As trends go, the UK’s soaring obesity levels have not been hard to miss. It does not take a doctor to point out that the public waistline is a growing problem. Hospitals are starting to go in for gastric band surgery more and more. Specialist treatment for obesity is one of the clinical services that are helping to bridge the gap between public and private sector. Spire Healthcare, the company that emerged out of the sale of Bupa Hospitals, carried out over 1,000 bariatric operations last years. Increasingly the NHS is offering the service. That number is likely to expand.
Bariatric surgery continues to struggle for legitimacy in the medical industry. Weight-loss procedures are still tainted by accusations of faddishness and tabloid stories of gory malpractice. But there is no shortage of demand for bariatric procedures.
Very few private medical insurance companies will offer weight-loss surgery as a benefit, so apart from the PCTs that offer it on the NHS, the only other option for patients is to pay for it themselves.
It is still quite a complex procedure and it does require a number of visits to hospital – it is not one of those procedures when you come along, have the operation and continue with the rest of your life.
More than half the adults in the UK are heavier than recommended. One in four men and one in three women in the UK are overweight. The number of obese people in the UK is rising, particularly among young adults. Since 1980, the number of obese adults in the UK has nearly tripled.
While slightly more women than men are obese (24 per cent versus 23 per cent), in the last ten years there has been a greater increase in the number of men who are obese. The Department of Health predicts that if this trend continues, by 2010 around 6.6 million men will be obese compared to 6 million women.
Your doctor will usually only consider medicines for weight-loss if changes to diet and exercise are not effective. You can be considered for weight-loss surgery if you are morbidly obese, or if you have a BMI between 35 and 40 and have a risk factor for an obesity-related disease.
This type of surgery is known as bariatric surgery. The three variants are gastric banding, gastric bypass and gastric balloon insertion.
Very few insurers deliberately include cover under PMI policies. Some include it by default; either because they feel numbers are very low, or more commonly that they have never thought about it. Some argue that it is excluded by terms intended to exclude cosmetic and other non-vital surgery. Some argue that it is excluded, as it is not specifically mentioned; this defence can only be used if they list out the treatments covered.
What complicates it is that some private hospitals and clinics will offer surgery even though it is not clinically imperative, as a longer (and more profitable!) solution than medication.
Very few, if any, health cash policies include weight-loss treatment, although one could argue that if a person is obese, reducing weight is a vastly more important ‘everyday health expense’ than care of the feet and back.
It is too easy to dismiss obesity treatment in a jokey way. But obesity kills, and means that people will need more treatment under PMI and health cash policies. So it is perfectly logical that insurers should fund weight-loss treatment/surgery, as in the long run it means they pay out less on claims.
When something like obesity treatment creeps up on them, insurers react in two ways. The knee-jerk reaction, as in cosmetic surgery and treatment abroad, is to add an exclusion to the policy. The other approach, is what happened on a range of natural cares like acupuncture and other complementary therapies, is to ignore it as long as possible, usually until your main competitors add it, and then add cover.
As I write this, I have the first sighting of weight-loss treatment on international PMI policies - a new product range where the insurer has a specific exclusion of it.
If ‘stop smoking’ treatment is regarded as a useful addition to health insurance cover on PMI and health cash, shouldn’t weight-loss treatment be even more useful? After all, more people are now overweight than smoke.
Health insurance hot topic: 03/04/2009
