When is it fiscally responsible to deny a citizen medical treatment?
The Manitoba government is trying to save $30,000 by denying a woman surgery to remove the thirty to forty pounds of excess skin she has due to a healthy weight loss program. They are waiting until it becomes cancerous and then they will spend over $100,000 to remove it and further treatment for the complications that will arise. Does this make economic sense to anyone?
I used to think that people who got fat (obese) should have to pay for their decision to eat too much. That was until I was in an emotionally abusive relationship and turned to food for comfort. But I was in that situation for only a few years. I had only a glimpse of what some people spend decades dealing with. With stress hormones and depression complicating the metabolism, becoming obese is not really an easy option to avoid.
I do not want to inventory the abuse this lady went through other than it started before she turned five. Although she was once removed from her mother's care, the authorities were bamboozled into returning her without proper follow up. She was very close to becoming another Pheonix Sinclair. Even her step mother(s) would beat her when she did spend time at her father's house. By the time she was in her twenties, she was convinced nobody would love someone like her and jumped at the first offer of a relationship, even though she knew he was an alcoholic and drug abuser. She was not allowed to buy healthy food because he needed the cash for his drugs.
With her son in tow, she finally broke out of that relationship and, with years of counselling, got her head sorted out. By then she had increased to 390 pounds on a five foot four inch frame. The doctor bluntly told her that she would not see her son graduate from high school or even middle school if she did not do something about her obesity. A gastric bypass was offered (with Manitoba Health offering to pick up the full expense for this plus the skin removal surgery following the weight loss) but with an aunt having had complications, it did not appear to be a good alternative for her. She instead chose to change her lifestyle, eat healthy, and exercise. It has taken over three years (due to a vehicle accident laying her up for a few months) of hard work, but she has lost most of the excess fat that would have caused major health problems (and expense for Manitoba Health).
But the skin did not shrink as fast as the fat disappeared under it. Instead, it has become like a thirty pound water balloon around her torso. She cannot fit into the regular desks at the university where she is attempting to upgrade her education to get a better job. The skin folds collect moisture and cause infections, often requiring prescription medication (paid for by the Manitoba government). Like a water balloon, the skin is getting caught and ripping, causing another opportunity for infection to set in and more expensive medication to be required.
To remove the skin around her torso costs approximately $12,000. To remove the skin from each arm and leg is between $4,000 and $5,000 or about $20,000 for all four areas. She has a hernia that needs to be fixed, but Manitoba Health will not fix it until the excess skin has been removed. It can be done at the same time, but they still will not cover the cost of the hernia surgery if it also involves the removal of the excess skin.
Patient has saved Manitoba Health Care:
Gastric bypass surgery
Future expenses from diabetic complications: $1,000 per month
Without the $30,000 surgery to remove the dead skin, the estimated expenses that will probably occur include:
Medication for skin infections: $2,000 per year
Hernia operation without skin removal, $5,000
High familial occurrence of skin cancer
therefore a very high risk she will also develop skin cancer
in the excess cells around her torso
resulting in surgery to remove infected skin: $50,000
Chemotherapy and other cancer treatments: $25,000
This patient has already saved Manitoba Health most of the cost of the $30,000 surgery to remove the excess skin. Once the skin is removed, she will be able to complete her education, get a good paying job and probably return many times that amount in the form of increased income taxes.
But people in Manitoba Health have their collective blinders on and can only see the $30,000 expense for the surgery today. They think they are being fiscally prudent to save this amount even if it ends up costing the taxpayers hundreds of thousands of dollars within the next decade.
Should Manitoba Health pay for the reconstructive surgery if a patient has managed to lose over a hundred pounds and keep it off for six months? Or should the citizens be encouraged to remain obese and cause additional expenses to the system?
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