Rationing of Healthcare

Due to the changing trends in lifestyle, there are a constantly increasing number of obese people in United States of America. Currently in America, more than 31% of the entire adult population is considered clinically obese while 16% of adolescents are also clinically obese. The numbers are even higher for younger children (WIN, 2009). Gastric by pass surgeries are also called bariatric surgeries. They entail reducing the size of the stomach and preventing the absorption of food by by-passing a part of the small intestine.
There is an increasing popularity among the American population in the use of gastric by pass surgeries to facilitate weight loss. A normal bariatric surgery costs up to 25,000 US dollars (WIN, 2009). Apart from the surgery team and the healthcare workers, the surgery also requires additional follow up by nutritionists and psychologists. There are additional expenses for medication and medical tests before and after the surgery. Gastric by pass surgeries require intensive patient care and in most cases are followed up by lengthy hospital admissions.
Various complications may arise from gastric by pass surgeries often requiring readmission into hospitals. This is followed up by a lot of inpatient care which could otherwise be directed to other patients. 2) Selection Criteria For health reforms to facilitate cost reduction while maintaining clinical effectiveness, it is imperative that certain services be rationed unless in extremely critical cases. Gastric by pass surgeries have gained popularity in America as a quicker and less involving alternative to weight loss.

Patients prefer gastric by pass surgery as compared to the effort it would take to loose weight normally through a change of lifestyle. More and more teenagers and young adults are filling up hospitals for gastric by pass surgeries. Gastric by pass surgeries should be exempted for all adolescents and young adults and in their place behavioral modification counseling should be emphasized. This will free up the already overworked nursing staff.
When it is offered, it should only be given if there is a pre existing condition that prevents the patient from acquiring a more physically active lifestyle or modifying their diet. Currently, most insurance cover companies explicitly exclude obesity treatment or any type of weight loss treatment (WIN, 2009). Any related care incurred by the patient is not paid for by the insurance companies. Gastric by pass surgeries may however be paid for if the patient can prove a medical necessity leading to the need for the surgery.

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