Jerry Kopel

Obesity Statute

By Jerry Kopel

Nov. 21, 2009

Colorado legislators will have to wait a while on weight issues by way of a pilot program on obesity treatment. At least that is the opinion of the Dept. of Regulatory Agencies for allowing the never-yet used pilot program to go out of existence.

In fairness to DORA, the staff decision is the normal result based on a statute long on the books that has never been activated. My suggestion is to partially rewrite the statute Title 25.5, Article 5 which deals with Medicaid recipients with a "body mass" of 30 or greater.

"Body mass' is an index that equals the individual's weight in kilograms divided by height in meters squared. At present, according to a 2008 study by the Centers For Disease Control and Prevention, the national average for adults 20 or older with a body mass of 30 or higher, is 27.4 percent.

Recent newspaper articles indicate Congress and the Executive branch are considering grants to states able to use such funds to examine causes of obesity among adults 20 or older. That type grant fits perfectly into our debate on retaining the statute.

Colorado according to the CDC consistently ranks as the leanest state. But even here, according to DORA, the obesity rate has doubled since 1995. "Currently nearly one in five Colorado adults is considered obese" claims DORA. That is still better than the national average.

At least one organization is devoted to denying that obese always means danger. Peggy Howell, public relations director for the National Association to Advance Fat Acceptance, recently told New York Times readers "We believe that fat people can eat healthy food and add movement to their lives and be healthy.

"And" she adds, "healthy should be the goal, not thin."

The Colorado program from the beginning was denied funding by statute for fiscal years 2005-06 and 2006-07 but invited grants and other donations to get the pilot program started.

Legislators interested in finding more information about such grants might contact Laura Khan, obesity expert at CDC, or New York Times reporter Matthew Dalton, who recently wrote "the U.S. government is increasing its funding for cities and towns to pursue so-called community based obesity prevention, in an effort to gather data about which kind of tactics work best."

The Colorado program would deal with those Medicaid recipients with 30 or greater body mass who have a comorbidity related to the obesity, including but not limited to diabetes, hypertension, and coronary heart diseases.

Other possible illnesses not listed but possible are sleep apnea, gall bladder disease, stroke, infertility, depression, complications during pregnancy, certain cancers and premature mortality. The recipient will receive behavioral modification, self-management training, and medication when medication is necessary.

DORA points out "With the increased incidence of chronic conditions, there is a commensurate increase in health care spending. Obese individuals spend approximately 36 percent more than the general population on health care services, more even than daily smokers, who spend roughly 21 percent more than the general population, and heavy drinkers, who spend 14 percent more. This increased expense is passed on to all Americans via higher health insurance premiums and increased Medicaid and Medicare spending."

One group of obese persons has never been discussed, at least recently. Those who consider size equals power. I know a now-retired lobbyist who took a small body frame ate a great deal to become obese and look powerful.

I would suggest taking the present statute, remove items no longer needed related to past year budgets. Add specific instructions to state employees to seek out federal grants. Put a new Sunset date of July 1, 2012 on the statute.

* * *

In another review dealing with a forest advisory board DORA made the right decision on allowing the statute CRS 24-33-202 (1) to be repealed.

Purpose of the board adopted through HB 00-1460 in 2000 was to help the newly created Division Of Forestry establish forest policy. But the board stopped meeting beginning in 2002.

In 2008, Gov. Bill Ritter created his own board of 24 persons under executive order B 004-08 The DORA report does not mention whether the 24 member board receives payment for necessary expenses.

The board formed by Ritter served the same purpose as the dormant board but with more representation and power to shape policy. That includes short and long term action plans for forest management.

(Jerry Kopel served 22 years in the Colorado House.)

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