Jerry Kopel

KOPEL: DORA WANTS TO TRIM NEVER-ACTIVATED TREATMENT

Obesity program goes the way of all flesh

Colorado legislators might have to wait a while on the weighty issue of a pilot program to treat obesity. At least that is the recommendation by the Department of Regulatory Agencies: Repeal a never-yet-used pilot program.

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 who have a “body mass index” of 30 or greater.

The BMI is figured by dividing an individual’s weight in kilograms by his or her height, in meters squared. At present, according to a 2008 study by the Centers For Disease Control and Prevention, 27.4 percent of adults 20 or older have a BMI of 30 or higher.

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’s still better than the national average.

At least one organization is devoted to denying that obesity 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 learning more about such grants might contact Laura Khan, obesity expert at the CDC, or New York Times reporter Matthew Dalton, who recently wrote that “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 BMIs of 30 or greater who have a co-morbidity related to the obesity, including, but not limited to, diabetes, hypertension and coronary heart diseases.

Other problems not listed, but possibly affected by obesity, are sleep apnea, gall bladder disease, stroke, infertility, depression, complications of pregnancy, certain cancers and premature mortality. Participants would receive behavioral modification, self-management training and medication when medication is necessary.

DORA points out that “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 equate size to power. I know a retired lobbyist who ate a great deal in order pack pounds onto a small body frame to become obese and look powerful.

I would suggest taking the present statute and removing items no longer needed that are 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.

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dealing with a forest advisory board — DORA made the right decision in allowing the statute CRS 24-33-202 (1), to be repealed.

The purpose of the board, adopted through House Bill 00-1460 in 2000, was to help the newly created Division of Forestry establish forest policy. But the board stopped meeting at the beginning of 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, and also had more representation and the power to shape policy, including the ability to frame short- and long-term action plans for forest management.

Jerry Kopel served 22 years in the Colorado House.