Senator: Insurance should cover weight-loss surgery

Frequence of surgeries

Weight-loss surgery

A letter from a 400-pound Wichita man convinced state Sen. Jim Barnett to conduct a hearing last month.

The man with sleep apnea, diabetes, congestive heart failure and arthritis wanted to undergo obesity surgery, but he couldn’t convince his health insurance company to cover it. Without it, he likely was headed for premature death.

So Barnett, a physician and Republican from Emporia, wants legislators to consider whether health insurance companies should be mandated to cover weight-loss surgery.

“I think this is one option that works,” Barnett said. “There is no other proven or effective therapy for obesity. This is proven, and this is effective. I think we should cover it.”

But insurance companies would disagree.

For starters, Blue Cross Blue Shield of Kansas spokesman Graham Bailey said it was an expensive procedure that still had a lot of complications.

And, Bailey said, the company has had almost no requests from its group insurers to have the surgery added as a benefit.

“Health care is expensive, and that makes health insurance expensive. We have to figure out a way to make it less expensive or more affordable. And adding things like that procedure to it just isn’t going to do that,” Bailey said.

According to Bailey, 100,000 people would qualify for the surgery in Kansas, which would add an additional $3 billion to health care costs.

Two years ago, the Kansas Health Policy Authority looked at the issue.

Deputy Director Andrew Allison said at that time, the literature pointed to varied outcomes with the best results coming from designated centers of excellence, which Kansas didn’t have at that time. Also, programs lacked the education needed to change a patient’s behavior after the surgery.

The recommendation was to not cover the surgery, but to promote weight-loss programs and healthy lifestyles.

Recent changes in medicine could alter the authority’s stance. The introduction of laparoscopic surgery, which allows physicians to perform the procedure through small incisions, has reduced the number of complications. Three weight-loss surgery programs in Kansas have been named as centers of excellence.

“It appears the surgery itself has progressed and is emerging as a more accepted procedure for severe obesity than it was two years ago,” Allison said.

Another option: gastric bypass

Tim Kolb has big plans: hiking the Grand Canyon, riding every roller coaster at Worlds of Fun, canoeing with his son and losing more than 200 pounds.

Two days after Christmas, the 38-year-old Chanute resident underwent the most common type of weight-loss surgery, the Roux-en-Y gastric bypass, in Topeka. Essentially, Kolb’s surgeon, Dr. Carlyle Dunshee, created a small stomach pouch, about the size of a golf ball, that connects to a y-shaped section of the small intestine. The procedure allows food to bypass the lower stomach and restricts how much Kolb can eat.

Weighing 470 pounds before the surgery, Kolb has already lost 55 pounds. After almost a month on a liquid diet, he is now making his way from pureed foods to solids.

“When I was doing my fast during Christmas, I would hear, ‘How are you going to celebrate?’ and ‘Aren’t you going to miss that?’ ” Kolb said. “I am like, ‘Man, I have gorged and porked out for the last 37 years of my life, and I am willing to sacrifice that so I can be around for next Christmas.’ You know, it is a totally different relationship with food.”

Since the surgery, Kolb has reduced his medications from five to four and his Type 2 diabetes has disappeared.

Kolb’s son wants him to lose weight so they can ride bicycles together.

“When you think you have been a good father, but you haven’t done those little things, it kind of breaks your heart,” Kolb said. “So I am looking forward to that stuff.”