August 14, 2010

Obesity Surgery For South Carolina Gov’t Workers

South Carolina government workers who are obese will be able to receive stomach-shrinking surgeries using a state health plan under a new program that begins in January 2011, according to the Associated Press (AP).

The state's employee insurance plan will cover Lap-band or gastric-bypass surgery costs for 100 people statewide on a first-come, first-serve basis, according to Stephen VanCamp, director of the employee insurance program.

The program is funded by Legislature, which also added an additional $19 million in costs next year because of the new federal health care law -- largely for the extension of healthcare coverage for dependents up to the age of 26. The costs are maintained to keep employees' monthly health costs from increasing.

Nearly 394,000 public workers, their dependents and retirees are covered under the state health plan.

Obesity rates have doubled in South Carolina since 1990, with 30 percent of adults reaching that definition. Nearly two in three adults in SC are considered overweight or obese, according to the US Centers for Disease Control and Prevention (CDC).

People who are obese have an increased risk of several health problems, including diabetes and heart disease. More than a billion dollars is spent annually on obesity-related illnesses in SC, according to the state health agency.

Under South Carolina's pilot program, patients' results will be tracked for 18 months to check for complications and see if the surgeries lead to healthcare savings.

Comptroller General Richard Eckstrom told AP that the state should encourage workers to control their weight, but bariatric surgery seems extreme. While the state hopes the surgeries will result in savings, "as an accountant, you can't measure hope," he said.

Eckstrom said the state should focus their attention more on preventing people from becoming so large that they qualify for the surgery.

Qualifications for workers or their spouses to get surgery covered by the insurance include a body-mass index of at least 40, considered morbidly obese, positive psychological exam, and post-surgical nutrition and support plans.

But, it makes no sense for the state to fund the costly operations during a recession, said state senator Greg Ryberg. He also doubts they will save money long-term.

Ryberg, who has sought ways for South Carolina residents to live healthier, last year proposed charging obese public workers an extra $25 per month for their healthcare premiums. But his colleagues criticized the idea, saying they supported the intent, but questioned how it would be enforced. The state already charges $25 extra for smokers.

AP reports that Ryberg will push next year for a bill that rewards people with healthy weights, instead of punishing overweight workers, by lowering their health premiums by up to $25 monthly.

At least six states require insurance companies to cover morbid obesity treatment, including: Georgia, Illinois, Indiana, Maryland, New Hampshire and Virginia, according to the National Conference of State Legislatures.