Question:
Comparative Costs

Still in the thread of costs for WLS, does anyone have an analysis of comparative costs for comorbid proceedures such as hip replacement, knee replacement, myocardial infarction, diabetes, heel spurs, etc, etc, etc...? Would this be good to include in an appeal letter to an insuror who has denied coverage? Thanks to all who respond.    — jeff P. (posted on May 24, 2000)

May 24, 2000
If you are trying to convince your insurance company to pay for wls, I think you should focus on the actual costs that they have paid for YOUR obesity-related problems in the past, and those that they will most likely pay in the future. Rather that saying that obesity costs our economy and average of $XX, and obese people are more likely to need this surgery and that surgery, you should say YOUR blood pressure medications cost $X per month, and YOUR diabetes costs them $X per month. And your PCP told you that you will need a knee replacement within two years if you don't lose weight which will cost $X. Averages and generalizations won't hit as close to their bottom line as real dollar figures regarding your own health care.
   — Lynn K.

May 24, 2000
Thanks for your input, Lynn. I agree with what you are saying. I am, in fact, considering a consult with a surgeon for hip replacement. I really don't want to do that - much prefering WLS if I am going to have any surgery at all. I also do have heel spurs which a podiatrist recommended surgical treatment for. I did not inquire as to the cost of the proceedure, but am thinking my insuror may be out some money for some other hefty "band-aid" proceedures as opposed to going to the core of the problem. I hope this clarifies a little better where I was coming from. Thanks again.
   — jeff P.