My submission to HR requesting Bariatric Surgery coverage.

I have the ear of the director of HR - she promised anything I sent her will be on the table at the negotiations for health insurance 2009. Our company just bought out another and doubled employees from 250 to over 500 so it's now or never! Help me, read this, critique, be frank, brutal, let me know if I missed anything! Also, I was going to include a "further reading" section with links to articles, etc - if you have some of your favorites to suggest, post them here!  ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Healthy Employees Makes Cents Well, you can hardly argue with this logic, can you? Healthy employees do not call in sick. There you go. They are at their desk, working, as they should be. Healthy employees do not need to go to the doctor as often. They do not need to manage chronic diseases or have costly medications and treatments. Healthy employees do not make other employees sad when they are in the hospital or make coworkers use company time to pass around cards to sign and take up donations for flowers and such. Healthy employees tend to be cheerful and happy. They are less likely to be overly crabby when you make yet another announcement about a change in the parking! [insude company joke] Larissa – Employee – My Story The majority of my family background is of varying normal sizes. My maternal grandmother however, was the exception. She was a normal sized child, a chubby teen, but after 6 children she ballooned up and over 350 pounds. My grandmother suffered from diabetes, heart disease, high blood pressure, arthritis, skin problems, and numerous other ailments. I remember looking at the number of medications she took in awe as a child and watching her injecting herself with insulin. I never imagined in my wildest dreams that any of this could possibly be in my future. I, too, started off as a normal weight little girl. In my teens I started to find myself getting chubby; towards my 20s and into having children, I could be classified as overweight. I was dieting on and off again - Slim Fast, Jenny Craig, NutriSystem, Weigh****chers, I tried quite a few. I had my best success with Atkins Low Carb – I lost quite a bit, getting myself down to the upper level of the recommended range for my height. But it was not sustainable. Imagine yourself, on a high wire… but then…slowly…you are losing your center…and you know, you can’t keep it up…and you ARE going to fall. When I tried to get back on the “wagon” so to speak, I found it harder and harder. Weight didn’t come off like it used to. I found also I had health issues creeping up - like unstable blood sugar, depression, and joint pain. My weight was creeping up and up and I felt powerless to stop it. I tried to find help, but unfortunately, medical obesity treatment of any kind was and continues to be a written exclusion in my employer provided medical insurance. So where am I now? Truthfully, petrified – without medical help, and soon, this path is leading toward the same fate as my grandmother. Three doctors have told me the same thing: Gastric bypass surgery is their recommendation. •    I am insulin resistant and pre-diabetic, and my blood pressure is borderline •    I suffer from gastric reflux •    I suffer from stress urinary incontinence •    I fight chronic fatigue and daytime sleepiness •    I suffer from depression •    I have arthritis and suffer daily joint pain in hips, back, shoulders and arms •    I have issues with walking long distances or getting winded easily •    I come from a family with a history of heart disease and diabetes •    I’m 38 but feel  much, much older •    I am a single mother to three beautiful children who need me to be around for a long, long time – they are my daughters Audrey (17) and Madeleine (11), and my son Alistair (15) •    I’m 5 feet, 2 inches tall and weigh 285 pounds, with a BMI of 52.1 – Super Morbid Obesity Obesity - A Few Words About This “Self Inflicted” Malady >>    Although there is no denying that diet and lifestyle lead to obesity and related health issues, a substantial amount of people need medical intervention. >>    Proven medical causes for obesity have been genetic, thyroid conditions, certain medications, depression, and recent research has pointed to the possibility of some viral causes. >>    Other “life style” health issues, such as smoking related problems like emphysema and lung cancer treatment, are not denied coverage by insurance companies. >>    To continue this line of thought to absurd proportions, you could say others who “brought it upon themselves” – alcoholics and drug addicts, perhaps even HIV positive sufferers – are covered for treatment in most insurance plans. But not the obese? >>    There is a federal law requiring that insurance cover the cost to reconstruct a breast lost to cancer – strictly for the emotional well-being of the woman – but no such law requiring insurance companies to save the life of morbidly obese woman. >>    Morbid obesity is not just about looking fat – it is about real disease, and the real risk of premature death. It increases the risk of: anemia, asthma, carcinoma (cancer), congestive heart failure, diabetes, depression, dyslipidemia (increased lipids in the blood), gallbladder disease, GERD (acid reflux disease), hyperinsulinemia (insulin resistance), hypertension (high blood pressure), incontinence, infertility, osteoarthritis, and sleep apnea. >>    Gastric bypass surgery, excluded from most insurance policies by name, is the only known cure for type 2 diabetes. >>    The National Institutes of Health (NIH), Medicaid, and Medicare all recognize bariatric surgery as a valid treatment for morbid obesity and have guidelines set down for coverage. >>    Several states recently have been debating bills requiring health insurance companies to include coverage for the disease of obesity. Some states already have such laws in place. >>    The general consensus among those working for change is the reason society has allowed this appalling treatment of the obese by insurance companies is that it is still, to this day, the last acceptable prejudice. To make fun of, and to blame, the obese for their fate.   The Case for Including Coverage of the Treatment of Obesity in the Company's Heath Care Plans Including obesity coverage would send a signal that the company understands the seriousness of the disease. It would remove the stigma from employees who are obese, and allow them to actively pursue treatments for the underlying cause of many other costly and debilitating medical conditions. There will no longer be this invisible line between those whose health problems are inside, and those who are outwardly visible, and clearly whose health problems would be covered, and who were going to have to suffer in silence. Including obesity coverage will improve not just the health, but the overall quality of life of obese employees and their families. These people face discrimination and hostility from every turn. They face issues you may not even have thought of, such as increased premiums, or denied life insurance due to their health issues. They face issues for things you may take for granted, such as decreased opportunities to participate in family activities due to their physical limitations.
Including obesity coverage will make financial sense in the bigger picture, despite any jumps in premiums at the start. There are two reasons for this. One, if the obese person gets treatment, they will be healthier, and take less time off from work. And when they are at work, they will be more likely to be more productive and alert. Second, if the obesity problem gets addressed, than there will be a reduced – or even eliminated – need to address diabetes, heart disease, arthritis, (you get the picture) very serious medical conditions that require expensive, ongoing, treatments and medications, for the rest of the employee’s life.

I really appreciate what you said, as obese people are ridiculed and there is so much prejudice about obesity. I can't tell you how many times I have heard the same thing said, "You've eaten your way to being obese," and they don't take into account that women suffer stresses men don't even think about, and their emotions are different as well. My husband is very weight conscious, and that comes primarily from his mother, who just tells me, "You and T would have a much closer and better physical relationship if you weren't so fat." Damm Cheek, I say, and have had my weight discussed at their family reunion as though I weren't even in the room. However, that was rewarded by salt in my MIL's Iced Tea instead of her 14 packets of Splenda!! Also, having seen the perils and treatment of obese people from the 20/20 undercover operation, where they put two well-known actresses in a fat suit, obese people are treated extemely badly, so when avenues have been tried and tested like the Jenny Craig, WW, Nutrisystem (if you can afford them to begin with), insurances should take an interest in helping these ones to become healthier, whether through surgery or through mental help from medical providers.

Funny, I thought there would be WAY more interest in this. No one else wants to fight the good fight at the employer level? So for the reaction has been excellent. If she can do it, she is going to get it in the plan for next year. I think she is basically going to include it in the packages as a given and not even show it as a separate cost to the big wigs!

Well I copied it to steal pieces of for my own letter. Does that count?

I am of two minds about fighting the exclusion. On the one hand, it pissed me off that my company of 7000+ who covers *everything under the sun* and prides itself on it's benefit doesn't cover this. On the other, I'm not going to wait for them to change their mind so I'd be fighting for the next person, not myself. It seems like a lot of work fighting bad attitudes and ignorance towards obesity when I could be concentrating on my own surgery and recovery.

This is exactly what I was looking for! THANK YOU SO MUCH!

 

So nice to hear how positive your HR person has been to this letter. Gives me hope. : )