Next came a report from JAMA Surgery that was a big upset, and bound to be a controversial one. Johns Hopkins University researchers paired two groups of obese patients insured by any of seven BlueCross BlueShield plans. One group underwent bariatric surgery while the other did not.
Despite the widespread belief that such surgery can dramatically reduce healthcare costs, Jonathan Weiner and health economist colleagues discovered that that after six years of follow-up, total claims for healthcare expenses were no different in the two groups. Bariatric surgery did not lower healthcare costs for the treated group.
Weiner and his team found that while patients who underwent surgery had lower pharmacy costs and lower costs for physician office visits in the six years after their surgeries, they were back in the hospital far more often than the non-surgical group, cancelling out the savings on drugs and doctor visits.
Why this should be so remains unclear, and a source of bitter dispute, with some bariatric surgeons accusing the authors of being biased, using data from 11 years ago when bariatric techniques were riskier, and not recognizing how much the procedure improved patients' lives.