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How Far Should Congress Go to Reform Health Care?

Reform of America's healthcare system is necessary to prevent economic instability for families, the medical industry, and the government, President Obama said on Wednesday.

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Two congressmen who are tackling the new healthcare legislation don't want to go too far in implementing potential solutions, however.

Remove Obesity From American Disabilities Act?

When asked if the government should change the Americans with Disabilities Act to permit the incentivizing of weight loss in companies, Rep. John Fleming, R-Louis., who is also a practicing family physician, said he would like to look into the idea a bit further.

Fleming said he thinks incentivizing weight loss would be beneficial for both healthcare costs and employee health as one-third of adult Americans are obese, and 75 percent are overweight.

"In my own practice, I've had a number of patients who've come to me wanting disability stickers for their automobiles and that sort of thing merely because they are obese, overweight and have difficulty walking," Fleming said, adding he often responds that walking is exactly what they should be doing.

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Rep. Frank Pallone, D-N.J., agrees that incentivizing weight loss would be a great solution to the obesity problem in the United States, but does not want to amend the ADA. Pallone, also the House Health Subcommittee Chairman, recently introduced a health care reform bill that details the many incentives that are associated with preventative care and eating well.

"These [preventative measures] create a lot of savings over the long run as the bill does as a whole but it is not something we can use for budgeting purposes in passing the bill," Pallone said.

Require Living Wills for All Americans?

Thirty percent of Medicare costs occur in the last year of life alone, and many Americans would choose to "pull the plug" earlier. But does that mean living wills should become mandatory?

Fleming: Encourages his patients to create living wills, but stops short of suggesting they be mandated by law.

"I do think living wills are important from the patient's perspective, not from a cost saving's viewpoint," Fleming said.

Pallone: Encourages living wills in his new bill but warned that cost savings would not be achieved without a mandate, which Pallone is unwilling to do.

"You're now getting into a whole area that deals with morality and people's end of life decisions, and if you mandate it, you would touch upon that and I think it would make it more difficult to pass the bill," he said.

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Ban Direct Consumer Advertising of Drugs?

Eighty-four percent of drug costs are for branded drugs mainly because they are advertised on TV.

Fleming: Strongly encourages the use of generic drugs, but believes commercials help in preventative care by bringing patients into his office.

"Statistics tell us that since cholesterol-lowering drugs have come on the market, heart disease has dropped by two thirds," Fleming said.

Pallone: Believes a ban on brand drug advertising would not happen.

"It probably would run into first amendment problems and be challenged in the courts and probably be successful. The opposition from the broadcasters in the media would probably kill it," Pallone said.