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Thread: Expanded coverage for obesity

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    Friend of Gossip Rocks! buttmunch's Avatar
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    Default Expanded coverage for obesity

    WASHINGTON Nov 23, 2005 The government proposed on Wednesday expanding Medicare coverage of weight-loss surgery for the disabled, but eliminating coverage of such surgery for the elderly.

    The Centers for Medicare and Medicaid Services said gastric bypass and other weight-loss surgeries may help people with extreme obesity. That is why the agency is proposing to make it easier for the disabled to get the surgery.

    Currently, Medicare covers the cost if the surgery is recommended to treat other health problems. The proposed expansion would allow for the treatment of obesity before associated health problems set in.

    "While the best proven treatment is a nutritious diet and regular exercise some beneficiaries may significantly reduce their health risks through surgery," said Mark McClellan, the agency's administrator.

    But recent medical studies also have shown that weight-loss surgery poses greater risks for the elderly, the agency said in explaining its proposal that Medicare not cover such operations for those beneficiaries.

    About 8,000 Medicare beneficiaries had weight-loss surgery covered through the program in 2004. About three-quarters of those procedures were for the disabled and one-quarter were for the elderly. Overall, the government paid about $13,000 per procedure, agency officials said.

    Last month, a study in the Journal of the American Medical Association showed that the death rates after weight-loss surgery for patients age 65 and older were two to three times higher than they were for younger people.

    The study tracked 16,155 Medicare patients who had obesity surgery. About 13 percent of men and 6 percent of women 65 to 74 died within a year of the surgery. In patients 75 and older, half of the men and 40 percent of the women died within the year.

    The proposal is not final and the agency is seeking public comment on how much to expand coverage for the disabled and how much to curtail it for the elderly.

    With obesity becoming more of a problem in the country, doctors and others are looking closely at weight-loss surgery for the elderly because it can improve health conditions such as diabetes and heart trouble.
    OK, I know lots of people have trouble with thier weight but wouldn't it be better to give these people a gym membership, a nutritionist and some good sound advice? And cheaper, too? And safer than major surgery?
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    Gold Member deckchick's Avatar
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    Default Re: Expanded coverage for obesity

    Expanded coverage for obesity



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    Default Re: Expanded coverage for obesity

    Glad I could be of service!
    'Those who sacrifice liberty for security deserve neither.' Ben Franklin

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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by buttmunch View Post
    OK, I know lots of people have trouble with thier weight but wouldn't it be better to give these people a gym membership, a nutritionist and some good sound advice? And cheaper, too? And safer than major surgery?
    The government proposed on Wednesday expanding Medicare coverage of weight-loss surgery for the disabled
    When you're disabled a gym membership might not be better. How much weight can you really lose at a gym when you only have function of a limb or two?

    My question is, what happens after the surgery? If you couldn't exercise before how do you keep the weight from returning? Surgery can help get you thin fast but only you can keep it that way.

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    Default Re: Expanded coverage for obesity

    And here in the UK, an NHS trust is banning hip and knee replacements for patients with a BMI over 30. Assholes.

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    Elite Member Sojiita's Avatar
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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by disruptivehair View Post
    And here in the UK, an NHS trust is banning hip and knee replacements for patients with a BMI over 30. Assholes.
    That is CRAZY! Is that then a deal-breaker?..just having a BMI over 30? That BMI is so simplisitic and way too generalized to use as a litmus test.

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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by Sojiita View Post
    That is CRAZY! Is that then a deal-breaker?..just having a BMI over 30? That BMI is so simplisitic and way too generalized to use as a litmus test.

    That's what a lot of people here have been saying.

    Here's an article about it:

    http://news.bbc.co.uk/1/hi/england/suffolk/4462310.stm

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    Default Re: Expanded coverage for obesity

    But what's teh point of replacing a knee or hip joint when the new one will just go the way of the old one? Get them to lose the weight and then do the replacement. And as far as disabled, you have to ask what qualifies as disabled. That could include people with diabetes that is brought on by obesity and poor health habits. I think preventive care is best. Major surgery, which is what this is, should not be the first line of defense.
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    Lil
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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by disruptivehair View Post
    And here in the UK, an NHS trust is banning hip and knee replacements for patients with a BMI over 30. Assholes.
    Is it the principle or the 30 BMI cut off you don't like, DH? It seems to me that the principle of letting overweight people who've knackered their knees get new ones is no different from letting alcoholics who have buggered up their liver have a new one.
    A big boy did it and ran away.

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    Default Re: Expanded coverage for obesity

    Good point, Lil. George Best burned through one, got another and burned through that one in a few years and now he's dead. What a waste of a life and of money and definitely of a liver.
    'Those who sacrifice liberty for security deserve neither.' Ben Franklin

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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by Lil View Post
    Is it the principle or the 30 BMI cut off you don't like, DH? It seems to me that the principle of letting overweight people who've knackered their knees get new ones is no different from letting alcoholics who have buggered up their liver have a new one.

    Oh please. I don't know many people here who have had hip and knee replacements since I'm 30 and I don't hang out with pensioners, but of the few I know who have had them...and they were youngish, in their 50s and 60s...none were fat. None. It's so refreshing that you assume that obese people will automatically require hip and knee replacements or that those replacements are guaranteed to fail. As if that never happens with thin people. *eyeroll*

    If there is no clinical reason to deny the operations to everyone with a BMI over 30, then one has to assume that the reason they're doing it is to pare down the waiting lists since a large percentage of British adults have a BMI over 30. One also has to assume that the NHS trusts in question are trying to save money, since Suffolk is chronically underfunded but is popular with pensioners, who create a much larger burden on the NHS than any other demographic. Or has it suddenly become OK to deny fat people care in a country that wrings its hands and blames ITSELF for the 7/7 bombings?

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    Lil
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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by disruptivehair View Post
    Oh please. I don't know many people here who have had hip and knee replacements since I'm 30 and I don't hang out with pensioners, but of the few I know who have had them...and they were youngish, in their 50s and 60s...none were fat. None. It's so refreshing that you assume that obese people will automatically require hip and knee replacements or that those replacements are guaranteed to fail. As if that never happens with thin people. *eyeroll*

    If there is no clinical reason to deny the operations to everyone with a BMI over 30, then one has to assume that the reason they're doing it is to pare down the waiting lists since a large percentage of British adults have a BMI over 30. One also has to assume that the NHS trusts in question are trying to save money, since Suffolk is chronically underfunded but is popular with pensioners, who create a much larger burden on the NHS than any other demographic. Or has it suddenly become OK to deny fat people care in a country that wrings its hands and blames ITSELF for the 7/7 bombings?
    I was interested in the apparent conflict, DH - you said the NHS shouldn't have given George Best a liver transplant because he was an alcoholic but you are saying it should give new knees to obese people. A food addiction is acceptable but an alcohol addiction isn't?

    Not sure what the London bombings have got to do with the price of fish, though.
    A big boy did it and ran away.

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    Default Re: Expanded coverage for obesity

    Quote Originally Posted by Lil View Post
    I was interested in the apparent conflict, DH - you said the NHS shouldn't have given George Best a liver transplant because he was an alcoholic but you are saying it should give new knees to obese people. A food addiction is acceptable but an alcohol addiction isn't?

    Not sure what the London bombings have got to do with the price of fish, though.

    Actually, I don't mind if people who have wrecked their livers through drink are given a second chance with a new liver. Alcohol is an addiction. I get it. However, George Best started drinking almost immediately after receiving his new liver. This indicates to me that he lied to doctors to get his new liver, which is inexcusable...or that doctors gave him a new liver despite the fact that his addictive behavior indicated that he was extremely likely to drink again and wreck the new liver, which is equally inexcusable. He killed himself, and I don't have any sympathy for him. That does not mean that I think he should not have received medical care. You're confusing me with someone else.

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    Default Re: Expanded coverage for obesity

    I think this is stupid. Limiting someone's access to equal and fair health care is degrading to society.

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    Elite Member Sojiita's Avatar
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    Default Re: Expanded coverage for obesity

    That BMI is so crazy..I guess if someone is a weightlifter or athlete and injures themself seriously somehow then they can forget about it if their BMI is 31..even if they have 8% body fat..I HATE that BMI and that it could be used to deny someone healthcare when it is such a stupid measurement to apply? You can be in great health otherwise but damn, if that BMI is up there then forget it, no matter what a team of doctors or reams of test info says.

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