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
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
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
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.)