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Thursday, December 18, 2008

Uncle Sam grows a backbone on gastric bypass

Hot News frum Big-Mouth Broad Casting; Dec. 18th, 2008

Dr. Aln Inglis, MD;

It doesn't happen often, but it's nice when our government stands up against powerful special interests in the medical community.

You know, like they're supposed to…

I'll admit, I was a bit surprised to see Medicare stand its ground recently and refuse to liberalize its standards for covering the latest medical flavor of the month, gastric bypass surgery. If you've been reading House Calls for a while, you know my feeling on this surgery. It's dangerous, it has killed people (when was the last time you heard mainstream media report that?) and similar results could be achieved through simple lifestyle changes.

But I wasn't sure these facts we're going to get in the way of a good story. Surgeons were pressuring Medicare to start covering weight-loss surgery for millions of diabetics — some 44 million disabled and elderly people. These special interests claimed gastric bypass was the future of diabetes treatment.

Really, this was a pure cash grab. Surgeons would love to see the government start paying for gastric bypass for folks who otherwise could not afford it. It would be great for business.

The Medicare officials said they were not convinced of the benefits other than for morbidly obese diabetics (those with a body mass index of 35 or higher), and the agency is loath to shell out up to $35,000 a surgery for questionable gains.

It's good to see a government agency such as Medicare paying attention to the science and resisting the herd mentality that is pushing this radical surgery on more and more candidates.

But the fight isn't over yet. Medicare's decision is just preliminary at this point, and the agency will wait to issue a final ruling until after a public comments period. You can bet the pro-surgery lobby groups will launch a letter-writing campaign that will be the biggest thing since Santa Claus got a mailbox.

Here's hoping Medicare weathers that process with its backbone intact.



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