Thursday, June 11, 2009

No $h*t, Sherlock!

Admittedly, this rant is biased...but also commonsensical.

In Medical News Today, an article was written discussing the importance of nutrition in the prevention of chronic disease. Well, duh. Unfortunately for me and my fellow RD's, we're S.O.L. until legislation changes.

But really, is it an over-sight? Are U.S. officials sitting back just hoping and praying that obesity will max itself out, and annual health care costs for chronic disease treatment and management secondary to obesity will eventually start to drop? Baaaaaahahhaa. I assure you, that's not the case.

Thanks, Doc.

Ninety-six percent of U.S. primary care physicians feel more emphasis needs to be placed on nutrition to treat, manage, and prevent chronic disease. However, M.D.'s cannot do it all. Only 12% of doctors are believed to present nutrition as a means of chronic disease management to their patients. Further, 80% of doctors reported "lack of reimbursement" as one of the top reasons providing nutrition services is not routine [1].

Keeping America alive and "well" (let's use that term loosely) has reached costs that we cannot entertain affording. Yet, we continue to superficially treat our people with "chronic disease management", spending trillions of dollars annual. Of our $2+ trillion in annual health care costs, 75% can be attributed to chronic disease management, according to the CDC [2]. Unless you are a renal disease patient (not receiving dialysis) or a diagnosed diabetic, you will receive NO insurance coverage for medical nutrition therapy as indicated by Medicare Part B [3]. Your insurance scoffs at the gravity of your BMI of 60 (a BMI falling into the 7th tier of "obesity"...if there should ever be such a thing ::hint hint:: -- doesn't "7th tier obese" sound a bit harsher than just "obese"??)...and rather than supplementing the cost to see a dietitian, would rather buy themselves a few years and then cover the costs of your bariatric surgeries, hospital stays, anesthesia, ambulance costs, [insert laundry list here]....

Nutrition is an over-sight in some ways, however, as other areas of health care have figured out that prevention is key!

According to the CDC [3]:
- For every $1 spent on water fluoridation, $38 is saved in dental restorative treatment costs
- A mammogram every 2 years for women aged 50-69 costs only $9,000 per year of every life saved
- For every $1 spend on the Safer Choice Program (a school-based HIV, other STD, and pregnancy prevention program), about $2.65 is saved on medical and social costs
- Implementing the Arthritis Safe-Help Course among 10,000 individuals with arthritis will yield a net savings of more than $2.5 million while simultaneously reducing pain by 18%

Glad I'm an eternal optimist, things are grim for the fatties.

"Change we can believe in" -- hook us up, Obama! Please?


What does ADA have to say about MNT reimbursement for weight management? Find out here.


[1] More Than 9 in 10 Primary Care Physicians Say U.S. Health Care Systems Should Place Greater Emphasis on Nutrition to Manage Chronic Disease, American Dietetic Association (2009).

[2] Chronic Disease Overview
[3] medical nutrition therapy: the assessment of the nutritional status of patients with a condition, illness or injury that puts them at risk. This includes review and analysis of medical and diet history, laboratory values, and anthropometric measurements. Based on the assessment, nutrition modalities most appropriate to manage the condition or treat the injury are chosen and implemented by the patient and nutrition professional.

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