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#1
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WLS and HMOs
Somewhat recently someone brought up the point that WLS couldn't be so
bad an option since HMOs were beginning to cover it. I didn't have an answer then but I thought of one now... HMO's primary priority is controlling costs, and the patient's health really has nothing to do with it. It could indeed be cheaper to the HMO for the morbidly obese to undergo the surgery and suffer through the horrific but intentional degradation of the digestive tract, rather than for the HMO to pay for associated health costs of the morbidly obese. That 1-3% of WLS patients die on the table or in post-op is most likely a net-win for the HMOs, too. |
#2
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WLS and HMOs
Heywood Mogroot wrote:
Somewhat recently someone brought up the point that WLS couldn't be so bad an option since HMOs were beginning to cover it. Are HMOs starting to cover it? My understanding is that the complication rate (20% need follow-up surgery) combined with the weight regain (a fair number still regain the weight) combined with the mortality rate (I'm in New England where quite a few people have died) have all brought it into sharp focus: now the HMOs want it studied for efficacy. That 1-3% of WLS patients die on the table or in post-op is most likely a net-win for the HMOs, too. Good point. It might be a consideration. Dally |
#3
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WLS and HMOs
Heywood Mogroot wrote:
Somewhat recently someone brought up the point that WLS couldn't be so bad an option since HMOs were beginning to cover it. Are HMOs starting to cover it? My understanding is that the complication rate (20% need follow-up surgery) combined with the weight regain (a fair number still regain the weight) combined with the mortality rate (I'm in New England where quite a few people have died) have all brought it into sharp focus: now the HMOs want it studied for efficacy. That 1-3% of WLS patients die on the table or in post-op is most likely a net-win for the HMOs, too. Good point. It might be a consideration. Dally |
#4
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Heywood Mogroot wrote:
Somewhat recently someone brought up the point that WLS couldn't be so bad an option since HMOs were beginning to cover it. Are HMOs starting to cover it? My understanding is that the complication rate (20% need follow-up surgery) combined with the weight regain (a fair number still regain the weight) combined with the mortality rate (I'm in New England where quite a few people have died) have all brought it into sharp focus: now the HMOs want it studied for efficacy. That 1-3% of WLS patients die on the table or in post-op is most likely a net-win for the HMOs, too. Good point. It might be a consideration. Dally |
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