Easily solved - dismantle the current shambles that is medicare, leave it to pay for secondary health care required by those who genuinly cannot afford private insurance (elderly, infirm, imbeciles, disadvantaged, etc). The rest of us can privately insure for the full cost of health care, or pay as you go. No GovCo subsidies for mindless fools who run to the GP when they get a runny nose (why should the taxpayer foot the bill for that???), or fattys who can't lay off the McHappy meals and want the surgeon to do what they merely lack to the willpower to achieve. Ditto smokers - let them bear the cost of the lung cancer removal, not the taxpayer. There you go - the argument that the taxpayer funds anti-smoking measures can become null and void, removing any claims the obese might lay for special treatment. I'm exhausted after that, I reckon I'll need some KFC for lunch.....

Before any of this should happen the person or persons should go through a program just like AA or any of thoes places. People have to TRY and help themself not just do short cuts. Not all people are fat due to eating, some take medication and that creates a problem as well. As I said before in the earlier remark people need to have a go at other ways of loosing the weight and then if there isnt any possible way they can take it off they should enter into an agreement before the tax payer pays for this...

Fair, reasonable, wise? One out of three : reasonable, given the economic imperative. Fair? No. In year 7 at high school, I (and most of us) learned some basic priciples of physics and thermodynamics. One is 'energy in = energy out" [energy can be created or destroyed]. So, calories in your mouth has to equal calories burned in exercise....or it is stored as fat (some of the calories are .....er......expelled). Why should I, as a responsible person, pay for another person's lack of responsibiloity?? [I know, I know - that's the price of having the society we live in....but it's bloody annoying!!!]. Wise? We can't say this is a wise thing. Allowing people to become moprbidly obese, then using the public health system to FORCIBLY stop them stugffing themselves! Why can't we tax them for being obese? Load their helath premiums? Do SOMETHING other than rob the taxpayer. Again. I choose to end this rant here.

I suspect we would get much more bang for our health buck from smoking cessation programs. There is a strong argument for significant subsidies for nicotine replacement therapies (NRT) and concurrent increases in tobacco prices. While ever the cost of NRT is similar to that of maintaining a smoking habit its effectiveness will be reduced. Combination therapies (eg patches combined with gum) have gained wide acceptance in the health community but are obviously more expensive than a single NRT. For those in lower socio-economic groups cost is a real driver in terms of using NRT in smoking cessation programs. While lap banding is an effective technique for weight reduction, I would hope that it is used only as a strategy of last resort. There as significant risk associated with this surgery, which are compounded by the co-morbidities commonly found in the obese – diabetes, cardiopulmonary disease and the like. I would hope that these patients take a place on the waiting list behind those requiring surgery for other than “lifestyle” associated problems, such as those requiring bowel resection subsequent to cancer. Ultimately for the vast majority of the obese, the only lasting solution is a complete change of lifestyle and attitude, focussed on caloric restriction and energy expenditure.

Sorry : typo. [energy can NOT be created or destroyed]. Blame the palsy.

I am in a cycling club and a bushwalking club which keeps me very fit. I too gave up smoking many years ago with help from a church group and its Five Day Stop Smoking Plan - and I paid for it myself. Now, I thoroughly enjoy life and go on regular bicycle tours here and overseas with friends and have a wonderful time. I walk and cycle to most places instead of driving and it keeps my weight down, my heart pumping and my wallet full. I also eat sensibly and keep my intake of "bad" things -glass of wine, piece of cheese, few chips etc - down to a minimum. Each year I have a check-up and at 60 am not far off 100 per cent healthy. In the vast majority of cases everyone could achieve a similar level of fitness and health. Obviously there are those genuinely sick and overweight because of illness or medication treatments and those people deserve all the help they can get. But those who drive their cars everywhere, don't exercise and eat all the wrong foods and drinks simply bring their problems on themselves. Let's spend taxpayers money on better things and let them pay for their own extra "health" care.

Yes & No Jeff...I say bring back the "Life Be In It" fitness progams & events they use to have at Nesca park when I was a child on a yearly basis. It was an initiative brought out mainly in yearly school programs, but everyone was welcome from 5-99years old on the weekend events they use to do. This type of event in Newcastle use to have thousands of people turning up young & old & it worked !! So I say,lets sing again Jeff...."BE IN IT TOODAY, IS ALL I CAN SAY..."LIFE BE IN IT" !!

'We' already pay for the health problems of the obese and smokers. So I'm more than happy for taxpayers to pay for prevention/cure programs. I would prefer intensive counselling, education and gym memberships before surgery. Dont we have tax payer funded programs for drug addicts? So the next step is to pay for food addicts. I still believe education is the best. Get the education of good nutrition, exercise etc. in schools on an equal par as the importance of reading, writing, numeracy. Because lets face it, we need healthy adults of the future working to pay taxes to look after us oldies who are overindulged and lazy.

We do have an obesity issue which is adding to the cost of healthcare and will only get greater. Shouldn't we support people who want to have some pretty drastic surgery which will ultimately reduce future healthcare costs? While promotion of healthy diets/lifestyle should be encouraged at a first step (and let's get rid of all fast food advertising) for some people it's gone way past that. If we could only get more people to eat chokos...

It's a hard call, the health system is undermaned, under funded and over used. If it is a medical problem that can be fixed using the technology available, then the patient should go on the waiting list and have it done. But maybe while this patient is on the waiting list 6 - 12 months they should be required to achieve some personal goals concerning their weight. I would doubt that anyone would want this invasive surgery unless all else had failed. If this surgery is not made available for free, then only the obese rich would get it. I don't see that as fair either.