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Are Obesity Treatment Mandates Necessary?

That's the conclusion of a study that appeared in the January issue of American Journal of Preventive Medicine. According to researchers, 85% of 1,139 people polled felt that employers who make exercise space available to workers should receive tax breaks. And 72% said the government should require health insurance companies to cover obesity treatment and prevention programs.

What remains to be seen is whether costs associated with mandated benefits will trickle down to members enrolled in a health plan in the form of higher premiums.

Responses to our question were taken from a discussion forum on the American Diabetes Association Web site.

DOC News asked:

Should the federal government require health insurance companies to cover obesity treatment and prevention programs?

I just have a problem with the government mandating how private business should be run. When it comes to prevention programs, I believe the evidence generally shows that they provide a long-term savings to health insurance companies through fewer claims. While I don't support mandating that private companies cover these programs, a smart company is going to anyway. I know most health plans I've been in have had some decent prevention programs and incentives.

On the obesity treatments, if the long-term results show lower health care costs, I would think a smart company would cover them too.... Many do not, and I am guessing that their experience shows that complications from the procedure (like gastric bypass surgery) are quite expensive.

The big picture, one that many choose to ignore, is that private companies were incorporated not to provide for the "common good," but rather to make money. History has shown that some have tried the "common good" method and, in the end, everyone gets the same equally crappy service.

David French
Civil Engineer
Roswell, Ga.

I think that all prevention programs should be covered to some extent. What is our diabetes coverage if not in part a program to prevent us from getting complications down the road? Obesity prevention and smoking cessation and gym memberships are not much different.

Managed poorly, such programs could increase the cost of insurance, but managed wisely they will decrease it. For example, a company could subsidize gym memberships as long as people are actually using the gym, but not if they stop going.

One problem with our current system is that the employer or insurance company that pays for a prevention program now will often not be the one that reaps the benefits later when the condition has successfully been prevented. So Blue Cross pays for an ounce of prevention, saving Kaiser a pound of cure 15 years from now. That kind of skews the ounce-of-prevention equation.

A single payer system, whatever else you might say about it, would make prevention a higher priority. Not to mention saving the approximately 25% of our health care money that now goes for marketing, advertising, and paperwork for mandated claims procedures.

Morris Older
Accountant
Orinda, Calif.

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