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If four-month-olds are being denied health insurance coverage, is anything sacred?

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Filed under: Insurance, Family Money, Health, Insurance - Health Insurance

In yet one more reason why the national dialog has changed from "health care reform" to "health insurance reform," Grand Junction, Colo. native Alex Lange was denied insurance coverage by Rocky Mountain Health Plans. Lange has never smoked, drank alcohol, nor has he ever been diagnosed with a chronic disease. In fact, he's only been to the doctor a few times for checkups, and has never missed a day of school or work in his life.

That impressive track record can be credited to the fact that Alex is just four months old and, in his short life, he has been fed nothing but breast milk. Nevertheless, he was denied health coverage because, according to growth charts, he's obese.

Alex's dad, Bernie Lange, is a part-time anchor on local news station KKCO-TV, and he recently went public with his family's denial. As Dr. Doug Speedie, medical director at Rocky Mountain Health told the Denver Post, "If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it."

After the news broke, however, Rocky Mountain Health issued a press release that said it has reversed its position and corrected its underwriting guidelines and "will now provide health plan coverage for healthy infants, regardless of their weight."

This case seems evidence enough of why health insurance needs to be reformed and tighter restrictions need to be placed on insurers' ability to deny coverage. If a baby has to lose weight before he can qualify, is anything sacred? Pediatricians routinely tell parents of breastfed babies not to worry about how their child's weight gain looks on the growth charts. After all, those that the CDC maintains are based on formula-fed babies whose growth curves are often quite different than those of breast-fed babies. My own three children were rated morbidly obese thanks to these charts and they weren't even a bit roly-poly, often slipping out of their baby pants because of insufficiently hearty bottoms.

Certainly, families can not alter the genetic makeup of their babies -- nor should they change a baby's doctor-recommended diet, letting him go hungry in order to drop a few pounds. The risk-averse approach to health insurance coverage ends up leaving families out in the streets, for no reason other than a company's fear of having to pay for that family to live healthily, and free of the crushing weight of medical debts.

It's a clear result of the mindlessness of actuarial tables and insidious in its undercurrent of selectivity. Rationing health care? We've got it right here. Only the healthy (according to the obviously insufficient charts) have any right to health.

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