Obesity rates put pressure on provinces to fund surgery

After having four children and putting on a lot of middle-age weight, Tracey Wurch tried to work off the excess pounds but couldn’t seem to get far.

The 46-year-old from Beausejour, Man., decided surgery was necessary and hoped medicare would cover the cost of a relatively new stomach-reducing procedure called laparoscopic gastric banding - commonly called lap banding.

But she was told that, like most provinces, Manitoba does not pay for the procedure, so last month she went to a clinic in Tijuana, Mexico, and paid $5,500 to have a different operation.

“I have high-blood pressure and (am) a borderline diabetic with borderline cholesterol. I just felt I needed to do something,” Wurch said Thursday. “You’re between a rock and a hard place.”

Wurch and others believe provinces should follow the lead of Alberta, which covers the cost of lap-banding for people who are severely obese. Manitoba’s NDP government is hinting that it may move in that direction, just not right now.

“It is something that we are doing more work on,” Health Minister Theresa Oswald said. “We have certainly not said no to it, and as we continue to do our review and get expert medical opinion on it, that will inform our decision as we choose what kind of additional services we choose to fund in Manitoba.”

Premier Greg Selinger opened the door earlier this week, when he told a caller on an open-line radio show that lap bands deserve to be considered. Selinger was questioned by a caller named Glen, who said he was filing a complaint with the province’s human rights commission because he could not get funding for the procedure.

There is a private clinic in Winnipeg that offers lap bands at a cost of $18,000- a fee Wurch said she simply could not afford.

She wanted the same procedure in Mexico, but was told by doctors in Winnipeg that they would not perform maintenance on any surgery done outside Canada. The bands, which are wrapped around the stomach in order to shrink it, have to be adjusted periodically so that they continue to allow the proper amount of food through.

Wurch ended up getting a sleeve gastrectomy, a more radical procedure also not covered by Manitoba’s medicare system, which permanently shrinks the stomach to roughly one-seventh of its original size.

There are other, older methods to control weight such as gastric bypass surgeries and stomach stapling that are covered by provincial health-care plans, but many patients don’t like them because they are more invasive and remove parts of the stomach or intestine.

“We have heard the opinion that the lap-band procedure is a less invasive kind of intervention compared to gastric bypass surgery,” Oswald said.

With obesity rates rising, governments have to decide between paying for operations such as lap banding now, or facing higher obesity-related costs later, Wurch suggests.

“Knee replacements, hip replacements, diabetic medication, everything,” she said. “If people can have this surgery, it’s a one-time cost for government. And later on, if you don’t have as many health issues ... I think it’s going to save millions or billions of dollars for the health-care system.”

The Canadian Press

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