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Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore

Cheryl Clark, for HealthLeaders Media, February 21, 2013

Next came a report from JAMA Surgery that was a big upset, and bound to be a controversial one.  Johns Hopkins University researchers paired two groups of obese patients insured by any of seven BlueCross BlueShield plans. One group underwent bariatric surgery while the other did not.

Despite the widespread belief that such surgery can dramatically reduce healthcare costs, Jonathan Weiner and health economist colleagues discovered that that after six years of follow-up, total claims for healthcare expenses were no different in the two groups.  Bariatric surgery did not lower healthcare costs for the treated group.

Weiner and his team found that while patients who underwent surgery had lower pharmacy costs and lower costs for physician office visits in the six years after their surgeries, they were back in the hospital far more often than the non-surgical group, cancelling out the savings on drugs and doctor visits.

Why this should be so remains unclear, and a source of bitter dispute, with some bariatric surgeons accusing the authors of being biased, using data from 11 years ago when bariatric techniques were riskier, and not recognizing how much the procedure improved patients' lives.

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1 comments on "Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore"


WS (2/27/2013 at 12:31 PM)
Over-treatment and unnecessary treatment are making us sicker and poorer. The medical surgical industrial complex is too driven by the "almighty dollar." We need to return to conservative treatments and stop messing with "mother nature." This will likely require a complete overhaul of the "fee for service" payment structure. Take women's health, for example. The two most overused surgeries are c-section and hysterectomy. As part of the Choosing Wisely Campaign to reduce unnecessary tests and procedures, ACOG included c-section on their list. Why is hysterectomy not on this list? This is especially suspect since a study concluded that 76% of hysterectomies don't meet ACOG's criteria for the surgery. And healthy ovaries are removed in about 73% of hysterectomies so oophorectomy is another surgery that's WAY overused. Women's organs are being removed at alarming rates - 600,000+ hysterectomies every year with 1 in 2 women having one by age 72. Just as a man's SEX organs are needed for optimal health his entire life, so are a woman's.