Et Tu, BBC?
Yesterday, the BBC woke me up with this news: Only a tiny fraction of the people who could "benefit" from lapbands are having them installed by Britain's National Health Service (NHS). Apparently, it would save the government billions of pounds if everyone in a particular BMI range (not specified) would do their patriotic duty and get their digestive systems butchered in order to
look more acceptable put themselves into a lower risk category for some diseases of old age. Did I mention that this was reported on the BBC with no critical analysis whatsoever?
I heard this on the radio and I thought "does anyone take this shit seriously?" Then I read the related article on the BBC website (thanks Charlotte) and noticed that this study was funded by "two firms involved in making equipment used in obesity surgery" and performed by the Office of Health Economics (?!). A privately funded study performed by a government agency? I haven't had a chance to read it yet, but this appears to be it.
There's precious little information in the article about the study itself; its methodology, its assumptions... However, the article does hint at some things:
- First, it seems very likely that the study assumed obesity is always the cause of (not a side effect of) disability. In reality, that is not necessarily the case.
- Secondly, it hints that obese people are automatically unable to work. We all know that most obese people are able and willing to work, and that most work full time and pay taxes. Most people who are eligible for the surgery are already fully productive citizens.
- Third, it assumes that obese people always cost the health system extra money. In reality, we do not necessarily cost the health service more than other people do. In fact, we're probably less likely to overuse healthcare, since we tend to have unpleasant experiences with it.
- Finally, and most strikingly, it appears to neglect the costs associated with weight loss surgery, other than the cost of the surgery itself. This is an elective surgery with a considerable risk of death that often has chronic, serious side effects that are expensive to treat. Even the "successful" surgeries almost always result in nutritional deficiencies that require regular doctor's visits to treat with injections; frankly, a similar level of care to insulin dependent diabetes. In more extreme cases, this surgery can take a healthy, productive person and give them health problems that make them unable to work. The study evidently assumes that the opposite is always the case.
If the NHS encouraged everyone who is eligible for this surgery to have it, then I suspect that it would cost them millions of pounds in treating side effects, redoing and undoing failed surgeries, and treating nutritional deficiencies. I suspect that, on average, people who have had weight loss surgery cost more to treat than BMI-matched people who haven't and that doing more of these surgeries would increase demands on the NHS. I suspect if you looked at every recipient of the surgery ten years later, then for every person who became more productive because of the surgery, there'd by one who became less productive.
The article notes "the government says the treatment should always be a 'last resort'," implying that the government is mistaken. In fact, the government is right. Suggesting that productive people with high BMIs undertake risky surgery with dangerous side effects because it may lower their risk of diseases that are unlikely to affect their productivity before retirement age is absurd. It would injure and kill people needlessly, it would not save the NHS any money, and who would it benefit? Manufacturers of lap bands. Oh, and bariatric surgeons, who are probably nodding in agreement with the article as I type.
The fat people who would "benefit?" Unfortunately, they'd benefit mostly from an improvement in social standing. They'd suffer less weight-based discrimination, at least while the effects of the surgery lasted (assuming it resulted in weight loss in the first place). Even though they might not be able to eat normally and they might suffer from inconvenient, painful and even life-threatening side effects, they might be happy with the results. It makes me incredibly sad that we think it's okay to hurt people so that others will stop mistreating them. It's adding injury to insult.
I plan to read the study within the few days to see if any of the issues I raised above were adequately addressed. I'd invite other BFBers to do the same.