Employer benefit

ktjajj
on 6/5/09 3:47 am - Buffalo, NY
I agree with what everyone said completely. One side of me is like good for the employees who work in that county. Less red tape dealing with insurance companies. Glamazon you and Valueme made points along the lines of what I was thinking about.

I guess my concern or question is...is the insurance company walking around writing checks to whatever surgeon the employee chooses? How are they regulating this? I work for an insurance company and I know for a fact that in order for in order for a doctor to participate then they have to meet certain standards. I also know that my insurance company required me to do certain things before approving me for surgery that I think was very helpful in helping me think about the serious decision they are about to undergo.

I think if you are footing the bill for a life changing surgery you basically assuming responsibility for the health and maintence of that individual. (which currently insurance companies do) Is a company ready to take on that responsibility? And if more employers start doing this how will that change the face of what doctor's require of you if they no longer have to keep up to the standards of an insurance company?
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"Real change comes from within"
MSW will not settle
on 6/6/09 3:33 am
I hope it will return things to the way it was when you and your doctor made the decisions, not the insurance company. 

I spent years in insurance when managed care was just taking hold and provider bonuses were based on denying testing, treatment, and proper medical care under the banner of cost containment.  Of course I can't say where I worked, but it was for a large multinational which owned several smaller HMO's and PPO's.  

I saw coincidentally, a TX based program where a woman's doc determined that given her other medical conditions, a band was the best option for her.  She was fine with it but the insurance specifically excluded the band.  With serious issues that may complicate an RNY, she and her doc had no other option. 

Insurance co standards are not the standard that we should be following. 

                   MSW   Roux-En-Y Gastric Bypass: Eat sensibly & enjoy moderation  

 Links:  Are you a compulsive eater?  for help OA meets on-line Keep Coming Back, One Day At a Time  Overeaters Anonymous 

               LV'N MY RNY.  WORKING FOR ME BECAUSE I WORK FOR IT. 

browngathers
on 6/5/09 9:10 pm - Brooklyn, NY
I agree with Purple and Glamazon. My best support for my oppinion is to say that although I do a wonderful job at work and I am very good at what I do, I know that after losing 100 plus pounds, I will be even better at it. No one knows how many things I shy away from, as  a worker,  because I am overweight and either too tired or too self concious. Bravo Texas!
(deactivated member)
on 6/6/09 12:43 am
I think its a great benefit!  We always complain about the high cost of health benefits and RNY is a proven cure for diabetes.  The weight loss will also limit the strain on the heart. I'm sure people interested in the surgery still have to fall within a pre defined category of BMI and co morbidity.  Diabetes and cardiac treatment are very costly in the long run for both pts and the company.

I am sure there are other benefits like discounted gym memberships, weigh****cher like programs at work, etc for those not heavy enough to qualify for a bypass.  Maybe I am biased becasue my company excludes weight related treatment, but also denied me additional life ins because I am too heavy.
MSW will not settle
on 6/6/09 3:15 am
It absolutely is ethical.  Each patient will still have to meet established best practice medical guidelines.  The caveat is those who meet those guidelines can no linger be refused treatment through administrative bs and policy exclusions. 

Like eveyone else, I've been told over and over about other options to get healthier.  The non obese world will never understand that we undertake surgical intervention because we've never been able to make these 'other options' work for ourselves.  Texas residents are no different which is why it is the fattest state in the country right now.  

I hope other states follow suite and blanket wls exclusions are eliminated nationwide forever.  The established one hunderd pounds over weight, BMI greater than forty or BMI under forty with co morbidities is a perfectly reasonable standard for serious health risks.  What other classification of health risks is routinely denied treatment besides the obese? 

Drug and alchahol abusers are covered.  We've removed the stigma from mental disorders to the point of popping pills just cause you had a bad day.  When do we remove the predjudice surrounding fat people and stop denying treatment. 

                   MSW   Roux-En-Y Gastric Bypass: Eat sensibly & enjoy moderation  

 Links:  Are you a compulsive eater?  for help OA meets on-line Keep Coming Back, One Day At a Time  Overeaters Anonymous 

               LV'N MY RNY.  WORKING FOR ME BECAUSE I WORK FOR IT. 

# 1 MACK_MAMA
on 6/6/09 8:05 am
It's only ethical to me if they keep the same qualifications intact.  Some folk are big and are NOT good candidates for WLS - being obese isn't the only issue.  Folk want the surgery but don't want to commit to the change in lifestyle and their behavioral modifications and end up worse off than if they were just fat.

Now - for those that DO meet standard - it is, indeed, a great thing!!! 

I don't just have issues, I have subscriptions!  I'm saving on the newsstand price.......

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