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Poor obese people fail to get surgery

Date

Julia Medew

OBESE people on low incomes are getting far less access to weight-loss surgery than people on high incomes with private health insurance, new research shows.

The finding has prompted doctors to call for more government-funded surgery as people in lower socio-economic groups are more likely to be severely obese, increasing their risk of diabetes, heart disease and premature death.

A study published in The Medical Journal of Australia on Monday found that the more money you earned, the more likely you were to access bariatric surgery including adjustable gastric banding, stomach stapling and gastric bypass.

The trend was so stark that people on a household income of more than $70,000 were five times more likely to get the procedures than people earning less than $20,000.

Researchers used data from the Sax Institute's 45 and Up Study to analyse who was accessing bariatric surgery and where. They found that while 312 out of 49,000 people in the study had had one of the procedures, only one person had the surgery done in a public hospital and three were treated under Department of Veterans' Affairs entitlements. The remaining 308 were operated on in private hospitals.

Dr Rosemary Korda, an author of the report from Australian National University, said the trend largely reflected systemic issues in Australia's health system, which led to inequities.

For example, she said while bariatric surgery had been listed on the Medicare Benefits Schedule for 20 years in recognition of its cost-effectiveness, many public hospitals that were mostly funded by the states did not offer the procedures.

This meant people were being sent into the private system where it costs more than $12,000 without private health insurance. While Medicare provides about $800 to fund the procedure in private hospitals, those with private health insurance will generally face more than $4000 in out-of-pocket costs.

''Our findings suggest that bariatric surgery, an MBS-listed procedure, is currently largely available only to those who can afford private health insurance and the associated out-of-pocket costs, with poor access to these cost-effective procedures in the section of the population that needs it most,'' she wrote in the journal.

Dr Korda urged governments to consider ways of funding more surgery because research showed it caused substantial weight loss, leading to improvements in cholesterol, sleep apnoea and joint problems associated with obesity.

It could also treat type 2 diabetes, with one trial showing remission rates of 75 to 95 per cent within two years of surgery. About 1.5 million Australians are estimated to have type 2 diabetes, costing the nation about $12 billion each year.

The president of the Australian Medical Association Victoria, Dr Stephen Parnis, said although doctors last year called for the state government to fund more bariatric surgery for people with severe obesity, this had not happened to date.

91 comments

  • My wife was one of the people a few years ago that had lap band surgery thanks to the Chronic Diseases part of the system allowing for it(she's diabetic) Since then she has lost 50kg and is no longer reliant on insulin or medication which is great ...........

    BUT .... Now the government has taken the funding away for any of the MUST HAVE surgery to remove the excess skin on her arms, legs and stomach.. We don't have the $8,000 to have her arms done let alone how many more thousands it would cost for her legs and tummy to be done....

    I see this as a Government that has FAILED in its "Duty of Care" to a patient to complete a procedure they started .,.. I see it a bit like you pay for someone to have their appendix taken out but lets not bother to sew them back up afterwards .............

    WHERE IS THE HELP FOR THIS NOW ????? ....... IT DOES NOT EXIST !!!!!!!!!!!

    Commenter
    BigG66
    Date and time
    December 10, 2012, 8:38AM
    • Big 66, surely no longer having to buy medication ect has meant that you can now pay for your own surgery, The taxpayer helped to save your wife's life, when does it become your responsibility to look after yourself?

      Commenter
      stop eating and see where that gets you
      Date and time
      December 10, 2012, 9:25AM
    • That's sad to hear, but is that endangering her life?

      So all the poor people out there with cancer who don't get government funding to feel good about themselves after treatment changes their bodies, whether through hair-loss or surgery to remove parts of their bodies and the other many things that can happen to them.

      Be glad shes got better health, not so many of us have that to be thankful for!

      Commenter
      Dee
      Location
      Melb
      Date and time
      December 10, 2012, 9:42AM
    • That is a fantastic outcome for your wife. Surely if you put aside the money saved on diabetes medication and treatment over the "few years" these savings would go a long way towards the cost of subsequent surgery? You have been lucky to reap long term benefits from the initial banding, financially as well as healthwise.

      Commenter
      Bemused
      Date and time
      December 10, 2012, 9:49AM
    • One is potentially life saving. The other is cosmetic.
      Likening this to having your appendix taken out, and not sewn back up, is a just wrong as a comparison.
      As a tax-payer, I would be more than happy for my dollars to be directed towards this type of surgery to save people's lives, but what I don't want, is my money going towards cutting back excess skin, after my money has saved your life.
      The cosmetic side of it is your responsibility, and it's your responsibility to save the money required to have the procedure done.

      Commenter
      DanB
      Location
      Melbourne
      Date and time
      December 10, 2012, 10:09AM
    • Excuse me - the government has failed in its duty of care to you?? Mate, YOU'VE failed in your duty of care to YOURSELF.

      How about a bit of personal responsibility, people? It's not the government's job to stop you from making yourselves fat - and for paying for the associated cosmetic procedures so you can feel better about yourselves.

      Why should I help pay for YOU and YOUR weight problem??

      Commenter
      greenpea
      Location
      syd
      Date and time
      December 10, 2012, 10:44AM
    • Wheres the rebate for my running shoes? For my basketball shoes? My cross country bike? My golf clubs? For fun runs and endurance events? For my weights? Swimming laps at the pool? Oh, that's right, I take responsibility for my life and physical condition rather than complaining that the taxpayer doesn't write me a big enough cheque after saving my life.

      Commenter
      Mick
      Location
      Melb
      Date and time
      December 10, 2012, 10:53AM
    • Note to the judgemental people commenting here: can you even begin to imagine the lack of self-esteem this poor lady must be suffering right now? Your comments are extremely unhelpful, to say the least. Your lack of empathy, whilst unfortunately not surprising, is sickening.

      Commenter
      Lynne
      Location
      Melbourne
      Date and time
      December 10, 2012, 11:04AM
    • @BigG66: Sorry, but I don't agree with you. I appreciate that having the cosmetic surgery done is very important for you wife's self esteem etc, but there are lots of procedures out that that people would love to have done which would make life a lot easier for them, but not really change their (physical) health outcomes.

      Do you really think that with a limited health budget that money should be spent on cosmetic surgery rather than more of the same life saving surgery that others need?

      Perhaps you just wrote in haste, but comparing a surgeon not sewing up an appendix patient is the same as comparing them not sewing up after any surgery.

      Commenter
      bornagirl
      Location
      Melbourne
      Date and time
      December 10, 2012, 11:13AM
    • Some of you miss a point ... The funding was there when the initial surgery was done - the State gov then decided to cut it about 6 months after doing the the surgery. The excess skin is now causing other health related issues and sores.

      To say the money saved on meds could pay for it ?? its would take 40 years of that to cover that type and amount of surgery.

      and yes I know there are people in far worse situations - I have a mother that's bedridden and in 11 out of 10 pain 24/7 as I type this waiting for double hip replacements - 2 people I love dearly and not much I can do to help either.

      Commenter
      BigG66
      Date and time
      December 10, 2012, 11:19AM

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