Article in the Atlanta Business Chronicle about Gastric Bypass Surgery

This article appeared in the Atlanta Business Chrinicle last weeek. It is important for all of us to get in touch with our state representatives and let them know we want them to support the legislation to require insurance companies in GA. to cover gastric bypass surgery. Insurers can't stomach bill to curb obesity Erin Moriarty Staff Writer Georgia legislators may weigh in on the state's obesity problem. Rep. Nikki Randall, D-Macon, has drafted a bill that would require insurance companies to pay for the treatment of morbid obesity. Supporters say the bill confronts Georgia's growing waistlines and the rising cost of health care, but insurers argue that mandating coverage of costly procedures will drive costs up further for everyone. "Whether we want to admit it or not, a major amount of our health- care costs can be attributed to obesity," Randall said. "It's hypertension, diabetes and heart disease that are driving costs up." Randall said several doctors approached her about the issue, knowing that she has had several friends and family members who underwent gastric bypass surgery to lose weight. Gastric bypass surgery creates a smaller stomach, which limits the amount of food a person can consume. Georgia legislators considered a similar bill in 1999, but before they passed it, they revised it to let insurance companies "opt" whether to cover obesity treatment. That legislation defined morbid obesity as people who are at least 100 pounds overweight or twice the ideal weight recommended given their frame, height, age and gender. Randall emphasized that the procedure would be a last resort for people whose health is seriously jeopardized by their obesity. "We're talking about morbidly obese, not someone who just wants to lose 30 pounds to be glamorous," Randall said. "These are people who have already tried every weight-loss and exercise program and some have even tried nontraditional means like hypnosis and acupuncture." Doctors say only a couple of insurers currently cover obesity treatments, such as gastric bypass surgery. The state's largest health insurance carrier, Blue Cross and Blue Shield of Georgia Inc., stopped covering the procedure in the fall. "This is a very expensive procedure and because we were one of the few insurers to cover it, we were having a lot of those procedures," said spokesperson Charlie Harman. "It was impacting our overall cost trend -- not just for those people having the procedures, but for all of our members -- so we made a decision to stop covering it." The decision has been very unpopular with doctors specializing in bariatric medicine. » Continued Page: 1 | 2 "Obesity is a disease. Obesity is now considered one of the leading causes of death, and it is the leading cause of heart disease," said Dr. Celio Burrowes of the Georgia Center for Bariatric Surgery. "If we don't look at it as a disease, we will always be struggling back and forth over whether we should cover it." Several other states, such as Indiana, Maryland and Virginia, have mandated insurers to cover gastric bypass surgery for the treatment of obesity. But insurers say creating a similar policy here would drive up the cost of health care for all Georgians. "What seems like a well-intentioned idea can turn into higher prices and fewer choices for people who are insured," said Michael Waldrip of the Georgia Associations of Health Underwriters. "We have somewhat of a crisis in the affordability of health insurance already and mandates don't help with that problem." Proponents of the bill contend that it would save money in the long run for insurers and those who buy insurance. "It's a real issue, and it's something that affects us all, either directly or indirectly, in terms of health-care costs," Burrowes said. "We shouldn't turn our back on it; we need to deal with it." Blue Cross Blue Shield is considering offering a rider to insurance policies for employers willing to pay extra to give their employees coverage of obesity surgeries, Harman said. The company, which serves 3.2 million people, also has asked hospitals to submit ideas on developing centers of excellence that specialize in bariatric medicine to ensure the highest quality of care. "There are authorities who say it's a legitimate procedure for people who are obese, so we are trying to look at offering the benefit but balancing out the costs for those people who are most directly affected," Harman said. As insurers and patients search for solutions, some doctors oppose the idea of requiring people to pay more for insurance that would cover obesity treatments. "What they're trying to do is make more money from the disease of hundreds of thousands of Georgians," Burrowes said. "They're asking employers to buy into the coverage of obesity. I don't hear them saying to employers you can buy a rider to get coverage for heart disease." Denise

I want to see more surgeons involved in this in print. Dr. Burrowes, I know, has helped to spearhead this, but others in the metro area carry clout too. Ask your surgeons what they're doing to further the cause when you have your next appointment. We need to ask Rep. Randall to organize a Support the Obese "walk" or "meet" down at the capitol. Surely, insurance companies can't turn down someone who weighs 500-600 lbs and can't walk, can they????? It's bad enough to have 100+ to lose, but those who are super mobidly obese are dying at a pace much faster than some of us. I had 200 lbs. to lose and felt like I was dying a slow death and even at that, so much better off than some of us. I'm down 87 lbs. and I praise God I have been given the opportunity for surgery and a new life. I want others to have that same opportunity. It seems to me that if ALL insurance companies were mandated to offer coverage, then BCBS would not be bearing the biggest burden. I know that many switched to BCBS in order to get the surgery. I understand their position, but it should be "across the board". If the expense is spread around no one company is hurting more than others. Shame, Shame, insurance companies.