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Monday, February 8, 2010

Insurance Prejudice

As I listened to my surgeon do an information session for those thinking about weight loss surgery I was stunned to learn the following. Insurance companies without hesitation will pay for heart bypass surgery even if it may only extend a patients life for a short amount of time. Yet they do all they can to prevent weight loss surgery which is proven to add between 7-13 years of additional life.

I ask my readers this: Why is that? I am curious to know what you think. I think this is because weight bias is the last acceptable prejudice in America. A bias exists that somehow the obese person could have completely prevented their obesity. Rarely is this true, if ever. I think obesity is the result of an eating disorder and heart disease in many cases is too. So, can someone help me understand the reasons to cover one procedure and not the other?


The Pondering Professor


  1. I too pondered this for many years. I am almost 9 years out and was barely covered because it was deemed medically necessary but now that doesn't assure you surgery. I'm healthier than I've ever been after going from 260 to 130 lbs and maintaining it but the insurance companies look at me like the devil. I kept saying "but we'll cost them less in the long run!". I finally got my answer. The normal time spent with the same insurance company is a little over 2 years so that's why they don't care. I've heard horrible stories about quotas where they say "everyone is denied today" but then another day they don't. It is a sad, sad situation and especially after getting a second chance at life I did not want to ever be a cynic but insurance companies have more power than anyone. They practice medicine, not the docs. I could go on for hours about the stuff my mentally ill brother has been denied as well as anything regarding WLS. You need a knee replacement because of obesity...done! (It costs about the same as WLS) Need the other knee replaced? Done deal too. It is a really bad situation. Thanks for bringing this up!

  2. Hello Justyvonne, thank you very much for your comment. First, congratulations on your success. I am inspired by it as I get ready to have my RNY on March 3rd. I am converting from a lap band. I had some success, but this wasn't the right surgery. My first surgeon talked me into lapband when what I really wanted was a gastric. What a learning experience.

    I had no idea the normal amount of time with an insurance company is 2 years. That tells me a lot as to why it would be in their interest to deny. I've been with the same company for 7 years and this is the second WLS surgery I've had. I feel very fortunate, but still the process was very difficult in the fact that I am really a number to them and the decision makers don't know a thing about me, the eating disorder I've recovered from and what is at stake for me.

    I think insurance companies need to have some of that power taken away from them. I noticed you look a lot from your pic like a woman that interviews people on the Weight Loss Surgery channel. Is that you?

    Also, I'd be honored if you would sign up to follow my blog. It would be fantastic to have someone with the years of experience adding to it. I've noticed readership is increasing. I'm trying to learn how to put a visitor counter on the blog but have no idea how to do it.

    Nice to meet you. Please stay in touch.