The government, like any employer, provides health insurance ultimately to get more out of its employees. One-third of Americans are obese, and therefore suffer from diabetes, hypertension, sleep apnea, arthritis and reflux, and lose between five to 20 years of lifespan. While fewer than 5 percent of patients will ever return to normal weight through diet and exercise, surgery provides for durable, significant weight loss, and cures or greatly improves all of these conditions.
The number of insurance plans that cover weight-loss surgery is increasing as insurers, driven by profit motive, realize that when they pay for surgery, they make their money back in decreased medication costs, doctor visits and hospital stays, usually within two years and certainly by four. In fact, one insurance-industry-driven study found that weight-loss surgery would still be cost-effective at $50,000, which is more than twice the average cost. The issue of cost-effectiveness has been extensively studied in the United States, Canada, Australia, Sweden, Germany and the United Kingdom. The evidence that surgery for weight loss reduces health costs long-term is no longer debatable. In fact, one U.K. study showed that government workers made significantly fewer health-care-related claims while productivity improved from 30 hours per week to 35 after weight-loss surgery.
The state of Louisiana has been through all of this. Louisiana now allows bariatric surgery for all of its obese state employees after their pilot program demonstrated an annual savings of $2,000 per employee-year.
Any employer, including the government, will save money and improve productivity in the long run by enabling obese employees to have life-saving weight-loss surgery. This is a not a liberal or a conservative issue; it is a commonsense investment in people.
Arthur B. Chasen, M.D.