Newfoundland native Andrew Murley has a medical problem. You see Andrew, through lifestyle change, has lost 224lbs, and now he's got folds of hanging skin that are markedly interfering with his quality of life, causing him pain, and putting him at risk for recurrent skin fold infections.
Andrew would like his province's Medical Care Plan (MCP) to cover the cost of the $7,000 surgery, but their response to date has been an outright, "No".
I'll get to the MCP in a moment, but first I need to address the CBC poll on Andrew's case that snidely includes this response as one of the poll's 4 options,
"I'd like MCP to cover my Botox and liposuction treatments too"While offering a poll response option that suggests this surgery shouldn't be covered as it might be considered cosmetic may be fair, comparing Andrew's request to Botox or liposuction is making light of a man's suffering, and I would have hoped that would have been beneath the CBC.
Now back to the MCP.
Let's look at a few other surgeries and their coverages:
1. Breast reduction surgery for a woman whose breasts' weight caused back pain - COVERED
2. Reconstructive plastic surgery for the drug addict who fell asleep with a lit cigarette that then burned down his house leaving him with second and third degree burns - COVERED
3. Open heart surgery for the diabetic who didn't bother taking their medications for over a decade and was consequently found to have severe hardening of their arteries - COVERED
4. A 1 month ICU stay, and multiple open reductions and internal fixations for the 4 compound fractures suffered by a man who drove his truck drunk into a wall - COVERED
A man who through his weight loss has saved the health care system far more money than he's seeking, who has a medical need for a procedure, who has a condition that markedly impairs his quality of life - DENIED.
And why are his needs being denied?
Purely because of blame based or hateful weight bias.
Shame on the bureaucrats who've denied Andrew this surgery. Medicine's not about blame, and if there's a medical need, at least on paper here in Canada we're supposed to meet it.
[NB - That's not Andrew up above, but certainly helps in visualizing why this is a medical need and not a Botox style indulgence]
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You need to look at this from an objective view. All of the four surgeries you mentioned had to be made to save peoples life / reduce cost for the society.
ReplyDelete1) Without a breast reduction she would have been worn out and had to go on disability retirement at young age.
2) Untreated burns leads to death.
3) Would eventually die of a heart attack.
Say what you want but he wasn't denied because of hateful weight bias. He was denied because to much skin isn't something that will result in death or leave your impaired for the rest of his life. Sure, it won't be a pleasure going to without a shirt but no overweight person likes that and then they would have to treat millions of people for the same reason.
IMO this surgery should definitely be covered.
ReplyDeleteI think this compares exactly to breast reduction surgery for women because of back pain. Certainly, the problems from continuous infections would be just as serious as the back pain a woman would continue to endure without surgery. How about people who need knee replacement surgery. Should we argue that "well, it's not life-threatening, lots of people use wheel chairs." This is not the same as lypo or botox and not the same as someone who loses 50 lbs and has a little tummy pooch they can't get rid of. Anyone who can't see that should look at those pictures accompanying this story again.
GREAT post Yoni. That amount of excess skin presents discomfort and medical risk, and should be removed. IMO plastic surgery ought to be covered for anyone who succeeds at massive weight loss and maintains for 3 years.
ReplyDeleteHere's another reason to consider. We don't want people wearing their "fat" clothes after weight loss - 1) it's too easy to regain because there is no reminder from a waistband and 2) there is a tremendous change in psyche from massive weight loss. Keeping excess skin is the same as wearing fat clothes. It's half of a transformation and can hinder adaptation.
If you consider the amount of healthcare dollars this man has saved any insurer over a lifetime with that level of weight loss, a body lift is an insignificant expenditure, and should be covered.
Bravo Yoni! Very important anti-discrimation work!
ReplyDeleteDavid Macklin MD
If his hanging skin gets severely infected and does not respond to treatment will they refuse to put him in hospital for treatment? This very well could be a lifesaving decision for him and our health care.
ReplyDeleteLillian Coakley
I've had two breast reductions that were extremely necessary. Not only is it hard on the back, but when you're that big, it makes finding lumps early almost impossible.
ReplyDeleteThat said, I had a friend who had excess skin from weight loss. I would say that her surgery to have it removed was far more necessary than mine. Let's forget esthetics. The skin caused lesions and infections constantly. Until she had the surgery, she was depressed. At times almost suicidally so.
If this guy had a fund, I'd donate money. No one should have to endure that.
This is so typical of our health care system; let the person first get his skin infected and then do something about it, which will cost more money, instead of doing some preventative medicine.
ReplyDeleteIt has crossed my mined just a wee bit, of what would happen if I'd lost alot of weight, what would happen to the excess skin and whether it is really worth loosing the weight. (Not an excuse, just a thought).
I was wondering if medical professionals could use that excessive skin to help burn patients with skin grafting. Just wondering if this was possible, so it would be a win win for everybody.
Anyway, congratulations to Andrew Murley for his accomplishment ... way to go!
I am still paying for the $17 000 worth of reconstructive surgery I've had. I'm offended my medical plan (BC MSP) wouldn't help me out, but I'm thankful I have a job that afforded me the means to finance it.
ReplyDeleteThere are plenty of medical procedures covered to save a patient whose life is at stake or to reduce cost to society. The purpose is to improve quality of life. My mother's cataract surgery didn't save her life of save society any better. But her quality of life is sure better now that she can read again. Can you imagine the quality of life when you're carrying around pounds of excess skin?
Stay obese and the system will shell out an unlimited amount of money to treat your co-morbidities. lose weight, re-claim your health, and ultimately save the system money, and there's no help for you.
Boy, I should have proofread that second paragraph. Should read:
ReplyDeleteThere are plenty of medical procedures covered for reasons other than to save a patient whose life is at stake or to reduce cost to society. The purpose is to improve quality of life. My mother's cataract surgery didn't save her life or save society any money. But her quality of life is sure better now that she can read again. Can you imagine the quality of life when you're carrying around pounds of excess skin?
I'm not saying that I disagree that this procedure should be covered (actually, I'm undecided), but there are two important thing you didn't mention.
ReplyDelete1. First, are you sure that being fat costs the health care system more money than having this surgery? This report from Manitoba would suggest that's not necessarily the case.
2. Most people who lose weight gain it back. Even a significant percentage of weight loss surgery survivors eventually regain. So, that extra skin may be needed.
Well, my comment is going to differ from most. First, I have really mixed feelings on whether the surgery should be covered or not. In my own mind, I can think of very good agreements both AND against.
ReplyDeleteWhat did strike me the most is the dramatic loss of muscle mass. This sort of muscle wasting is not a necessary component of fat loss. What in the world did this guy do to himself? Crash diet? Not enough protein in the diet? No strength training... cardio combined with starvation?
Yikes...
OK... just re-read and saw the disclaimer that this "is not Andrew."
ReplyDeleteWhy in the world would you post these photos and not expect that readers would presume that the photos were indeed of the subject in question?
Sensationalism, anyone???
Hi Yoni,
ReplyDeleteDid you realieze that in Ontario we take discrimination in reconstructive surgery one step further?
Some reconstructive surgery after a huge weight loss is covered in Ontario, mostly to remove excessive skin on the abdomen. Some surgeons won't even try to get it covered and some will
(That another whole legal ball of wax). But get this, as a female if I apply for reconstructive surgery on my chest due to excessive skin, it is denied, If I am male it gets covered. Discrimination on the basis of gender anyone?
I don't think OHIP should pay for implants or even auto auto-augmentation on females but repositioning the breast tissue to a natural position and removing the excessive skin, would seem to be on the same level as removing excessive tissue and skin from males chests. For some reason that darn double X chromosome makes difference.
I think it should be covered.. If he didnt loss this weight on his own he could have been referred by his DR to get weight loss surgrey covered by MCP that cost over $20,000.00 so why not help this man who done all the hard work but just need help getting rid of extra skin that can cause him pain and infections.
ReplyDelete