Tuesday, October 13, 2009

Love Your Insurance Company ***Updated***

Here's something to love them for - they're not jacking up your rates by covering fat, lazy babies.

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."
Quit whining. If you cover that child, an insurance company shareholder might have to give up one of his cars. Is that what you want?

***Update*** My more-widely-read blogger pal WAMK points out that the people at Rocky Mountain Health Plans did an about-face before I posted, and now promise to cover all healthy babies, too fat or not. I'm not as comforted by this as he is. Why did they review the policy? Because they are trying to beat down the threat of the public option. Without the publicity and threat, I doubt we'd have the same result. More likely they'd cover babies two years from now only after tweaking the rules to disallow acne sufferers. AND raising rates again.

And more importantly, this result came about because of the threat of competition from a public option, which proves that it does exactly what proponents promise it will do - keep the insurance companies honest.

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