US Healthcare Reform and Body Mass Index

Earlier I wrote about how to figure body mass index because I saw an article where the government, as part of the stimulus bill of 2009, will now require doctors to make a BMI measurement for all patients and keep it as part of an electronic record. This question was way? Really this is 2 questions, first why are they using stimulus money to fund this? And second, why are they doing this to every American?

What do BMI measurements have to do with economic stimulus?

Let's start with the first part...What part of a BMI measurement for everyone a form of economic stimulus? The simplest answer is that someone with some sort of agenda had it put in there. Could be the health insurance companies? Could be those who knew they wanted to pass health care reform in the later months?

Who knows but like many of the spending bills that come out of our government, this was probably just a throw in. Not sure how mandating that everyone with a medical record have an electronic BMI included in their records has a stimulus effect on the economy? The answer is nothing at all. Which leads me to believe that it fits into someones agenda because it is not the typical do nothing build a bridge to nowhere project.

Now for the second part of this question, why are they even doing this? There are generally 2 reasons that I could see;

1) To study and monitor the health of US citizens from an epidemiological sense. Meaning they want to make sure the US as a population is healthy. Certainly this is noble goal. Problem is health records already have height and weight measurements. Couldn't someone just do the simple calculation and get the same information? If this is true, why do everyone?

Statistical sampling theory says that you can get extremely accurate results just sampling a relatively small sampling of the population. For example, this is how TV ratings are only done. Only a few homes participate in the sample and the results are extrapolated out to the entire population for total viewer ship of any one program. Clearly there is no need to get a BMI for everyone. This would save a ton of money so the 'stimulus' could be used in other ways...or not spent at all.

2) To easily segment the population for some other purpose. What are some of those purposes? How about a fat tax? How about higher health premiums? How about denial of health services? Think this is a crazy idea? Accepting for a minute that we can not afford as a nation to give everyone Cadillac health insurance, the nationalized path that we are on, must somehow see to ration care.

What is Rationing of Health Care?

First let's look at what rationing, in terms of health care means. It means having less care based on a circumstance because there is only finite resources for care available. Those circumstances may or may not be within a person's control.

In a sense you get the portion of care you have based on a set of criteria and circumstances. Currently the US health care system is a price based rationing system. You get the amount of health care you can afford. In other words, the only way to hold premium rates constant if you fit into one of the rationed categories is to accept less coverage. Ergo, rationing.

What factors are traditionally used to ration care? If you consider that higher premiums a form of rationing, they look at age, weight, lifestyle choices (smoking & alcohol consumption) etc. to determine a premium. One can only begin to guess what some bureaucrat may dream up.

Heavy may be Cheaper?

If in fact the Government tries to limit or ration costs based on factors like BMI, the irony of irony about health care costs and people with traditionally excluded categories is that it may be less costly to cover these people than that of those considered healthy. While the person who smokes/drinks/weighs too much etc, may require more care initially, they tend to die much younger. This means over a lifetime, the cost to cover their health is less than a healthy person. The overall burden of the system is much less costly.

What it all Means....

First the fact that they stuck this in an economic stimulus bill means it is either another worthless Government program or someone has another objective and needed to it paid for.

Second given the track record of the current power base in Washington DC to want centralized control, this is probably going to be used in connection with health coverage.

Third, I guess I'm going to boycott getting weighed or have my height measured!

First let's look at what rationing, in terms of health care means. It means having less care based on a circumstance because there is only finite resources for care available. Those circumstances may or may not be within a person's control.

In a sense you get the portion of care you have based on a set of criteria and circumstances. Currently the US health care system is a price based rationing system. You get the amount of health care you can afford. In other words, the only way to hold premium rates constant if you fit into one of the rationed categories is to accept less coverage. Ergo, rationing.

What factors are traditionally used to ration care? If you consider that higher premiums a form of rationing, they look at age, weight, lifestyle choices (smoking & alcohol consumption) etc. to determine a premium. One can only begin to guess what some bureaucrat may dream up.

Heavy may be Cheaper?

If in fact the Government tries to limit or ration costs based on factors like BMI, the irony of irony about health care costs and people with traditionally excluded categories is that it may be less costly to cover these people than that of those considered healthy. While the person who smokes/drinks/weighs too much etc, may require more care initially, they tend to die much younger. This means over a lifetime, the cost to cover their health is less than a healthy person. The overall burden of the system is much less costly.

What it all Means....

First the fact that they stuck this in an economic stimulus bill means it is either another worthless Government program or someone has another objective and needed to it paid for.

Second given the track record of the current power base in Washington DC to want centralized control, this is probably going to be used in connection with health coverage.

Third, I guess I'm going to boycott getting weighed or have my height measured!

Update - It has been less than a week since I wrote this and it seems one country that has single payer health is considering taxing the obese. In another part of the story they are suggesting weighing school children to give them different diets. This is what governments do.

Update 2013 - As predicted, here's what happened in on US school. An athletic volley ball player at a middle school was sent a notice that she was 'at risk' for severe health problems based on her BMI. A real life example of an abuse and misuse of information by a government agency.