As health insurers escalate fight against reform, more bad PR... baby denied coverage, is too fat... - Edit 2
Before modification by everynametaken at 12/10/2009 08:28:43 AM
Parents of "chunky" infant weigh in on health insurance reform
GRAND JUNCTION — Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.
But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.
Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.
Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."
"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.
By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.
"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."
Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.
" 'Your baby is too fat,' she told me," Bernie said.
Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."
His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.
At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.
"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."
Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.
The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.
The Langes are counting on the fact that Alex will start shedding pounds when he starts crawling. He is already a kinetic bundle of arm- and leg-waving energy in a baby suit sized for a 9-month-old.
They joked that when he is ready for solid food, they will start him on Slim-Fast.
Meanwhile, they made Alex's plight public on KKCO this week. They plan to appeal Rocky Mountain's denial.
If that doesn't work, they plan to take their case to the Colorado Division of Insurance.
"My gripe is not with Rocky Mountain," Bernie said. "It's with the general state of the health care system."
BTW, I just know someone is going to pipe in something stupid about how they already had coverage and that one company denied them. Those points only add to the absurdity of the situation. They had to try and find new insurance because their current insurer hiked their rate 40% after their child was born. That kind of increase is fucking outrageous! And, while yes, one company denied them the point is still the same, denying the family because their newborn is "too fat" is, as the father said, absurd regardless of whether they can find another company wit better rates or not.
I also found the insurer's quote about doing it because everyone else does it very enlightening as to the kind of racket-mentality that insurers have in general.
EDIT:added additional comments.
GRAND JUNCTION — Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.
But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.
Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.
Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."
"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.
By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.
"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."
Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.
" 'Your baby is too fat,' she told me," Bernie said.
Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."
His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.
At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.
"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."
Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.
The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.
The Langes are counting on the fact that Alex will start shedding pounds when he starts crawling. He is already a kinetic bundle of arm- and leg-waving energy in a baby suit sized for a 9-month-old.
They joked that when he is ready for solid food, they will start him on Slim-Fast.
Meanwhile, they made Alex's plight public on KKCO this week. They plan to appeal Rocky Mountain's denial.
If that doesn't work, they plan to take their case to the Colorado Division of Insurance.
"My gripe is not with Rocky Mountain," Bernie said. "It's with the general state of the health care system."
BTW, I just know someone is going to pipe in something stupid about how they already had coverage and that one company denied them. Those points only add to the absurdity of the situation. They had to try and find new insurance because their current insurer hiked their rate 40% after their child was born. That kind of increase is fucking outrageous! And, while yes, one company denied them the point is still the same, denying the family because their newborn is "too fat" is, as the father said, absurd regardless of whether they can find another company wit better rates or not.
I also found the insurer's quote about doing it because everyone else does it very enlightening as to the kind of racket-mentality that insurers have in general.
EDIT:added additional comments.