Please help reverse WLS coverage suspension in Iowa - This Friday (7/22/2011)
Hi All.
Do you think the verbiage below is fair? Let me know.
I hope you are doing well at this stage of your journey! I'm trying to reach all of our members in Iowa regarding the decision for Iowa Medicaid to withdraw coverage for weight loss surgery. If you could share this email with anyone who might be interested, we at ObesityHelp.com would greatly appreciate it.
If you or anyone you know near Des Moines can make it, a Medicaid advisory council will be meeting this Friday. (Their next meeting after that is Oct 21st). WLS is _not_ on their stated agenda (see the web page below), but such might have been prepared a while ago. We suspect you would have some opportunity to meet Advisory Council members for the purpose of expressing to them your appreciation for their support (past, current, and future) of WLS over the years, independent of the governor's decision. Also, you might also learn what they think about the recent legislation and what their current recommendations might be.
http://www.ime.state.ia.us/MAAC/CAC_Index.html Friday 7/22/2011, 1pm-4pm, Iowa Medicaid Enterprise at 100 Army Post Road in Des Moines, Iowa (See meeting agenda on the URL above {scroll down to find} ). They meet every 3 to 4 months.
Eric Klein
Founder, ObesityHelp.com
Making the Journey Together
================ DETAILS BELOW ======================
Medicaid coverage cessation.
Starting August 1st, coverage for WLS in the state of Iowa will stop (see exact verbiage below). While this was merely part of highly politicized efforts to prevent a state government shut down, the language adopted was biased, citing patient non-compliance as a cause of standard surgical complications. Whether intentional or not, this paints the obese in a poor light and should be addressed. Medicaid is responsible for a lot of long-term coverage and therefore should be at the forefront of example-setting. In recent years 45 out of 50 states have covered WLS, but if that number were to start slipping, other payers -- both public and private sector -- could be motivated to follow suit. So even if you are not covered by Medicaid this could potentially impact -- for years to come -- your access, or that of your children or other loved ones -- to bariatric procedures such as revisions or potentially plastics. So, one way or another, you probably have some personal stake in this.
How you can help.
Soon we plan to send some information you could use to contact the governor's office and other elected officials prior to upcoming hearings on the matter. Stay tuned for this. Today, however, I wanted to encourage you to consider (our apologies for the short notice, but we wanted to get this one as right as possible) attending a Medicaid Advisory meeting (details above). Teresa LaMasters MD, FACS is one surgeon (who works in Des Moines) who intends to be there, potentially with some of her co-workers. If you can't make it there yourself, perhaps you have friends or relatives in the Des Moines area who could. They might have some opportunity to show support for pro-WLS committee members (listed in the annual reports below). Some of them might have advice for the WLS community.
Introducing the Clinical Advisory Committee (CAC).
"The IME Medical Services unit assembled the CAC. The CAC is charged with recommending clinically appropriate healthcare utilization management and coverage decisions for the medial assistance program and IowaCares population to the Department. " Please take a moment to familiarize yourself with their recent support of weight loss surgery:
http://www.ime.state.ia.us/docs/SFY2009AnnualReport.pdf
http://www.ime.state.ia.us/docs/SFY2008AnnualReport.pdf
http://www.ime.state.ia.us/docs/SFY2007AnnualReport.pdf
They're certainly working to manage costs for WLS, along with many other things, but their work is very rational. They did really well, in particular, in years past by reducing a mandatory two year wait period for WLS to just six months. Chances are, one or more of these people live near you (they are listed within the annual reports above).
Take home pointy here is that in "emergency" legislation, the government of Iowa stopped WLS Medicaid coverage without -- it seems -- the input of its own Medicaid's Advisory Council.
At the very least, this could be an educational experience for you if you were to attend. Many of us who care are not near Iowa (I'm stuck here in Southern California, for example) but we do see this, ultimately, as a national issue. Whether or not you are able to attend, please share your thoughts on the Iowa message board:
http://www.obesityhelp.com/forums/IA/a,messageboard/board_id ,4814/
====================================================================================
Additional Details Below
====================================================================================
=============================================================================================
Full Statement - with inserted commentary (by Eric Klein).
=============================================================================================
Name: Elimination of Bariatric Surgery
Implementation Date: August 1, 2011 Summary:
Medicaid will eliminate coverage for bariatric surgery for the treatment of morbid obesity. This coverage elimination applies to all forms of this surgery, including, but not limited to the following: gastric bypass, lap-band, roux-en-y, etc. These services have always required pre-procedure review (i.e., prior authorization).
• All authorizations issued through July 31, 2011 will expire on October 31, 2011.
• All members and providers with an active authorization in place will be notified by letter of the expiration date.
• No new bariatric surgery services will be authorized after July 31, 2011. Informational Letter: The Informational Letter announcing this change will be # 1030 . All Informational Letters can be viewed at http://www.ime.state.ia.us/Providers/Bulletins.html.
Rules: Rules will be posted at http://www.dhs.state.ia.us/PolicyAnalysis/RulesPages/Dockets.htm. Not posted there yet as of 7/19/2011. July 6, 2011
HUMAN SERVICES DEPARTMENT [441]
Adopted and Filed Emergency
Pursuant to the authority of Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a), the Department of Human Services amends Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services," Iowa Administrative Code.
These amendments eliminate Medicaid coverage for bariatric surgery, including gastric bypass, lap-band, and other methods. This change is one of the Medicaid cost containment strategies recommended by Governor Branstad. Legislation passed by the Eighty-Fourth General Assembly authorizes the Department to implement these recommendations. Note the term "Emergency". This reflects current budgetary climates. (For some context... as the federal government heads towards potential default, the state of Minnesota just to the north of Iowa remains in a state of government shut down). This Governor-origin is consistent with the medicaid clinical advisory committee not having withdrawn its support for bariatric surgery.
Concerns with bariatric procedures include noncompliance and complications. Patients who are unprepared or noncompliant put themselves at increased risk of complications following weight loss surgery, as this is a lifelong commitment for the individual. Noncompliance can lead to multiple medical procedures to manage complications such as vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcers, hernias, kidney stones, hypoglycemia, blood clots in the legs, leaking at one of the staple lines in the stomach, pneumonia, narrowing of the opening between the stomach and the small intestine, and dumping syndrome. These repeat procedures add additional cost to an already expensive procedure.
Although weight-loss surgery can reduce or eliminate such conditions as diabetes, hypertension and hypercholesterolemia (and the need for treating these conditions with costly medications), a patient may have increased need for treatment in other areas. It has been noted that people who have had weight loss surgery also needed treatment for gastrointestinal-tract disorders, anemia and vitamin deficiency. This level of clinical detail is impressive. The point by point specificity (versus any typical "not enough data") opens the field up for transparent discussion of particular statements. These amendments do not provide for waivers in specified situations because the savings assumed in the Department’s appropriations will not be achieved if waivers are provided. Requests for the waiver of any rule may be submitted under the Department’s general rule on exceptions at 441--1.8(17A,217). So there is apparently some due process for case by case appeals. After analysis and review of this rule making, no impact on jobs has been found. A perfunctory requirement, most likely. It very expressly claims no association between weight loss surgery and improved employability.
The Council on Human Services adopted these amendments on July 13, 2011.
The Department finds that notice and public participation are impracticable because the Department's appropriation for the fiscal year beginning July 1, 2011, assumes the implementation of the cost containment strategies recommended by the governor without delay for notice and public comment. Therefore, these amendments are filed pursuant to Iowa Code section 17A.4(3). Along with reference to "Emergency" further above, this implies that some potentially broad swath of internal assets may have been bypassed.
The Department also finds, pursuant to Iowa Code section 17A.5(2)“b"(1), that the normal effective date of these amendments should be waived, as authorized by 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments are also published herein under Notice of Intended Action as ARC 9xxxB to allow for public comment.
These amendments are intended to implement Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments became effective August 1, 2011.
The following amendments are adopted.
ITEM 1. Adopt new
h. Services provided for intestinal or gastric bypass surgery for treatment of obesity. paragraph 78.1(1)“h" as follows:
ITEM 2. Rescind and reserve subrule 78.3(4).
-------- Original Message --------
Subject: Kindly seeking your insight regarding changes to weight loss surgery coverage.
Date: Fri, 15 Jul 2011 13:22:14 -0700
From: Eric Klein
To: [email protected]
Mrs. Andi Dykstra, RN, CPHQ.
We are a patient education organization. We're seeking any insight that you might kindly provide. Our economically challenged members in Iowa have, by the way, appreciated your service to them over the years -- for which we remain in your debt. Regarding the upcoming cessation of coverage for weight loss surgery, might you kindly address any of the following questions?
1) To what degree -- if any -- was this prompted by any uncommonly urgent cost cutting measures?
(Unlike its neighbor to the north, Iowa has not shut down 1/3 of its spending, but it was unclear how much such writing might have been on the wall, so to speak, in the current legislative climates (both federal and state levels).
2) Since scientific evidence and thinking evolves all the time, was the committee sensitive to any changes in data or findings from any particular external authoritative sources with respect to cost to benefit trade-offs? And/or, were there any insightful findings within its own data sets? (Such could be informative to other state medicaid departments). In the past, for example, recommendations from Univ. of Iowa dept of public health and the federal AGRQ might have been used by the CAC to refine its support of weight loss surgery coverage.
3) Is there any formal process by which any observers or guests are welcome and/or allowed to attend the CAC meetings?
Thank you in advance for your attention.
Eric Klein
Founder, ObesityHelp.com
Do you think the verbiage below is fair? Let me know.
I hope you are doing well at this stage of your journey! I'm trying to reach all of our members in Iowa regarding the decision for Iowa Medicaid to withdraw coverage for weight loss surgery. If you could share this email with anyone who might be interested, we at ObesityHelp.com would greatly appreciate it.
If you or anyone you know near Des Moines can make it, a Medicaid advisory council will be meeting this Friday. (Their next meeting after that is Oct 21st). WLS is _not_ on their stated agenda (see the web page below), but such might have been prepared a while ago. We suspect you would have some opportunity to meet Advisory Council members for the purpose of expressing to them your appreciation for their support (past, current, and future) of WLS over the years, independent of the governor's decision. Also, you might also learn what they think about the recent legislation and what their current recommendations might be.
http://www.ime.state.ia.us/MAAC/CAC_Index.html Friday 7/22/2011, 1pm-4pm, Iowa Medicaid Enterprise at 100 Army Post Road in Des Moines, Iowa (See meeting agenda on the URL above {scroll down to find} ). They meet every 3 to 4 months.
Thank you in advance for helping -- via whatever means -- show the world all that we can be, working together. I hope you won't mind if I possibly contact you on this issue once more, possibly next week. Please share your thoughts: http://www.obesityhelp.com/forums/IA/a,messageboard/board_id ,4814/ .
Eric Klein
Founder, ObesityHelp.com
Making the Journey Together
================ DETAILS BELOW ======================
Medicaid coverage cessation.
Starting August 1st, coverage for WLS in the state of Iowa will stop (see exact verbiage below). While this was merely part of highly politicized efforts to prevent a state government shut down, the language adopted was biased, citing patient non-compliance as a cause of standard surgical complications. Whether intentional or not, this paints the obese in a poor light and should be addressed. Medicaid is responsible for a lot of long-term coverage and therefore should be at the forefront of example-setting. In recent years 45 out of 50 states have covered WLS, but if that number were to start slipping, other payers -- both public and private sector -- could be motivated to follow suit. So even if you are not covered by Medicaid this could potentially impact -- for years to come -- your access, or that of your children or other loved ones -- to bariatric procedures such as revisions or potentially plastics. So, one way or another, you probably have some personal stake in this.
How you can help.
Soon we plan to send some information you could use to contact the governor's office and other elected officials prior to upcoming hearings on the matter. Stay tuned for this. Today, however, I wanted to encourage you to consider (our apologies for the short notice, but we wanted to get this one as right as possible) attending a Medicaid Advisory meeting (details above). Teresa LaMasters MD, FACS is one surgeon (who works in Des Moines) who intends to be there, potentially with some of her co-workers. If you can't make it there yourself, perhaps you have friends or relatives in the Des Moines area who could. They might have some opportunity to show support for pro-WLS committee members (listed in the annual reports below). Some of them might have advice for the WLS community.
Introducing the Clinical Advisory Committee (CAC).
"The IME Medical Services unit assembled the CAC. The CAC is charged with recommending clinically appropriate healthcare utilization management and coverage decisions for the medial assistance program and IowaCares population to the Department. " Please take a moment to familiarize yourself with their recent support of weight loss surgery:
http://www.ime.state.ia.us/docs/SFY2009AnnualReport.pdf
http://www.ime.state.ia.us/docs/SFY2008AnnualReport.pdf
http://www.ime.state.ia.us/docs/SFY2007AnnualReport.pdf
They're certainly working to manage costs for WLS, along with many other things, but their work is very rational. They did really well, in particular, in years past by reducing a mandatory two year wait period for WLS to just six months. Chances are, one or more of these people live near you (they are listed within the annual reports above).
Take home pointy here is that in "emergency" legislation, the government of Iowa stopped WLS Medicaid coverage without -- it seems -- the input of its own Medicaid's Advisory Council.
At the very least, this could be an educational experience for you if you were to attend. Many of us who care are not near Iowa (I'm stuck here in Southern California, for example) but we do see this, ultimately, as a national issue. Whether or not you are able to attend, please share your thoughts on the Iowa message board:
http://www.obesityhelp.com/forums/IA/a,messageboard/board_id ,4814/
====================================================================================
Additional Details Below
====================================================================================
Parking Every visitor to IME must have the "IME VISITOR" sign on their dash if they park in the front lot at IME. This applies to everyone including State employees who do not work at the IME building. If you do not have the "IME VISITOR" sign visible in your car, you run the risk of getting an orange sticker on your car. After you have received three (3) stickers, your car can be towed. Parking in the back lot on Dickman Road does not require the "IME VISITOR" form.
=============================================================================================
Full Statement - with inserted commentary (by Eric Klein).
=============================================================================================
IOWA MEDICAID ENTERPRISE – 100 ARMY POST ROAD – DES MOINES, IOWA 50315-6241
Cost Savings Strategy #12 SFY 12 BudgetName: Elimination of Bariatric Surgery
Implementation Date: August 1, 2011 Summary:
Medicaid will eliminate coverage for bariatric surgery for the treatment of morbid obesity. This coverage elimination applies to all forms of this surgery, including, but not limited to the following: gastric bypass, lap-band, roux-en-y, etc. These services have always required pre-procedure review (i.e., prior authorization).
• All authorizations issued through July 31, 2011 will expire on October 31, 2011.
• All members and providers with an active authorization in place will be notified by letter of the expiration date.
• No new bariatric surgery services will be authorized after July 31, 2011. Informational Letter: The Informational Letter announcing this change will be # 1030 . All Informational Letters can be viewed at http://www.ime.state.ia.us/Providers/Bulletins.html.
Rules: Rules will be posted at http://www.dhs.state.ia.us/PolicyAnalysis/RulesPages/Dockets.htm. Not posted there yet as of 7/19/2011. July 6, 2011
HUMAN SERVICES DEPARTMENT [441]
Adopted and Filed Emergency
Pursuant to the authority of Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a), the Department of Human Services amends Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services," Iowa Administrative Code.
These amendments eliminate Medicaid coverage for bariatric surgery, including gastric bypass, lap-band, and other methods. This change is one of the Medicaid cost containment strategies recommended by Governor Branstad. Legislation passed by the Eighty-Fourth General Assembly authorizes the Department to implement these recommendations. Note the term "Emergency". This reflects current budgetary climates. (For some context... as the federal government heads towards potential default, the state of Minnesota just to the north of Iowa remains in a state of government shut down). This Governor-origin is consistent with the medicaid clinical advisory committee not having withdrawn its support for bariatric surgery.
Concerns with bariatric procedures include noncompliance and complications. Patients who are unprepared or noncompliant put themselves at increased risk of complications following weight loss surgery, as this is a lifelong commitment for the individual. Noncompliance can lead to multiple medical procedures to manage complications such as vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcers, hernias, kidney stones, hypoglycemia, blood clots in the legs, leaking at one of the staple lines in the stomach, pneumonia, narrowing of the opening between the stomach and the small intestine, and dumping syndrome. These repeat procedures add additional cost to an already expensive procedure.
Although weight-loss surgery can reduce or eliminate such conditions as diabetes, hypertension and hypercholesterolemia (and the need for treating these conditions with costly medications), a patient may have increased need for treatment in other areas. It has been noted that people who have had weight loss surgery also needed treatment for gastrointestinal-tract disorders, anemia and vitamin deficiency. This level of clinical detail is impressive. The point by point specificity (versus any typical "not enough data") opens the field up for transparent discussion of particular statements. These amendments do not provide for waivers in specified situations because the savings assumed in the Department’s appropriations will not be achieved if waivers are provided. Requests for the waiver of any rule may be submitted under the Department’s general rule on exceptions at 441--1.8(17A,217). So there is apparently some due process for case by case appeals. After analysis and review of this rule making, no impact on jobs has been found. A perfunctory requirement, most likely. It very expressly claims no association between weight loss surgery and improved employability.
The Council on Human Services adopted these amendments on July 13, 2011.
The Department finds that notice and public participation are impracticable because the Department's appropriation for the fiscal year beginning July 1, 2011, assumes the implementation of the cost containment strategies recommended by the governor without delay for notice and public comment. Therefore, these amendments are filed pursuant to Iowa Code section 17A.4(3). Along with reference to "Emergency" further above, this implies that some potentially broad swath of internal assets may have been bypassed.
The Department also finds, pursuant to Iowa Code section 17A.5(2)“b"(1), that the normal effective date of these amendments should be waived, as authorized by 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments are also published herein under Notice of Intended Action as ARC 9xxxB to allow for public comment.
These amendments are intended to implement Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments became effective August 1, 2011.
The following amendments are adopted.
ITEM 1. Adopt new
h. Services provided for intestinal or gastric bypass surgery for treatment of obesity. paragraph 78.1(1)“h" as follows:
ITEM 2. Rescind and reserve subrule 78.3(4).
-------- Original Message --------
Subject: Kindly seeking your insight regarding changes to weight loss surgery coverage.
Date: Fri, 15 Jul 2011 13:22:14 -0700
From: Eric Klein
To: [email protected]
Mrs. Andi Dykstra, RN, CPHQ.
We are a patient education organization. We're seeking any insight that you might kindly provide. Our economically challenged members in Iowa have, by the way, appreciated your service to them over the years -- for which we remain in your debt. Regarding the upcoming cessation of coverage for weight loss surgery, might you kindly address any of the following questions?
1) To what degree -- if any -- was this prompted by any uncommonly urgent cost cutting measures?
(Unlike its neighbor to the north, Iowa has not shut down 1/3 of its spending, but it was unclear how much such writing might have been on the wall, so to speak, in the current legislative climates (both federal and state levels).
2) Since scientific evidence and thinking evolves all the time, was the committee sensitive to any changes in data or findings from any particular external authoritative sources with respect to cost to benefit trade-offs? And/or, were there any insightful findings within its own data sets? (Such could be informative to other state medicaid departments). In the past, for example, recommendations from Univ. of Iowa dept of public health and the federal AGRQ might have been used by the CAC to refine its support of weight loss surgery coverage.
3) Is there any formal process by which any observers or guests are welcome and/or allowed to attend the CAC meetings?
Thank you in advance for your attention.
Eric Klein
Founder, ObesityHelp.com
I talked to Dr. LaMaster's office in Des Moines today. Gov. Branstad signed (approved) the cessation of baraiatric surgery effective as noted above.
I am speechless as I am waiting for Medicaid to approve my surgery before the cut off date. I NEED this surgery to help me stay alive, not only for myself but my 7 year old daughter.
I am appalled that Branstad cut this very important surgery.
I am speechless as I am waiting for Medicaid to approve my surgery before the cut off date. I NEED this surgery to help me stay alive, not only for myself but my 7 year old daughter.
I am appalled that Branstad cut this very important surgery.
I learned the same from Kari, just 30 minutes after it happened, apparently.
Some discussion of potential extensions or loopholes or whatnot.
There IS hope : this was not medicaid's doing, and there are some indications that processing staff there are very empathetic to the situation.
Many of us are working very hard on this behind the scenes -- and very soon not so behind them. Stay tuned for an update soon.
Hang in there.
Some discussion of potential extensions or loopholes or whatnot.
There IS hope : this was not medicaid's doing, and there are some indications that processing staff there are very empathetic to the situation.
Many of us are working very hard on this behind the scenes -- and very soon not so behind them. Stay tuned for an update soon.
Hang in there.
I have spent the past hour or more scouring the DHS and Iowa Legislative websites. I just can't find the information I was looking for. I want to know what I can do or what my friends that support me can do.
I asked Dr. LaMaster's office. They have a petition there that they are encouraging their clients to sign regarding this. I don't know what I can do....suggestions?
I asked Dr. LaMaster's office. They have a petition there that they are encouraging their clients to sign regarding this. I don't know what I can do....suggestions?
Good news.
I just met with bariatric center staff (including Kari at Dr. LaMaster's office), and we're starting to get coordinated. More info to come by next week, but for now, here are some things you can do:
1) Start doing background research on these individuals here:
http://www.legis.state.ia.us/aspx/Committees/Committee.aspx? id=53
This is the rules review committee. These elected officials will be influential in the near future. More details later. If you could organize any research on what types of health related bills they might have voted for or against in the past, that could prove useful.
2) Share your full story!
Click here to tell your full story (as you can at this stage of your journey):
www.obesityhelp.com/morbidobesity/members/profile-admin/upda te-survey.php
This is behind the MyOH tab, under "Survey".
Please go into as much detail as you can about any expenses or lost work productivity or lost taxpayer contributions that you feel have resulted from morbid obesity. Medications, their names and possible costs. Health conditions. Lost productivity. We're going to be compiling these stories and sharing with lawmakers. The survey above was just one tool to help guide individuals toward before, or before & after stories, wherein we could collect as many histories as possible of WLS resulting in cost savings and other improvements.
3) Research any health writers in Iowa. Below is a list of newspapers in the state. Within these, and any orther publications, can you identify any writers or journalists with any history of covering public interest stories addressing health issues?
Ames Tribune 515-232-2160
Fort Dodge Messenger 515-573-2141
Globe Gazette (Mason City) 641-421-0524
Sioux City Journal 800-397-3530
Quad City Times (Davenport)
I just met with bariatric center staff (including Kari at Dr. LaMaster's office), and we're starting to get coordinated. More info to come by next week, but for now, here are some things you can do:
1) Start doing background research on these individuals here:
http://www.legis.state.ia.us/aspx/Committees/Committee.aspx? id=53
This is the rules review committee. These elected officials will be influential in the near future. More details later. If you could organize any research on what types of health related bills they might have voted for or against in the past, that could prove useful.
2) Share your full story!
Click here to tell your full story (as you can at this stage of your journey):
www.obesityhelp.com/morbidobesity/members/profile-admin/upda te-survey.php
This is behind the MyOH tab, under "Survey".
Please go into as much detail as you can about any expenses or lost work productivity or lost taxpayer contributions that you feel have resulted from morbid obesity. Medications, their names and possible costs. Health conditions. Lost productivity. We're going to be compiling these stories and sharing with lawmakers. The survey above was just one tool to help guide individuals toward before, or before & after stories, wherein we could collect as many histories as possible of WLS resulting in cost savings and other improvements.
3) Research any health writers in Iowa. Below is a list of newspapers in the state. Within these, and any orther publications, can you identify any writers or journalists with any history of covering public interest stories addressing health issues?
Ames Tribune 515-232-2160
Fort Dodge Messenger 515-573-2141
Globe Gazette (Mason City) 641-421-0524
Sioux City Journal 800-397-3530
Quad City Times (Davenport)
Iowa City Gazette 319-339-3101
Council Bluffs Nonpareil
Marshalltown Times Republican 641-753-6611
More soon....
=========================================
National Public Radio to Cover the Medicaid Story
=========================================
National Public Radio to Cover the Medicaid Story
=========================================
Dr. LaMasters (of Des Moines) and one of her patients did an interview to discuss the Medicaid Bariatric Surgery coverage issue. It will run Monday afternoon (Aug 1st) between 4:40 and 5pm. And then Tuesday morning (Aug 2nd) I think at 5:30am and 7:35 am. It will also hit the website Monday at noon. So you can look for it under news at www.iowapublicradio.org
Many thanks to Kari Boyens and to Dr. LaMasrters for pulling this off and updating us!
~ I had this surgery in 2006. This isn't just a weight loss surgery but in MANY cases it can be a lifesaving tool. Every person I know that has been through this has been restored to better health and become more productive citizens... I truely believe that without this I would'nt be here on Earth today and enjoy my children and grandchildren... The saving is in the SAVING LIVES. Thanks for allowing my input.
Yep.
And, for good measure, I was looking for a good place to interject some contrarian thinking, if only to make the point that we're all unique with our own opinions. This was something that someone had shared earlier elsewhere:
"I don't feel it {WLS} should be paid for {by Medicaid}. I've been on medicaid before and thought about surgery when I was. But now that I actually have it I know that I wouldn't have been able to afford everything else that comes with having the surgery. The vitamins and supplements, the appointments, the gas money spent, the daycare paid. I can barely afford it now and my husband has excellent insurance and works at John Deere. Plus if you are poor and on medicaid I would suggest getting a Good job that you can actually pay your bills with and that has it's own insurance before worrying about having a surgery that you have to take off of work for to make you even more broke! I'm sorry if this isn't the answer you were looking for but I don't think people think about things before they jump into them."
"I've been in both situations and thought long and hard about all my options and how things would be if I had made other choices. My life with 3 kids broke and no job would have been hell if I would have had surgery when I was on medicaid. Others should think about that too before they try to push to keep it paid for by medicaid. I hope this made you think a little different as well."
"I bet the reason most are non compliant is because of all the cost that people don't think about. The cost of vitamins are expensive and if they are like me i can't tolerate them and I've been through 10 diff multivitamins, calciums, and protiens supplements and bars. plus the iron and b-12 complex. Then the gas to drive to these appointments and daycare costs are ridiculous. So I don't blame people for being non compliant. They probably aren't doing it just to be non compliant they probably just can't afford it."
There are thousands of different perspectives and stories, of course, for thousands of different individuals, each with their own particular set of health and cost specifics. Taking on ANY major project (and WLS is certainly a major project) is likely to be easier to do if/once one is better off financially. The flip side, of course, is that disability is often a major impediment toward becoming better off financially.
What do any of you think?
here is my deal....i understand there will be more expenses with the surgery (vitamins, gas to get to and from appts, food or other types of food stufff, etc etc). but those of us who PLAN for these things, are able to make it work. I may not have all the money in the world but if this is that important to me, which it is...I will forego the cost and just do it. it's my health or my death. which to choose? i choose LIFE.
I am on medicaid not because I want to be but because I really have no other choice at the moment. I am working on my bachelors degree and will get a "real job" out there when I am finished. I understand that there are some people who can't work because of their health issues related to their weight stuff. But knowing that if there was a way to get the weight off, then be able to have the energy and good health to get a job...I bet they would do it.
I am on medicaid not because I want to be but because I really have no other choice at the moment. I am working on my bachelors degree and will get a "real job" out there when I am finished. I understand that there are some people who can't work because of their health issues related to their weight stuff. But knowing that if there was a way to get the weight off, then be able to have the energy and good health to get a job...I bet they would do it.
I have been lurking on this subject long enough and now it's my turn to "voice" my opinion on this issue.
I am a social worker and some will say it's because I am a "bleeding heart liberal" that I feel the way I do. Such is not the case with me. I am a humanist and would say the same things if I weren't a social worker because I think every life is valuable no matter what the ability/disability of the individual. Not saying that those in need of WLS are disabled in any way, but I know that some overweight folks are very limited in their ability due to weight related issues.
It is my belief that no matter what your financial situation, if you have insurance, insurance should pay for medical needs. If those needs are bunion surgery, mole removal, hemorrhoid surgery, treatment for a broken arm, treatment for substance abuse, etc, then the insurance should cover it. I'll even go one step further and say insurance should cover it 100%. (ouch, I'm seeing glares from insurance reps) Again, these are my opinions.
WLS has long been viewed as "the easier/softer way out" of obesity. Well, as a person who has had WLS, I'm here to tell you it's FAR........no make that FAAAAAAAAAAAARRRRRRRRR from the easier way. Unless you've had gastric bypass, you don't know what it's like and no two cases are the same so I can't even say that I know what someone else went through. Some of us needed it to thrive and not merely survive through life. Many others out there will need it one day to thrive just as I did.
Not once in my life did I ever answer, "an obese person who gets ostracized by everyone around me" when asked what I wanted to be when I grew up. I turned to food for whatever reason and it got me extra weight. Those of you who are obese/overweight, know what I"m talking about here. We didn't sign up for, didn't ask for, didn't want to be obese or overweight!! When will those outside the medical community realize that? We aren't lazy............many times we want to exercise but can't due to our weight. We don't want to eat the wrong foods.............for some it's what brings us comfort. We don't want to be overweight or obese.............it's how it is for some of us and we feel trapped. Some of us ate very little, but gained weight anyway. Some of us felt caught up in the cycle of weight gain. Some of us got on the "wrong bus" when it came to eating and once on it, couldn't get off.
So, after going on for the past few paragraphs, I'll say this. Poor people have health issues too and those health issues include weight related problems requiring WLS. Shame on Medicaid and the powers that be who don't value ALL people. It's clear to me that they only find value in "the wealthy" people.
Thanks for listening and for all of you on Medicaid, first, you have my sympathy for being at the government's mercy. Second, keep fighting for the reinstatement of Medicaid paying for WLS. You are your best advocate, and you deserve to have your medical needs met!
Carol
I am a social worker and some will say it's because I am a "bleeding heart liberal" that I feel the way I do. Such is not the case with me. I am a humanist and would say the same things if I weren't a social worker because I think every life is valuable no matter what the ability/disability of the individual. Not saying that those in need of WLS are disabled in any way, but I know that some overweight folks are very limited in their ability due to weight related issues.
It is my belief that no matter what your financial situation, if you have insurance, insurance should pay for medical needs. If those needs are bunion surgery, mole removal, hemorrhoid surgery, treatment for a broken arm, treatment for substance abuse, etc, then the insurance should cover it. I'll even go one step further and say insurance should cover it 100%. (ouch, I'm seeing glares from insurance reps) Again, these are my opinions.
WLS has long been viewed as "the easier/softer way out" of obesity. Well, as a person who has had WLS, I'm here to tell you it's FAR........no make that FAAAAAAAAAAAARRRRRRRRR from the easier way. Unless you've had gastric bypass, you don't know what it's like and no two cases are the same so I can't even say that I know what someone else went through. Some of us needed it to thrive and not merely survive through life. Many others out there will need it one day to thrive just as I did.
Not once in my life did I ever answer, "an obese person who gets ostracized by everyone around me" when asked what I wanted to be when I grew up. I turned to food for whatever reason and it got me extra weight. Those of you who are obese/overweight, know what I"m talking about here. We didn't sign up for, didn't ask for, didn't want to be obese or overweight!! When will those outside the medical community realize that? We aren't lazy............many times we want to exercise but can't due to our weight. We don't want to eat the wrong foods.............for some it's what brings us comfort. We don't want to be overweight or obese.............it's how it is for some of us and we feel trapped. Some of us ate very little, but gained weight anyway. Some of us felt caught up in the cycle of weight gain. Some of us got on the "wrong bus" when it came to eating and once on it, couldn't get off.
So, after going on for the past few paragraphs, I'll say this. Poor people have health issues too and those health issues include weight related problems requiring WLS. Shame on Medicaid and the powers that be who don't value ALL people. It's clear to me that they only find value in "the wealthy" people.
Thanks for listening and for all of you on Medicaid, first, you have my sympathy for being at the government's mercy. Second, keep fighting for the reinstatement of Medicaid paying for WLS. You are your best advocate, and you deserve to have your medical needs met!
Carol
Most Active
Recent Topics
The moment you've all been waiting for . . . OH2015 Location Announcement!
Kathy S. · 0 replies · 6611 views
Kathy S. · 0 replies · 6611 views
