Denver Post – 10/10/2009:

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.”

Update: Insurer Rocky Mountain Health Plans has relented and will now offer insurance to cover Alex Lange.

“A recent situation in which we denied coverage to a heavy, yet healthy, infant brought to our attention a flaw in our underwriting system for approving infants,” says Steve ErkenBrack, president and CEO, Rocky Mountain Health Plans. “Because we are a small company dedicated to the people of Colorado, we are pleased to be in a position to act quickly. We have changed our policy, corrected our underwriting guidelines and are working to notify the parents of the infant who we earlier denied.”




  1. Improbus says:

    Republican Plan: Die Quickly. Har!

  2. Olo Baggins of Bywater says:

    When its the Government who screws you, they can’t be sued…you have no place to turn…

    Do you know what insurance companies do when you sue them? Probably not, because Rush doesn’t tell you that part. Grisham wrote a great book about it in 1995, The Rainmaker.

    FWIW the government’s programs have mechanisms for resolving disputes. And you don’t usually need a lawyer. So get the facts before spewing Republican crap, willya?

  3. Drewbanger says:

    This is stupid. In Texas, any child under the age of six is guaranteed health coverage, no questions asked, no way around it. Why is this not adopted everywhere?

  4. Named says:

    5, Olo Baggins of Bywater,

    Don’t you find it humourous that people actually think that having the ability to TRY and sue a multi-billion dollar company after they kill your child from denying care is a feature of private health care?

    Complete and utter madness.

  5. Named says:

    8, pedro,

    You don’t know what “related” means do you? No of course not. You’re retarded.

  6. Don Quixote says:

    Insurance brought to you with blessings from the same people who did such a great job of protecting your wealth over the past 10 years.

  7. MikeN says:

    Yes make insurance companies take on people with preexisting conditions, and make them charge everyone the same rate. That means that premiums will go up. Then people who are healthier drop out, which means premiums go up even more.

    This has actually happened in several states, where premiums now run over a thousand a month, to the point where insurance companies just left the state.

  8. Woah hoo says:

    Maybe it’s time for people to provide their own insurance. Some places to get it are fresh fruits, fresh vegetables, lean protein, and exercise. There’s no denial of coverage.

  9. noname says:

    Fat people don’t have a right to live, right?

  10. GigG says:

    In the related stories area of TFA is this story….

    Colorado already has a public option in health care — it’s just exclusive to sick people who have been rejected by private insurance companies.

    Colorado already has public option for health care

    It’s called CoverColorado, and it insures 9,800 people who have to pay about 140 percent of what the average Coloradan pays in health- insurance premiums. It is not too far-fetched, though, that the program could morph into a true public option open to everyone — a competitive choice in the individual health-insurance market.

  11. Tim says:

    Under health care reform the underwriting will come in the form of taxes on fattening foods, alcohol, crap that pollutes the air, tobacco, added whatever else our leaders decides has an adverse effect on our health.

  12. Faxon says:

    “Obese” is NOT “chubby”.
    “Morbidly obese” means headed for death.
    I’m with the insurance companies on this one.
    Now, it comes to mind. Have you EVER seen anyone over 6 feet tall who is over 75 or so years old?
    I haven’t. I always kind of feel sorry for tall people. They all die by age 68 or so, it seems.

  13. Nth of the 49th says:

    A society that glorifies plastic breasts and chemical erections doesn’t understand the results of a natural process.

    Imagine that.

  14. freddybobs68k says:

    #16 Faxon

    http://www.businessweek.com/technology/content/jul2009/tc2009071_442911.htm

    So 25% of people shouldn’t be allowed to have any health insurance. Is that what you’re saying?

    How about

    http://www.nationmaster.com/graph/hea_obe-health-obesity

    Something needs to be done about obesity in the us. We are no 1 in obesity. Go us.

    Or lets try it this way. Americans have the highest rate of obesity in the world and its getting worse. What are we going to do about it? I’ll point out the ‘free market’ solution which we have (of profiting off selling crap cheap food, and convincing people its great and good for you via advertising) doesn’t seem to be working out so well. So what to do?

    Is the solution that obese people can’t get health care – so they die earlier? Is that what you’re suggesting?

    I’ll say it cos it it bears repeating…

    Universal health care means everybody has health care, and it costs _everybody_ less. It works, and is used in the rest of the industrialized world. Why is America incapable of doing it?

    If we had universal health care – it would be more directly in the interest of the country to actually address these problems. Perhaps we could actually sort some of this stuff out.

    Instead we have the attitude of ‘not my problem’ and ‘I’m alright jack’, that is leading us all to inevitable and predictable failure.

  15. freddybobs68k says:

    # 18 Pedro

    ‘BTW, where’s the responsibility of the parents for properly feeding the kid? I betcha they fill his piehole just to keep the kid from crying instead of feeding him only when supposed to.’

    Agreed the parents are a big part of the problem.

    It seems unlikely they will spontaneously become good parents.

    So what’s supposed to happen? How do we fix this? Or at least start addressing Americas obesity problem.

  16. bobbo, the devout evangelical anti-theist says:

    With all the “exclusions” that come to light every day during this heightened awareness==one has to stop and wonder how there is any coverage at all except for employer based group plans?

    “The theory is all wrong.”==Healthcare is not the kind of service that “FITS” the for profit competitive market driven economic model. Buyer and seller are not equally informed. Buyer and seller are not equally able to evaluate/select alternatives. Quality of the product/service cannot be objectively determined. The service is fairly immobile. Time constraints operate to negate “time to comparison shop.” And on and on depending on what your definition of a “free market” actually requires.

    Free markets tend to monopolies with a few profiting off the many. Healthcare even has a mandated monopoly==only doctors can provide medical services and the AMA regularly sues nursing groups who encroach on their turf.

    Silly not to recognize the social utility of medical care being provided like fire/police/education/national security/public health services. But a few do get rich off the many which provides dreams for already deluded.

  17. Breetai says:

    Democratic plan. Blame republicans for his being fat and ban soda at schools

  18. freddybobs68k says:

    #22 Breetai

    So whats the right plan?

  19. yanikinwaoz says:

    #4 Alfred…
    Wow…really?

    All US senior citizens are already covered by Medicare, a tax payer funded medical insurance program. Congress set this up because no private medical insurance would cover this group. It has been this way for decades.

    Yet I don’t hear of Medicare death panels in the news, and decisions to cut off medical care. You would think that Medicare would already have this down pat by now.

    Re: “Nor anyone with a unique and costly disease”

    You don’t think the private insurers deny coverage now? They routinely do it. There are stories every day in the news about someone who has to sue their insurance company because they refuse to pay for treatment for something more than a cold.

  20. LibertyLover says:

    #23, Lose weight.

    If you want a car but can’t afford it, what do you do? Ask the government to buy you one? Never mind on answering those questions. I’m not sure I would get a truthful answer.

    Stop thinking with your emotions. Use some logic for once.

  21. freddybobs68k says:

    #25 LibertyLover

    Hows that plan working out?

    And seeing as it effects us all – having an unhealthy workforce – you’d think you’d care.

    Unfortunately you are the very essence of ‘not my problem’ and ‘I’m alright jack’.

    Stop thinking just about yourself. Even if you only have a selfish viewpoint, your neighbors suffering effects you to, so its even in your selfish interest. How about that.

  22. Ralph, the Bus Driver says:

    pedro,

    I looked and couldn’t find anything to back up your first link. I did find this study though.

    Summary
    What is clear from this analysis is that Canadian waiting lists are undoubtedly a problem for many Canadians on certain elective procedures. What is not clear, however, is the magnitude of the problem, and it is certainly not necessarily true that there is a Canadian “waiting list crisis.”

    • The lack of quality data on waiting lists from the Canadian government, coupled with the
    limitations of surveys (e.g. differing methodologies), makes it very difficult to conclude with any certainty the size of the true waiting list problem.

    • The Canadian experience with waiting times will necessarily be uneven, as waiting times
    vary by specialty, procedure, province, and region. That is, any given individual
    Canadian will have different experiences with waiting times. This may partly explain the
    existence of anecdotal reports of intolerable waits from certain individual Canadians
    (such stories often are dramatized in the media), juxtaposed with the denial of the
    problem from other Canadians.

    • The U.S. does not experience problems with waiting lists as much as Canada does,
    although the problem does exist for some Americans.

    • There is a small minority of Canadians who receive care in the U.S., and even a smaller
    minority who specifically come to the U.S. to receive care. The idea that hordes of Canadians cross the border to avoid waiting lists is a myth.

    And your second link? Anything coming out of the Frasier Institute is always very suspect. I also firmly believe the study I posted above more than adequately answers this “report”.

  23. LibertyLover says:

    #26, Even if you only have a selfish viewpoint

    Let’s talk about selfishness.

    Would you let your wife die to save 10 strangers?

  24. freddybobs68k says:

    #28 LibertyLover

    You really have a problem.

    I can only conclude that you _are_ you’re wife.

    That’s the only explanation that makes sense of you’re point of view.

    Repeating the same empty meaningless madness over and over again, it’s sad. If you’re ‘wife’ was a real person, even she’d agree.

  25. LibertyLover says:

    #29, Oh, wait! You’ve already lied. No need to carry this any further.

  26. LibertyLover says:

    #29, To be quite honest, I have a hard time believing you truly feel that way. I mean, if you’d lie about saving your wife, I wonder what else you would lie about.

  27. freddybobs68k says:

    #30 LibertyLover

    Thus proving my point.

    Please don’t say anything – unless you’ve actually got something interesting or useful to say.

    I’m sure your ‘wife’ underneath feels the same way. And you should bring up your ‘wife’ next time you’re in therapy. I think it will help ‘both’ of you.

  28. LibertyLover says:

    #32, Please, you’re a liar. Anything you say is suspect.

  29. qb says:

    About the whole American vs Canadian health care. It’s apples and oranges. The stats on both sides are misleading.

    For example, my experience with MRI. Need one now for a nagging but not critical problem, it’s scheduled about 3-4 weeks out. 6 years ago went to emergency with a critical problem, got an MRI in less than 1/2 an hour.

    One big problem for the US is that they’ve spent too heavily on a public system without committing to it (Rep and Dem alike). You don’t do pubic health care well because you don’t want to.

    The other big problem is that you don’t do private health care well either. You don’t get great value for the immense amount of money you spend since it’s based on a commodity consumer model. That works well for driving down the cost of hamburgers. It is also killing your business competitiveness since it’s a huge hidden tax.

    Overall, I don’t think the US should adopt the Canadian system, or Canada adopt the US system. If I was the US I would look seriously at the Swiss model, not the Canadian. Do public or private well, instead of both poorly.

  30. freddybobs68k says:

    #33 LibertyLover

    So your not denying it. That’s good. An excellent first step.

    The first stage of fixing a problem is recognizing that you have a problem. So good for you! You’re ‘wife’ would be proud.


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