Via The Downey Report and The State newspaper, I saw that South Carolina’s Medicaid program is beginning a program, at considerable cost, to expand access for poor residents to doctors and nutritionists to fight obesity.

Current regulations allow doctors only to treat obesity-related disease. Now, for $10.5 million more, participants will be funded for six doctor visits a year expressed to treat obesity, not only its effects, and as many visits to a licensed dietitian.

“The goal here ... is to make people healthier and to reduce spending on health care, and that goes hand in hand,” said state Rep. Murrell Smith, R-Sumter, chairman of the House budget subcommittee that oversees Medicaid’s budget. “We are not just giving people a health insurance card and saying, ‘You go get medical treatment.’ We are working on improving health.”

I find that a pretty progressive attitude, and I applaud it. I’m happy to bring attention to it. Complete stop.

However, I find these things worth noting as well:

* It betrays my northern cracker mentality — and probably my good sense — to say out loud that I’m surprised it’s championed by Republicans. From South Carolina. I tip my hat to them.

* As much as I like the idea, it exposes one of the gravest stumbling blocks to overcoming obesity in America. It turns to doctors and dietitians for help! Yes, of course, who are they going to send patients to, pipe fitters? Granted. Completely.

But who have been the recognized experts during the expansion of obesity from 12 percent in 1960 to 36 percent today? Doctors and nutritionists! The vast majority of doctors received mere hours of nutritional instruction during all their years of training. Yes, it is a fair expectation that they would be appropriate sources for guidance. But they are not. According to Medscape’s Physician Lifestyle Report from 2012, 42 percent of male physicians and 32 percent of female physicians are obese or overweight. Noted: those rates are well below the general population.

* Dietitians, in my experience, are not to be trusted just because they have a shingle. [Emphasis very important. I owe much of my health to a dietitian. Read more here.] Most dietitians I have consulted, or about whom I have second-degree knowledge, are hidebound by principles that have, in a macro view, resulted in 2 or 3 American adults and 1 in 3 American children being obese or overweight. Not every one of those fat people has consulted a dietitian, of course, but a disproportionate ratio of their clients come from those ranks. And besides, it’s fair to say the Academy of Nutrition and Dietetics has achieved its mission of making its members viewed as arbiters of nutrition. Would anyone outside its ranks say nutrition is in good shape in America?

I was particularly amused by The State’s first sentence of report on how dietitians regard the new Medicaid program.

Nina Crowley, past president of the S.C. Academy of Nutrition and Dietetics, said the plan would create more jobs for dietitians.

Perfect! That’s the AND mindset — not, “how will this affect South Carolinians,” but “how this will affect us?” That national AND is the same way: Its mission statement says nothing about us; it says, “Empowering members to be the food and nutrition leaders.”