This, THIS is what is wrong with insurance today! When I read this story I was truly shocked. My son was a chunky jovial healthy baby, and he also was approximately 17 lbs at four months. Although the insurance company eventually acquiesced and covered the baby, that they even DARED to deny at all should outrage us all. Why should it require media attention for American citizens to obtain decent health care coverage.
112 Thoughts to “4 Month Old Baby DENIED Health Care Coverge”
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Sounds like it was just a flaw in the UW system of just this one insurer. http://www.denverpost.com/ci_13547963?source=rss
Colorado insurer changes course on chubby baby
Updated: 10/13/2009 10:40:21 AM MDT
Kelli Lange holds her son, 4-month-old, 17-pound Alex in Grand Junction. The Langes won a victory to get health insurance for their son. (Nancy Lofholm, The Denver Post)Related
Oct 12:
Colorado insurer changes course on fat infantsOct 10:
Heavy infant in Grand Junction denied health insuranceGRAND JUNCTION — An insurance company that last week turned down a 4-month-old, breast-fed infant for coverage because he was too fat has changed its policy toward chubby babies.
Rocky Mountain Health Plans announced Monday that it found a flaw in its underwriting system and now will provide coverage to healthy infants, regardless of their weight.
“As a small company we were able to act quickly and decisively,” said Rocky Mountain spokeswoman Kayla Arnesen. “We are really pleased we are going to be covering Alex and other healthy babies.”
Rocky Mountain, a Grand Junction-based not-for-profit company, had turned down 17-pound Alex Lange when his parents, Bernie and Kelli Lange, sought to change the family’s individual coverage. Another company had raised its rates 40 percent after Alex was born, so the Langes applied to Rocky Mountain, hoping for less expensive coverage.
Flood guy,
I am positive there are more stories just like this, people are denied coverage for multiple reasons. Being healthy is not a priveledge in my mind and if people need medical care they should be able to afford it!
The “poor” get it for free.
It’s middle-class people that get squeezed.
You are so right Rick, it is the middle class that is bearing the brunt of insurance profiteering. I will say, I believe the whole system is broken, doctor compensation, medical malpractice, inefficent competition, not enough personal health care responsibility, and overall outrageous compensation packages for insurance execs.
Any way an insurance company can squeak out of paying a claim, they will surely do. Yet this is the lobby that is throwing billions of dollars into lobbying against health care reform.
Now, you have to ask yourself, what’s wrong with this picture? Surely no one really thinks they are on your side?
a Flaw?? It was Design – designed to reject infants above the 95 weight percentile. And the only reason they changed their policy, I believe is because of the media coverage.
Elena, from your standpoint and mine, it is “broken”. But in a sense it’s been designed this way, by stockholder-run for-profit conglomerates, who hire lobbyists galore and are big players in Washington.
I see Obama/Baucus/Pelosi/Reid’s attempts at “health care reform” basically collusion with those same conglomerates. It’s just furtherance of the same bargain Bush struck – leaving everyone alone to charge an arm and a leg so long as they give more care to the subset of Americans who need it most.
The Democrats abandoned any real efforts at cost containment. Very quickly.
We’re going to stay in this current state until someone shows real leadership on this. Obama showed none. His backroom deals with lobbyists do not constitute “leadership” by most peoples’ definition.
Rick,
Are you for the public option, is that why you believe they abandonded real reform?
absolutely, had the insurance company not been called out on this, they would not have changed their policy.@Pat.Herve
The baby looks surprised by the news. He shouldn’t be. I am all for regulation of the insurance industry. I think it’s time we let go of the idea that unregulated markets are somehow good for America. “Deregulation” is good for those who have deep pockets enough to manipulate political discourse and bring pressure to bear on Congress. It’s very good for them.
I don’t understand, though, why we have to force people by threat of heavy fines to become ensured in exchange for these behemoth bloodsucking insurance companies to ALLOW us to regulate them. What is wrong with this picture.
I could be for the public option depending on the context. I haven’t heard anyone in Congress propose anything reasonable. I want to see targeted measures. First, drug reimportation.
What would sound reasonable to you Rick? What would the public option look like if you could create one.
Great question! There is something VERY wrong with this picture. It’s the backbone of the Democratic party, or lackthereof.
How will his parents explain this to him when he grows up?
I layed out my best-case proposal a little while back at length. Discrete steps. Allow drug reimportation. Let Medicare negotiate prices down. Make the poor perform public service for free medical care. Deport illegal aliens after they use emergency rooms. Now, start cost analysis on things like doing away with pre-existing conditions disqualifying people, increasing portability, etc. – maybe it can be paid for by repealing some of the tax cuts on the wealthy. DO NOT hold any one of these items hostage to the other. DO NOT rely on some corrupt deal with one business interest or another, and ad money. Fight the good fight, change we can believe in, etc.
If any used car salesman comes at you saying that they have crafted some precarious “comprehensive” deal and that you need to act right away because the deal won’t be here tomorrow and you’ll never get a better one, LAUGH IN THEIR FACE which is the quite right reaction most Americans have to the line of manure Obama and his party have trotted out.
Having stepped away from the Democratic party, I am amazed at the degree to which so many on the left accept as common sense the crazy deals and schemes the Democrats have been proposing. Everyone needs to step back and take a good look at what’s been proposed and whether it addresses the ostensible goals. Forget antipathy towards “tea party” screamers and let’s just take a rational look at this.
I’m sick and tired of government deals that don;t address root cause but get done because ine party nor the other feels it will help them to claim victory. This deal with the drug companies, yesterday’s villains, is just crazy.
You can see it in the baby’s eyes, he thinks giving Nancy Pelosi and Harry Reid more power, more tax dollars, and more of our freedom is the answer!!
Well, at least the media did something useful here! Imagine how much good they could do if they could stop worshipping Obama for five minutes!
This is a very good example of why we need a public option. If greedy private insurers do not want to cover babies, then the public option should do so.
Lobbyists! Lobbyists! We don’t need no stinking lobbyists! Isn’t that what Obama eluded to during his campaign. Well chalk that one up to ‘Not Done’ also.
SA,
You can’t get rid of lobbyists, but you can negate their influence. Unfortunately, that is not compeletly possible. However, in this fight, the Republicans clearly have more at stake then the Dems. The Repubs are the ones holding out for any real comprehensive change. Obama has no control over them, clearly, they will vote no on any comprehensive change. Simply “tweaking” the insurance industry will do nothing to initiate real reform.
There are only one way in which insurance companies can cover costly preexisting conditions and stay in business -> have a larger pool of insureds to spread the risk over. In order to do that the fed govt is either going to have to REQUIRE everyone to carry insurance or have the tax payer subsidize the difference.
People are just plain dumb when it comes to understanding how insurance companies work. They don’t turn down pre-existing conditions because they’re evil, they turn them down to stay in business.
“When I read this story I was truly shocked.”
You shouldn’t be. Grandma Love isn’t processing these claims with her gentle cookie baking hands. A recent college grad is processing these things using a matrix with height and weight parameters. They key in the numbers and either get an approve or deny based on tables created by a heartless actuary.
meant applications instead of claims in the above post… need edit function!
Elena, you CAN get rid of lobbyist in your administration, especially if it’s one of the first bills you sign. But it doesn’t seem to work that well when you also allow an ‘ethics waiver’ so that lobbyist can come aboard.
In the first 14 days of Obama’s administration he appointed 17 of them even though he vowed ‘they would have no place in his administration’!
Sounds like a good reason to to change the way they do business.
People also aren’t evil because they have pre-existing conditions. What are they supposed to do, just die to get rid of the condition?
Best reason I have heard yet for comprehensive health care reform.
Mando,
The CEO of United Health are recieved an 18 MILLION dollar bonus. That is not evil, but on the backs of those needing medical coverage and being denied payments, it is certainly immoral and greed driven.
BTW, welcome back 🙂
Hello,
Agree about hiring lobbyists in the adminstration, very disappointing.
Babies who are in the 90th percentile in both height and weight are NOT considered overweight.
Would baby who was 99% in height and 10% in weight be considered healthier? They should not be.
and there are no ideas for real reform. Doing nothing is not an option. The only option that the Republicans keep saying is Tort Reform, which is a States Right – and they should reform tort – but it is not enough.
Doing small tweaks here and there will also not work. The US Healthcare is about 17% of GDP, much hire than any other country, for questionably better care. It is also the stealth tax on many companies, as the cost of healthcare has risen faster than any other expense.
I heard this one yesterday – a couple picked the doctor because he was in the plan, they picked the hospital because it was in the plan. When the newborn was put in the NICU (down the hall from maternity), it turns out that the NICU is not in the plan and wants to be paid full freight, as the insurance company says that the NICU is out of network – how are you supposed to know that? This is just another way that the insurance companies dictate and ration healthcare today. I had the same problem with the anesthesiologist not being in the plan and wanting $9,000 for 1 surgery.
Getting rid of the pre-existing condition restriction is a priority, and the best way to do that, is to require coverage by all – you do not get home owners insurance after the fire, so why let someone get health insurance after the onset of a problem. How else do you remove the pre-existing conditions while being fair to the payer?
Not sure who is being considered a lobbyist in the administration. Those are terms too easily thrown about. As long as they are not working for a health care company, they aren’t a lobbyist.
Agreed, Pat. It has to go or there is no real reform.
And all those healthy 20 somethings that are needed in the pool of insurees are the very ones who walk out on bills when they get in traffic accidents or all beaten up in bar room brawls or on the job injuries. Yea they should have to have coverage.
Say what Moon? So according to you they have to work for a health care industry to be considered a lobbyist?
This is just another example of why I think of you as ‘far left’. No matter what the subject is you still deny the obvious. You can never find fault with Obama or his administration no matter how much evidence there is, that is what I call ‘far left’.
Here is just a short list of them (see if you can find the ones who lobbied in the health care industry): http://www.nationaljournal.com/njmagazine/sl_20090321_4967.php
Problem isn’t with lobbyists. Every entity deserves representation. Problem is, OUR lobbyists (representatives) aren’t acting in OUR best interest. The only tangible incentive for politicians to represent us is our vote. And we keep proving we’re had pretty easily.
I guess you were really opposed to Dick Cheney as VP then, what with him being a former Halliburton exec and them having proprietary non-compete contract in Iraq. He was also on the board of Bechtel.
Their business model works and the proof is that they’re still in business. If you think the govt. can teach them how to do business better, you’re in for a very rude awakening.
People aren’t evil for their preexisting conditions. But, for the most part, they ARE responsible for them. Others bad health and poor life decisions are not my fault nor my responsibility. I give to charity for those less fortunate, I DO NOT want the govt. taking more of my money simply because people feel entitled to it.
Correct me if I’m wrong Moon but Bush never campaigned for MONTHS saying that LOBBYIST WOULD NOT FIND A JOB IN HIS ADMINISTRATION. Neither did he sign a bill when he got into office reinforcing it. Am I wrong? Can you please find me an example of when Bush promised us all that?
I’m an equal opportunity opposer. But what does that have to do with the discussion at hand? My distaste for being bent over has nothing to do with party affiliation.
I guess you just shouldn’t have voted for Obama then.
Most people with White House connections, regardless of administration have lobbyist connections. Just the way the rules work. Now I see who/what are being considered ‘lobbyists’ I cam going to issuue a big, resounding, so the hell what! Its almost funny.
Yeah, it is almost funny how you can defend it… Just keep the blinders on I suppose, Obama can do no wrong.
At least Elena can admit it “Hello, Agree about hiring lobbyists in the adminstration, very disappointing.”
Mando, you consider yourself a libertarian? I think we discussed this but I can’t remember it.
Hello, you might want to read up on the rules of registering as a lobbyist. It might calm your nerves over this issue; put your mind at ease even. You are getting yourself all worked up over those silly little rules. Most people register just to be on the safe side. My husband even did. Better safe than sorry. White house or Congressional dealings….register.
It’s the party that best represents my ideals.
Just another way to excuse it I suppose Moon… I would give you that if it was one or two, it was 17 in the first 14 days. Who knows how many after that but who cares, you will explain that away as well.
I get it now, no matter what the issue is, no matter what the evidence is, in your eyes Obama and his administration do nothing wrong. Which is why I consider you to be ‘far left’. A moderate, like Elena, would be able to at least see faults… you obviously are not capable of that.
Hello, have we had a talk about sticking to issues rather than ad hominem attacks? Lets have it now: stick to issues and stop the ad hominem attacks on me and anyone else.
non-compliance = moderation
I don’t care what you think I am. It is irrelevant.
I was only commenting on what Elena had said about lobbyist… you then continued to take it to another level.
Back to the issue, I agree with LBH, this baby seems to have been mighty surprised when he got the news he was too fat to be covered. By the way, does anyone know which insurance company this was? Kind of scary because my son is around the same age and weight but I have not had any issues with my insurance… yet.
I’m glad that changed their mind and I agree with most that this type of thing is just one issue that needs to be address with ‘reform’.
In order to cut weight my son has started a workout routine of 20 minutes of cardio in a bouncy seat followed by 5 minutes of rolling around in his baby gym, then a big old poop, some carrots and apples with about 10 minutes of 5oz curls of his bottle then he hits the showers.
Maybe Ill get him in touch with this baby to see if he can help the little guy out.
It happens more often then you’d think. Think body builders or just plain big and muscular dudes. Denials are based on outliers of actuarial data. Numbers. Everyone has the legal right to contest a denial and with proper evidence of good health, most are overturned.
This one just happened at the right time for a media blitz.
Mando, then you are just going to be much more anti government than the average bear. You trust the free markets much more than I do. I see the free markets as being capable of shooting all the buffalo and causing bank failures because of risks. I think govt regulation is necessary some times (to reign in the beast in us)
Then someone has to come along and reign in the govt. I probably see it as a push me/pull me situation.