Lawmakers are struggling to push legislation that will change the way insurers view obesity from a willpower issue to a disease.
Bob Clegg knows about the dangers and high costs of being obese. As told in a Reuters report, for years he struggled with his weight and his insurance company was forced to pay some $3,000 per month for his doctor visits.
But when Clegg’s doctor confronted him in 2007, he gave him a choice between gastric bypass surgery or a tracheotomy. Clegg chose surgery, and since then, his medical problems, which included joint pain, sleep apnea and esophageal problems have gone away along with his medical bills.
Clegg’s story is similar to that of many Americans who struggle with obesity. But many of them shudder to find that although insurance companies will pay for a tracheotomy, they will not pay the $20,000 needed for gastric bypass. Clegg says that’s an irony he’s trying to change.
As a Republican member of New Hampshire’s senate, Clegg took his experience and transformed it into a bill, which he introduced a year ago. The bill would require insurers to offer surgery as a treatment option, just as the state’s Medicaid program for the poor does.
Being overweight adds to the risk of diabetes, hypertension, heart disease, osteoarthritis, stroke, gallbladder disease, sleep apnea and respiratory problems and even some cancers. These issues also add to the cost healthcare providers must pay out.
According to a 2000 report from the US Surgeon General, obesity costs about $117 billion each year through direct and indirect costs.
“At the root of this is that people still have a real problem thinking about obesity as anything other than a willpower issue,” Christine Ferguson, associate professor at George Washington University School of Public Health and director of STOP Obesity Alliance, told Reuters. “It is still perfectly acceptable to think about excluding treatment.”
“If I have to balance my budget at the end of each year, I have a choice between investing money in children who have mental retardation, or children with developmental disabilities … or investing in people who have obesity, choosing obesity is a very hard case to make,” she said.
Clegg noted a societal bias as part of the reason his bill was unable to succeed. Analysts say that economics are becoming an increasingly large factor in policy approval.
Researcher Pierre-Yves Cremieux, with the economic consulting firm Analysis Group, has presented the findings of a study showing that bariatric surgery costs could be recovered within two to four years, and eventually can lead to savings for healthcare providers.
“If we could only get our lawmakers to understand, like they did in New Hampshire,” said Jeff Haaga, at 360 pounds is classified as morbidly obese. He has lobbied for Utah to require insurance companies to provide more coverage for obesity.
“Insurers are covering people who are morbidly obese one way or the other, whether it’s surgery or just keeping us alive with medication.”
The Trust for America’s Health, a nonprofit group that focuses on disease prevention, reported that adult obesity rates rose in 37 states in the past year, while no state saw a decrease, according to Reuters Health.
—
On the Net:
Comments