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luvmylabs23139
07-16-2010, 04:52 PM
(CNSNews.com) – New federal regulations issued this week stipulate that the electronic health records--that all Americans are supposed to have by 2014 under the terms of the stimulus law that President Barack Obama signed last year--must record not only the traditional measures of height and weight, but also the Body Mass Index: a measure of obesity.

The obesity-rating regulation states (http://www.hipaasurvivalguide.com/hit-subchapter-d/hit-170-302.php) that every American's electronic health record must: “Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient’s height and weight.”

The law also requires that these electronic health records be available--with appropriate security measures--on a national exchange.

The new regulations are one of the first steps towards the government’s goal of universal adoption of electronic health records (EHRs) by 2014, as outlined in the 2009 economic stimulus law (http://www.cnsnews.com/public/content/article.aspx?RsrcID=43463). Specifically, the regulations issued on Tuesday by Health and Human Services Secretary Kathleen Sebelius and Dr. David Blumenthal, the National Coordinator for Health Information Technology, define the "meaningful use" of electronic records. Under the stimulus law, health care providers--including doctors and hospitals--must establish "meaningful use" of EHRs by 2014 in order to qualify for federal subsidies. After that, they will be subjected to penalties in the form of diminished Medicare and Medicaid payments for not establishing "meaningful use" of EHRs.

Section 3001 (http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ005.111) of the stimulus law says: "The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to the following: (i) The electronic exchange and use of health information and the enterprise integration of such information.‘‘(ii) The utilization of an electronic health record for each person in the United States by 2014."

Under this mandate in the stimulus law, Secretary Sebelius issued a regulation--developed by Dr. Blumenthal--that requires that all EHRs keep track of a person’s Body Mass Index (BMI) score. Body Mass Index is a ratio between a person’s weight and height, and is used to determine whether or not someone is overweight or obese. It is the preferred method of the Centers for Disease Control and Prevention (CDC) for measuring obesity.

Michelle Obama has made dealing with the problem of childhood obesity the main theme of her term as First Lady.


http://media.cnsnews.com/resources/63584.jpg
U.S. Surgeon General Regina Benjamin. (Photo by Penny Starr/CNSNews.com)
According to the CDC (http://www.cdc.gov/healthyweight/assessing/bmi/index.html), “BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.”

A person’s BMI score is used as a tool to screen for obesity or excessive body fat that could lead to other health problems. While it does not actually measure body fat directly, according to CDC, the BMI scores generally correlate with a person’s body fat percentage.

The new regulations also stipulate that the new electronic records be capable of sending public health data to state and federal health agencies such as HHS and CDC. The CDC, which calls American society “obesogenic” – meaning that American society itself promotes obesity – collects BMI scores from state health agencies every year to monitor obesity nationwide.

“Electronically record, retrieve, and transmit syndrome based public health surveillance information to public health agencies,” the regulations read.

With the spread of electronic health records, the CDC apparently will be able to collect such data more efficiently and with greater accuracy because the electronic record keeping systems can send the data automatically, eliminating the need for government – both state and federal – to keep, send, and process physical records.

Cody Covey
07-16-2010, 07:21 PM
BMI is a joke it makes no sense except for the skinniest of people. My BMI states i should weigh 160 lbs. Even when i was in college playing basketball 2-3 hours everyday and not eating complete crap I was only 180 at my smallest. I'm wide and BMI doesn't take that into account at all...

sinner
07-16-2010, 07:50 PM
BMI is a joke it makes no sense except for the skinniest of people. My BMI states i should weigh 160 lbs. Even when i was in college playing basketball 2-3 hours everyday and not eating complete crap I was only 180 at my smallest. I'm wide and BMI doesn't take that into account at all...


ever hear of the bell curve?
I agree and my research use to be in body composition.
Now for the ultimate obesity test. Get naked (alone or with your chosen partner) jump up and down in front of the mirror: if you jiggle where you shouldn't jiggle your are over weight.
Give me your height & weight and I will calculate with what we have how much you should weigh for free.
I have heard your complaint for years.

road kill
07-16-2010, 09:32 PM
ever hear of the bell curve?
I agree and my research use to be in body composition.
Now for the ultimate obesity test. Get naked (alone or with your chosen partner) jump up and down in front of the mirror: if you jiggle where you shouldn't jiggle your are over weight.
Give me your height & weight and I will calculate with what we have how much you should weigh for free.
I have heard your complaint for years.

I am 6'4" 225#
58 years old.
I am supposed to weigh 195,even though I am a mesomorph.

I am considered obese.

I hit the gym everyday (not weekends, but every week day).
48" chest, 34" waist.

****Oh, and I still bench 315#****
(call me on it:D)

My Doc told me the obese rating, I laughed in his face, told him if he was 2" taller he would be round.


BMI is a poor way to get an accurate measurement.
It is used as a predicter of future disease risk.
I guess that info will come in handy for the "death panels?"

ISSA certified "Elite" trainer here.

I prefer a comprehensive skinfold measurement for body fat estimates.


Just sayin......



rk

sinner
07-16-2010, 11:32 PM
Skin folds are quick and easy and measuring error high.
The whole field of human body composition measurement is faulty. All formulas are base on 25 males age 20 to 51 that were executed in Brazil in 1929 and their bodies were boiled down and chemically assayed. Not what I would call an adequate data based.
US soldiers that died in Japanese prison camps of starvation were also studied in the same manner. None were less than 6% fat. (How many athletes have you heard of that were less than 6% fat by our current measurements._
Animal studies are excellent because it is acceptable to kill them and boil them down to assay.
I can quote you many more but that won't change the fact the in one way you are correct.
1940 professional athletes were being turned down for the military because by the standards use then they were obese. That is when doubts were raised about height & weight chats. If you care to look up the studies look for the name Col Harry Krizwicky MD. He did many studies for the ARMY.
By the way I am 74 and go to lift and slog (can't jog any more) 5 days a week and I have a PhD in exercise physiology, a lic, physical therapist and I am a certified athletic trainer. I taught ex physiology for 17 years at the university level.
If you are interested I can give you lots more research outcome or direct you to it.
I have a study using skin folds plus 4 of measurement tools plus cattle judges that demonstrated that the judges were the most accurate and reproducible.

david gibson
07-16-2010, 11:52 PM
Skin folds are quick and easy and measuring error high.
The whole field of human body composition measurement is faulty. All formulas are base on 25 males age 20 to 51 that were executed in Brazil in 1929 and their bodies were boiled down and chemically assayed. Not what I would call an adequate data based.
US soldiers that died in Japanese prison camps of starvation were also studied in the same manner. None were less than 6% fat. (How many athletes have you heard of that were less than 6% fat by our current measurements._
Animal studies are excellent because it is acceptable to kill them and boil them down to assay.
I can quote you many more but that won't change the fact the in one way you are correct.
1940 professional athletes were being turned down for the military because by the standards use then they were obese. That is when doubts were raised about height & weight chats. If you care to look up the studies look for the name Col Harry Krizwicky MD. He did many studies for the ARMY.
By the way I am 74 and go to lift and slog (can't jog any more) 5 days a week and I have a PhD in exercise physiology, a lic, physical therapist and I am a certified athletic trainer. I taught ex physiology for 17 years at the university level.
If you are interested I can give you lots more research outcome or direct you to it.
I have a study using skin folds plus 4 of measurement tools plus cattle judges that demonstrated that the judges were the most accurate and reproducible.

i remember in college i was 6'0 and 205#, 24 yrs old, ran 5 miles 3 times a week, martial arts, etc...and the skin fold test resulted in "obese"

bogus

sinner
07-17-2010, 07:52 AM
Yep!
and where are you now?
Tried a cattle judge, they are more accurate:D!

BrianW
07-17-2010, 10:20 AM
Whether or not the BMI is "accurate" is kind of beside the point.
It's more private, personal info that Gov.org is assuming unto itself to "protect you from yourself" and, I believe, is going to be used somewhere down the the line in determining if/what kind of health care you're going to get by the National Coordinator, review board etc., whatever "alphabet agency" is placed in charge.
Soon they will demand monitoring/reporting of daily caloric intake, grams of fat, sodium, sugar etc. etc because ala the movie "Demolition Man", it has been determined that these are "bad" for you.
Then, what are you doing to "improve" your situation?
No?!?

Look at the city of San Francisco restricting 'sugary drinks" on city property and New York trying to restrict salt in restaurants.
Look to Michelle's own past statements, "Barack will never allow you to go back to your lives as usual -- uninvolved, uninformed."
"All of us driven by a simple belief that the world as it is just won’t do -- that we have an obligation to fight for the world as it should be."
While these sentiments weren't said in diect relation to this cause, they do show the basic attitude that the First Couple has towards the status quo.

Previews of coming attarctions, my friends.

Gerry Clinchy
07-17-2010, 01:34 PM
It's kind of curious, maybe, that Roe v. Wade ultimately turned upon right to privacy. Right to privacy about what a woman does with her own body.

Yet, there is mention of an employer being able to legally not hire an employee who smokes in the privacy of their own home. This is ostensibly based upon the fact that smoking will decrease productivity (illness & time off) and increase health insurance costs.

Will that be extended to include alcohol usage habits? Or unhealthy dietary habits?

Will an employer also be able to legally not hire an individual whose BMI classifies him as obese?

One might argue that an abortion does not affect general health. OTOH, more than one abortion might be a be a signal a pattern of practicing of unprotected sex, thus presenting a higher risk of STD. Could an employer then legally ask for that kind of health information as well? Even though it has already been deemed covered by right to privacy?

I think we can all see the value in having health records and basic physical information available to assist in prompt and effective health care. Yet, it also opens up doors to other issues.

If an employer can already ask you whether you smoke in your own home, will they be able to ask you to relinquish your privacy of additional health records as a condition of employment?

sinner
07-18-2010, 08:55 AM
Read the HIPAA regs
www.hipaa.org
By the way do you pay more for your auto insurance if you smoke?
Do you have to have a hunter safety course to get a hunting license?

This sounds like the seat belt issue all over again to me!

bobbyb
07-18-2010, 11:17 AM
what it's really about is when you got to buy your health insurance they will double the cost cause you're FAT !!!!!!!! Michele Obama needs to look behind her on self to see what's following her....
BobbyB
cajun

Gerry Clinchy
07-18-2010, 04:47 PM
Read the HIPAA regs
www.hipaa.org (http://www.hipaa.org)
By the way do you pay more for your auto insurance if you smoke?
Do you have to have a hunter safety course to get a hunting license?

This sounds like the seat belt issue all over again to me!

Sinner, could you be more specific in the URL that you have in mind? I have no clue how to find what you're saying about auto insurance above as relted to the URL you gave.

A question that occurs to me: the govt mandates that ALL conditions must be covered. Pre-existing conditions may not be excluded. At this point, the govt is not actually dictating how much the insurance company can charge for this coverage. If such coverage is very expensive, then it is quite likely that the govt will be subsidizing the premiums, just as they have provided for subsidies based on income level for everyone else. If the govt places a limit on the amount it will provide in subsidy, then those with pre-existing conditions mayl still find themselves in an unsustainable situation with premium cost.

However, it appears that the health bill will require everyone to have insurance or pay a penalty if they don't.

People are actually realizing now that those people who are ill or who live lifestyles that are unhealthy are costing everybody else more for health insurance. So those who don't have the unhealthy lifestyles are "demanding" that those who do be penalized for their unhealthy habits.

Smokers are bad. Obese people are bad. I'd imagine that alcoholics are also bad. And drug abusers. And maybe even gay people (since they might have a higher incidence of AIDS). Will people who have high incidences of cancer in their family (for example, I'm thinking of the breast cancer gene that they think they've found) be precluded from having children because those children will be more likely to get cancer?

Obese people who did not smoke, probably felt it was perfectly all right to penalize smokers. But now these same people may become the next group to be penalized. God help you if you are a fat smoker! Or a fat, gay smoker! Your health insurance premium could be more than your mortgage payment.

If you suspect that I see no real way out of this dilemma, you're right. If we decide we must provide everyone with the health care they need, no matter what. Then it simply means that everyone who has an income will pay more for that decision either by generally higher income tax, higher premiums for the same coverage they have now, or premium penalties for either not purchasing insurance or for purchasing a deluxe plan.

While this may be an attempt at redistributing wealth, it may simply widen the gap between the wealthiest and the poorest. The wealthiest will still have resources to purchase the health care they need. The poorest will take what they can get, which may not be a lot as there will be many more people competing for the care available.

If a much smaller country, like the UK, has found it necessary to ration care, I don't see that this reform bill provides for a better outcome once it has been in place for a couple of decades.

In the end whether the govt actually provides the healthcare, or there is a single-payer system, or simply regulates the insurance costs with immutable mandates for coverage as this bill does, the net result is that the govt controls the system for the delivery of health care. We already know that there are going to be a heckuva lot more govt employees to populate the bureaucracy to administer the reforms passed.

The big difference of opinion seems to be whether the govt controlling the system is a good thing or not such a good idea. Some have contended that letting HMOs or insurance company run the system is no different. However, people have sued both entitities for their negligence or "malpractice". Not sure that anyone would ever be successul in doing that with the govt in charge.

sinner
07-18-2010, 06:09 PM
Sinner, could you be more specific in the URL that you have in mind? I have no clue how to find what you're saying about auto insurance above as relted to the URL you gave.

A question that occurs to me: the govt mandates that ALL conditions must be covered. Pre-existing conditions may not be excluded. At this point, the govt is not actually dictating how much the insurance company can charge for this coverage. If such coverage is very expensive, then it is quite likely that the govt will be subsidizing the premiums, just as they have provided for subsidies based on income level for everyone else. If the govt places a limit on the amount it will provide in subsidy, then those with pre-existing conditions mayl still find themselves in an unsustainable situation with premium cost.

However, it appears that the health bill will require everyone to have insurance or pay a penalty if they don't.

People are actually realizing now that those people who are ill or who live lifestyles that are unhealthy are costing everybody else more for health insurance. So those who don't have the unhealthy lifestyles are "demanding" that those who do be penalized for their unhealthy habits.

Smokers are bad. Obese people are bad. I'd imagine that alcoholics are also bad. And drug abusers. And maybe even gay people (since they might have a higher incidence of AIDS). Will people who have high incidences of cancer in their family (for example, I'm thinking of the breast cancer gene that they think they've found) be precluded from having children because those children will be more likely to get cancer?

Obese people who did not smoke, probably felt it was perfectly all right to penalize smokers. But now these same people may become the next group to be penalized. God help you if you are a fat smoker! Or a fat, gay smoker! Your health insurance premium could be more than your mortgage payment.

If you suspect that I see no real way out of this dilemma, you're right. If we decide we must provide everyone with the health care they need, no matter what. Then it simply means that everyone who has an income will pay more for that decision either by generally higher income tax, higher premiums for the same coverage they have now, or premium penalties for either not purchasing insurance or for purchasing a deluxe plan.

While this may be an attempt at redistributing wealth, it may simply widen the gap between the wealthiest and the poorest. The wealthiest will still have resources to purchase the health care they need. The poorest will take what they can get, which may not be a lot as there will be many more people competing for the care available.

If a much smaller country, like the UK, has found it necessary to ration care, I don't see that this reform bill provides for a better outcome once it has been in place for a couple of decades.

In the end whether the govt actually provides the healthcare, or there is a single-payer system, or simply regulates the insurance costs with immutable mandates for coverage as this bill does, the net result is that the govt controls the system for the delivery of health care. We already know that there are going to be a heckuva lot more govt employees to populate the bureaucracy to administer the reforms passed.

The big difference of opinion seems to be whether the govt controlling the system is a good thing or not such a good idea. Some have contended that letting HMOs or insurance company run the system is no different. However, people have sued both entitities for their negligence or "malpractice". Not sure that anyone would ever be successul in doing that with the govt in charge.

the web site I suggested is a federal law on Health Information privacy.
I suggested you take a look at your auto insurance because where I live a non smoke gets a reduce price.
Your last post was great. I can assure you that what ever the insurance companies do will cost you & I more and for every high risk individual that they insure those who can pay will pay: however we are all ready doing that through the provider system write offs for charity care and cost shifting.

Is it just possible that Coors original study does have some implications for assisting people that have unhealthy behaviors and those who have a chronic disease get as much help to move in a positive direction as possible?
Sure did at Coors for 13+ years.

I would strongly favor Health Risk appraisals for all before you can get any insurance (after one year) a reduction in your premiums if you reduce your risk or have a low HR index. I also favor the same plan for those with chronic disease that they are doing every thing they can to manage their disease.
The payoff is not just health care costs!

sinner
07-18-2010, 06:17 PM
Here is another site you may want to take a look at. This was started by fortune 100 companies in the NE as they are attempting to get health care improvement.
http://www.ncqa.org/

luvmylabs23139
07-19-2010, 09:57 AM
I would strongly favor Health Risk appraisals for all before you can get any insurance (after one year) a reduction in your premiums if you reduce your risk or have a low HR index. I also favor the same plan for those with chronic disease that they are doing every thing they can to manage their disease.
The payoff is not just health care costs!


Who determines the risks? Seriously, I admit that I am a smoker but who is really a higher risk? The person that swims a mile or more everyday without taking a break but smokes or the obese person that couldn't make it one lap in the pool because they are so out of shape?:rolleyes:
I figured when I decided to hit the pool again after many years off, I'd flop and bomb and it would be my motivation to finally quit. It didn't work.