Connecticut Legislation re: Obesity Surgery

I just read this on the Yahoo news site. We should be sure our voices are heard when it comes to this type of legislation, we are the ones *****ally understand what this is all about. Write your Congressman and send a copy of this to them. You know that our legislators will be under a lot of pressure from the insurance companies to NOT pass this type of legislation, we need to be sure we apply pressure that convinces them that our vote counts!!! d States Consider Obesity Surgery Coverage By NOREEN GILLESPIE, Associated Press Writer HARTFORD, Conn. - A proposal before Connecticut lawmakers would require insurance companies to cover the surgery for people with a body-mass index of 30 or more if a doctor deems the surgery medically necessary. The BMI is a widely used formula based on height and weight. The Connecticut proposal may not get off the ground this session because lawmakers are struggling to define under what medical conditions the surgery should be covered, said Sen. Joseph Crisco, a Woodbridge Democrat who chairs the legislative committee looking at the issue. The debate is not unlike others across the country. Georgia lawmakers are considering a similar bill this year. And in Louisiana, 40 state employees were chosen last year from 1,200 applications to get the surgery on the state's dime. The standard surgery, which can cost between $20,000 and $35,000, involves using staples to separate a small pouch at the stomach's top from the rest of the stomach, greatly limiting the amount of food that can be eaten. The procedure also involves bypassing much of the small intestine so that less food is absorbed into the body. Blue Cross and Blue Shield of Alabama recently stopped paying for the operations while it decides how to handle claims; Blue Cross and Blue Shield of Florida has also decided to stop paying for the operation. In Connecticut, many major plans offer coverage only for large numbers of employees. Others are considering offering the coverage for an additional charge. "What we're starting to see is an increase in what we would consider at best, unnecessary, and at worst, unsafe, surgery," said Keith Stover, a lobbyist for the Connecticut Association of Health Plans. "Many plans decide the best course of action simply is to exclude coverage." But many physicians say the long-term benefits of weight loss surgery outweigh the risk. Gastric bypass surgery can help cure obesity-related health problems such as high cholesterol, high blood pressure, sleep apnea and even diabetes, said Dr. Jonathan Aranow, director of the Middlesex Hospital Center for Obesity Surgery. It can also cut down on the long-term cost of medications, he said. "The surgery pays for itself in under three years," he said. "There is no question that there are cost savings." Last year the federal government opened the door for Medicare coverage of gastric bypass surgery. But some lawmakers and insurers are also worried about risks. State Rep. Anthony D'Amelio, R-Waterbury, said noted two people in his district died after having the operation. Complications strike as many as 1 in 5 patients having the surgery, and it is believed that for every 200 patients, 1 to 4 will die. Estimates are that more than 100,000 people will have the surgery this year. "I would rather see people try to do it the harder way, exercise and eating properly," D'Amelio said. "I know it's a struggle ... I think it's the safest route." But for some patients, the hard way hasn't worked. Deborah Sicaras, 36, of Wethersfield, has tried Weigh****chers, Jenny Craig, diet pills and liquid diets; she also teaches ballet, tap and jazz four days a week. "I'm one of the fortunate ones who will be able to have this surgery in the very near future," she said. "I can't do this by myself. I need assistance. I've dieted my whole life."

Friends, I have found an email address for the lawmaker in this article. I emailed him at: [email protected]. Here is the text of my letter: Rep. D'Amelio, I am not a constituent, but I feel compelled to send you a short message about your comments in your state's legislature this week concerning weight loss surgery. I will not waste your time arguing several points, but I do need to let you know that bariatric surgery patients are not exempt from exercise and proper eating habits after "the easy way out." Please sir, understand that the hard road starts in recovery. We must count carbs, count calories and exercise is stressed the second you can stand on your own after surgery. For the first time in my life, I look at nutritional values of everything I buy in the stores. I cook for myself and my family more than before because my lifestyle must be worked on each day. My weight loss surgery allows me to eat anything I choose. I choose a balanced diet including low carbohydrates, fruits, vegetables and responsible lean protein. When I stray from this formula, I don't do well. (Trust me, I tried -- no hard work, no progress) I can not exercise at this moment because of an unrelated illness and I'm at a plateau in my weight loss. I WILL NOT reach my goals until I can complete the circle and begin an exercise regimen. I know you are looking at the insurance company's bottom line, but trust me, so are we. The cost of dialysis, heart bypass or colon cancer treatment will cost my insurance company more if patients like me enter their 40s morbidly obese and chronically ill. It's not the easy way out, but it is the only way out for a select number of sufferers. Respectfully yours, Frances Y. Spencer My blog: Wellness and goals not defined by a scale http://francesspencer.blogspot.com/2005/01/wellness-and-goals-not-defined-by.html

Dear Sir: My insurance company decided to refuse to pay for or allow me to get my prilosec prescription filled several years ago, as it would cost them too much money for their part of the cost. They kept the prescription and mailed me a form letter. I could not get the medication and was forced to treat my acid reflux with over the counter medicines. In addition to being in pain continually from that time on, my reflux continued and could not be controlled that way. I have had three years of terrible respiratory problems, and was forced to take a leave of absence from my job in October 2004 because I coughed so constantly that I could get no more than an hour or two of sleep each night. I had been under my PCP care the whole time for this and other health issues. I recently went to a pulmonologist and had to be put on 5 new expensive prescriptions. The culprit for my respiratory problems was acid reflux that was entering my lungs at night and burning them. It is one of the three top causes for major respiratory problems. This was because the insurance company decided that I did not need the medicine. I went to fill my medicines and the insurance company would only let me fill a half of a months reflux medicine. I guess the theory is that if I can only get half of the medicine that the rest of the month a miracle will occur and I won't need it. When I went back to fill the other half, it cost me $40. Using simple math, I am paying at least $80 a month for this medicine so that I can breathe and not constantly cough, and have my lungs and stomach on fire. It also allows me to drink water or eat food without a searing pain, and choking sensation. This does not include the 5 new medicines that my lungs now require. Just one of them costs me $140/month. I am sure that you are wondering why I am writing. There is a medical procedure that would fix this problem and prevent me from having to take medicine for this, and cure or improve a number of other illnesses. The procedure would also reduce my likelihood of having a heart attack or stroke. Are you curious what the procedure would be? A type of bariatric surgery, RNY. I am writing because I feel that you should take additional time to investigate the statistics and medical conditions that it improves or cures. The surgeon that I have chosen to do my surgery has had NO deaths of patients for this procedure, and very few complications. The key to reducing deaths is carefully choosing a well educated and trained surgeon. The key to eliminating future complications is a dedicated program of follow up after the surgery. Therefore, instead of trying to get rid of the surgery, you (in my humble opinion) should be trying to require a more stringent follow up program and more education of doctors on the subject of gastric bypass so that they will have a better understanding of patients that will walk through their office/hospital doors in the future. Getting rid of a life saving procedure to solve some problems with it when there are other ways to sufficiently fix them, is very simply -- OVERKILL! Don't deny the masses to benefit the few. Do the responsible thing, and institute a program involving education. It would be much cheaper than the far reaching effects of morbid obesity. If you must, limit the procedure to the morbidly obese. An ideology that pushes a "Just Say No To Eating/Obesity!" is as ineffective as a "Just Say No To Aids!" policy has proven to be. The 'just don't eat as much and exercise' mentality shows a definite bias that clearly discriminates against the obese. Obesity is a disease and not an excuse for prejudice. It is time for lawmakers to stand up and support their higher weight voters instead of ignoring our needs. Thanks for your time. N Gause

It would not surprise me to find that a staffer of the Conn. Leg. simply deletes our emails without the fellow ever seeing them..... LOL.

I like your letter and I like your style. I'm saddened that you have had to suffer this much to make a valid point. Yeah, they might delete our emails, but it I light a fire and you light a fire, at some point SOMETHING'S GONNA BURN! Keep lighting the fires... Frances

Thanks. One of the reasons that I posted the letter was so others might see it and realize that their respiratory problems might be Reflux, and do something before they get as bad as mine did. You have had your share of problems too, I notice, it is a shame. It is also a shame that often people disregard others simply because they are heavier than some mental ideal that the person has in mind.