Ontario to cover lapband surgery in 2008

[square 0]

YIPEE - free lapband surgery is finally coming to Ontario! :bounce:

My girlfriend's daughter had it and Manitoba covered most of it. Has anyone heard about the OHIP coverage for the band?

My doctor told me that the surgery will be covered by OHIP in April 2008 (or maybe she said March 2008) Each dr. will get less than $600 per procedure - with 2 surgeons, 1 anethestic, 2 nurses, plus the cost of an OR that's pretty cheap... compared to current prices.

She wasn't sure if the band would be covered, she hasn't seen anything on this. But she expects when OHIP starts coverage the only cost I'd have is the band -- but to expect the Ministery of Health would negotiate a price break and have one primary supplier. So the cost could be almost half price of current going fee in Canada $4,000 that I've been quoted.

The other cost she said is fills which she wouldn't expect covered since the government now charges for things like allergy shots. I know there are drs doing that for the allergan band, about $100... as Dr. Colburne's staff told me.

I can't understand why soemone would spend thousands of dollars, when it will be covered in April in Ontario. My question, if we're sending people to the US for R&Y will they send us for this procedure due to the long wait times? Does anyone know the Ontario wait time for the by pass?

I'm interested to see what others are hearing about OHIP coverage and how it's making you rethink getting ti done now.

I'll not book my surgery now with this new news. It's too expensive for me. :think I've got 75 pounds to lose (although the # sounds better in kilos)

Square (hoping to become a rectangle!):confused:

[Cindy_D 1]

I think this is wonderful news IF IT IS TRUE.

However, Ontario is about to go into an election in October - depending on who is elected, this may only be a dream. My surgery is booked, paid for, and I will not wait. April is 9 months away and there is currently a 4 - 6 year wait list for gastric bypass surgery. With my experience of government red tape, followed by hospital, and ministry timelines, it could be much longer before this becomes a reality. I think you are very fortunate to have the time to wait - for some of us - it is not a luxery we can afford.

[beau 0]

Hello, read you're posting this a.m. and contacted the O.H.I.P office a couple minutes ago. They are unaware of anything that is in the decision stages and don't know until approx. one month before the changes are made. Doesn't mean its not happening, just that they cannot confirm this info. I have also thought.......what will the criteria be? How long will the wait be for surgery, apparently bi-pass covered through O.H.I.P is up to five years. Another question I asked was, if the surgery is done prior to coverage, could receipts be submitted for re-imbursment? The answer was.........no. I wish I could report that things are progressing in regards to coverage, but I can't.

[Gaffer 1]

She wasn't sure if the band would be covered, she hasn't seen anything on this. But she expects when OHIP starts coverage the only cost I'd have is the band -- but to expect the Ministery of Health would negotiate a price break and have one primary supplier. So the cost could be almost half price of current going fee in Canada $4,000 that I've been quoted.

Are you talking $4,000 for the entire surgery? The band device itself costs that much alone. Currently it costs about $16,000 in Canada to be banded. I dont think that they are going to get qualified band surgeons to drop thier private practice to do public bands at a cut rate, especially if they are only going to give them $600 like you say. I would be livid if Dr. Coburn started doing high volumes of cut rate bands as it would limit my access to aftercare which I paid my own money for.

The other cost she said is fills which she wouldn't expect covered since the government now charges for things like allergy shots. I know there are drs doing that for the allergan band, about $100... as Dr. Colburne's staff told me.

Fills are free for Coburn patients at the clinic. Only those who are out of town have to pay. Any public system would be foolish to not cover the fills as it is the adjustments that make the whole thing work. Why would they pay to have the band put in and then have people not properly adjusted because they are too cheap to get their adjustments. Aftercare is the key to success with the band, charging people would not work.

I can't understand why soemone would spend thousands of dollars, when it will be covered in April in Ontario. My question, if we're sending people to the US for R&Y will they send us for this procedure due to the long wait times? Does anyone know the Ontario wait time for the by pass?.

Why would people pay. Ughhh, maybe they dont wait 3-5 years to have it. The band is covered here in Alberta, but they have more surgeries and need for surgery than the system can handle. The government recently annouced that they would be doing an additional 100 bands. Gues what, the wait time is longer than ever because there is no capacity in the health system to perform the surgeries and perform the aftercare. Lapband are a low priority comapred to surgeries that can immediately save peoples lives.

I will guarantee that even if they are coveing the band that you people would still be waiting years before they are banded.

That is why I decided to pay for mine. I wanted to stop dieing and start living. Here I am, over 100lbs lighter and adding years to my life when I would still be waiting to see a surgeon to book a lapband 2-3 years from now, with a surgeon who only does a handful of lapbands a year. I will take Dr. Coburn (or any of the other experienced private surgeons, even in Mexico) over a surgeon who has done less than 50 bands himself.

I'm interested to see what others are hearing about OHIP coverage and how it's making you rethink getting ti done now.

I dont think you will find many people who would give up their bands or rethink them, especially on the outside chance that OHIP MIGHT cover it. Before I was banded I was on the fence about private or pay for service health care. Based on my experience with my lapbanding I can say that I am 100% in favour of being able to pay for services privately so long as it does not come at the expense of the public system and peoples access to care.

To me it sounds like your Dr. does not know what she is talking about or you may not have all the facts. If I were in Ontario I certainly would not be holding my breath, especially during an election year. A lapband program would take years to set up properly.

Andrew

[JLB 0]

Well I'd say Andrew about covered everything that was running thru my head when I read this post.

I would hope that gov't does recognize the benefits to the lapband sooner rather than later, however, I'm not going to hold my breath.

[peaches9 3]

Wow, wonders never cease!

I too would be pleased for the others who follow me into LAP BAND... but I have my doubts.

A previous question was "how long is the wait time for RnY in Ontario by Cdn Doctors?" and how long a wait would it be for Lapbanders???"

Well, one thing I know for sure. As my Best friend was approved by OHIP (paid for ) to go to the US. (Michigan Barix clinic) for her surgery. all she had to do was prove that a Canadian surgeon would not see her fro a consultation for at least a YEAR and then Surgery would be another 2 yr wait... Her health was so drastically affected by her weight that OHIP approved her in 10 days and the clinic opperated on her in two wks of that!!! so from start to finish it was one month for her..

She had her bypas in Feb and has lost over 65 #'s since then. (I went with her)

Don't forget WE can use our $16,000 bill on our incometaxes this year as a deduction.

[argon 3]

Andrew said it all... but i want to add one thing.

I'll not book my surgery now with this new news. It's too expensive for me. :think I've got 75 pounds to lose (although the # sounds better in kilos)

I'd be careful. I don't know how much you weigh or how tall you are, but if you've got "only" 75lbs to lose, don't be so sure the gov't is going to pay for it. They'll probably want it to be more than 40, and if you're lucky, 35 if you've got some co-morbitites. What's your BMI?

Most likely this thing will go over like it did and still is, in Alberta... a handful of people will be the lucky ones who get to try it out first... and they'll probably only be able to do limited numbers for quite a while. If they don't take people who are currently on bypass waiting lists and move them to the lapband, the list is gonna get VERY long, very quickly... just like the bypass.

[susansilver 0]

I am already 47 years old and wish that I had the band 15 years earlier! I personally would not waste any more time hoping and wishing for the government to pay for my surgery. I am very glad I did it, paid for it and can get on with the business of regaining my health and quality of life.

[Gaffer 1]

Most likely this thing will go over like it did and still is, in Alberta... a handful of people will be the lucky ones who get to try it out first... and they'll probably only be able to do limited numbers for quite a while.

An interesting side note to this. My boss has been in the weight management clinic which is the first step to getting a provincially paid band. Some people may have heard that Alberta was going to fund an additional 100 bands this year.

Well from what I have been told by my boss who is in the program, Dr. Coburn and my fill provider is that the will not be able to do any where near this many bands. There is no capacity in the health region to do the triage to see who gets them, the counsiling that goes with it, the actualy surgery and recovery as well as the aftercare for the patients. You can buy 100 bands, but they aint doing any good sitting on the shelves and they wont install themselves.

It is tragic as there are so many people that could benefit from these surgeries.

Andrew

[andreerichards1 4]

When I was banded last week DR C told me about this He also said that no surgons will do the surgery through OHIP becouse the $600 does not cover the costs.

[Ginger_ 0]

I was at TLBC for the nutritional seminar Tuesday - Jill Seward talked about this - she had called a higher-up at OHIP that day and was told it is "on the bill for the next election". I would think it could be ages before and if it gets approved. She also said the BMI would have to be very high, she said 50, but probably less with other risks, so personally I wouldn't get approved anyway.

It's so much better than the gastric bypass, WAKE UP POLITICIANS!!

35 sleeps to go!!! :clap2:

[gayle 0]

Ginger, I was also at the class in Toronto on Tuesday evening. I left without thinking that I should ask you for your e-mail address. I would love to make a connection for some support. what do you think?

[joe7777 1]

Not just that...look at the lineups for RNY, people literally dying before they can get the surgery...things won't change even IF (HUGE IF) they change it to cover the lapband too.

PS. I sent a letter to OHIP like 2 weeks ago and just got it back, they definitely arent covering anything now (not news) But i had to do that formality for insurance reasons.

[Ginger_ 0]

Hi Gayle - that would be great! Which one were you? I was AV girl, changing the pages. I will figure out how to send you a personal message with my email through lapbandtalk, keep an eye out for it.

Cheers!

[Donna 0]

The $16,000 that I spent on my lapband was well worth it. My understanding is that most private band surgeons will not accept OHIP coverage IF it ever is approved because they would have to accept the flat fee OHIP deems appropiate. Surgeons would not be allowed to charge an additional amount so it would not make it worth their while to give up banding privately. It all comes down to supply and demand - as long as people are willing to pay privately for the band the majority of skilled doctors will continue to have private clinics.

Again IF OHIP ever starts to fund the lapband there will be a ton of people who will apply for it (including those waiting for RNY or DS) and there will be several years wait for it.

Donna

Banded by Dr. Cobourn/06 Revised From VBG/87

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