While most of Washington is waiting around, nervously chewing on its fingernails in anticipation of the Supreme Court's Obamacare decision (may I have the envelope, please), there are some who are still in the fight. As Melissa Healy writes in the Los Angeles Times:

a federal health advisory panel on Monday recommended that all obese adults receive intensive counseling in an effort to rein in a growing health crisis in America.

That too many Americans weigh far too much is indisputable. That they need counseling in order to find out why they are fat and what they can do about it ... well, less so. One suspects that most overweight people have heard the old mantra of "eat less; exercise more." Why, one wonders, should it require "intensive" counseling to get this message across? Is it that hard to understand?

And, then, there is the question of costs and who pays them. As Ms. Healy reports:

Few private health insurers now reimburse physicians for weight-loss counseling or pay for programs that patients seek out on their own.

And worse:

A growing number, in fact, charge obese patients more for coverage — a policy that some public health officials have denounced as punitive and ineffective.

People who are at risk, because of their own behavior, paying higher insurance premiums. Why the sheer, brutalizing, inhumanity of it.

And one does wonder if the higher premiums might serve as an actual incentive to cut back on the potato chips and start taking the stairs. Lose weight, save money. Most people would understand the appeal of that even without intensive counseling.

Still, maybe the counseling route is worth the effort, one thinks. After all:

Obesity and obesity-related diseases are already responsible for an estimated $147 billion in annual healthcare spending.

So maybe we should go the panel's route, even though:

Widespread adoption of [its] recommendation would increase ... spending, at least initially.

And much of the increase will be borne by the non-obese, since that's the way subsidies work. But if it slims the population down enough to cut back on the cardio-vascular afflictions, the diabetes, and the other ills associated with obesity, then maybe we should soldier up and go with more government, less personal responsibility, and a spike in the population of counselors instructing grown-ups on the importance of eating more leafy green vegetables.

Except that:

The panel acknowledged that one problem with its recommendation was that no studies have shown such intensive programs provide long-term health benefits.


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