What is your BMI?

…and should you care? Perhaps you have no answer to either of those questions and until today neither did I. I still cannot answer the title question but I have a tentative answer for the second. But, between now and the year 2014 we shall in all likelihood become very familiar with said acronym.

A bit of an explanation.BMI stands for Body Mass Index which one can actually calculate for themselves  at the website for the  National Heart Lung and Blood Institute (nhlbisupport.com/bmi) which is an affiliate of the National Institutes  of Health. When one provides the appropriate figures the site calculates one’s body mass index on a numerical scale. The numbers are categorized on four levels which are underweight, normal, overweight and obese.

As  another feature of the economic stimulus plan sees the light of  day, we are learning that one’s BMI is going to become a very important number indeed. By the way, both of the above mentioned agencies belong to the Department of Health and Human Services. That brings us to an announcement made a few days  ago by HHS Secretary Kathleen Sebelius.

The secretary announced new regs this week  stipulating that the electronic health records that we are supposed to have by 2014 ( thanks to Obama’s  2009 economic stimulus bill)  must  record the BMI as well as height and weight,etc. The law also requires that these electronic records be  available on a  national exchange, with the proper security measures of course. Health care providers must, by 2014, establish meaningful  use of these electronic health records or face cuts in their  Medicare/Medicaid payments.

Ok, no what might be the reason mandating that BMI be maintained ? How exactly is it used? Well, the CDC uses the figure as its primary method for measuring obesity.

Ok, what is the first lady’s big mission, childhood obesity. Various and sundry legislators continue to float proposals to heavily tax soft drinks and the fast food industry is  a prime target of  Science in the Public Interest. Perhaps none of this means anything but I believe that it does. Added together it is rather strong effort at dictating what you can eat or perhaps even what you can weigh ( admittedly taken to te extreme) and if you do not comply, perhaps there could be a health insurance surcharge as  a penalty. Shucks, maybe one of the unknown provisions in Obamacare, as Speaker Pelosi termed it, already does this.

Don’t you just love the concept of greater government control?

The New Most Powerful Cabinet Officer

Move over Hilary, forget it Gates, a new sheriff is on the way. Her name, Kathleen  Sebilius. One of the by products, by design or not, who knows, will give the HHS secretary quite  a bit more clout than she now possesses.

Traditionally, the HHS Secretary is not headed by  a  household name, either when their term begins or when they are done. Try naming the most famous or notable occupant of the position. Not easy is it? How about even naming her predecessor? It was Utah’s own Moon Landrieu. Probably the office’s most celebrated occupant harks back to when it was  Health, Education and Welfare. That would be our friend Jack Kemp.

But, if the health care bill lurching along through the Senate becomes law, Secretary Sebilius is poised not only to become very well-known but also significantly more  influential than she now is.

According to an article in the Washington Examiner by Susan Ferrechio, HHS would become  a “giant”  federal powerhouse.  Devon Herrick is  a health care expert at the National center for Policy Analysis. He says that there are almost 1,700 (1,697) times in the bill when the  when the HHS secretary is given leeway to create, define or determine things in the bill. Seems  that HHS will have quite a bit of wiggle room to interpret things in the bill. He cites an example or two. One of the biggies, perhaps the biggest, gives HHS the authority to regulate insurance, currently  a state function.  The feds  would no doubt  perform all sort of wondrous things to improve  the insurance  system or maybe just regulate it death. Who really knows?  Here  is  another. HHS would be empowered to create a Center for Medicare and Medicaid Innovation  which could  make cost savings cuts on its own without the approval of Congress. Sounds just peachy. This is just one of a potentially large number of new government agencies that are likely  to arise. And remember, this bill  is revenue neutral. Riiight!!

I have got to wonder if Hilary maybe  would  be  interested in a do over on this Cabinet position stuff. She would have a lot more power as HHS secretary than she now has. Besides, I seem to remember that health care reform was once her bailiwick.

Wanna Be An Inspector General?

The title is not really  a trick question, but then again, it may be. I will confess to having not even heard of the position until just a few days ago. I am sorta familiar with inspectors of different kinds  and I know a general is a big deal. But what do we know about the position now in the news because of a dismissal?

Let us go backward first .AmeriCorps was begun 1994 and is in a sense, a domestic Peace Corps. Gerald  Walpin was the inspector general of said service organization. Heavily involved in a  leadership position was former NBAer Kevin Johnson, also  a FOO (Friend of Obama) Mr Walpin allegedly found some misuse of funds and voila, he is gone. His firing, justified or not, did not follow  the guidelines set down in a 2008 law that required 30 days notice and a full accounting to Congress as to why the firing took place. Neither of these things to place. Only after Senator Claire McCaskill, Democrat from Missouri questioned the firing did the administration release information.The AmeriCorps board wanted him gone, Walpin was not candid with the board and at times was confused and disoriented, etc.

Now, let us just say this and more is accurate. It would seem the the Administration could have presented these reasons publicly, before the fact, waited the requisite time and the acted . Why so quick to fire first and then respond? Oh, almost forgot to describe this suddenly newsworthy position. The Office Of Inspector General is part of the Department Of Health and Human Services and serves as fiscal watchdog over HHS programs.

Now, back to the building controversy. White House lawyer, Norman Eisen, called the firing an ” act of political courage”. Ok.  Meanwhile Senator Charles Grassley , Republican, Iowa, has requested more info from the White House. According to  a detailed article from Michelle Malkin on June 12, it is very possible that the First Lady even  had a role in the Walpin firing. Could get verrrryy interesting, could it not?

Still interested in that job is an opening. Wonder what Mr Walpin discovered when he wasn’t being disoriented, a bit of corruption and/or misuse of funds?

Let me close with this telling exchange. Glen Beck asked him if he thought he was going to win in his attempt to keep from being destroyed. He replied  in the negative. When Beck asked him why continue the fight he said because I couldnt live with myself if I didn’t. That may be the real act of political courage in this drama that continues to play out.

How Much Privacy Do You Need Anyway?

In an electronic society,filled with Facebook, My Space, You Tube, Latitude and probably numerous others I have not listed, how much privacy do we have? Perhaps, this has become the no privacy era. Wanna act stupid on television, reveal private or embarrassing information, there  is a “reality” show for you.The younger the person, the more willing it seems that they will reveal heretofore private things about themselves. Or at the least,they were considered private by previous generations.

And, we have “role models” for sharing this private information. Check out the magazine racks where an industry thrives on telling how much weight this celebrity has gained or lost, what drugs they do or don’t take. Have they had plastic surgery, what can their housekeeper or nanny reveal about them and so on. The funny part is when the aggrieved celeb says it has gone too far.

Now, we have a much more disquieting invasion of privacy and it seems to be somewhat unreported. In the stimulus(read porkulus) bill there is a provision that should be very troubling to all of us.  The Washington Times has an editorial entitled “Health ‘ efficiency’ can be deadly.The worrisome or potentially scary feature that they discuss  concerns the National Coordinator of Health Information Technology. This person or office will be in charge of collecting and monitoring the health care that is provided to any one of us. Got your attention yet ?

Consider a central, federal database that tracks every visit you make to a doctor or clinic or hospital and collects information on the diagnosis,treatment etc. Sure there is language in the bill that guarantees that these records remain strictly confidential. Believe that and I have swampland that I would love to sell you cheap.

One more little goody. The three purposes of the database are to improve the quality,safety and efficiency of our health care. How does one achieve greater efficiency in health care? One way is to make decisions on who gets what care, ensuring that you or I are worth the cost of being treated. Wonder who would make that kind of decision? Probably not you or your physician, ya think?

I will close with this thought from Tom Daschle who was the choice for HHS secretary before his own issues surfaced.We as Americans just use too much health care and that must change.