Question for Gary (or anyone else with an opinion).

As insurance companies fall over themselves to exclude WLS, and a few states have required it's coverage, what do you see as the future for WLS? Will it be pushed out of exsistence by lack of coverage? Will it become mandatory for insurance companies to address the issue of obesity and it's effect on weight? Just wondering what everyone thinks.

Linda, I actually have a paper I was asked to prepare and will post on my website or our blog this weekend. But basically, the trend is to try to exclude the surgery. Many States mandate coverage of medically necessary surgery. ERISA covered plans,self insured plans are for now protected because to be short, ERISA allows them to do what they want. However, they are slowly losing, and in fact in June the Supreme Court will rule as to whether ERISA really pre-empts state law. In the meantime, the insurance companies will try many things. Exclusions and restrictions and hope they work. Then fund studies to prove the surgery is too costly, dangerous or fails in a few years, increase malpractice premiums etc. That's why all the stories in the press are about failures and big mistakes. The AMA will have to step up and show pro-surgery stories. That's why it is important for everyone, especially post op to stay active and help others. If we gain the weight back,that's what they want. To show it doesn't work. In this case, Lawyers actually will help. The more we sue and win the more they lose. Hope this helps. Gary www.obesitylawyers.com http://obesitylawyers.blogspot.com/

I agree with Gary, to a point. Most insurance companies do not want to litigate, and the cases rarely make it to court. What scares me is that I'm seeing a trend beginning to exclude Reconstructive Plastic Surgery for post op WLS patients. I think the answer is going to be legislative rather than judicial. I think everyone of us needs to lobby our Congressional representatives to push for laws to prevent exclusion of WLS - even if the group is self insured. The media is focused on the obesity crisis right now. We need to keep telling our stories to them as well, in order to sway public opinion. When 52% of the population is obese, it's hard to believe that the majority still thinks its because we are gluttonous pigs. Just my two cents.