On June 16, Federal Reserve chairman Ben S. Bernanke told a Senate panel on Capitol Hill that bolstering the performance of the health care system is one of the biggest challenges facing this country. According to Mr. Bernanke, aging baby boomers and rising sickness costs must be addressed by offering improved access to medical care, better quality of care and, of course, finding a way to lower the costs of care. He did not recommend any financial or other incentives that might lead taxpayers to take better care of themselves. Nothing was said about the need for aging boomers and others to get more exercise, choose better diets or shape more supportive environments. In short, he offered no recommendations whereby Americans might be more likely to stay well in the first place. Instead, Mr. Bernanke urged Congress to adopt an eclectic approach to controlling medical costs.

Well, eclectic might be another way of saying, I have no idea what Congress should do about the problems - just do something.

Not very imaginative, Mr. Big Shot Federal Reserve Chairman, Sir!

Maybe Mr. Bernanke ought to investigate efforts underway in other countries to deal with problems of risking costs of sickness care due in part to aging populations and unhealthy health habits. An interesting place to start is to look to the nation of Japan. In at least one respect, Japan leads the world in taking bold action at the federal level to motivate, prod and support citizens to do something to reduce national health care costs. That something is lose weight. In Japan, weight loss is the chosen focus of a radical experiment, now underway for two months, to deal with the problems that Mr. Bernanke addressed.

Why Japan, you might ask? When you think about countries with pudgy populations, Japan is probably not the first nation that comes to mind. In fact, Japan might not be considered at all, unless you think of sumo wrestlers. Instead, citizens everywhere recognize that it is America that has a weight problem. In terms of body sizes, we make the Japanese (except the sumo boys) look anorexic.

All the same, it is the Japanese government that has taken the lead in efforts to do something about overweight citizens. Japan has a unique new federal law that mandates waistline limits. The idea is to bring about, over time, a reduction is the number of overweight people and thereby reduce illness and the rising costs of health care programs. In the Japanese language, there is a word for being overweight - metabo. Too much metabo - not good. Must reduce metabo.

How does the new law lead to less metabo? According to an article by Norimitsu Onishi (Japan, Seeking Trim Waists, Measures Millions, June 13, 2008, NY Times), it attempts to do so by putting into motion a series of policies to motivate, prod and support older workers to take up healthful living.

The key part of the new law requires the Ministry of Health to create systems wherein all older workers are measured and periodically re-measured for girth. The idea is that waist control measures will, in time, reduce heart disease, diabetes, stroke, hypertension, breathing problems, disability, some cancers and higher mortality rates.

Under the new law, organizations are now responsible for taking the measure, literally, of 56 million older employees, older defined as aged 40 to 74. Each company or local government must measure the waistlines of its employees in the targeted age range. This measuring is done in the context of annual checkups. More than 56 million waistlines are to be checked, which amounts to about 44 percent of the entire population. The goal is to reduce the percentage of the country's metabo in five years by 10 percent. The goal by 2015 is a 25 percent reduction. This seems quite ambitious.

The standard of acceptable waist circumference for an adult male is 33.5 inches or less; the standard for women is 35.4 inches or less. (By contrast, the National Center for Health Statistics reports average waist size for Caucasian American men to be 39 inches, Caucasian women 36.5 inches.) Japan's standards are based upon recommendations by the International Diabetes Federation. The measures are tied to health risk data. If a worker measures over the standard, a second measurement is taken in three months. If still over, more education is provided prior to being subjected to another test six months later. If still over the required standard after a third test, the hapless fatso is taken off for liposuction. If after that he/she still fails to shape up, half the intestinal track is removed and the rest is stapled.

(Let the record show that I was only kidding about the liposuction and stapling. But the rest preceding this silliness is accurate. No promises are made concerning what follows.)

The real prod or motivational emphasis is applied not to individuals directly but to the employers in private companies and local governments. These organizations are financially penalized if their people fail to meet specific targets.

So, what should we make of all this? Is the waist measurement requirement for older workers a good idea in Japan? Anywhere?

No, it's terrible. It's invasive, it's off-putting, it's discriminatory and it risks all manner of unintended adverse consequences, such as overmedication, fad dieting, quackery, televangelists run amok (Send money for my divinely inspired, biblically based waist-loss prayers) and New Age remedies for abs of steel. Some concerned workers might even take up (or continue) smoking - a nicotine addiction has long been associated with weight management. The Times author cited above quotes a public health expert and professor at Tokai University School of Medicine, one Yoichi Ogushi, that there is no need at all" for the Japanese to lose weight...the Japanese are already so slender that they can't afford to lose weight. The professor added, the Americans, however, there would be benefits, since so many weigh more than 100 kilograms (220 pounds).

The worst aspects of the odd Japanese weight control effort is that it is not wellness worthy. That is, it isn't positive, fun, educational or otherwise addressed to building higher quality lives, with more meaning and purpose, love, happiness, support for others and similar REAL wellness values.

The Japanese plan to deal with metabo IS innovative and does express the nation's recognition of the seriousness of the problems that Mr. Bernanke addressed in his appearance before the Congress. However, it's not the right approach for Japan or any other country. No politician in the US would escape impeachment if he/she proposed such a thing, which could only happen after a long night of boozing with pharmaceutical industry lobbyists.

Still, there is nothing to stop YOU from taking your own waistline measure, but don't pay that much mind to a little excess girth unless you are WAY over the standards noted in this report. More important is that you have a good sense of how fit you are, how well you are doing with regard to experiencing a fulfilling life, using your reasoning faculties, choosing ethically, practicing common decencies, making contributions, using your talents, having fun and looking on the bright side of life.