State to pay for bariatric surgeries

COLUMBIA -- South Carolina lawmakers chose paying for weight-loss surgery for obese state workers at $24,000 a pop over putting teachers in the classroom, one state senator said Thursday.

Sen. Greg Ryberg, R-Aiken, said special interest groups won a victory over taxpayers when the Legislature decided to put $2.4 million toward gastric bypass and Lap-Band surgery for 100 of the state's heaviest employees, under a state health plan pilot program that begins Jan. 1.

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"I think that with folks being furloughed or losing their jobs that it's the wrong message to send," state Rep. Mike Sottile, R-Isle of Palms, said.

But Senate President Pro Tem Glenn McConnell, R-Charleston, said obese state workers are destined for massive health problems, and finding ways to cut health costs is a good idea.

"If it will save us money and save their lives," he said, "then together it's a good investment."

Meanwhile, T. Karl Byrne, a surgeon at the Medical University of South Carolina, said gastric bypass and adjustable gastric band surgery, among other stomach-shrinking procedures, already have been proved to be cost-effective investments. North Carolina, Georgia and Virginia are among the majority of Southeastern states that cover the procedure for state workers, he said. Medicaid and Medicare also cover it, Byrne said.

"We do not need 100 patients in a pilot program in this state," Byrne said. "We already know what the results are."

Byrne said the initial cost of the surgery is high, but the cost savings over time are tremendous. Most of the time, obese people after significant weight loss no longer need treatment for high blood pressure, diabetes, sleep apnea and a host of other health issues, he said. So, with an up-front investment, the state can save cash over time by avoiding the cost of prescription drugs and associated treatment for obese individuals on the payroll, Byrne said.

Byrne said he is worried that the state's pilot program will be shortsighted by looking only at one budget year to the next instead of factoring in long-term savings. Bariatric surgeons such as Byrne have access to a national database with thousands of cases documenting the success and risks of the procedures, he said. The database provides proof that the procedure is a sound investment for the state, Byrne said.

"You're going to save a boatload of money," he said.

Only 17 slots are open for state workers in the tri-country area, Byrne said. The state health plan -- including educators and retirees -- covers about 394,000 people. About 60,000 live in Berkeley, Charleston and Dorchester counties.

The state Budget and Control Board gave its stamp of approval on the pilot program Thursday.

The state covered bariatric surgery for state workers from 2001 to 2004, but the procedures were deemed too risky and not cost-effective.

Access to the pilot program will be divided among the state's regions and provided on a first-come, first-served basis. The state does not track how many employees are overweight or obese, nor would those individuals be targeted for the surgery.

The state health plan will monitor the 100 patients for 18 months to see if the pilot program is cost-effective.

South Carolina's population is among the worst nationally when it comes to weight problems. Nearly 63 percent of adults are overweight or obese, which is higher than the national rate of 60.8 percent, according to the Kaiser Family Foundation. South Carolina's children are also heavier than many kids elsewhere. Nearly 34 percent of children in the state are overweight or obese, compared with 31.6 percent nationally.

The House and the Senate had little, if any, floor debate on the pilot program, according to legislators. The program also did not receive an up or down vote because it is authorized as a provision tucked into the $5 billion budget.

Ryberg said he voiced his opposition in the Senate Finance Committee, which removed funding for the pilot program. It was inserted back into the budget during hurried end-of-session conference negotiations.

Ryberg was on the losing end of another fight. He proposed charging obese state employees a $25 monthly surcharge on their insurance premiums. State workers who smoke started paying an extra $25 a month for insurance this year.

Reach Yvonne Wenger at ywenger@postandcourier.com or 803-926-7855.