International Panel of Experts Issue the Toronto Charter for Mental Health and Obesity

TORONTO, ONTARIO--(Marketwire -07/05/12)- Policy makers and health professionals have their work cut out for them when it comes to treating co-existing obesity and mental illness, if an international group of opinion leaders has their way.

In response to a worldwide epidemic of obesity and mental health disorders, the Canadian Obesity Network (CON-RCO) and the International Association for the Study of Obesity (IASO) in partnership with the Centre for Addiction and Mental Health (CAMH) organized a Hot Topic Conference on Obesity and Mental Health, in Toronto, Canada June 26th-28th.

Although obesity and mental illness are major health issues that affect millions of Canadians, the links between them are not well understood. Excess weight, beyond its adverse physiological consequences, also affects self-esteem, body image and eating behaviours while promoting depression and anxiety. The opposite is also true - a disproportionate number of patients living with mental health challenges struggle with obesity, diabetes, heart disease and premature mortality, all of which are interrelated. Both illnesses are associated with significant bias and discrimination.

As part of the event, hundreds of participants ratified the Toronto Charter for Mental Health and Obesity, a detailed call to action for health system funders, researchers and health practitioners to deal with this emerging issue. The Charter lists specific calls to action for governments and health providers to reduce the global burden of obesity and mental illness, chief among them:

 -- Mandatory education for health professionals on how to treat obesity and co-morbid mental illness.-- Immediate affirmative action by policy makers and funders to prioritize research and mandatory evaluation of interventions.-- Conducting a cost-analysis of mental illness co-morbid with obesity-- Compiling standards for responsible media coverage of obesity management and healthy body image.

The full Toronto Charter for Mental Health and Obesity can be viewed and downloaded here (http://www.obesitynetwork.ca/page.aspx?page=2899&app=182&cat1=457&tp=12&lk=no&menu=37).

"Separately, mental illness and obesity are understood to be huge health challenges, and it's an uphill battle for health systems to keep up with patients' needs," says Dr. Arya M. Sharma, scientific director for CON-RCO. "But taken together, the issue is greater than even the sum of its parts. The Charter was conceived as a discussion starter among stakeholders, and the first step towards real action."

"The fields of obesity and mental health are intimately linked, of enormous public and personal health importance but both remain under-recognized, under-resourced and under-researched," Professor Nick Finer, chair of the IASO's Education and Management Task Force, said. "It is our hope that the Charter begins to change all of that."

About the Canadian Obesity Network - Reseau canadien en obesite (CON-RCO)

CON-RCO was founded in 2006 to link the research, policy and practice communities to advance the development and delivery of effective obesity prevention and treatment solutions. The network's core strategies focus on addressing the stigma associated with excess weight, changing the way policy makers and health professionals approach obesity, and improving access to prevention and treatment resources. Currently, more than 7,000 professionals in Canada are members of the network. CON-RCO is hosted by the University of Alberta, and is based at the Royal Alexandra Hospital in Edmonton, AB. www.obesitynetwork.ca.

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Health Care Ruling: Experts Discuss Outcome of High Court Decision

The Supreme Court upheld the health care reform law on Thursday, ending--at least temporarily--a battle over the controversial act that served as background for most of President Obama’s incumbency. We’ve asked some of our Perspectives contributors, a diverse collection of think tanks, advocates and leaders in their fields, as well as several other experts to tell us what they thought on the ruling.

Here’s what they had to say.

Mee Moua, president and executive director of the AAJC, said in a statement that she applauded the ruling, calling it “critical in ensuring that communities of color have access to health care and key preventative services.”

“Our task at hand is to spearhead and move forward with implementing this law, so that the 2.5 million Asian Americans, Native Hawaiians and Pacific Islanders will have affordable health insurance, eliminating the current health disparities that plague our communities.”

“While we welcome today's decision that brings us one step closer to health equity in this country, we cannot forget the Supreme Court's ruling, just three days ago, in the Arizona anti-immigrant law, which will likely lead to discrimination against communities of color. These important debates reinforce the need for our communities to act and make our voices heard, loud and clear."

Kathy Lim Ko, president and CEO of the APIAHF, said the Supreme Court’s decision “validated a landmark civil rights law.” The APIAHF is an advocacy organization promoting policy and community programs that benefit the health of Asian-Americans and Pacific Islanders.

“The ACA will improve access to quality health care for millions of Asian Americans, Native Hawaiians and Pacific Islanders, protect our communities from unfair insurance company practices and make substantial investments in our nation’s public health infrastructure,” she said in a statement.

“We know that the work ahead is still significant and we must continue to fight to ensure that all people--including our nation’s immigrants--have the right to health and health care. We will continue to analyze today’s decision in more detail and work to defend the ACA against continued attempts to repeal the advances that have been made.”

Neera Tandeen, president of educational institute and think tank Center for American Progress, called the ruling a “victory for millions of Americans who are already benefiting from the health reform law.”

“It’s not about Democrats or Republicans winning or losing, it's about people’s lives. All of us—Democrats and Republicans—must move forward with making health care work for every American and that means stopping the political games and implementing the law,” she said in a statement.

Tandeen called for an end to the bipartisan battle over the act, adding in her statement, “But will Republicans stop their politics-at-all-costs campaign long enough to make sure America’s health care system works for every American?”

“No more slash-and-burn politics. No more delay tactics. Republican attorney generals have wasted millions of dollars using the courts to achieve their political ends. Today the court affirmed its role as the neutral arbiter of the law for all Americans.”

The GOProud, a gay and straight alliance promoting conservative ideals, criticized the Court’s ruling, saying the decision gives the federal government “unchecked power.”

“Today is a good day for big government and a bad day for individual liberty,” said Jimmy LaSalvia, executive director of GOProud, in a statement.

He continued: “This decision reminds us of how important it is to elect conservatives to the House, Senate and the White House that will protect our individual liberties, because it is clear that the Supreme Court is unwilling to do so.”

“Free market healthcare reform would expand access to domestic partner benefits and put gay people in charge of their healthcare decisions. By upholding Obamacare, the Supreme Court has upheld legislation that hurts all Americans, but especially hurts gay and lesbian families.”

The Hispanic Leadership Network, an initiative by the American Action Network to engage the Hispanic community on center-right issues, issued the following statement from Executive Director Jennifer Korn.

Korn maintained that the Supreme Court’s decision would ultimately hurt Latinos and the American public, especially in light of the faltering economy. She called on Congress to work on a bipartisan solution that would replace the key provisions of the health care act that would create “quality and affordable healthcare while protecting future generations from a mountain of debt.”

“In its opinion, the Court shed light on the truth--that Obamacare is, in fact, a one trillion dollar tax-hike imposed on the American people,” she said. "A federal mandate is not what the American people need or want to improve our health care system. Simply because something is deemed constitutional, it doesn’t mean it is good policy.”

“This law endangers quality private coverage for families, while robbing $500 billion from seniors to help pay for it. As it stands, this law puts the financial security of countless Hispanic families at risk and irresponsibly places the burden of debt on our children and grandchildren--jeopardizing the American dream.”

The HRC, a civil rights advocacy organization for LGBTs, said the ruling “paved the way for important new protections for and investments in the health.”

“The Affordable Care Act addresses a number of the barriers LGBT people face in obtaining health insurance, from financial barriers to obtaining affordable coverage to discrimination by insurance carriers and healthcare providers,” said HRC President Chad Griffin.

“While there is a great deal more that must be done to ensure that the health needs of all LGBT people are fully met throughout the healthcare system, today’s decision is an important victory in the fight for healthcare equality.”   

NAACP Chairman Roslyn M. Brock released a statement saying she applauded the decision to uphold the health care act.

“Access to quality, affordable health care is a civil and human right that should not be reserved for the wealthy or the few. The 32 million American men, women and children covered under this law can now breathe easier,” she said in a statement.
“Many serious health issues are preventable,” Brock said. “But far too often, patients who lack health insurance--especially patients of color--enter medical facilities late in the progression of their diagnosis. This sad reality is costing lives and costing American taxpayers hundreds of millions of dollars in unnecessary health care bills. States can now move forward in implementing health care reform with the knowledge that the Affordable Care Act is not going anywhere anytime soon.”

The conservative organization dedicated to closing the gap between the Republican party and America’s Hispanic population expressed its dissatisfication with the Supreme Court’s decision.

“President Obama and the Democrats in Congress forced Obamacare on America without one Republican vote of support and against the sentiment of the American people,” said RHNA chairman Alci Maldonado in a statement.

“We Americans must repeal and replace Obamacare with a more common sense reform to our health care system, currently the best in the world, although all would agree that it does need reasonable reform.”

The RHNA sided with Sen. Marco Rubio, R-Fla., and Gov. Mitt Romney in their assertion that the health care act would only increase taxes on all Americans, affecting the middle class most severely.

Perspectives regularly features guest commentary, analysis and insights from a diverse field of thought leaders, think tanks, research institutes and more. The Next America is always looking for input from all sides of the story. If you or your organization is interested in participating in this conversation, please e-mail The Next America team.

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Top Experts in Health, Videogames, and Technology Gather for 2012 Games for Health Conference

Tue, Jun 12, 2012, 8:28 AM EDT - U.S. Markets open in 1 hr 2 mins

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Accretive Health Initiates Panel of Health Care Policy Experts to Establish National Standards for Health Care ...

Tue, May 15, 2012, 6:03 PM EDT - U.S. Markets closed

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Legal Experts See a Close Win for Health-Reform Law

THURSDAY, March 22 (HealthDay News) -- The U.S. Supreme Court seems likely to uphold the sweeping health-reform legislation known as the Affordable Care Act when it takes up the case next week, according to a small survey of legal experts.

The experts base this prediction on a number of factors linked to the nine justices' legal history, political considerations and the constitutional questions raised by the case itself.

"The folks [26 states] who are challenging the act have somewhat of an uphill battle," said Gregory Magarian, a professor at Washington University Law School in St. Louis. "It's been some time since the court has struck down a major piece of federal legislation on the theory that it exceeds Congress' constitutional authority."

The major argument over the constitutionality of the law -- passed by Congress and signed by President Barack Obama in March 2010 -- centers on the so-called individual mandate. That's the piece of the Affordable Care Act that requires most adults in the United States to have some sort of health insurance or face a fine.

The individual mandate offers the law's opponents fodder for debate, Magarian said, because it requires people to purchase health insurance whether they want it or not.

"That's something the federal government has never exactly done before," he said.

State governments have made related requirements of people -- auto insurance being the most prominent example. But even a requirement to purchase auto insurance isn't universal.

"You can avoid buying auto insurance by not having a car," Magarian said. "Being alive is what triggers the requirement for health insurance."

But, many of the legal experts surveyed believe the justices will conclude that the individual mandate falls squarely within the confines of the Commerce Clause, the part of the U.S. Constitution that gives Congress the right to govern interstate economic activity.

"There really is an interstate commercial effect of not having a federal health-care policy," said Leslie Meltzer Henry, an assistant professor at the University of Maryland School of Law. "In the absence of federal intervention in this area, individuals who desperately need insurance can't get it."

The law professors said the individual mandate is needed to make many of the Affordable Care Act's provisions work. For example, insurance companies that will be required to cover everyone -- even people with preexisting health conditions -- can only survive financially if most adults are required to buy health coverage, whether they are healthy or sick. That will ensure there's enough money in the risk pool.

Neil Siegel, a professor of law and political science at Duke University School of Law, noted that the U.S. Supreme Court has in recent years acted to limit some of Congress' powers under the Commerce Clause. But those cases involved social issues such as banning the carrying of firearms in public schools. Conversely, Congress' economic powers under the Commerce Clause have been upheld and protected by the high court, he added.

"The court has held that in issues of economic activity, Congress can act as if we have an integrated national economy," Siegel said. "Here you have economic conduct [health care] with massive interstate effects. Health care is an area of already pervasive federal regulation."

There are other considerations at work that will affect the justices' decisions, the experts said.

While the Supreme Court hasn't been shy about reversing some legislation, the experts said you have to go back to the Great Depression and President Franklin D. Roosevelt's New Deal to find an example of the High Court striking down a landmark piece of legislation as large and momentous as the Affordable Care Act.

"I think it's unlikely the court wants to create a major public or policy upheaval, which is what it would be doing if it overturned the law," said Robert Field, a professor of law in the department of health management and policy at Drexel University's School of Public Health in Philadelphia. He added that a rejection of the law could potentially have consequences for other major federal programs such as Medicare, Medicaid and Social Security.

But Stephen Presser, professor of legal history at Northwestern University School of Law, believes the health-reform law will be ruled unconstitutional in a narrow 5-4 decision.

"I think [Justices Antonin] Scalia, [Clarence] Thomas, [Samuel] Alito and [John] Roberts will all have to view this as Congress going much too far and virtually ignoring the 10th Amendment," Presser said. "Justices [Stephen] Breyer and [Ruth Bader] Ginsburg have always been strong voices for expanded Congressional power, and Justices [Elena] Kagan and [Sonia] Sotomayor are not going to embarrass the man [Obama] who appointed them, so there are four sure votes to uphold the legislation as well. That leaves only [Anthony] Kennedy as the swing vote, as most commentators, I think, understand."

And Presser believes Kennedy will vote with the conservative justices, based on prior rulings that have argued for states' rights as the best way to preserve individual liberty. "If he follows that logic he will have to vote to overturn the ACA's individual mandate," Presser added.

Political considerations will also be in the back of the justices' minds, the experts said. The challenge to the Affordable Care Act is taking place in a presidential election year, and could strongly affect President Obama's re-election chances.

"If the court strikes down the act," Magarian said, "all of a sudden, the left/center-left is going to be whipped into a frenzy. The path of least resistance would be to uphold the thing and let the status quo stand."

But, some of the experts believe there's also a good chance the Supreme Court will punt on the issue, declaring that the time isn't right for judicial review of the Affordable Care Act.

"I think it's interesting they're going to spend a lot of time -- a third of oral arguments -- on whether the case is 'ripe' for judicial review," said Drexel's Field. "That could be a signal from the court that they're spending that much time on that part of the argument."

Added Allison Orr Larsen, an assistant professor of law at the College of William & Mary in Williamsburg, Va.: "My best guess would be they don't decide it on the merits."

The reason why: the individual mandate, which takes effect in 2014, is a form of tax, and federal law doesn't allow a legal challenge to a tax that has yet to be collected.

"You can't challenge a tax until after you've paid it, and then you can sue for a refund," Larsen said, noting that this legal argument has come up in some lower court rulings on the law.

Such a ruling would delay any challenge to the Affordable Care Act until 2015. This would give the Supreme Court the chance to take the issue off the table in an election year while not explicitly endorsing or scuttling the law. "That's why I think it would be an attractive option for them," Larsen said.

Field agreed. "There's a good chance that they'll do that," he said. "The public might be left very frustrated, from not having a definitive answer, but we should be prepared for that outcome."

All the legal observers believe that the court's reasoning will become much clearer during the three days of arguments that begin on Monday.

"Because the hearing is going to be so long, I think we're going to come out of it with a good idea of what the justices are thinking about," Magarian said.

More information

For more about the current justices, visit the website of the Supreme Court of the United States.

To read an overview story on the Affordable Care Act, click here.

To learn more about the expansion of Medicaid under the Affordable Care Act, click here.

To learn more about the importance of the individual mandate to the Affordable Care Act, click here.

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Health Policy and Legal Experts Discuss U.S. Supreme Court’s Upcoming Ruling on Health Reform

NASHVILLE, Tenn.--(BUSINESS WIRE)--

Nearly 300 members of the Nashville Health Care Council and Leadership Health Care heard from a diverse panel about the future potential implications of the U.S. Supreme Court’s pending decision on the constitutionality of the Patient Protection and Affordable Care Act.

"The highly anticipated Supreme Court decision on health reform is much more than a legal opinion, it’s a defining event in the health care marketplace," said panel moderator Dick Cowart, chairman, Health Law & Public Policy Department, Baker, Donelson, Bearman, Caldwell & Berkowitz. "These historic proceedings have the potential to change the way health care companies do business."

The Court will hear arguments on the Affordable Care Act from March 26-28, just over two years after the bill’s passage into law. The Act made sweeping changes to the nation's health care system, including individual and employer insurance provisions, payer requirements around preexisting conditions, age thresholds and preventative care, along with Medicaid expansion.

The panel, Supreme Decision: The High Court on the Affordable Care Act, discussed views on how the Court’s decision could impact health care providers, payers and consumers. Participants included Lyle Denniston, journalist and dean emeritus of the U.S. Supreme Court Press Corps; Paul Heldman, senior health policy analyst, Potomac Research Group; Tony Hullender, senior vice president and general counsel, BlueCross BlueShield of Tennessee; and Tevi Troy, senior fellow, Hudson Institute, and former Deputy Secretary, U.S. Department of Health and Human Services.

View panel member interviews on YouTube and event photos on Flickr. Photo credit: (c) 2012, Harry Butler, Nashville.

The Court has established an unprecedented six hours for the oral arguments. During the March proceedings, the Court will evaluate four issues relating to the law, including: 1) the “individual mandate,” or requirement that every American citizen purchase health insurance; 2) “severability,” whether the overall health care law can stand even if the individual mandate provision doesn’t; 3) the law’s new Medicaid requirements for states and 4) the Anti-Injunction Act, whether it’s appropriate for courts to currently hear challenges to the law given that its mandates do not take effect until 2014.

“The Court is taking this matter very seriously, as it should, given the scope of the law and the kinds of changes it represents, not only to the health care system but also to matters as grand as the separation of powers and the very structure of our constitutional republic,” said Troy.

According to Denniston, the case is multi-layered and historically significant. “The Court could have only focused on the constitutionality of the individual mandate,” he said. “But the Court has chosen broader deliberations around severability and the implications of the law’s expansion of Medicaid.”

The health insurance industry, a sector integral to health reform’s impact, is poised for implementation regardless of the outcome. "The individual health insurance mandates are a key part of health care reform's goal to control the cost of care,” said Hullender. “With this in mind, our industry understands the need for their inclusion in the original law."

Heldman said he leans toward the view that the law's requirement that individuals buy insurance will be upheld. "It’s our thinking that the Supreme Court will leave much of the health reform law standing, even if it finds unconstitutional the requirement that individuals buy coverage. But, in my opinion, removing the individual mandate could destabilize the insurance market and negatively impact providers who might be exposed to increased bad debt.”

The panel discussion comes on the eve of the Leadership Health Care’s 10-Year Anniversary Delegation to Washington, D.C. The annual trip will feature industry perspectives on key components of health care reform, discussions on federal reimbursements and budget issues, and expert views on the likely outcomes and industry impact of both the March Supreme Court hearing on reform and the November elections.

“Today’s discussion was an exceptional opportunity to hear from experts and key stakeholders on this highly anticipated decision,” said Council President Caroline Young. “The outcome will have an unprecedented impact on the future of the Affordable Care Act, the national landscape of the health care industry and Nashville as a health care capital.”

About the Nashville Health Care Council

The Nashville Health Care Council, founded in 1995 as an initiative of the Nashville Area Chamber of Commerce, is an association of health care industry leaders working together to further establish Nashville’s position as the nation’s health care industry capital. Worldwide, Nashville’s health care industry generates more than $70 billion in revenue and over 400,000 jobs, and is Nashville’s largest and fastest growing employer. For more information on the Council, please visit www.healthcarecouncil.com.

About Leadership Health Care

Leadership Health Care (LHC) is an initiative of the Nashville Health Care Council started in 2002. LHC fosters the next generation of health care leaders by providing educational and networking opportunities for over 650 motivated professionals. Learn more at www.leadershiphealthcare.com.

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Women's Health Experts Speak Out

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100% of male experts agree: nobody knows more about women's issues like birth control than late-middle-aged men and the Republican party is well aware.

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More Diet Tips From Our Experts

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