So I'm looking at the tv this morning and I see a commercial for lap band surgery it's got a doctor on it touting all the bariatric surgeries he's done (bypass, band,and sleeve)

He goes on to say that he recommends the band to most of his patients because its much safer than the SLEEVE ???

It then shows a study at the bottom that said banded patients have 64% FEWER complications after one year and 74% less in 30 days...

Interesting, very, very interesting...

Thats insane..canada is still crazy though...insurance will cover the lap band in canada but they wont cover the gastric sleeve...its so stupid..at least in british columbia...i know other parts of canada cover the sleeve but dont insure for the band or bypass...

I have to go to Mexico just to get the sleeve cause its a 5 year waiting list just to get the sleeve in another province...

Gosh...you would think they would have removed it as a choice..considering allthe complications..but maybe they just cover there butt by saying "it reduces obesity costs overall"

Thats insane..canada is still crazy though...insurance will cover the lap band in canada but they wont cover the gastric sleeve...its so stupid..at least in british columbia...i know other parts of canada cover the sleeve but dont insure for the band or bypass...

I have to go to Mexico just to get the sleeve cause its a 5 year waiting list just to get the sleeve in another province...

Gosh...you would think they would have removed it as a choice..considering allthe complications..but maybe they just cover there butt by saying "it reduces obesity costs overall"

At least your country gives health insurance to its people haha

Obamacare will be like that here. Most nurses and doctors I know hate it. Oh well I guess the people who voted for it will find out.

Obamacare is nothing like Canadian health care

The Patient Protection and Affordable Care Act, also referred to as Obamacare by his rivals and opponents, seems here to stay. Naturally, there has been lots of vigorous debate over whether this particular brand of health-care reform is right for America, but what I have found particularly perplexing is the recurring comparison of Obama’s plan with Canada’s current health-care policies. It has been fun at times to read about the chaos that would be sure to ensue should the U.S. adopt a Canadian model. For instance, there is much hand-wringing about death panels, wait lists, and crushing tax hikes. Conservatives in the U.S. have repeatedly trotted out Canadian native Shona Holmes who, in televised attack ads, shares her cautionary tale of being told to wait six months for treatment for a brain tumor she claims would have killed her. Rather than accept the cruel fate socialized health care had bestowed upon her, she travelled to the U.S. for surgery. (I should mention her sobering account is also apparently a fictional one, as Holmes’ “tumour” was actually a benign cyst and not life-threatening.) Still, it strikes right at the hearts of many Americans who are wary of implementing a Canadian-like health-care system in the US. They really needn’t worry, though, as the Affordable Care Act resembles Canadian health care about as much as Honey Boo Boo resembles Justin Bieber. For starters, it is often characterized as a total restructuring of U.S. health care in the direction of socialized medicine, but this is hardly the case. In reality, Obama’s plan comes down to much-needed insurance reform. Insurance companies will now have baseline standards they must offer in all their policies, for instance. There is also a mandate that everyone gets some type of health care coverage (their choice) or pay a tax penalty. In a nod to the ideals of a free-market system, there will be “health insurance exchanges,” which provide consumers with a transparent means of comparing the available insurance policies. How this keeps getting compared to Canada’s publicly funded, single-payer system is beyond me, as Americans will still be free to choose their insurance providers. This supposed freedom is a recurrent theme in U.S. health-care debates and is often a key criticism of Canadian health care. While the Canadian system is not without its flaws, I would argue there is also a certain amount of liberty in not having to worry about financial ruin from a serious accident or losing coverage after a devastating diagnosis. I can personally attest that the so-called “freedom” to choose one’s own health insurance isn’t all that meets the eye. When I lived in the States, I was “free” to choose whether to pay into coverage provided via my employer, and then given a short list of accepted doctors and hospitals (yes, one had to be careful not to get driven to the wrong ER in an emergency). Likewise, being free of insurance co-pays here in Canada did take some getting used to. I was living here two years before I stopped awkwardly pulling out my wallet at a doctor’s appointment. The ability to choose my own health-care provider seems much more “freeing” than choosing my own insurance provider from a list of companies out to maximize their profits. So, if you’re reading this America, don’t worry. Obamacare is still going to allow you the beloved national pastime of paying insurance companies too much money for sub-par care. Fear not, you’re not getting Canadian health care, though you should be so lucky.

Written by a "crazy lady"

Obamacare is nothing like Canadian health care

The Patient Protection and Affordable Care Act' date=' also referred to as Obamacare by his rivals and opponents, seems here to stay. Naturally, there has been lots of vigorous debate over whether this particular brand of health-care reform is right for America, but what I have found particularly perplexing is the recurring comparison of Obama’s plan with Canada’s current health-care policies. It has been fun at times to read about the chaos that would be sure to ensue should the U.S. adopt a Canadian model. For instance, there is much hand-wringing about death panels, wait lists, and crushing tax hikes. Conservatives in the U.S. have repeatedly trotted out Canadian native Shona Holmes who, in televised attack ads, shares her cautionary tale of being told to wait six months for treatment for a brain tumor she claims would have killed her. Rather than accept the cruel fate socialized health care had bestowed upon her, she travelled to the U.S. for surgery. (I should mention her sobering account is also apparently a fictional one, as Holmes’ “tumour” was actually a benign cyst and not life-threatening.) Still, it strikes right at the hearts of many Americans who are wary of implementing a Canadian-like health-care system in the US. They really needn’t worry, though, as the Affordable Care Act resembles Canadian health care about as much as Honey Boo Boo resembles Justin Bieber. For starters, it is often characterized as a total restructuring of U.S. health care in the direction of socialized medicine, but this is hardly the case. In reality, Obama’s plan comes down to much-needed insurance reform. Insurance companies will now have baseline standards they must offer in all their policies, for instance. There is also a mandate that everyone gets some type of health care coverage (their choice) or pay a tax penalty. In a nod to the ideals of a free-market system, there will be “health insurance exchanges,” which provide consumers with a transparent means of comparing the available insurance policies. How this keeps getting compared to Canada’s publicly funded, single-payer system is beyond me, as Americans will still be free to choose their insurance providers. This supposed freedom is a recurrent theme in U.S. health-care debates and is often a key criticism of Canadian health care. While the Canadian system is not without its flaws, I would argue there is also a certain amount of liberty in not having to worry about financial ruin from a serious accident or losing coverage after a devastating diagnosis. I can personally attest that the so-called “freedom” to choose one’s own health insurance isn’t all that meets the eye. When I lived in the States, I was “free” to choose whether to pay into coverage provided via my employer, and then given a short list of accepted doctors and hospitals (yes, one had to be careful not to get driven to the wrong ER in an emergency). Likewise, being free of insurance co-pays here in Canada did take some getting used to. I was living here two years before I stopped awkwardly pulling out my wallet at a doctor’s appointment. The ability to choose my own health-care provider seems much more “freeing” than choosing my own insurance provider from a list of companies out to maximize their profits. So, if you’re reading this America, don’t worry. Obamacare is still going to allow you the beloved national pastime of paying insurance companies too much money for sub-par care. Fear not, you’re not getting Canadian health care, though you should be so lucky.

Written by a "crazy lady" <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/biggrin.png' class='bbc_emoticon' alt='' />[/quote']

Not crazy, informed and not falling for false political rhetoric. I appreciate that

Not a fan, sorry.

Obamacare will be like that here. Most nurses and doctors I know hate it. Oh well I guess the people who voted for it will find out.

I'm a nurse also, and most nurses and doctors that I know are for it.

So I'm looking at the tv this morning and I see a commercial for lap band surgery it's got a doctor on it touting all the bariatric surgeries he's done (bypass' date=' band,and sleeve)

He goes on to say that he recommends the band to most of his patients because its much safer than the SLEEVE ???

It then shows a study at the bottom that said banded patients have 64% FEWER complications after one year and 74% less in 30 days...

Interesting, very, very interesting...

[/quote']

I know of someone that has had the band for years and has no problems however, they have not lost a substantial amount either.

Maybe the below will provide a bit of clarity as to the 'nuts and bolts' of things. This first academic journal was published in May 2013. So, it doesn't get more 'up to date' with regards to evaluating the comparative effectiveness in the three biggest weight loss procedures. I have only reproduced the abstract, for copyright reasons and have quoted the source below. Besides, the abstract covers the salient information we require anyhow. The second section is all about the metrics, with a snapshot of all the procedures being evaluated in a tabulated form. The primary and secondary sources are also cited. Better to make decisions based on rigorous scientific research, than hearsay and charasmatic sales pitches, I feel... Hope it helps. Abstract: Objective: To evaluate the comparative effectiveness of sleeve gastrectomy (SG), laparoscopic gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB) procedures.

Background: Citing limitations of published studies, payers have been reluctant to provide routine coverage for SG for the treatment of morbid obesity.

Methods: Using data from an externally audited, statewide clinical registry, we matched 2949 SG patients with equal numbers of RYGB and LAGB patients on 23 baseline characteristics. Outcomes assessed included complications occurring within 30 days, and weight loss, quality of life, and comorbidity remission at 1, 2, and 3 years after bariatric surgery.

Results: Matching resulted in cohorts of SG, RYGB, and LAGB patients that were well balanced on baseline characteristics. Overall complication rates among patients undergoing SG (6.3%) were significantly lower than for RYGB (10.0%, P < 0.0001) but higher than for LAGB (2.4%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736) but higher than for LAGB (1.0%, P < 0.0001). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001), but was 77% higher for SG than for LAGB (34%, P < 0.0001). SG was similarly closer to RYGB than LAGB with regard to remission of obesity-related comorbidities.

Conclusions: With better weight loss than LAGB and lower complication rates than RYGB, SG is a reasonable choice for the treatment of morbid obesity and should be covered by both public and private payers. SOURCE: Carlin A, Zeni T, Birkmeyer N, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Annals Of Surgery [serial online]. May 2013;257(5):791-797. Available from: MEDLINE with Full Text, Ipswich, MA.

September 2012: Morbidity and mortality associated with LRYGB, LSG, and LAGB from the ACS-BSCN dataset LRYGB LSG LAGB 30-d mortality (%) 0.14 0.11 0.05 1-y mortality (%) 0.34 0.21 0.08 30-d morbidity (%) 5.91 5.61 1.44 30-d readmission (%) 6.47 5.40 1.71 30-d reoperation/intervention(%) 5.02 2.97 0.92 SOURCE: Data from Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 2011;254(3):410–20 [discussion: 420–2], in: Timothy D. J, Matthew M. H. Morbidity and Effectiveness of Laparoscopic Sleeve Gastrectomy, Adjustable Gastric Band, and Gastric Bypass for Morbid Obesity. Advances In Surgery [serial online]. n.d.;46(Advances in Surgery):255-268. Available from: ScienceDirect, Ipswich, MA

I'm a nurse also' date=' and most nurses and doctors that I know are for it.[/quote']

Yes, my husband is an ER PA. He and his coworkers welcome the healthcare act.

Whoa! I don't know anyone around here that do. The idea is good but the actual mechanics of it are seriously flawed. That's the part I have a problem with. It will bankrupt this country worse than it already is. 20% of the population pay the majority of taxes. Of course those who benefit from free services vote for obama. I am also a certified trauma and ER nurse. Now working as a ER case manager and really have gotten to understand how insurance and benefits work. Having the title of "insurance" isn't the same thing as being fully covered when you have an emergency. The coverage will be extremely limited and god forbid you need extended care or extra services it will not be covered or your share of costs will make it cost prohibitive. Many of my patients are in the same boat. A lot of my md friends are going private practice in fear of obamacare. Get paid 10 cents on the dollar like medicare but do 500% more work? Forget it. As a nurse I am concerned about uninsured people but this is not the answer. It needs a lot of tweaking and input. Obamacare will be bare bones coverage with very limited benefits. Basically you will be underinsured. People will find out. Let's talk in a few years when hospitals keep closing because they can't afford to operate under 10 cents per dollar pay scale. 10 hospitals in my area have closed past 10 years and I live in one of the richest counties in southern california. Sad. We needed those.

And fyi. Those of us who pay for our insurance through our employers will have a 400% rate hike next 5 years. We already had the first 100% increase last year. Google blue cross blue shield california increased premiums. The medical groups have to recover their costs somehow and we will be the ones paying for it. And no, obamacare won't cover wls. Read the bill.

My LapBand slipped and it's all Obama's fault!!!!

My LapBand slipped and it's all Obama's fault!!!!

Haha!

Medicaid, ER Studies Make Strong Case for Obamacare.

the New England Journal of Medicine published a major study of Medicaid in Oregon which has rapidly emerged of a Rorschach test of sorts. That is, partisans on either side of the political divide tend to see what they want to see in its results. While conservatives claim Medicaid expansion has been debunked by numbers showing little change in blood pressure, cholesterol, and diabetes over two years between those who did and did not gain access to Medicaid, liberals tout findings revealing "Medicaid improved rates of diagnosis of depression, increased the use of preventive services, and improved the financial outlook for enrollees." Ultimately, as Ezra Klein, Kevin Drum, Aaron Carroll and Austin Frakt all conclude, the limited sample size, short-time frame and narrow measures of "health outcomes" make conclusions about the efficacy of Medicaid difficult to reach. But combined with other recent research, there is little question that Medicaid expansion will make the financial prospects and quality of life significantly better for the previously uninsured. As for the legion of Republican politicians instead insisting "no one goes without health care in America" because "you just go the emergency room," studies documenting the rapid disappearance of ER's and trauma centers show that GOP talking point is just a cruel joke. Writing in the New York Times, Annie Lowrey provided a concise summary of what the NEJM paper says--and doesn't say--about the 10,000 out of 100,000 Oregonians who won the state's Medicaid lottery: The Oregon Health Study released a new round of results on Wednesday, showing that Medicaid coverage does not seem to improve low-income adults' blood pressure, blood sugar or weight in a two-year time frame. It says nothing about the chance of diagnosis of, eventual health outcomes for or costs associated with any form of cancer, Alzheimer's, Parkinson's or dozens of other debilitating medical conditions. It also says nothing about health results outside of a two-year time frame... Where it says something, it says a lot: it provides strong evidence that Medicaid recipients will spend more, use more tests, experience less depression, have fewer bills sent to collection agencies, and so on. It shows health insurance working just the way insurance is supposed to work: protecting the financial stability of the people purchasing it. As it turns out, other recent analyses also had a lot to say about what happens when the uninsured gain coverage in ways similar to what will happen under the Affordable Care Act starting in 2014. In Massachusetts, the 2006 health care reform Governor Mitt Romney signed into law lowered the uninsured rate from 10 percent to a national low of two percent. Even with its individual mandate, "Romneycare" is extremely popular, generally enjoying a 3 to 1 margin of support from Bay State residents. In August 2011, a study by Charles J. Courtemanche and Daniela Zapata published by the National Bureau of Economic Research (NBR) showed that universal coverage in Massachusetts is indeed making people there healthier. As Klein summed up their findings: The answer, which relies on self-reported health data, suggests they did. The authors document improvements in "physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity." The gains were greatest for "women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law's subsidies." As it turns out, those conclusions were largely in keeping with another NBER paper published in July 2011. It confirmed, as Harvard researcher and former member of President George W. Bush's Council of Economic Advisers Katherine Baicker put it, "Medicaid matters." That analysis ("The Oregon Health Insurance Experiment: Evidence from the First Year") provided the first results of Oregon's Medicaid expansion. After Oregon in 2008 established a lottery to add 10,000 people to it limited Medicaid rolls, the NBER team interview 6,000 of the lucky ones and 6,000 of the 90,000 who lost out. The results were striking: We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group. The New York Times provided some of the details of the Medicaid success story: Those with Medicaid were 35 percent more likely to go to a clinic or see a doctor, 15 percent more likely to use prescription drugs and 30 percent more likely to be admitted to a hospital. Researchers were unable to detect a change in emergency room use. Women with insurance were 60 percent more likely to have mammograms, and those with insurance were 20 percent more likely to have their cholesterol checked. They were 70 percent more likely to have a particular clinic or office for medical care and 55 percent more likely to have a doctor whom they usually saw. The insured also felt better: the likelihood that they said their health was good or excellent increased by 25 percent, and they were 40 percent less likely to say that their health had worsened in the past year than those without insurance. As the Washington Post's Klein summed up the findings, "knowing that Medicaid matters is good, but we already sort of knew that." What we also knew, this time with great certainty, is that the emergency room is no alternative to having health insurance. It's not just that the ER is no place for those with chronic conditions like diabetes, cancer and cardiac disease. As it turns out, the emergency room--the place GOP leaders including George W. Bush, Mitch McConnell and Mitt Romney said the uninsured can go for care--is an endangered species. The Atlantic's Jason Silverstein documented that precise point in the wake of the Boston Marathon bombings. The availability of top-notch trauma care that saved so many lives in Boston is absent or disappearing in much of America. And the Americans who will have to travel far or go without emergency are overwhelming poor, minority or rural--very people the Obamacare Medicaid expansion was designed to help. Citing four years of research by Renee Hsia, an emergency medicine physician, and Yu-Chu Shen, an economist, Silverstein reported that cost is leading to ER closures even as the volume of ER visits has risen precipitously. "Compared with travel times six years earlier," he wrote, "Hsia and Shen found that one out of every four people had to travel longer to get to a trauma center" and "nearly 16 million had to travel at least thirty minutes more." Why? It isn't that there are fewer emergencies. According to the American Hospital Association, from 1991 to 2010, emergency department visits soared from 88.5 million to 127.2 million. That's an increase of nearly 44 percent. But during this same period, emergency departments closed at a rate of almost 11 percent. We see something similar with trauma centers. Between 1990 and 2005, 339 trauma centers shut their doors. The New York Times offered more details on Hsia's findings two years ago. And the picture isn't a pretty one: Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitals with emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent. Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found... Emergency rooms at commercially operated hospitals and those with low profit margins were almost twice as likely as other hospitals to close, Dr. Hsia and her colleagues found. So-called safety-net hospitals that serve disproportionate numbers of Medicaid patients and hospitals serving a large share of the poor were 40 percent more likely to close. Those dismal numbers don't just mean people in states rejecting Obamacare's Medicaid expansion will be out of luck when it comes to emergency care. And that's in the best of times. In the worst of times like a major terrorist strike, the Institute of Medicine (2006) and a House Oversight and Government Reform Committee study (2008) both warned, the American ER system is woefully unprepared to handle a "predictable surprise" attack on the scale of the 2004 Madrid bombing: The results of the survey show that none of the hospitals surveyed in the seven cities had sufficient emergency care capacity to respond to an attack generating the number of casualties that occurred in Madrid. The Level I trauma centers surveyed had no room in their emergency rooms to treat a sudden influx of victims. They had virtually no free intensive care unit beds within their hospital complex. And they did not have enough regular inpatient beds to handle the less severely injured victims. The shortage of capacity was particularly acute in Los Angeles and Washington, D.C. Sadly, the shortage of common sense is also particularly acute in Washington, DC. So while the Republicans' water-carriers at places like the CATO Institute declare the Oregon Medicaid study is "throws a stop sign in front of ObamaCare's Medicaid expansion," the bigger picture of America's 50 million uninsured and 84 million underinsured at a time of declining ER capacity instead can only mean only one thing for the Affordable Care Act.

So what do you think we should do??