By Larry Tate
February 9, 2004

Richmond (CA) Mayor Irma Anderson chaired a meeting of the Children, Health and Human Services Committee that dealt with two broad issues: general health promotion, with a focus on obesity, and the new Medicare prescription drug act. Anderson began by reviewing the Conference of Mayor's various health initiatives, and then introduced Miami Mayor Manuel Diaz.

Diaz discussed the emerging public health crisis of increased levels of obesity, especially among young people. A report released that day estimated that Medicare and Medicaid spend $75 million a year in obesity-related health expenses, a problem that, Diaz noted, is seen first at the local level. "We-re going to have a very unhealthy America in the future," he said, unless the problem is addressed. Mayors, he said, "should make this a national priority."

The mayor suggested several actions that mayors could take this year, including convening a national summit on the specific issue and developing a set of Best Practices for communities to follow. On the local level, he mentioned such ideas as walk-with-the-mayor events, after'school exercise programs and new initiatives in city design, to encourage a more active lifestyle. Other mayors joined in the discussion and Anderson reminded everyone that, although obesity is a more severe problem among minorities, it is a major problem for all groups. The mayor also proposed collaboration between the Arts, Parks, Entertainment and Sports committee and the Children, Health and Human Services committee to work together on the issue of obesity, which Anderson embraced.

On a similar note, Carter Blakey, a senior official in the Office of Disease Prevention and Health Promotion, spoke about the Department of Health and Human Services' prevention initiative, Steps to a Healthier U.S. The initiative offers grants to local communities for projects promoting such basic activities as eating well, exercise, and health screenings, to combat obesity, asthma, and other chronic diseases. She announced a summit on chronic disease prevention and health promotion, to be held in Baltimore April 29-30. She also described a personal initiative of Health and Human Services Secretary Tommy Thompson in which various federal agencies compete in programs to encourage healthier behaviors among their own employees.

The other principal issue in the committee session was the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Rob Foreman, a senior official in the Centers for Medicare and Medicaid Services, described the act's provisions in detail, beginning with a reminder that, by 2020, Medicare will have 62.4 million beneficiaries and $898 billion in yearly expenditures. As he delineated the act's many complexities, he noted certain areas where apparent gaps in coverage might need to be addressed in future legislation. Stacy Sachs, Senior Health Policy Fellow to Senator Edward Kennedy (MA), said that undoubtedly many bills would be introduced to try to deal with perceived problems with the 2003 act. She described a bill introduced by Senator Kennedy that would bring the act closer to the bill originally passed by the Senate. Several mayors commented that the economic issue of health coverage "starts at city hall," with city employees, and questioned how the new federal program would affect state programs already in place. Foreman noted that each state would have to resolve its own health- coverage issues.