Should health insurance programs pay for stomach stapling for fat people?
Stated as insensitively as possible, that’s a major philosophical question right now for Columbia County. The county government’s health insurance won’t pay for it, and after the first of the year the school system’s plan no longer will, either.
Other health insurance programs from private employers are all over the map on the issue, but those two government entities also are two of the area’s largest employers, so their direction is significant.
This issue probably isn’t on the radar screen for most people. If you aren’t morbidly obese, or close to someone who is, you probably haven’t given it much thought. I have a couple of friends who have found great success with the procedure, but I haven’t given it much thought.
Dr. Paul Fischer has. He’s a well-known Augusta physician and was instrumental in kicking Joe Camel out of cigarette advertising. He’s also in the midst of a legal challenge to some of the nonsensical reimbursements from federal health insurance programs. (I’m also a patient of his at Centers for Primary Care.)
So he thinks about this sort of thing in a big way. And he’s frustrated that the insurance companies think about it only in the smallest ways.
He explains it like this: Gastric bypass, or stomach-stapling, or whatever you want to call it, is a surgical last resort for the morbidly obese – and there are more and more morbidly obese people each year. The surgery makes it all but impossible for the patient to consume more calories than he or she can burn, and the resulting weight loss can be dramatic.
It’s also life-saving. Patients who go from being morbidly obese to being closer to optimal body size are far less likely to have heart problems, they don’t become diabetic (or, if they already were, it quite often reverses the condition and its physical damage) and they no longer have impaired mobility.
In short, they’re healthier. Because they’re healthier, their health-care costs decrease dramatically.
So: The $15,000 one-time expense of bariatric surgery, Fischer says, typically is paid back in less than five years with the elimination of all the pharmaceuticals and medical care necessary to keeping alive someone who is morbidly obese.
Insurance companies, however, would rather pay thousands of dollars, each year, every year, to help patients stay alive but morbidly obese, instead of paying a higher, one-time cost to make them healthy.
Look at it in a way that hits closer to home: The insurance companies you help fund with your taxes would rather spend thousands of dollars each year on blood-pressure medicine and diabetic supplies than make individual investments that in the future could save you money.
So even if we’re insensitive to fat people, we must really like them – because we’re paying to keep them that way.
(Barry L. Paschal is publisher of The Columbia County News-Times. Email firstname.lastname@example.org, or call 706-863-6165, extension 106. Follow at twitter.com/