OAC Community Perspectives: By Walter Medlin, MD, FACS. Find me on Twitter: @BonusLife
Hello all. My name is Walt Medlin, and I’m a bariatric surgeon actively practicing in Utah. I also self-paid for my own Sleeve Gastrectomy in 2008, and I’m now more than 10 years post-op.
Every day that I work in my bariatric clinic, my team struggles to help at least a third of the patients we see. This is either because of insurance restrictions or because surgery is too expensive for many patients’ budgets. I was personally lucky to be able to self-pay for my surgery almost 11 years ago, but it was pretty scary because I knew I was risking not being able to afford the extra cost if I had a complication with my surgery — even a minor one.
Access to care for the disease of obesity is one of the most important (and overlooked) health issues in our nation today! I have so many thoughts on this that I actually struggle to organize them.
Looking at the Whole Picture
Other patients (looking beyond those seeking obesity treatment) with almost any other problem in surgery have pretty decent access to care. Issues like hernias, gallbladder problems, breast or colon cancer may require insurance approval delays for treatment, but patients still know that surgery WILL happen. And even if there are approval issues for medications, there is always at least something “on formulary” in every group of medication — except for those which treat obesity.
Healthcare and Our Country
Medicare in the U.S. sets the example for “Evidence-based Medicine” — or using science and research to guide care recommended care, usually covered by insurance. Typically, this covers surgery very well! But in terms of medications, an old rule from the 1960’s actually prevents many insurance companies from covering medications such as those which treat obesity (think about Elvis and “diet pills”).
Now with modern medications created through evidence-based research, it’s super important for us to fix this rule. That’s why legislation such as the Treat and Reduce Obesity Act (TROA) is critical for us to pass through Congress. It will give patients much greater access to obesity treatment options and allow payment for healthcare professionals — such as dietitians, specialists and others.
Legislation such as TROA may not be as visible as others, but I promise there is need in every state, city council and school board for more support! See who your local representatives are and contact them about TROA. You might be surprised at where it leads! You can even use the OAC Action Center to identify your state reps and talk to them about co-sponsoring TROA in the 2019 Congress.
Hope for Access to Obesity Care
When it comes to creating better access to obesity care, I’ve learned that persistence works. Never give up! The more you can simply get started, educate yourself about access to care and support its improvement, the better. If a patient can’t even get get themselves to a necessary appointment they need for their health, how can they ever go forward and manage their weight successfully?
A greater future is not as far off as we may think. It will not just arrive perfectly formed or easily, but even minor changes to laws and attitudes can make a world of difference.
If you remember anything from this post, hear me out on this one: we need to treat obesity like any other disease! IF every patient affected by obesity would come to healthcare providers with the same access to care as if they had hernia or gallbladder problems, we would see so much change in obesity statistics. Warning: they will still have deductibles and co-pays!
Remember that all of healthcare is evolving, but the world listens to those who show up and fight. Local and state actions are going to make a difference and your voice counts.