Maggie Gallagher

A study of the cost savings from laparoscopic bariatric surgery for managed care was recently published in the American Journal of Managed Care. The cost of such surgery ($17,000) for morbidly obese patients was recouped by the insurance carriers in just two years.

Yet insurance companies are cutting this benefit, no doubt because it tends to attract the morbidly obese -- expensive folk to insure.

Solutions? Please, not government health care. In Canada, according to a description of a clinical trial being sponsored by the University of Alberta, "waiting lists are several years long. Provincial governments, unable to keep pace with surgical demand, are sending patients to the U.S. for surgery."

Mandating insurance coverage is one possibility but not the one I prefer.

Let's take advantage of the fact that people are willing to spend a lot of their own money for this health care. Because, let's face it: It's not particularly fun to be fat in this world. We can both increase the public health and decrease the public costs -- and draw more personal money from young people into health care -- by taking advantage of the fact that becoming thinner is not only healthier, it is sexier. Young folks are not that interested in the former but they are really interested in the latter.

Why don't we create fat-fighting health savings accounts for Lap-Band surgery? We could let anyone donate to them on a tax-deductible basis (i.e., let Grandma help). We could add a subsidy for poor and working-class people, and also make low-cost government-guaranteed loans available to moderate-income patients to help cover the cost of the surgery. If you can finance a car, you can afford Lap-Band surgery.

Watch a market blossom: better health, lower public costs, more satisfied clients in control of their lives.

Now watch: Would something that simple and sensible ever happen on Capitol Hill?

Maggie Gallagher

Maggie Gallagher is a nationally syndicated columnist, a leading voice in the new marriage movement and co-author of The Case for Marriage: Why Married People Are Happier, Healthier, and Better Off Financially.