Thursday, September 26, 2013

CMS decides Your Life Doesn't Matter

As always, Ted Kyle of ConscienHealth sums it all up for us nice and neatly for us. The Centers for Medicaid and Medicare Services (CMS) have unfortunately made will have injurious consequences. It's going to get messy, and not messy in a way that will be cleaned up easily. It's going to cause people to lose their lives due to a lack of quality care and strict standards. Sadly, the group that will bear the brunt of this decision is.... Surprise, the poor and elderly.  Shame on you, CMS.  Shame on you, Congress (for your current lack of concern for healthcare in this country.)  I wish these public servants would put their egos aside and work for the people, not the corporations.

This decision has far-reaching consequences due to the guiding force that is CMS.  Insurance companies use the policies and protocols of CMS to make their own decision making models for their policy holders. This decision will trickle down to every individual who has dealings with bariatric surgery.  I guess the only good measure that might occur is that some surgeons may be more willing to see patients who've undergone procedures with other surgeons.  Maybe.  I mean, it certainly hasn't been helpful that so many refuse to perform follow up care on other surgeon's patients. Heck, most doctors shy away from it because they lack a knowledge and understanding of bariatrics. Honestly though, their malpractice insurance isn't anything to scoff at, so I don't blame them for taking a stand on their professional liability, but... everyone needs care. A patient presents with you a variety of symptoms, construct-- patient has had bariatric surgery, what kind and how do you adjust your treatment approach?

Let's go back to the undermined group in our American society today though.  That group that is so under-served, we don't even talk about them.  The working poor, the people who work so hard but have nothing in the means of healthcare.  No back up, no access to care, just their paychecks and the mercy of primary care doctors willing to see them for well-appointments for less than their average wages.  Those Americans wishing for a healthy life, should have access to the available treatments for obesity.  People who are educated enough to know they need to do something for their health, but can't because their employers have written them out of the quality equation.  It's sad but true, let's all get Federal Government Health Insurance, we are as deserving of it as the people who are suppose to be serving us.

But I digress, as of 2011, there were 48 million uninsured Americans. That number isn't shrinking, employers are shrinking coverage to quality treatment.  Healthcare providers are scurrying and in panic over the confusion of Obama care.  Let's stop making up programs and start providing CARE.  Let's stop trying to save the world and save our people home, Make Americans Well.  Let's find ways to support our nation by giving everyone the same access to treatment options if and when they want them, and support them in the follow up of their choices.

Let's educate our society about the benefits and the RISKS involved in surgical weight loss procedures.  Let's stop ignoring the fact that some procedures fail at an alarming rate of 40-60% .  Don't turn a blind eye to this statistic and blame the individual when the wrong treatment was selected.  Where is the compassion?  It's gone. We would rather shame people with obesity as a society than help them. The haves versus the have nots will always have a louder voice.  Be compassionate, you never know what someone else's story is until you listen to them. I won't turn a blind eye to the problems I see in the care continuum of bariatrics.

So many people approach their weight as the singular problem.  It's usually not.  There are usually underplaying the psychological struggles they're having with food-- that's why you hear people say "How do I pass the psychological assessment process and get the green light to surgery?"  You wanna know how?  You learn to be 100% honest with yourself.  You dig deep, real deep.  You look at compulsive, obsessive, binge, and overeating behaviors with no filters.  You say to yourself, I got here over the long haul, and you realize the work is going to take a lot of time and effort to find health.

You also learn humility.  That even when you're doing it all right, you might meet biological forces that provide resistance.  Unseen resistance with the naked eye-- hormones: thyroid and metabolism-- medical conditions that will make it difficult, even with surgery, for you to get to a health weight.  BUT, you will persist in your efforts because you have and understand the importance of SUPPORT and EDUCATION. You won't shun the weekly or monthly groups your doctor's office has available to you or you will seek out support online and find others who are rooting for you.

Oh, wait... back to the CMS decision.

Those support groups and education efforts of your surgeons' offices will be at their discretion.  Never mind, giving you the tools to help yourself and stressing the underlying importance of addressing the psychological and emotional basis for your obesity isn't important.   Moot points... Well, I'm done.  Stick a fork in me. All arguments I have are invalid because a small lobby from the State of Michigan decided that MBSAQIP (Formally known as the Bariatric Centers of Excellence) standards are not as important as their own agenda. Credentials are a money making industry too, but respect is give to organizations that are run by the leaders in the medical field.  ASMBS and ACS are THE agencies in the US that provide standards of continuing education in surgery.

This all boils down to egos and agendas.  We're not on Congress' agenda.  We're not on CMS's agenda. If you don't have money in this country, you are powerless. Sad, but true.

We can only hope the all of the Congress persons will realize that every life is valuable.  Each person on this Earth has purpose.  The impact we can have in our generation to make sure others will live the longest and healthy lives possible.  Our digital age gives us access to one another to build ideas into realities. Find your passion.  Do good things for yourself and others.

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