There is some debate about whether or not state health insurance plans should cover bariatric surgery. Some people feel that people should have to pay for this surgery on their own, without the use of “taxpayer money”. Others point to the lifesaving benefits of this type of surgery, and its expense.
For some reason, there are a lot of people who feel that people who use a state or federal form of health insurance should not have access to the range of health care treatments and services that are available to people who are able to afford to pay for private health insurance. Phrases like “taxpayer money” get thrown around.
When the conversation includes health issues that are related to obesity, it seems that everyone suddenly has a very strong opinion. There are those who feel that all a person needs to do in order to lose weight is to eat less and exercise more. There are those who realize that it often takes more than that simple piece of advice in order for a person to lose weight.
A woman named Alice McCormack spent 31 years working in the Walker County, Georgia, school system. She is now retired, and gets her health insurance from the state of Georgia. This summer, she learned that her health insurance plan would cover weight loss surgery.
She is five feet, and two inches, tall, and she weighs 305 pounds. Her body mass index is more than 56. She has asthma, arthritis, sleep apnea, high blood pressure, and gastric reflux. All of these conditions are ones that can be made worse by obesity.
According to the American Society for Metabolic and Bariatric Surgery, a person must have a body mass index of 40 or greater, or a BMI of 35 or greater and one or more obesity related health conditions, in order to be eligible for bariatric surgery. It appeared that Ms. McCormack would be able to get the health care she needed.
However, that is not what happened. Instead, Ms. McCormack’s health insurance decided to eliminate coverage for surgical weight loss in 2012. Before a person can get weight loss surgery, the person is required to go on a special diet for six months.
This meant that Ms. McCormack didn’t have enough time to complete the diet before the end of 2011. It also meant that if she wanted to have bariatric surgery that she was going to have to find a way to come up the money herself, (without the help of her insurance plan). The surgery is extremely expensive.
Essentially, this means that state employees, like Alice McCormack, no longer have access to bariatric surgery. This means that the health problems that they are experiencing, that can be made worse by obesity, are not being treated.
There are people who will insist that “taxpayer money” shouldn’t be used to help people afford bariatric surgery. They feel that this group of people can be cured by exercise and portion control alone. Other people realize that this surgery truly can help many people to have better health.
Image by Kevin Old on Flickr