Coverage of weight-loss surgery shelved for more study

Genevieve Winegar, 23, says "without a doubt" gastric-bypass surgery saved her life. After she underwent the procedure in 2002, the 5-foot-9-inch Winegar lost 200 of her 348 pounds.

"I was an obese child, an obese teen," said Winegar, who had suffered diseases such as acid reflux and was so depressed she thought of suicide. Now, she says she's happy and healthy.

The idea of covering the costly surgery was discussed Wednesday by members of the House's Workforce Services Committee, who opted for further study of the issue this year.

Committee members raised questions about the cost to the state, whether the requirement would raise insurance costs in general, and the risks involved with such surgeries.

Rep. Steve Mascaro, R-West Jordan, sponsor of HB225, said that the procedure is a preventative measure.

"Why do we provide immunization shots to children?" Mascaro said. "Because we know it's way less expensive to give them a shot than deal with all those diseases. ... The question is, when does it become most cost effective for use as a part of public policy?"

Mascaro said the bill's fiscal note of roughly $9 million in the first year and $5.4 million in the second also was a factor in his request for interim study.

"What we don't know is what are the costs over the third year, the fifth year, the 10th year," Mascaro said.

The procedure is expensive. Estimates found on the Internet place the surgery's cost at about $25,000. The bill, as written, would only apply to about 33 percent of the Utah marketplace, mostly small businesses, said Kelly Atkinson, executive director of the Utah Health Insurance Association. The only major carrier that covers the procedure on a "very limited basis" in the state is Altius, he said.

Dr. Steven Simper, a surgeon with the Rocky Mountain Associated Physicians, described morbid obesity as a "very, very serious" condition that can lead to several medical conditions such as type II diabetes, high blood pressure, sleep apnea and degenerative joint disease.

For those with morbid obesity, diet and exercise often offer "almost no benefit," Simper said. "Surgery is the only reliable long-term treatment."

Simper said the risks of complications are less than that from hysterectomies, the nation's most common surgery.

However, Atkinson pointed to the risk, saying, "we know that 2 percent of the time patients die." Some patients suffer complications or don't manage to maintain all their weight loss.

"We're not even sure what the best procedure is right now," he said. "There are over 13 different procedures you can have to lose weight in this category. ... If they are wrong that is a significant expense to pay."

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E-MAIL: dbulkeley@desnews.com

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