Government May Revamp Medicare Coverage of Obesity Surgery Costs

The Centers for Medicare and Medicaid Services have said that weight loss surgeries such as the gastric bypass may offer a permanent solution for morbidly obese people. The agency is lobbying to make it easier for disabled people to have weight loss surgery if it will improve their overall health.

Medicare currently covers the cost of weight loss surgery if a doctor recommends it as a treatment for other health problems besides obesity. This week the government proposed expanding Medicare coverage of weight loss surgery for disabled people, but at the same time eliminating coverage of weight loss surgeries for the elderly. Mark McClellan, the administrator of the Centers for Medicare and Medicaid Services, said, "While the best proven treatment is a nutritious diet and regular exercise, some beneficiaries may significantly reduce their health risks through surgery."

The proposed revision to Medicare regulations would allow patients to have weight loss surgery before any weight-related health problems begin to occur. But recent medical studies have shown that the surgery itself proposes greater risks for elderly patients. Such statistics are the reason the agency is suggesting that Medicare should not cover such operations for those patients. A study in the Journal of the American Medical Association revealed that the death rate after weight loss surgery for patients age 65 and older is two to three times higher than for younger people.

In 2004 there were about 8,000 weight loss surgeries covered for Medicare beneficiaries. About 75% of those surgeries were for disabled patients, with the remainder being elderly patients. Each procedure cost an average of $13,000. Because of the steadily advancing obesity problem in the United States, researchers and physicians are studying the benefits of weight loss surgery for elderly patients because it can improve weight-related health problems such as heart disease and Type II diabetes. Many physicians feel that even if an elderly Medicare patient faces greater risks from surgery, they should not be denied the choice to have it simply because of their age. The proposal to revamp Medicare regulations is still being considered, and public comments and suggestions are being welcomed in regard to how drastic the changes should be.