Dealing with Obesity

Dealing with Obesity

You’re not feeling well so you go to the doctor. You expect your health insurance, assuming you have it, to kick in and help cover the costs. The same is true if you’re having an operation you rarely think twice. But, a growing health problem is sometimes being ignored cheap jerseys by insurance companies.

Kim Lohman makes her way around the kitchen no problem. But, it hasn’t always been that way.

“We’re not doing it to make people thinner. We’re doing it to make people healthier and in fact to live longer,” says Dr. Michael Garren, a bariatric surgeon at UW Health.

“Bariatric surgery is basically weight loss surgery,” he says.

Kim had gastric bypass surgery. Doctors made her stomach smaller.

“It simply works by restricting what a patient can eat,” adds Dr. Garren.

“I lost 65 pounds in the first two weeks,” says Kim.

And the weight kept coming off. Prior to surgery Kim was considered morbidly obese. 9 million Americans fall into this category.

“The National Institute of Health has stated in a consensus statement that the only effective treatment for morbid obesity is bariatric surgery,” says Dr. Garren.

But, he says getting the health insurance industry to believe that is a tough sell.

“If you look at the major HMO providers in the Dane County area, all of them specifically exclude bariatric surgery,” he adds.

One Madison based insurance company lists weight loss services, including the gastric bypass, in its general health plan exclusions section.

“We would not step into that type of public policy question, because that’s what it really is. Whether an insurance company should be required to cover an obesity treatment,” says Eileen Mallow with the state office of the commissioner of insurance.

“There isn’t any law right now that would require an insurance company to cover it,” says Mallow.

That’s in Wisconsin, but she says four states do mandate insurance benefits for weight treatments Georgia, Indiana, Maryland, and Virginia.

In 2004, Medicare changed its policy after the federal government classified obesity as a disease.

Gastric bypass surgery is not cheap. Dr. Garren says it costs between 25 and 30 thousand dollars.

Kim’s insurance, based out of Michigan, covered 80 percent of her surgery.

“There is not a chance I ever would have been able to have this surgery done out of pocket,” Kim says.

Dr. Garren says insurance companies need to look beyond the cosmetic aspect of these operations.

“We are highly selective in who we will offer this too. It’s not a quick fix and it’s not for everybody,” he says.

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