Managed Care

Health Care Again Asked To Attack a Social Problem

John Marcille

The problem of obesity is so vast, broad, and complex that it throws off images that seem at first to be its opposite, something like black holes, stars that absorb light. The intense media coverage over revelations concerning Mary-Kate Olsen's eating problems is an example. Here is a young woman (a very wealthy young woman, a young woman that you'd think hasn't a problem in the world) starving herself to fit in with a distorted view (Society's distorted view? Hollywood's? Are they the same?) of what's beautiful.

Of course, that's an aesthetic issue. This is a journal that focuses on the business of managed care and the clinical issues associated with it. That's just the point. As Contributing Editor John Carroll makes clear in his cover story, it's too easy to throw up your hands when it comes to America's dance with image.

But it's not just about how you look. It's also about how healthy you are. And whether you are a starlet starving yourself or one of the many who are supersizing themselves, you know that America is starting to wake up to the fact that we have a weight problem.

More to the point, employers are beginning to get hip to how much this costs. It's a lot, and increasing. They're turning to health plans and asking: "Just what are we going to do about it?"

This is like your boss asking, "What are we going to do about it?" The "we" is immediately translated to "you." Some health plans have taken the stance that society's problem can only be cured by society. That, after all, is how tobacco addiction is being battled.

But it's not that easy. Most obviously, there's the expensive matter of bariatric surgery and who's going to pay for it. How long do you think you can dodge?

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