialis нещо повече от виагра

Anonymous said...

buy cialis cialis online prescription order - купить cialis риге

Anonymous said...

generic viagra order viagra from us - order real viagra

Anonymous said...

viagra online without prescription buy viagra prescription - buy viagra online cheap us

Anonymous said...

buy cialis buy cialis online germany - is generic cialis real

Anonymous said...

cheap viagra viagra online us - buy viagra online from us

Anonymous said...

cheap generic cialis cialis daily safe - cialis daily for sale

Anonymous said...

buy cialis cialis daily 2.5 mg - online order for cialis

Anonymous said...

generic cialis buy cialis paypal payment - cialis refractory period

Anonymous said...

buy soma online buy soma pills online - soma bras chicos

Anonymous said...

viagra online viagra buy cheap - viagra online purchase

Anonymous said...

soma pills soma pills 2410 v - soma positive drug test

Anonymous said...

cialis cost cialis daily when to take - cialis online lilly

Anonymous said...

tadalafil online how much does cialis daily cost - cialis price at cvs

Anonymous said...

buy cialis buy cialis pills - generic cialis online usa

Anonymous said...

buy soma online soma san diego directions - muscle relaxer medications soma

Anonymous said...

buy cialis online cialis price rite aid - generic cialis line

Anonymous said...

online soma soma 500mg side effects - soma jackson ms

Anonymous said...

buy cialis cheap cialis generic online - cialis online in nz

Anonymous said...

buy cialis cialis online bestellen erfahrungen - ordering cialis online legal

Anonymous said...

buy soma online soma vainusau usc - soma muscle relaxer narcotic

Anonymous said...

viagra online viagra dosage take - viagra headquarters

Anonymous said...

buy cialis brand cialis online - buy real cialis online

Anonymous said...

soma for sale buy soma online from usa - soma bras sold stores

Anonymous said...

cheap soma buy soma in us with - soma san diego silversun pickups

Anonymous said...

buy cialis cialis online purchase - where to order cialis online safe

Anonymous said...

buy soma online soma food trucks - soma bras online

Anonymous said...

purchase viagra viagra dosage young men - cheap viagra au

Anonymous said...

buy generic cialis target pharmacy price cialis - can buy cialis usa

Anonymous said...

buy soma online soma pills 446 - soma for sale online

Anonymous said...

order soma online pills called soma - soma generic 350 mg

Anonymous said...

buy soma online soma bras san diego - who makes generic soma

Anonymous said...

viagra online viagra buy safe - order viagra online from us

Anonymous said...

buy cialis no prescription cheap cialis in australia - cialis online without rx

Anonymous said...

buy soma online soma online pharmacy - buy soma intimates usa

Anonymous said...

viagra online buy viagra new zealand - buy female viagra us online

Anonymous said...

buy cialis cialis daily low dose - generic cialis us pharmacy

Anonymous said...

buy soma online buy soma online texas - buy soma online legal

Anonymous said...

order soma soma 350 mg get you high - soma quad gate

Anonymous said...

soma online soma muscle relaxer company - jogo de soma online

Anonymous said...

soma online crystal castles soma san diego 2012 - soma drug test

Anonymous said...

soma carisoprodol soma 350 pills - soma 350 mg pills

Anonymous said...

buy soma online order soma overnight cod - soma line no prescription

Anonymous said...

soma drug soma 350 mg wiki - generic soma compound

Anonymous said...

buy soma online no prescription best place buy soma - soma muscle relaxer narcotic

Anonymous said...

buy soma online soma coupons printable store - soma bras san diego

Anonymous said...

buy soma soma muscle relaxer erowid - soma online no prescription overnight delivery

Anonymous said...

generic soma soma generic 350 mg - what does soma pills look like

Anonymous said...

soma muscle relaxant where to buy somatropin - soma online mastercard

Anonymous said...

buy retin a retin a gel under eyes - retin a micro vs ziana

Anonymous said...

buy soma soma class of drug - soma line no prescription

Anonymous said...

soma drug buy soma intimates usa - soma narcotic

Anonymous said...

cheap soma online soma quote from brave new world - buy soma 350 mg

Anonymous said...

soma for sale cheap soma online overnight - soma drug interactions alcohol

Anonymous said...

buy soma soma wellness - generic soma overnight

Anonymous said...

buy retin a micro buy retin a cream no prescription - where to buy retin-a forum

Anonymous said...

soma online buy soma online with no prescription - soma yelp

Anonymous said...

buy soma buy soma american express - soma 250 drugs

Anonymous said...

soma drug buy soma online usa - where to buy aura-soma products

Anonymous said...

buy soma soma bay online - cheap soma

«Oldest ‹Older   1 – 200 of 229   Newer› Newest»