A Patient’s Guide to Advocating for Access to Weight-Loss Surgery in Collin County, TX (Click here for a PDF version of this guide.)

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The Importance of Advocacy

Advocacy is defined as the act of pleading or arguing in favor of something, such as a cause, idea or policy. Advocacy comes in many forms. This guide will specifically highlight how to effective work with elected and appointed officials as well as other members of government. For more information on other types of advocacy, request the Obesity Action Coalition’s (OAC) publication, “Your Voice Makes A Difference. A Guide On How You Can Help Fellow Patients Affected By Obesity.”

Elected and appointed United States officials at the local, state and federal level play a significant role in our society and healthcare. Often, the laws they create or administer directly influence our day-to-day lives or regulate the medical treatments we receive. However, the majority of elected and appointed officials know little about obesity, its effects and treatments. The OAC seeks to increase awareness among our elected officials by encouraging those affected by obesity to become advocates.

As an American, it is your right to build relationships with your elected officials and to advocate for positive change. It is through the voice of patients, family members and medical professionals that legislators and other officials learn how current, pending and future laws and regulations impact obese Americans.

The OAC encourages you to become an advocate for change.

Accessing Weight-Loss Surgery in Collin County, Texas

Collin County (Dallas/Ft. Worth area) Commissioner, Matt Shaheen, is seeking to ban coverage of bariatric surgery for county employees. Such a vote may happen as soon as January 27, 2009. Bariatric surgery is currently covered for Collin County employees, but Commissioner Shaheen is rallying, and getting other commissioners involved as well, to quit covering the procedure. Commissioners are citing the expense of the procedure, in addition to the medical complications that arise, as to reasons to end coverage of bariatric surgery, but are failing to discuss improved health and cost savings among their employees who have surgery.

Call to Action

The OAC is asking you to write to the Collin County commissioners and share with them how obesity has impacted you and how those affected need access to medical interventions, which include bariatric surgery. Even if you do not live in Collin County, we need you to respond to this important issue so that this does not become precedent for other Texas counties. There is truly power in numbers!

Anyone can be an advocate. Here are a few suggestions on what you can do.

• Share this information with family, friends and support groups and encourage them to get involved. The more individuals involved, the stronger our voice. Feel free to make copies of this guide, call the OAC National Office at (800) 717-3117 for additional copies or you may download an electronic version to send via e-mail by visiting the OAC Web site at www.obesityaction.org.

• Write, e-mail, visit or call your legislators and other key officials listed in this guide.

• Let your employer know about the need for bariatric surgery and obesity management coverage through your human resources department and/or union representation.

• Keep the OAC informed of your actions. Did you write or e-mail your legislator? Did you post a link to this guide on your Online support group? Let us know by mailing or e-mailing us a copy of your letter or message.

The OAC has targeted the following Collin County, TX officials.

Keith Self, County Judge-Collin County
Collin County Commissioners' Court
Collin County Government Center
210 S. McDonald St. Suite 626
McKinney, TX 75069
Phone: 972-424-1460 ext. 4631
Fax: 972-548-4699
Email: keith.self@collincountytx.gov

Matt Shaheen, Commissioner - Precinct 1
Collin County Commissioners' Court
Collin County Government Center
210 S. McDonald St. Suite 626
McKinney, TX 75069
Phone: 972-424-1460 ext. 4631
Fax: 972-548-4699
Email: mshaheen@collincountytx.gov

Jerry Hoagland, Commissioner - Precinct 2
Collin County Commissioners' Court
Collin County Government Center
210 S. McDonald St. Suite 626
McKinney, TX 75069
Phone: 972-424-1460 ext. 4626
Fax: 972-548-4699
Email: jhoagland@collincountytx.gov

Joe Jaynes, Commissioner - Precinct 3
Collin County Commissioners' Court
Collin County Government Center
210 S. McDonald St. Suite 626
McKinney, TX 75069
Phone: 972-424-1460 ext. 4631
Fax: 972-548-4699
Email: jjaynes@collincountytx.gov

Kathy Ward, Commissioner - Precinct 4
Collin County Commissioners' Court
Collin County Government Center
210 S. McDonald St. Suite 626
McKinney, TX 75069
Phone: 972-424-1460 ext. 4631
Fax: 972-548-4699
Email: kward@collincountytx.gov

Below, please find some suggested topics, facts about obesity and bariatric surgery, do’s, don’ts and a sample letter.

• If you are a post-bariatric surgery patient or have participated in an obesity management program, please share in your letter the difference your weight-loss has made in your life from both a quality of life and health standpoint. For instance, if you are no longer a diabetic, you now take a reduced number of medications and/or no longer suffer from sleep apnea. Your personal story is powerful.

• If you are a Collin County employee, please include this information.

• If you are seeking weight-loss surgery or obesity management, explain your personal preparation, what health complications you are currently experiencing, how they affect your quality of life and the burden that could be placed on you by the exclusion of weight-loss surgery and obesity management services as a benefit.

• If you are a family member or friend of a weight-loss surgery or obesity management patient, detail the difference weight-loss has made in your family member/friend’s life or how much they would benefit from receiving these services.

• Publicly question why Collin County officials want to deny access to weight-loss surgery and obesity management services.

• More than 5,380,000 residents of Texas are considered obese.

• Approximately one million are morbidly obese (more than 100 pounds overweight).

• Individuals who are obese have a 50-100 percent increased risk of premature death from all causes, compared to individuals with a healthy weight.

• More than $5.34 billion is spent annually on the medical expenses associated with obesity in Texas.

• Extends the lives of patients.

• Causes significant weight-loss.

• Decreases the incidence and costs of obesity-related diseases, such as diabetes (completely resolved in 76.8 percent of patients), hypertension (resolved in 61.7 percent of patients) and sleep apnea (resolved in 85.7 percent of patients).

• Improves the quality of life of the recipients.

• For more facts, see the OAC publication, “Fact Sheet: Why it makes sense to provide treatment for obesity through bariatric surgery.”

• Write legibly and be brief and to the point. Short letters (one-page) are the most effective.

• Mention the Collin County effort to end coverage of bariatric surgery.

• Give your reasons for opposing the exclusion of weight-loss surgery and other services.

• Be courteous and reasonable.

• Be sure to address the individual by the correct title.

• Include all of your contact information.

• Double check your information for accuracy.

• Use correct grammar and complete sentences.

• If typing your letter, remember to use a spell check feature.

• Include your personal story.

• Write a follow-up letter thanking the individual.

• Try not to be longwinded.

• Avoid a righteous tone.

• Avoid abbreviations.

• Refrain from apologizing for writing or taking valuable time.

• Do not threaten anyone.

• Try not to mention more than one issue per letter.

• Do not demand anything from the individual.

• Avoid form letters.

• Do not refer or allude to politics as sleazy or dishonorable.

Below, please find a sample letter and the OAC's letter to Matt Shaheen, Commissioner.

Sample Letter

Your Full Name Your Full Address Your City, State and Zip Your Phone Number with Area Code Current Date The Honorable (Insert Legislator or Public Official Name Here) Legislator or Official’s Address Legislator or Official’s City, State, Zip Dear Title (Commissioner, etc.), In your first paragraph, mention the following points: 1. You are writing to express your concern with the suggested removal of bariatric surgery from the Collin County's health insurance plan. 2. Discuss how this specific issue affects you and your family. In your second and third paragraphs, mention the following items: 1. Further elaborate how the issue affects or has affected you. 2. Share your personal connection with the issue in question. (Remember to remain brief. A short letter can accomplish just as much as a long one.) In your last paragraph, discuss the following closing items: 1. Urge them to vote against the removal of bariatric surgery from the county's health plan or at a minimum, delay such a vote until the issue can be fully evaluated. 2. Request that the individual write you back, informing you on their position regarding the issue. 3. Thank the individual. Sincerely, Your Full Name

OAC's Letter

Joseph Nadglowski, Jr. OAC President and CEO Obesity Action Coalition 4511 North Himes Avenue, Ste. 250 Tampa, FL 33614 January 20, 2009 Dear County Commissioner Matt Shaheen, I was disappointed to read in media reports that the Collin County Court was considering eliminating coverage of bariatric (sometimes referred to as obesity, lap band or gastric bypass) surgery from their employee insurance coverage. On behalf of the Obesity Action Coalition (OAC), I would urge you to vote against such action. Obesity is a complex issue involving behavioral, social, environmental and genetic issues. Our country's focus on blaming the individual affected and claiming that diet and exercise alone are the solution are a major part of the problem. Personal responsibility and behavioral changes are a part of the solution, but not the whole solution. Individuals develop conditions and disease for a multitude of reasons, yet with obesity, it is often seen solely as a personal failure. Add to that the stigma applied to obese people in the United States and it makes any solutions or efforts to address obesity a challenge. The County Court's coverage of bariatric surgery showed leadership and courage by recognizing the complexity of the issue and attempting to address obesity among its employees. Please do not take a step-back by eliminating such coverage. Specifically, I would challenge you to dig a little deeper into the costs and savings associated with bariatric surgery. Although the media report focused on the upfront surgical costs of the procedures, it did not go into detail about the massive cost-savings experienced after bariatric surgery is performed. Is the Court going to consider this information? If not, I would urge you to do so. In fact, across the country, most groups are expanding coverage to these procedures because of the dramatic impact on health and long-term cost-savings including Medicare, TRICARE (military health insurance), Texas Medicaid and many, many more. Bariatric surgery is about health. It is not a cosmetic procedure. Most people who have these procedures go off all of the many medications they take for various conditions including diabetes, hypertension, heart disease, sleep apnea and many more. In fact, the reduction in obesity related co-morbidities saves so much money in pharmaceutical costs and physician services that bariatric surgery has been shown to have a return on investment (recouping of all monies associated with surgery) within two years. I’ve attached a Fact Sheet the OAC created on why it makes sense to cover bariatric surgery procedures. I’d urge you to review it and vote against ending such coverage or at a minimum vote to delay such a decision until the full economic costs and savings can be evaluated. A rash decision to eliminate coverage will likely substantially increase Collin County’s health costs in the long-run. Please feel free to call me at (800) 717-3117 or e-mail me at jnadglowski@obesityaction.org to discuss this issue in more detail. Thank you. Sincerely, Joe Nadglowski About the OAC: The OAC is a national non-profit membership organization made up of individuals who are seeking ways to address the obesity epidemic in our country including thousands in Texas and many in your county. Our membership consists of those who have been personally affected by obesity, those who have successfully treated their obesity, healthcare professionals and members of the public. As an organization, we encourage government, employers and individuals to work together to combat the obesity epidemic.