SP Round Table: Fat baby denied health insurance

Kate started us off by pointing to this horrifying story about a 4-month-old baby in Colorado who was denied health insurance for being too fat. Super fun quote from the article:

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.

We began this roundtable with general email screaming. Once we calmed down, here’s what we had to say.

Tall Chairs Round Table (by moriza)

Tall Chairs Round Table (by moriza)

Kate:
A) The kid is at the 99th percentile for height AND weight, so WTF? B) This is exactly why we need universal health insurance. Because, setting the height thing aside, let’s say the kid really is bizarrely fat at 4 months. There’s virtually no chance that this is the parents’ fault in any way. (Not that it would be the parents’ fault if the kid were old enough to eat solid food and exercise, mind you, but go with me here.) Which means that if this kid IS much fatter than one could reasonably expect him to be, it’s almost certainly because of * the possibility that it’s a genetic disorder — of the sort that gets older kids stolen from their parents because authorities are convinced it’s all calories in/calories out — becomes increasingly likely. And I would not be one fucking bit surprised if that’s part of the insurance company’s calculation here — not that fatness will make the baby expensively sick down the line, but that fatness suggests the baby might ALREADY be expensively sick. And of course, the important thing is making sure we don’t spend money on sick children.

Sweet Machine:
I find it really sad that the parents in the article are joking about the diets they’ll have to put the baby on. Because of course that’s the kind of joke that I’d make, too, but it actually points to the problem so well: is this what the insurance people want? What exactly can you do to an infant to make them skinnier that does not constitute grievous harm? I’m no pediatrician, but really, what the hell?

Fillyjonk:
That upset me primarily because I’m not sure how long it will remain a joke. It’s one of those bits of satire that’s so close to some people’s reality that it’s uncomfortable. I mean, people switch their babies to skim milk, and put them on diets while they’re still in diapers. Making a crack about weaning the kid to Slimfast is funny, especially with the jab at expensive weight-loss products, but it isn’t even far enough outside of the norm to function as satire. Some people hearing that joke are going to say “and well you should.”

If they’re in a position where they can either let the kid remain uninsured or put him on a diet, they’re going to put him on a diet. It’s all very well to recognize that feeding a baby Slimfast is absurd, but a) it’s not absurd for a lot of people and b) how long can they afford to acknowledge its absurdity?

A Sarah:
My first thought was of how incredibly, incredibly fragile the first year of life has been for most of human history.  Getting babies adequate nutrition and hydration to live on is a GODDAMN SERIOUS ISSUE for our species, seeing how human newborns come into the world VERY dependent relative to the young of other primates.  (Tradeoff for the bipedalism and the big brains.)  Plenty of healthy babies still are one infection, bout of diarrhea, or disruption in the food supply away from life-threatening malnutrition.  The arrogance of saying, “Well, the baby’s fat, and healthy… but FAT, and FAT babies might become FAT GROWNUPS, and I mean… EW! and anyway, all the other insurance companies are doing it.  I mean, there’s MONEY involved, y’see.”

FUCK.  I mean, FUCK. Have these people ever seen a sick infant?  A truly sick infant?  Or, hell, a WELL infant?  I’m so angry.

SM:
That is such a great point. I mean, there’s a reason that chubby babies have traditionally been seen as desirable, right? It’s really obscene.

And of course this points to, once again, the complete clusterfuck that is the US health system. Which will make me all rantypants if I say another word about it.

FJ:
As infuriating as this is, denying obese adults health insurance might be even more infuriating. Babies who can’t get health insurance are the top 5 percent of heavy babies — the adults who can’t get health insurance are, as we hear over and over again, the top 30 percent.

SM:
Have y’all read amandaw’s post about pre-existing conditions and how ableist it is to be, like, extra-angry about only the more outrageous cases? It’s on my mind because she reposted it on the new FWD blog, and I’m wondering how this plays into it. I think basically it actually highlights the ableism involved in denial of care, because, as amandaw says, the underlying assumption of our ableist culture is that if someone’s sick, they did something wrong. Somewhere, somehow, sometime, they secretly brought it on themselves (though of course some patients are “more deserving” than others). But a 4-month-old, pretty much by definition, can’t have done anything wrong. It really points to the identity-versus-behaviors problem of the “obesity epidemic.” Here is someone who is innocent in every way we understand that word — but who is being treated as guilty by a system that assumes that if adults are fat or sick, it’s their fault.

AS:
Throwing this into the mix, not sure how it fits: I was astounded, when I had kids, to realize just how vulnerable even a very very very healthy young baby (like, 6 mos.) is. Up to some point (can’t remember how many months) a fever over 101 is a medical emergency and you don’t call the doctor, you call 911.  To have the misfortune of getting chicken pox and strep at the same time can be life-threatening.  Diarrhea is pretty serious.  Frequent well baby checkups if you’re going by the AAP recommendations.  Lots of things that are vaccinated against now routinely killed children before immunizations (and very rare vaccine reactions injure babies today.)  That’s not to be all OMG PARENTING MEANS MARINATING IN FEAR — because it also turned out that a bump on the head or an accidentally-burned finger or the TV being on or some store-bought baby food does not in fact teach babies NEVER TO LOVE OR LEARN — but since we’re talking about things that send babies into the healthcare system, it seems pertinent.

So we have these poor little innocent babies (and yeah, I mean, who doesn’t love babies?) but when one considers how great are the healthcare needs even of young babies with NO known medical conditions, it just seems so ridiculous and disingenuous.  So, okay, insurance company, you’re concerned that the baby might be eating too much breastmilk (omgwtf?!?) and, what, will be fat and expensive and selfish and lazy someday?  Right. Couldn’t be that babies are big consumers of healthcare, or that they’re one of the groups for whom there sometimes are public programs, or that you’re just looking for a way to save a buck without appearing like the hater of human life that you are.

*ETA: My original language there was problematic. –Kate

197 thoughts on “SP Round Table: Fat baby denied health insurance

  1. Honestly, the only think I can think to say is: what the FUCK???

    Oh, and my little brother had a fever of over 101 F when he was 10 days old. He was in the hospital for over a week and we’re lucky he’s ok (currently 22 and a healthy, generally “normal” PhD student, though his immune system is definitely weaker than mine), but I have no idea how my parents would have dealt had we not had health insurance. They were a mess over their infant son being seriously sick and probably couldn’t have even thought about anything financial at that point.

  2. Well, obviously, this is the mother’s fault. Her breast milk is way too fat filled. SHE should go on a diet! Stop eating those baby donuts.

    NOT.

    Who is the person out there that thinks this is rational? I want to hit them with a clue by four.

  3. I can’t get past the first sentence — I keep staring at it and thinking I’m not actually awake, because my living room suddenly being replaced by a mountaintop in the Himalayas makes more sense.

  4. The thing that really gets to me about this is that this kid will grow up with this fucking article. For the rest of his fucking life he will be that super fat baby who was so fucking super fat that he couldn’t get health insurance. At family dinners they will make jokes about him eating too much, or some such shit. He will forever be reminded of this. How often do you think baby Jessica gets told not to go too close to wells? Still? I bet this kid grows up to develop some serious self image issues.

  5. SM: “Have y’all read amandaw’s post about pre-existing conditions and how ableist it is to be, like, extra-angry about only the more outrageous cases?”

    I’ve been thinking about this recently, and all the false moral judgments we heap on some types of illness.

  6. Please indulge me, because this is off-topic, but I posted the last comment on the Schrodinger thread while Kate was posting to say the thread was closed. I obviously have no problem with my comment being deleted, but I want to be sure I’m not going to be banned. My post appears after hers, which makes it seem like I ignored the official closure. Could a mod please confirm I’m okay? Thanks.

  7. I’ve been thinking about this recently, and all the false moral judgments we heap on some types of illness.

    I highly recommend amandaw’s post if you haven’t read it already — she really lays it bare.

  8. Oh my god, babies are supposed to be fat! That’s the whole point! They carry extra fat because they grow all the time and can get sick and don’t have any reserves! My daughter is almost 5 months old and for the first few months of her life, we worried a lot that she didn’t seem particularly fat. The doctor said her weight was fine, but we looked at her and thought, “what if she gets sick? she doesn’t look like she has energy to spare!” We were relieved when she started putting on more fat because she finally looked like a healthy baby to us.

    Uh, I just realized this sounds like I’m excusing fatness in babies and thereby implying that it is not excusable in adults, but that’s not at all what I mean.

    Also, what Kate said initially: if the baby is in the 99th percentile of weight and height both, it is by definition not fat (that is, carrying extra adipose tissue). It’s a big baby. There’s a huge variety in sizes of babies – that’s the point of following their growth on a percentile chart. You can’t just say “all babies should be x pounds by y age.” It’s nonsensical when one baby starts at 4 pounds and another starts at 9 pounds. The percentile is just a comparison to other babies born around the same time.

  9. …the fuck?

    I’m going to have to come back to formulate a real response later, because I just can’t wrap my mind around this.

  10. Too absurd and sickening for words. As a (former) Canadian, though, I’m not so swift to deem universal health care a solution to problems like this. I have a chronic condition–my body doesn’t process B12 correctly–and I couldn’t get treatment in Canada because I was too fat. My doctor’s hands were tied–he couldn’t treat me until I slimmed down to a lower BMI. I came to the US initially for the health care and wound up staying because I met my husband here.

    The idea that universal health care will be good for fats is not necessarily true. Many health care options will not be available for overweight patients unless they lose weight first.

  11. I just came here as well to see if y’all had seen this.

    Breastfeeding infants are the very definition of intuitive eating — they eat when they’re hungry, and stop when they’re full. You can’t force a baby to nurse when it’s not hungry, or persuade it not to eat when it is, or feed it “junk food” breastmilk. The weight ranges for infants are so small that the baby would be back in the “normal” range if he lost less than a pound (i.e. had a diaper change, or was weighed on a different scale). That’s why it’s absolutely insane to make meaningful judgments about babies’ weights.

  12. SM, thank you for the disabledfeminists link — not only is that specific post great, there’s a lot of other really good thinking there.

  13. Am I totally missing something here? Aren’t those charts of heights and weights just showing he’s taller/heavier (statistically speaking) than 99% of other babies? SOMEONE has to be at the top of the chart, right? Even if you knock off the “unacceptable” heights or weights, there’s still always going to be a 99th percentile? And a 50th and a 1st? It doesn’t imply any sort of health measure.

    Even though the BMI is stupid and pointless, at least that appears to get at something – a ratio of weight to height where you have too much (or too little) weight for your height. But if he’s in the 99th percentile for both, isn’t he right on track, with a “perfect” ratio? If he were in the 99th percentile for weight, but only the 50th for height, I could sort of see the “problem”. Shouldn’t a baby who’s extra tall for his age also weigh more?

    I’m *really* confused about why being the biggest baby automatically makes you unhealthy.

    Generally speaking, it’s those babies down at the other end of the chart – the ones in the 1st or 15th, or 35th percentile that use the most healthcare resources and dollars. Those 1 lb premies that stay in the NICU for 6 months. But no one would dare say don’t cover them.

  14. Oh, I also wanted to say that I’m a bit bothered by Kate’s suggestion that the baby must have a genetic disorder like Prader-Willi to be so fat. It sounds a lot like saying, oh, he’s so big, there must be something WRONG with him!

    I’m pretty 101-level with both ableism and FA, so maybe I’m the one who’s off-base here. Still, I think it would be wrong to assume a fat adult must have a genetic disorder (as opposed to having a genetic predisposition to a certain weight range). Is it OK to make those kind of assumptions about a baby? Isn’t that like saying that all babies *should* weigh no more than a certain amount, and that exceptions must therefore be the result of bad behavior or major genetic abnormality?

  15. I am very much wtfing at the fact that they’re calling the baby fat when he’s in 99th percentile for both weight an height, because that just sounds proportional but large to me.

    That aside, WHAT THE HELL DENYING BABIES MEDICAL COVERAGE?! And there doesn’t seem like there’s a possible good outcome for the parents here – if they let their kid eat and grow naturally they’ll be accused of overfeeding him and making him fat, if they starve the kid to make him acceptable skinny they’ll be, well, starving their freaking baby. Really hoping this case doesn’t end up echoing the really horrific one about the (peruvian?) couple who had their toddler taken away from them because she had an unidentified genetic condition that made her gain vast amounts of weight.

  16. Not only does this point show an example of why healthcare reform is needed in general, it shows specifically why we need bills like HR 3200. Not only would insurance companies be prohibited from excluding coverage for any preexisting condition (I guess that includes being a fat baby), it would also require insurance companies to cover things like vaccinations and other preventive care that are ESPECIALLY vital for children to have.

  17. Is it OK to make those kind of assumptions about a baby? Isn’t that like saying that all babies *should* weigh no more than a certain amount, and that exceptions must therefore be the result of bad behavior or major genetic abnormality?

    Emma B, what I take from Kate’s comment is that if this baby truly were record-breakingly, health-endangeringly, mind-bogglingly fat for a four-month-old, to the extent that it was considered a medical emergency, it wouldn’t be simply because he ate too much, which is what many people accuse very fat adults of doing. Like, even the most fatphobic arguments don’t hold water here, because the kid has done nothing in his life but be a baby.

  18. Fuckity fuck fucking FUCK. I have a friend who is ecstatic that her preemie finally made the weight to come home from the hospital last week – they were sweating it as he slowly gained ounce by ounce, and would have loved to have this “problem”. This makes me so fucking mad I can’t say anything but fuck.

  19. SM, thank you for the disabledfeminists link — not only is that specific post great, there’s a lot of other really good thinking there.

    It just launched! I am super excited about it. I am already a fan of amandaw, annaham, and Meloukhia, so I’m glad they’ve joined forces. Everyone, go check them out: http://www.disabledfeminists.com

  20. Oh, I also wanted to say that I’m a bit bothered by Kate’s suggestion that the baby must have a genetic disorder like Prader-Willi to be so fat. It sounds a lot like saying, oh, he’s so big, there must be something WRONG with him!

    Emma B, I can see how you’d read it that way, but I wasn’t trying to suggest that fat baby = disorder. I was speaking hypothetically — “Let’s say he really IS an incredibly, unusually fat baby, not just a big baby.” (Though my very first point was that, given his height also being in the 99th percentile, this sounds like a plain old big baby.) The whole premise of the rest of that argument is that our hypothetical baby is much bigger than even plain old fat genes would suggest he should be — in which case, one assumes doctors would be looking for a disorder. (The fact that there’s no mention of parents or docs investigating a disorder here is one more point in favor of the “just a big baby” theory — though I suppose it could also be a really dispiriting example of fat panic leading to a total medical logic fail.) My point was not that any fat baby probably has a genetic disorder, but that a truly off-the-charts (and not height-proportionate) fat baby eating nothing but breast milk would likely be suspected of one, at the very least — which means insurers would be reluctant to provide coverage. Which is, you know, evil.

  21. Generally speaking, it’s those babies down at the other end of the chart – the ones in the 1st or 15th, or 35th percentile that use the most healthcare resources and dollars. Those 1 lb premies that stay in the NICU for 6 months. But no one would dare say don’t cover them.

    Disagree with this, because there are LOTS of people who will tell you that the parents of those children (who are often much-loved and long-awaited, and who often go on to live meaningful lives regardless of health conditions) should just disconnect them and save us all the million-dollar bills.

    This is doubly true if your children are premature because they’re the result of a multiple pregnancy conceived after infertility treatment. Then, the New York Times points out how much your obsession with having babies at any cost impacts us all!

    (As a mother of IUI multiples, I actually agree with the bulk of that article, but it chaps my hide every time someone feels the need to point out how expensive infertility pregnancies are. There are only about 15,000 IVF multiple births a year, and probably about the same number of IUI multiple births, although those aren’t tracked by CDC. The absolute numbers are just way too small to be a major health care cost driver.)

  22. Insurers don’t take babies above the 95th percentile, no matter how healthy they are otherwise.

    …unless they’re being added to an employer’s group policy, perhaps? I wasn’t asked my husband’s height and weight when I added him to my policy when we were married. Or is this new?

  23. Shit. Fucking shitty shitmaking hellfire shit.

    My eldest child was in the 99.8th centile for weight pretty much from birth. She crawled at 4.5 months, walked at 9 months, did all sorts of things which require big strong muscles. Grew it all before birth, really. She’s slim and muscular and child-shaped.

    Breastfed, so it wasn’t Teh Eebil Formula (which saved her friend’s life, as it happens), either.

    My second child was born 25th centile and is about 50th now.

    This whole shit is so shitty I want to put it in a week-old cloth diaper and close the bucket lid on it.

    Thank fuck for the NHS.

  24. living: I have to assume that they do not have group coverage and that they tried to obtain individual insurance for the baby.

    Because in my employer provided group plan, there was no test to see what my baby weighed at birth or later. He was just automatically covered as soon as he was born.

  25. Aiee. I want to phone them up and say “You people live in a place that denies medical care to INFANTS, people! BABIES!” because surely then they’d get it?!

    (FWIW, I lived without access to medical care for financial reasons for much of my childhood and early adulthood. So this is quite close to the bone for me.)

  26. I keep thinking I can’t be any more horrified by the U.S. health insurance system, and then…I come across another story about it, and I am. :( Nothing I can do about it – not my country – but I hope it improves for you guys. No one should be denied health care for any reason.

  27. DanielZ: From that assumption (which seems reasonable) I’d go on to assume that they do not have group coverage because they don’t have the employment perks or personal wealth which would allow it.

  28. I had to come out of lurkdom to comment, as someone who had not one but THREE — yes, all three — of my kids end up off the height/weight charts entirely during their first year. We come from big stock, and my boys were in size 1 by three months and size 3 by one year. We had to switch the two oldest into booster seats at age 2 because they were too tall/heavy for the upper car seat limits. Thank god manufacturers figured out that the seats needed to be bigger; we were able to keep our youngest in a proper seat until 3 and a half. It is a logistical nightmare having kids who grow out of every baby product before they can walk; I can not fathom being denied medical coverage because of this. I can see the medical bias though, because our first pediatrician accused me several times of overfeeding my firstborn and it wasn’t until my second came along that he accepted that we just “grow them big.” Our current doctor has never had a problem, and all my kids are still tall but proportionate. The charts are ridiculous and desperately need to be updated.

    This baby isn’t even off the charts either. I am so glad we aren’t having any more kids, and I feel for the parents. They didn’t ask for this. Nobody wants their kid to be that big, trust me. I’ve been a longtime supporter of FA but I think this is the article that will show my family and friends exactly how dangerous the current attitudes towards obesity are.

  29. “… you’re just looking for a way to save a buck without appearing like the hater of human life that you are.”

    I read (probably far too much) Grisham, and always figured GreatBenefit was likely modeled on some real-world insurance company.

    The baby is four. months. old.

    Starting to think seriously about the Brave New World soma thing, because between this, the public-option healthcare watering-down, and the “post-sexist” “post-racist” “there’s no such thing as ableist language” people, some days I just want to crawl into a nice quiet hole and pull it in after me …

  30. ‘I want to phone them up and say “You people live in a place that denies medical care to INFANTS, people! BABIES!”’

    I can’t help but hope this turns into the worst possible PR scandal for that insurance company ever.

  31. @alibelle: I hope this kid lives to be a hundred, healthy as all fuck, constantly being reminded that he was so fat that the insurers wouldn’t touch him, and becoming living proof of their absurdity. Granted, he doesn’t have a choice, and that’s not especially fair, but his situation is all the more poignant because of it. I also hope that he lives [full stop], given how dangerous infancy can be for families without medical care. Jackasses.

  32. I keep trying to wrap my mind around excluding some people from health care (by making it effectively impossible to get). I keep wondering how we got to that.

    For example, a lot of us can see how we all benefit if everybody can read. Enough of us see the real benefit and downright self-interest to that for us to have started publicly subsidized education, and to keep trying to keep it going and/or improve it.

    I keep trying to figure out how that can co-exist with it not being collectively accepted that we all benefit if everybody is as healthy as they can be, enough that we publicly subsidize health care to a similar level.

    I’m not sure if that made any sense, but I keep hitting a Giant Wall of Noncomprehension when I try to think about it.

  33. I just want to walk up in the middle of the Senate session tomorrow with this story and scream “THIS IS WHAT HAPPENS WHEN HEALTH CARE IS FOR-PROFIT” at the top of my lungs.

  34. @living400lbs I was actually just thinking the same thing, because I didn’t have to have a physical done when I joined my employer’s group plan.

  35. littlem: I can’t really believe that it’s actually possible in real life for someone to sit in a meeting room somewhere and decide “Oh, I know, let’s deny medical care to… oh… 1% or 5% of babies? What do you guys think we can get away with? 99th centile sounds big, we’ll use that. Shall we go for a beer?”

  36. And somehow I pressed submit before I finished what I wanted to say: It may also depend on the insurance company.

  37. Thank you for linking to amandaw’s article, which addressing something I’d been wondering as I read about this baby – why do the articles focus on how outrageous the single denial is, rather than on the ethics of denial of coverage?

    So, in this case, much of the space in the article is devoted to ruling out fault on the part of the parents, including the likelihood of immediate genetic cause … which no doubt helps ramp up outrage for this specific case, but does nothing to challenge the decision to arbitrarily deny coverage to all infants above the 95 percentile in weight, nor does it question the ethics of denial of coverage for pre-existing conditions in any other respect.

    I also keep thinking, that the same space used for cute quotes from the parents, could’ve been used for opinions from a respected pediatrician or two, and wasn’t.

  38. Actually, I don’t like being around babies at all. I really don’t. But you know what? It’s not the baby’s fault that it’s a baby and all, and does things that babies do – like screech and be moist and emit aromas. I can’t hold a baby’s baby-ness against the baby itself, and as long as I’m able to remove myself from the situation and nobody’s asking me to hold a tiny breakable human, no harm, no foul. I’m not going to be all pissed off at a helpless little human for being what it is.

    Which is sort of my other major point here. Because what these colossal fuckfaced assrags are doing re: this big ol’ baby is exactly that: holding a baby’s essential nature against it for no goddamn good reason. That’s part of the bias against fat people in general, holding our fat against us, but when you apply it to an INFANT, oh pale, waltzing CHRIST it becomes immediately apparent to anyone with a brainstem and two misfiring synapses that the whole issue is fucking ridiculous.

    I hate insurance companies.

  39. I am appalled. Utterly, utterly appalled. I have a 10 month old, and have been known to privately roll my eyes when my American friends with young babies worry that their kid is ‘too chubby’ because it’s, like, 50% for height but 75% for weight. I’m all, it’s just a statistical spread, it’s not a value judgment.

    But apparently it is, and I’m just too privileged and smug to have realised that. Denying coverage to a baby. A BABY. What. The. Fuck.

  40. Ailbhe: It must be an individual plan because HIPAA prohibits the exclusions of preexisting conditions for newborns.

    “In addition, a preexisting condition exclusion cannot be applied to a newborn, adopted child under age 18, or a child under 18 placed for adoption as long as the child became covered under the health plan within 30 days of birth, adoption or placement for adoption, and provided the child does not incur a subsequent 63-day or longer break in coverage.”

  41. “I want to phone them up and say “You people live in a place that denies medical care to INFANTS, people! BABIES!””

    That’s next. I’m trying not to give them ideas.
    Srsly, I wouldn’t put it past them doing a bit of mother-blaming and saying she’s feeding the baby too much. They’ve gone this far.

    And, like someone said upthread – all of a sudden I can’t find who; am I hallucinating? – if she feeds the baby less, Jeebus forbid, she’ll be starving the baby.

    I can’t deal. I’m near tears, and it’s only Monday.

    *small voice*
    (KH, my first read was the same as Emma B’s, to the point where I thought “I have to read this again – she couldn’t have meant what it reads like she *might* mean.”
    I think it’s the ‘almost certainly because of’ phrase — tweaking that might also forestall the “You’re not a health professional; how do you know”-esque Troll Model.)

  42. @Ailbhe –
    In one of the last gasps of twisted humor I can likely muster on this topic, I don’t think they drank beer at GreatBenefit. Only 18-year-old scotch.

  43. SM and Kate, I get, and agree with, the intent, but then we’ve just spent a lot of pixels in the last week talking about how statements != intentions, right?

    Of course, a true Gigantor Baby should be worked up by hir physician for serious illnesses, but the same would (hopefully) true for an adult with unexplained large weight gain, or an adult who is “truly off-the-charts and not height-proportionate” while demonstrably eating an appropriate diet. I think what bothered me is the way Kate concluded Gigantor Baby “almost certainly” has a genetic disorder, rather than bringing it up as a possibility to be investigated.

    Consider the underweight baby (I breastfed three of these, one of whom narrowly missed being officially branded “failure to thrive”). Would you, a random Internet stranger, feel good about concluding that my appropriately-fed baby “almost certainly” has an illness? I didn’t mind when my pediatrician wanted to investigate their health, or even when she asked questions to find out if I were a secret child-abuser. If a journalist had been writing about me being denied health insurance, I might not have minded if the journalist asked about health conditions. But I can tell you that it used to tick me off royally when people in the grocery store would stop and comment about how tiny all of my babies were, and ask if they were preemies, or what was wrong with them.

    You’re not exactly doing that, but to me, it still carries echoes — maybe it’s the juxtaposition of your certainty, and your relative lack of knowledge. And sure, maybe it’s also some defensiveness on my part. Ultimately, I think I’m still going to conclude that this was badly phrased, but like y’all are always saying, a) we don’t all have to agree about everything; and b) saying something ableist isn’t the same as being an Evil Ableist Oppressor.

  44. Please forgive if I’ve missed this being posted already, but

    http://www.denverpost.com/ci_13545594?source=bb

    “Colorado insurer changes course on fat infants”

    Bowing in one tiny case to massive publicity does not, of course, make the whole system one whit less stupid. But for this one family–and possibly others in their situation, one can only hope–good news?

  45. @ Samtha said: The idea that universal health care will be good for fats is not necessarily true. Many health care options will not be available for overweight patients unless they lose weight first.

    I am a fat Canadian, and I have never been denied treatment because of my weight, or told that I have to lose weight in order to obtain treatment. I am shocked that you had the negative experience you did – that doesn’t sound anything like the universal healthcare I know and love!

    Both of my babies ended up in the special care nursery at the hospital when they were born – I will always be grateful that we didn’t have to associate the beginning of their lives with a shocking burden of debt – or have to worry that our second daughter, who was a big baby, would be denied coverage because of her size. Or even that I would be denied coverage because I am obese – because the shame and self-loathing spiral would start, for me, at the point where my body and the denial of healthcare would intersect.

  46. “SM and Kate, I get, and agree with, the intent, but then we’ve just spent a lot of pixels in the last week talking about how statements != intentions, right?”
    *sigh* This, I think.

    (Especially when the writing voice in question is an increasingly prominent one and, as such and also as a feminist voice, that much more likely to be scrutinized.

    That’s a compliment.)

  47. WTF??? Has anyone noticed that by refusing to insure anyone above the 95th percentile, they are automatically refusing to insure 5% of the population – no matter what the overall health of a population is?

  48. he’s in 99th percentile for both weight an height, because that just sounds proportional but large to me

    Indeed, Shiyiya. In fact, if the kid is 99th height and much less for weight — say 40th or 30th — that could indeed be an issue on its own, assuming it persists.

    (Babies grow fast. )

  49. I am so glad you galz jumped on this. I heard a sound byte about it last night and was completely flabbergasted. The baby’s picture came on, and both me and the spouse went, ‘Awww!’ Then the sound byte (thiz babeh iz two faaattttt!!!!!), and we both went, ‘????!!!??? are we in Bizarro World? What just happened?’

    I would like to urge everyone who reads this to write to their congressional reps and tell them that we need a ‘public option’ (or whatever the hell they want to call it — just something that isn’t the current ‘deny treatment to make money’ model) — in the Health Care bill. That is something constructive to do with our anger.

    Here’s some links to make this easy for y’all to do:

    https://writerep.house.gov/writerep/welcome.shtml

    http://www.congress.org/

    http://www.senate.gov/general/contact_information/senators_cfm.cfm

    There are also two fairly serious petitions for a public option currently circulating:

    http://www.standwithdrdean.com/

    http://www.citizensforapublicoption.com/

    Without an option, we’ll all be forced to do business with these criminals, which, frankly, I can’t understand any thinking person believing is a ‘solution’ to our health care problem.

    Sorry to soapbox; ymmv, caveat emptor and all that.

  50. I have a chronic condition–my body doesn’t process B12 correctly–and I couldn’t get treatment in Canada because I was too fat. My doctor’s hands were tied–he couldn’t treat me until I slimmed down to a lower BMI.

    I know health care in Canada differs by province and isn’t nationalized, but this is the first I’ve heard of someone being denied care there — not just surgery, but doctors’ treatment — for their weight. I’d love to know if anyone else has experienced this. It seems to me that bureaucracies that fixate on numbers, whether the number fixation comes from the motivation of “profit” or from that of “coming in under budget,” are going to leave a lot of people totally screwed.

    But yeah. A baby. Must be all the intravenous Big Macs.

  51. This hits too close to home for me to form a coherent response right off the bat.

    But in the meantime…what the FUCK?!?

  52. I have a friend whose 8 month old has been (affectionately) described as the Michelin Man, Jaba the Baby, or Babyzilla. She’s absolutely gorgeous and hugely fat, and very very healthy. The thing that bothers me is her mom/my friend has told me that her relatives are making comments along the lines of “don’t worry, she’ll thin out once she starts walking.” The idea that anyone could possibly conceive of baby fat being unhealthy just astounds me. It’s as arbitrary as making judgments about the size of a baby’s cheeks (I have another friend whose baby has these amazing round cheeks of cuteness).

    I’m also more and more seeing the patholization of normal baby stuff. I generally run with the crunchy moms, so I’ve probably heard that my baby “might have a dairy allergy” no less than 40 times in the 3.5 months my baby’s been alive, because of things like fussiness, infant acne, cradle cap, the occasional diarrhea, being big, not gaining weight fast enough, one cold, normal stool variations, etc. In short, for being a baby. It’s gotten to the point that when I took my baby to the doc cuz of some poop issues, the first thing the (naturally-minded) doc said was that it almost certainly wasn’t a dairy allergy.

  53. I changed the language in the post. I agree that the “almost certainly” was problematic, and I apologize.

    And I appreciate your willingness to rethink, above and beyond the question of the language.

    (Rest Of The Internets, please observe and take careful notes.)

  54. I can’t help but hope this turns into the worst possible PR scandal for that insurance company ever.

    It has. The company has backed down. Since this is a local news story, I’ve had plenty of chances to see the baby in question. He’s a cute little dimpled guy and doesn’t look any fatter than your average healthy baby. He does look more like 6 months old rather than 4 months old, but big whoop. Yet another example of ridiculous anti-fat hysteria.

  55. The idea that universal health care will be good for fats is not necessarily true. Many health care options will not be available for overweight patients unless they lose weight first.

    You mean exactly how it is here now? Except for how a ton of people have no coverage at all? Including obese people who are routinely denied it? You don’t think being able to go to the doctor in the first place might just improve life for a whole lot of fat people?

    Seriously, I have exactly zero patience right now for an argument about whether insuring every citizen is the right thing to do. It is the position of this blog (which was founded by a sometime Canadian) that universal health care, however imperfect, is the only ethical system; that for-profit insurance leads inevitably to such horrendous abuses that its limited advantages for those who can afford it interest us not at all; and that this country should be marinating in shame for letting millions go entirely without coverage because we are so morally fucking backward as to think any of this is legitimately controversial.

    Excluding fat (or otherwise “unworthy”) people from treatment — which, again, is very much already happening here– is abhorrent. But excluding fat people, poor people, people with disabilities or chronic illnesses, various other marginalized groups and four-month-old babies from ANY COVERAGE AT ALL is abhorrent, too, and at least Canada’s got that one right. We can argue all you want about the details, but if your ideal healthcare system does not begin with covering everyone, just fuck off, because I am not even having that shit right now.

  56. I’ve heard of a number of cases where PR scandals have made companies change course like that — which to me suggests that the more we *know* about how insurance companies actually operate, the more horrified we’re likely to be.

  57. I just want to echo the “health insurance reform may not help out fat people” comments – today I was listening to a discussion of reform bills on Marketplace, and the issue of “cost containment” came up. One of the commenters said that for reform to succeed, physicians and facilities have to stop being paid per intervention, but be paid per outcome, so basically if you use a treatment and the patient gets well, you get paid, but if they don’t, you may have to eat the cost.

    Ostensibly the goal is to get health care practitioners to use good judgment before universally prescribing the latest fancy drug or the most expensive tests, and to use empirical research on efficacy to influence their choice of interventions.

    But you can see where this is going, right? Physicians will start refusing to treat fat patients, because everybody knows we all die young, need a billion dollars worth of medical care, and are probably just going to die of a heart attack in the middle of our mammograms (which would be unsuccessful anyway because how can a mere machine be expected to see cancer through all that fat?)

  58. Um yeah, my son will be 4 months two weeks and he is 17 lbs right now, possibly closer to 18. I guess it’s good that I am one of the lucky people who has good health insurance from her employer and don’t have to worry about being rejected for stuff like that!

    I love my chubby little son. I nom his chubby little cheeks all the time. (He noms my fingers and shoulder constantly so it’s only fair.)

  59. Sunflowermoonbeam – great points. I, too, tend to run with the crunchy mamas … and I’ve observed all these things, and participated in some of it (though I loathe the way some people blame everything on food allergies). I suspect there is an evolutionary component to obsessing over our baby’s intake/output/size/health – we want them to survive! My daughter required heart surgery at a week old, and required a feeding tube afterward – after a month in the hospital with her, weighing and inspecting every diaper, measuring every thing she consumed, monitoring her weight by the gram, it’s hard to shake loose of that, 11 months later. But I need to do it.

    Anyway, ladies, thanks for all the good reading. I only came upon this site a few days ago and am re-thinking so many things. The thread about passing on diet-centric and fat-phobic attitudes to our kids was powerful. I want my daughter (12 months) to have a positive self-image and a healthy relationship with food. That means hubby and I need to stop with the dieting (we both gained a lot of weight when I was pregnant, and have lost most, but not all of it since the birth), and talking about our weights, etc. Then I have to talk to our families about it because one side of the family eats the SAD and is always on some type of diet, and the other side of the family is super crunchy but also ALWAYS talking about food (one parent is a holistic health counselor).

    We might need to move to another country.

  60. … which is not to say we don’t need universal health insurance because we do. I’m just not expecting many fat people to suddenly be allowed enter the promised land, so to speak.

  61. One of the commenters said that for reform to succeed, physicians and facilities have to stop being paid per intervention, but be paid per outcome, so basically if you use a treatment and the patient gets well, you get paid, but if they don’t, you may have to eat the cost.

    Or they can just get paid a salary for doing their best to treat each patient, regardless of outcomes, as they are at the Mayo Clinic, several other hospitals in the U.S., and in other countries. Al Franken is more knowledgeable about that than I am.

  62. I’m just not expecting many fat people to suddenly be allowed enter the promised land, so to speak.

    I hear you on that and am not totally optimistic myself, but since we’re light years from the promised land right now, a baby step in the right direction — like, say, being acknowledged as human beings who deserve any coverage at all — would be nice.

    ETA: Elusis, to be clear, I know you’re not making the argument I was just railing against.

  63. This pretty much made me cry.
    Another angle on this: infant weight charts are generally compiled using data from a lot of formula fed or breast-and-formula fed babies. Exclusively breastfed babies tend to have different growth patterns, namely that they stack weight on fast for the first few months and then start evening out at a younger age than most formula fed infants (whose weight gain starts steadier but continues at a rapid pace for longer). So a breastfed infant’s ‘normal’ growth at four months is even less likely than most would expect to be represented with reasonable accuracy on the chart. Of course, the bottom line is that you can’t actually apply arbitrary numbers to any human being and expect to get a good health measurement — but you could at least TRY to get the numbers vaguely right for that human being’s circumstances.

    This is just beyond ridiculous. Another reason I’m glad I live in Australia.

  64. Oh, hell. There must surely be some way to shut down those goats of insurers by sheer public outrage, right? Right?

    Gaaaah.

    My sister weighed fifteen (15) pounds at her one-year checkup. My brother weighed fifteen (15) pounds at his THREE WEEK checkup. Both were healthy and gorgeous babies, just different. They are now perfectly healthy adults. My brother is 6’2ish and in the solid 220 lbs range. He’s a big man. My sister is 5’2ish and in the solid 110 lbs range. They are both fine. They are just not the same people. And they’re full siblings! With the same care and diet! Aughhh! Who are the idiots running this world, and how do we stop them?

  65. Or they can just get paid a salary for doing their best to treat each patient, regardless of outcomes, as they are at the Mayo Clinic, several other hospitals and the U.S., and in other countries. Al Franken is more knowledgeable about that than I am.

    I really have no opinion on physician compensation reform, but I don’t think its fair to compare the general population of doctors to those at top hospitals at the Mayo Clinic. The idea behind pay-for-performace is to encourage doctors to work their hardest (and most efficient) to get patients well. It isn’t much of a leap to say that the motivation driving doctors at a world class hospital like the Mayo Clinic is different than the population of doctors as a whole.

  66. And I appreciate your willingness to rethink, above and beyond the question of the language.

    (Rest Of The Internets, please observe and take careful notes.)

    *TIMES A KABILLION*

  67. It isn’t much of a leap to say that the motivation driving doctors at a world class hospital like the Mayo Clinic is different than the population of doctors as a whole.

    Yeah, but it also isn’t much of a leap to say that working for a salary should be sufficient motivation for doing your fucking job, when it is for most of us. If doctors aren’t going to offer adequate care because they’re not getting paid by the case, then that’s one more healthcare problem that needs fixing. Treating sick people really shouldn’t be a commission-based business.

  68. Seriously, I have exactly zero patience right now for an argument about whether insuring every citizen is the right thing to do. It is the position of this blog (which was founded by a sometime Canadian) that universal health care, however imperfect, is the only ethical system; that for-profit insurance leads inevitably to such horrendous abuses that its limited advantages for those who can afford it interest us not at all; and that this country should be marinating in shame for letting millions go entirely without coverage because we are so morally fucking backward as to think any of this is legitimately controversial.

    *hands KH several platters of WURD sauce-smothered internets*

    *tries not to burst into tears*
    *fails*

  69. Yeah, but it also isn’t much of a leap to say that working for a salary should be sufficient motivation for doing your fucking job, when it is for most of us. If doctors aren’t going to offer adequate care because they’re not getting paid by the case, then that’s one more healthcare problem that needs fixing. Treating sick people really shouldn’t be a commission-based business.

    I agree, and again, I’m not very knowledgable about the issue. I don’t really understand the different between pay-for-performance and the usual method of paying the best doctors the biggest salaries.

  70. My husband is a physician and is well behind healthcare for everyone. We have a hard fucking time collecting our pittance from the insurance companies – sometimes a year later, sometimes not at all. We work for free when people need care and have no funds to pay for it. Because that IS the ethical thing to do. Sorry for the derail, but when I read him this story, he wanted to scream. I’m becoming increasingly paranoid about even using my health insurance lest I be labelled as having some pre-existing condition that makes it so I can’t switch plans n the future.

    Down with insurance companies, I say!

  71. It’s really time to get rid of health insurance as America knows it.

    I’m still trying to comprehend how a measure of height and weight can be used in this way, especially as a balance between height and weight indicates all is goodly.

    This is particularly bewildering to me, because I have always thought the correct response on hearing a baby is in the 99th% , is to wave their little hands in the air shouting “The Winnah!” and high five the parents. I mean, totally on the top! Whoo hoo! Don’t look down on all the kids who are only in the 27th%, now.

  72. The other mind numbing thing to me is this year Aetna, BC/BS and one other company with whom we do business has CUT our reimbursement, unilaterally, and that will cost us about 20K per year in revenue. That amount doesn’t even cover our group plan for a staff of four – which increased by 20%. Thanks, insurance companies! We really needed to get paid less for the same fucking job we did last year! I hate them all.

  73. “For the rest of his fucking life he will be that super fat baby who was so fucking super fat that he couldn’t get health insurance.”

    My hope is that maybe by the time this kid has grandchildren he can sit them down and tell them stories about how ridiculous attitudes used to be about fat. I hope that by that time those grandchildren won’t be able to grasp such an outrageous concept and he’ll have to pull out these articles to prove it.

  74. @SweetMachine,

    I really liked the article. I think one of the biggest issues is trying to convince people that lots of tests/overuse of medicine is a serious issue. A lot of people seem to think that cutting back on waste means rationing of necessary care.

  75. THis story is OUTRAGEOUS, even the “changing their badly thought out policy” (I can just IMAGINE the boardroom: “DIDN’T YOU READ THE PART OF THE APPLICATION WHERE HE SAID HE WAS A TV NEWSCASTER???”).

    Yet, at the same time, I am GLAD, GLAD I TELL YOU! that this outrageous story is in the news at this critical juncture, to PROVE how AWFUL the current system is. May this baby become the “joe the Plumber” type media fixation for the side of the Angels. You know, OUR side, the Public Option eventually becoming single=payer side.

  76. A Sarah has already gotten an earful via email from about bullshit fat policies from insurance companies. But just assume that my rage is mighty.

    And I’m off to read amandaw’s post!

  77. The for-profit healthcare system must be destroyed. It’s killing people, and witnessing it robs the rest of us of human dignity.

    http://pnhp.org/

    for a sane system to replace it with, and some beautifully crunchy numbers in the FAQ to show how doing so would actually make us richer. And some other data informing you of the obvious: we don’t actually /have/ to replicate the flaws of Canada’s (really very good) system.

  78. “…read the comments. Now need brain bleach. What is WRONG with some people?”

    DW, I don’t think you want my opinion on that.

    (I did put the caveat at the end of the links …)

  79. FUCK. This would have been my eldest. In part because he’s so TALL – he was always a bit heavier than tall, say 97th percentile for weight and 95th for height. Not fat, though. Normal, just big.

    You know, all the time, there’s a push in Canada to get Canadians to consider other models; public and private together, etc. Canadians tend to stick their fingers in their ears and yell LA LA LA NOT LISTENING! I think this sort of thing is why; most of us have Americans in our families or our lives, and it lands as being too close for comfort’s sake.

  80. I second that article in the New York Times about the cost of the healthcare system, as it led to some really great dialogue between me and my dad, who is a pediatric intensivist (speaking of babies). He’s extremely enthusiastic about the subject, not surprisingly (and firmly in the “we need to fix this broken bullshit by covering everyone” camp).

    At any rate, that story is appalling. I don’t like the majority of babies (the top 5% in cuteness can sway me, as can the really quiet ones), but that doesn’t mean I think any of them deserve any less than basic human decency. And I also don’t think it’s okay for me to comment on their size or appearance, unless it’s unquestionably complimentary (ones with pretty blue eyes, for instance, as that is one of my weaknesses in children). For goodness sake, my older brother (who is now 6’8” and around 400 lbs, but only somewhat fat) was nearly 10 lbs when he was born, and naturally quite tall for almost all of his childhood and onward. And my mother said she’d sometimes get comments, until they saw our dad, and went “oh, well that explains it.” Because, SURPRISE! Large people make large babies! And everyone in my family is large (including my oldest brother, who was a slightly smaller baby and is now one inch shorter than the one mentioned above, who’s the middle child). We’re not just tall, we’re built like brick houses (big bones, big heads, thick hair, huge feet). So it would make no sense for any of us to be tiny little babies.

    I find it interesting that the article doesn’t mention how tall either of the parents are, just that they’re slender (and how many people here know babies who were quite chubby who turned into thin adults? I’m not willing to bet on that number). I’d be interested to know their heights. Because, yeah, that kid could totally end up being 7′ tall and thin as a rail. Or he could end up being a fairly average 5’10” and chunky, or 5’9” and slender, or any other combination of things. What was that phrase I’ve heard before, let me think… oh yeah! No two people are alike! That applies to how your body grows too!

  81. *cleans up pieces of brain*
    That article made my brain explode. Sorry about the mess.

    I just wanted to say I’m a fan of the round table format; I like seeing the interaction and discussion the four of you are having.

  82. “My hope is that maybe by the time this kid has grandchildren he can sit them down and tell them stories about how ridiculous attitudes used to be about fat. I hope that by that time those grandchildren won’t be able to grasp such an outrageous concept and he’ll have to pull out these articles to prove it.”

    Dear god I hope so. We were discussing in one of my education classes what thing being taught currently would be the future “oh my god what were we thinking?!?!” thing. One word came to mind: FAT. Oh and GAY, but as a fully privileged straight person, fat came to mind first.

    I seriously pray that one day it will be a ridiculous notion that fat is bad. As it is, when we were discussing how Pizza Huts’ book it program was flawed the first thing someone said was, “It’ll make kids fat!”

    Yeah, just like feeding a baby when it’s hungry will make it fat.

  83. The idea that universal health care will be good for fats is not necessarily true. Many health care options will not be available for overweight patients unless they lose weight first.

    Hey, it seems like fat prejudice may exist outside of the United States and as Canadians we also need to be educating our health care professionals and governments about it!

  84. Thank you VERY much for the link, and I really appreciate the comments here too. It’s something that has bugged me *so much.* Because no one deserves to be denied health care. Though if it takes the extreme cases to get people to realize that, I suppose I’ll be satisfied in the end.

    A Sarah’s first quote is what really sent my head spinning. Because while I was already outraged, I hadn’t even thought of it like that. SO FUCKING RIDICULOUS. This entire fucking situation. Uuuughhhh.

  85. Someone told me about this story today because my baby–affectionately nicknamed Gigantor–is 90th for height and 95th for weight. I guess we’re just under the wire? Actually, though, I wasn’t asked for any information about his size when we had him insured. He’s on public insurance. They only asked about our income. WIC evaluated him and didn’t comment. Weird.

    I know this has been said, but the fact that his height and weight are in the same range and they *still* have a problem with it boggles my mind.

  86. I just wanted to say I’m a fan of the round table format; I like seeing the interaction and discussion the four of you are having.

    Thanks, Charlotte! We’ve been tossing it around as an idea for a while. Of course we edit it judiciously from our actual email exchanges, which inevitably devolve into fantasy shopping after a few rounds. Then we all go to the ladies’ room together and touch up our lipstick. ;-)

  87. Pre-existing condition exclusions are forbidden on group insurance as long as the person is certified by their last insurer and has not had a gap of more than (x days, 30-60) between insurance coverage. This varies by state, I think.

    HOPEFULLY IT WILL CHANGE SOON. Ahem.

    Anyway, this is why you get asked fewer questions when joining employers’ insurance (or public insurance, which obviously can’t refuse you if you’re eligible on a means/etc. basis). However, afaik they CAN change rates on you depending on… well basically anything they want, including age/weight/conditions/etc.

    This is why I get all paranoid when my insurance asks me to complete yearly health surveys “so we can refer you to our awesome programs!!” (which don’t actually apply to you at all!). They’re basically collecting information to discriminate against you with. And don’t tell me they don’t do it. Just like banks don’t rearrange your deposits and debits to be able to charge you as many overdraft fees as possible, because they are Good and Wholesome Institutions.

    … I doubt there is such a thing as any institution which is not riddled in failure and corruption, actually, which is of course why we are sure to install many checks and balances in the system, and not sell them off for handouts from big business interests…

  88. @littlem, you DID warn us, I know. But I’m a sucker for punishment and I couldn’t resist.

    @amandaw – I feel all weirded out by those surveys, too. Recently, I’m getting all these letters from my insurer about diabetes and diet counseling – my doctor says I DON”T have a diabetic condition. So WTF?

  89. Argh, that followup news article!

    “The insurer said Monday it would change its policy for babies that are healthy but fat. “

    ‘…But babies who actually need medical care can fuck off and die.’

  90. When I first saw this, I was simply “WTF??!!”. It is still stunning that they could even think of it.

    Then on the total other end of it there is this article, convenitently up today: tooskinny. (i hope that link works!)

    Just leave the babies alone already! Gah!

  91. ‘…But babies who actually need medical care can fuck off and die.’

    OMG I fell out laughing. Good googly-moogly, couldn’t hardly breath! Thanks for that lauredhel. It’s a damn sad situation but at this point it’s laugh or cry.

  92. When my girlfriend’s baby was just starting solids, her doctor was concerned that she was in very low percentages for height and weight, according to those pesky charts. She scared my friend quite a bit by telling her how important a little extra fat on a baby was in terms of brain development, and that she had better work on getting some fat on her bones, or face the fact that the child may grow up a little less intellectually capable than she would otherwise have potential to be.

    Her suggestion?

    Feed the baby some butter.

    WTF? (The baby, an intuitive eater, hated butter, and wouldn’t eat anything with butter on it.)

    The baby’s dad looked into the origin of the height/weight charts, and discovered that they were based on some strapping Ohio babies from, like, decades ago. And this baby’s dad was Asian. . . and not very tall, and very thin. (The doctor seemed bewildered that this might be a factor, and the revered chart might not apply neatly to everyone on the planet.)

    Maybe we need some slim/”normal”/pudgy infant shots in the form of the BMI project.

  93. This could have been my son at 4 months; his birthweight doubled and doubled again, only on breastmilk, very quickly. He’s now three and the size of a 5 year old in height and heavier than some in weight. He’s very healthy, has never been seriously ill ever and a bundle of energy. I can’t imagine how this boy’s parents must be feeling, and I hope their positive attitude about their son’s size continues.

  94. aliciamaud74, that cracked me up, that doctor was so, well, silly. Over-adherence to charts can go into some really strange territory.

    Body temperatures in my family run low by about a degree Fahrenheit. This leads to a lot of comedy with newborns in hospitals, where medical personnel keep sticking the baby under the baby toaster while the kid sprawls out and does everything but pant like a dog from the heat. It takes days of this before they start to believe that cooking the kid up to 98.6F is a losing battle.

  95. Aliciamaud, that “put butter on everything” thing is actually a pretty common piece of advice to parents of underweight infants – my son was one (he’s been on the weight chart for a WHOLE YEAR now! Yay! – but it didn’t happen til he was 3, so we got plenty of angst about it.)

    It’s actually the experience of feeding this small child that really convinced me of intuitive eating. He had a same-age cousin who was underweight after a surgery and recovery. Slathering her food with butter made her gain weight. Slathering my kid’s food with butter (or adding cream or sugar or any other way of making it more calorie dense) made him eat less. Why? Because he was a perfectly healthy weight for him and wasn’t interested in ingesting more calories.

    sunflowermoonbeam – that “i suspect my kid is allergic to X, Y & Z” thing among nursing mothers always struck me as Diet Consciousness gone nuclear – as if you can control everything in your life by controlling what you put in your mouth.

  96. My nephew was born 22 inches long, 10 lbs, (a Caesarean section per 1975…) , and had a huge head, and a baritone baby scream. He was so far beyond 99 % it wasn’t funny! I babysat! him! whoa! and when he had a tantrum—— Katy!bar the door!—- At 2 years, he looked like he was 5 years old. He now is a gorgeous – Brad Pitt look- a- like with the greatest blue eyes ever! 6 ft 4 !

    !He bit his first dentist… awww, but now!!!!

    What moron C plus doctor or insurance agency –blasted –fool with him now……………..!!!!!!!!

  97. Friend of mine has an off-the-charts baby, and by the time the baby was 6 months old the health visitors (UK) were telling her to dial down the formula and feed her daughter more ‘solids’ and especially vegetables.

    The idea of watching one’s weight at 6 months old makes me inexpressibly sad.

    (Karen, BTW: ‘moron’ = ableist language, you might want to come up with a less privileged insult. I suggest ‘scum of soy paste’ or perhaps the always-appropriate ‘fart-chicken’.)

  98. Can I just point out that (in this case) it isn’t actually a doctor making this judgement, but an insurance company. I hope I’m right here – I’m not an American myself. So as I see it, this is some idiot who doesn’t understand statistics – the 95th centile just means that 5% of NORMAL people are in this group – it is just too f-ing stupid to not accept people for this reason alone. I hope this doesn’t sound like bashing the US health care system (I’ve been accused of this before) but seriously, as a non-US doctor, you people have some serious problems over there…

  99. my mum put me on my first diet whe I was 2 and now I weigh 300lbs having been fat my entire life- can’t help feeling there’s a correlation…

    Elizabby- my thoughts exactly!

  100. Oddly enough my brother was a really fat baby, and I was of normal weight; but right now, my brother is of superb health (and still fat, really) and I’m a regular at the doctor’s with all my health problems (and also fat).

    Baby weight, unless part of an illness or disorder, really says little about how you’re gonna turn out as an adult. Babies are SUPPOSED to be fat. There’s even a special word for it, get this: ‘babyfat’. OMG! Babies grow freaking’ fast, so they actually need the fat and the skin to grow into. Anyone who doesn’t get that should reconsider if they’re fit (ha!) to raise kids at all.

  101. that “i suspect my kid is allergic to X, Y & Z” thing among nursing mothers always struck me as Diet Consciousness gone nuclear – as if you can control everything in your life by controlling what you put in your mouth.

    Rosa – this hits home for me. I was really worried about my son having food allergies (my brother had a lot, they were serious, yadda yadda), and I really wanted to be able to control the situation. With a breastfeeding infant, all you can do is not eat the Wrong Thing, right? It made sense at the time…

  102. Hidden Tohru said: ” (and how many people here know babies who were quite chubby who turned into thin adults? I’m not willing to bet on that number). ”

    Yeah. That would be my older brother and I both (though I was a skinny baby who turned into a moderately-sized adult). He was a really fat baby, to the point where my dad called him the Infant Mutant Sumo Toad. Fast forward 19 years, and he is 6’3″ and between 140 and 150 pounds, known as Stickman and Beanpole. I was two months premature and weighed 3 pounds 6 ounces at birth. I gained weight so slowly that I was eight years old before I weighed the requisite forty pounds that would allow me to stop riding in a car seat. Ten years later, I am 5’5″ and weigh between 130 and 145 pounds. Both of us are living proof that the size you are as a baby /=/ the size you are as an adult, and I’m still three weeks away from officially being an adult!

    This preexisting condition stuff is such a load of bullshit. Maybe I’m sensitive because of a nice little provision that says private coverage can be denied to anyone who has ever been on dialysis, so my mom has to work for the rest of her life in order to be able to get insurance to cover the exorbitant cost of the antirejection meds she takes for her kidney transplant. Seriously, fuck the preexisting condition stuff and just give coverage to people who need it. ILU Kate, for your wonderful comments about how a system should cover everyone. *hands you cookies* I think the insurance companies are bastard-coated bastards with bastard sauce and bastard filling, and I hope their moneygrubbing souls rot in hell for all eternity.

    I really do apologize to the rest of the world on behalf of my state. Not all Coloradoans are this idiotic, I promise!

  103. Re: ‘pay for performance’ models

    How, exactly, is that supposed to work? How do you measure ‘performance’ in health care? If it’s by whether or not the patient gets well, that’s the same system we have now under another name. It would force doctors to cherry-pick patients in order to keep their percentages up. In other words, the sickest people would be denied care. Just like now.

    I have to say that I am with Kate on this issue; any model that doesn’t extend equal care to EVERYONE, across the board, is not ‘reform,’ it’s just a shell game to keep the money flowing into somebody’s pocket at the cost of some other body’s health. As civilized people, we pay for basic education for everyone because we understand that it is to our benefit as a society to do so. How we have managed not to come to this same conclusion about health care is beyond me.

  104. Seriously, I have exactly zero patience right now for an argument about whether insuring every citizen is the right thing to do.

    Thank you, Kate.

    And in response to all the “we’re built big, of course we have big babies,” etc people… I’m very small. My first baby was 10% of my adult bodyweight at birth. My second was below the 50th centile. Genetics: it’s a total crapshoot.

    It was after my eldest was born I started looking into Fat Acceptance and so on because although I’d come up against thin bashing I knew what she was likely to get was worse. She’s 5 and a half and wears clothes labelled age 6-9. She’s not tall for her age, just big and muscly and thriving. She’s not in the least fat, but her child-chart BMI says she’s obese.

    My-friend-who-was-headhunted-from-Ireland-to-the-Mayo-Clinic took years to realise that I hadn’t had gestational diabetes, that some people are just big.

    The Fat Acceptance movement is up against Common Sense, not medical facts. All we have are evidence and facts and human decency, and I’m not sure that’s enough to fight Common Sense.

  105. My mother chained smoked through her entire pregnancy and I was born tiny and jaundiced and needed extended hospital stay. (my brother was born with a blind eye) I have a feeling if I was born today, my tiny self or my brother wouldn’t be allowed health insurance.

    I went from severely tiny underweight baby to being obese at age 7. I don’t think birth weight tells one much about the future of the child’s weight.

  106. I think it’s very likely that the health insurance company just doesn’t understand what a normal distribution is; which is worrying enough in itself. I’m a vet. When we are looking at blood test results, we compare the figures for each patient with a normal range, which (if I remember aright) is the range that 95% of the population would be expected to be within. That means that 2.5% of the population will be outside the normal range at the top end, 2.5% at the bottom end, for any one particular parameter without having anything wrong with them; so in vet school 101 we were taught that if a generally healthy animal had one abberant value on a blood screen that was just a bit above or below the normal range, we should always remember that it might be normal for that animal and of no consequence at all. It sounds to me as if the insurance company is using the normal distribution as a cut off for its claims without remembering that by definition lots of normals don’t fit within the normal distribution, as someone said upthread.

    Which is stupid on the scientific level; on the common sense level it’s also stupid. My older daughter was a well-over 90th centile breastfed baby. She is now 15, 64″ tall and 45 kilos (99 pounds – did the maths!), having been fed an unrestricted diet with a good proportion of chocolate all along (albeit second hand chocolate at first). Infant weight proves nothing, as others have said. It’s commonly known that infant growth charts were developed using bottle-fed white babies 50 or so years ago, and are really of very little value for those who aren’t bottle fed or aren’t white, maybe not even for those who are. It’s hard to imagine this decision was made by anyone who knew anything about babies, science or common sense. Awful.

  107. @Rosa: Interesting. I had never heard that before, but then again, I am barely keeping my plants alive, so babies are nowhere on the horizon. I just thought butter was a pretty weird leap. I mean, if fat intake is the issue, what about, like, avocado?

  108. I think it’s very likely that the health insurance company just doesn’t understand what a normal distribution is; which is worrying enough in itself.

    Oh, I think they understand exactly what it is. They just also realize that the obesity epidemic makes a good cover for cutting off care to 5% of the population.

  109. @ Alison:

    I think the idea with the cutoffs is that while a person (or animal) with values outside of the middle 95% may still be healthy, there is also a significant chance that there is, in fact, a problem. Because insurance companies would rather make the mistake of not covering a healthy person than addicently granting coverage to a sick person, they choose not to cover anyone outside that 95% range. So while it may not be good science, it IS good business for the insurance company.

  110. Oh, I think they understand exactly what it is. They just also realize that the obesity epidemic makes a good cover for cutting off care to 5% of the population.

    I don’t know about this, actually, because they don’t make money by cutting off insuring people, per se, no?* It seems like it’d be illogical if they didn’t really believe the person in questions was going to cost them more than they’d make from premiums. So I feel like they must be letting irrational biases control their decision making on this stuff. Not, of course, that it would be okay if they really were right and the baby in question was likely to cost them more money, of course, hence health care reform.

    * Or maybe they do with children in these plans and the money comes from the parents?

  111. I didn’t read all of the posts, so maybe this came up, but people who are too skinny are denied insurance as well. My friend’s little sister is not covered under her parents policy b/c she is too skinny. Yes, she is skin and bones, but the health insurance company even paid for a nurse to do a complete physical and nothing was found to be wrong with her. She had normal cholesterol levels, no vitamin or mineral deficiencies, nothing wrong with her. She was considered the epitome of health. But since she weighs 85 lbs and wears a kid’s size 0, she is not insurable.
    So it’s pretty disgusting no matter what way you look at it, the health insurance industry sucks, period.

  112. To add to the anecdotes, my brother and I were both very skinny babies and toddlers. We had not an ounce of body fat. We were also perfectly healthy, aware, active babies. We both started gaining weight around age 5. We are both now short and broad. I’m fat, my brother isn’t. I look exactly like my great grandmother and mother, and my brother looks exactly like our grandfather. Whooo, genetics.

    I’d like to point out that I’ve been disturbed by some of the language here, being quick to point out that chubby babies grow into average-sized or thin adults. Yes, they can, just as skinny babies can grow into fat adults. But even if the fat babies grew into fat adults they should STILL be covered by insurance companies, or better yet, a public plan.

  113. Whoa. This is truly outrageous. It’s certainly more proof that we need reform and we need it now.

    Both of my children were covered by Medicaid as infants. My second child was born average size, just over 8 lbs and she continued to grow at an astonishing rate for the next few years and was always between 96-98th percentile for height and weight. Medicaid never denied her coverage. I’m sick of the “government doesn’t know how to run healthcare” peeps talking out their asses.The best healthcare we ever had was government provided. Now we can’t even get health insurance because I have pre-existing conditions. Yep, let’s keep insurance private ’cause that is working out so damn well.

  114. I hope this doesn’t sound like bashing the US health care system (I’ve been accused of this before)

    Oh, by all means, bash the US health care system! It screws us all. I say this as someone who is currently fully insured (knock wood). I fucking hate it and the chance to change it is one of the primary reasons I voted the way I did last year. (Now don’t screw it up, legislators…)

    I’d like to point out that I’ve been disturbed by some of the language here, being quick to point out that chubby babies grow into average-sized or thin adults. Yes, they can, just as skinny babies can grow into fat adults. But even if the fat babies grew into fat adults they should STILL be covered by insurance companies, or better yet, a public plan.

    I agree, but I see where it’s coming from. I think many people are going, “Okay, even if we temporarily accept the Moon Logic of the obesity epidemic booga booga, this still doesn’t make sense.” Which makes the whole debacle seem even more cold-hearted and disingenuous.

  115. This whole thing just shows a gross misunderstanding of how growth charts work. They’re used because there is so much variation in size among children and they’re a way you can measure a baby’s growth against hirself.

    That is not a “fat” baby. That is an adorable baby who’s thighs I want to nom on. It would never have occurred to me to be concerned about a healthy baby being denied insurance but now I am. Luckily we have affordable group insurance through my husband’s job because my little man was born above the 95% for height and weight. He’s actually skinnier and taller than the baby in the article so at 4 months he was down to the 75% for weight (still off the charts for height at 28 in though). Silly me I’d been worried about that when apparently I should be relieved.

    I was glad that the mom said she wasn’t going to try to feed him less and that their pediatrician hadn’t told them he was too heavy. As my midwife said “It’s impossible to overfeed a breastfed baby.” Statistically speaking he’ll probable slim down once he starts crawling and I hope he does so they can get their insurance. I bet his parents will miss his nomable thighs though.

  116. I mean, if fat intake is the issue, what about, like, avocado?

    Butter is cheaper than avacados. At least, cheap butter is. If a mom suggested using avacados instead, I can’t imagine a doctor saying no.

  117. @ Shoshie – Sorry, I see what you mean, but I think Sweet Machine’s right – what I, at least was meaning was, “anyway, people don’t follow linear growth curves throughout life, as this anecdote illustrates, so to extrapolate from the weight of a 4 month baby to predict anything at all about its future weight is a waste of time.” I was assuming the right to health care as a given, but then I’m English, so it (more or less, on the whole) is.

  118. This is just…wow. I would like to add a huge WTF to the fact that birth weight usually has fuck all to do with how a person turns out! I was a “normal” sized baby, very slender as a child, and then puberty hit and *BLAM* fatty fat fat. It doesn’t happen that way for everyone obvs, which is why we CAN NOT judge babies by the same standards as adults! Is it too much to ask that the asshats who provide our insurance know a LITTLE something about medical science? Like AT ALL!?

  119. Blech. This is my town and my insurance company. I really fear having children being a large baby myself despite prematurity and being married to a 10 pounder-at-birth. I really hate RMHP. What I hate more is that it is lauded as a great provider.

  120. “the underlying assumption of our ableist culture is that if someone’s sick, they did something wrong. ”

    Those fucking Lipitor commercials where the pensive 50 something year old guy says “I should have done more!!!!!” Like what, exactly? Choose parents who didn’t have a genetic predisposition to heart disease? I HATE that. Sometimes you get sick. Sometimes you have a heart attack. Sometimes you’re a fat baby and there is absolutely nothing wrong with you. We all deserve care.

    Anectdatally, my two daughters were an interesting study in how they’re born and how they grow up.

    Elder daughter was 8.5 lbs, got chubby, was a fat little kid, a moderately chubby preteen, is a petite, (5’4″) slender but very muscular adult in perfect health.

    Younger daughter was 7.5 lbs at birth, was very skinny (long arms and legs, we called her the stick figure baby), was a thin child, a thin pre-adolescent, and when puberty hit, she got fat. She’s now a fat, tall (almost 6 feet tall) healthy adult.

  121. Is it too much to ask that the asshats who provide our insurance know a LITTLE something about medical science? Like AT ALL!?

    They don’t need that, they have Common Sense, and possibly even a bit of It Stands To Reason.

  122. They don’t need that, they have Common Sense, and possibly even a bit of It Stands To Reason.

    I have this image of Michael Scott on The Office pointing at Ryan (remember the Fire episode?) saying “Ryan has book smarts. I have street smarts. We’re both equally smart, just differently smart.” Or something like that.

    Michael Scott = Insurance companies…

  123. Um…when did this happen? the 95 percentile cutoff thingy? (guess I should read the entire article) Maybe I am remembering this wrong, but I’m pretty sure my oldest son was 97 or 98-he was an adorable roly-poly guy for sure, but healthy and happy and smart. Now he’s 15 and he is tall and skinny like his dad.

    What a crock of shit.

  124. Also, to whomever said this upthread, I too had the same reaction to the update of the story in which the insurance company stated it will no longer deny “Healthy” babies coverage. Sick babies? You’re just out of luck!

  125. I just read The New Yorker article, and noticed that one of the “low cost, high quality” health care communities they discuss is Grand Junction CO. It points out that GJ has implemented measures to improve care, but they operate in a health insurance and HMO system.

    So I am wondering if routinely denying health care to people for bullshit reasons AND having efficiency-and-care increasing measures helps explain Grand Junction’s good showing in the charts. I suppose one would have to look at who is denied care and why system-wide in Grand Junction to get a handle on that.

    On the one hand, I am all for using models that increase efficiency in establishing a public option (or better yet, single payer system) and reforming health care.

    On the other hand, I am more in favor of prioritizing covering everyone first and then figuring out costs. This Kate says in her comment-of-golden above anyway.

  126. Sorry: I mean, routinely denying people care at a higher rate than other health care systems AND implementing efficiency-increasing measures. Or are the bullshit denials of insurance companies in Grand Junction (ZOMG FAT BABIES ALLLLARMMMM!!!!!) run of the mill in quantity and quality?

  127. @aliciamaude – I assume the butter thing is cultural. One of my stepsisters had her kids in Mexico, and there avocado is commonly fed to babies as one of their first solid foods. We actually fed him quite a bit of avocado, and also lots of nut butter (almond, naturally – which actually makes sense for us because bizarre legume allergies run in my family, but I peanut butter think is universally proscribed for kids under 1) – but of course, we were so crazed with the “pack calories in” thing that at one point I could tell you which were the most calorie-dense of each brand of commercial baby food.

    What’s funny now is, the kid comes home from daycare saying stuff like “It’s healthier to leave the butter off your vegetables and eat them plain!” and the RN aunt who gave us the “butter on everything” tip reluctantly agrees that it’s probably OK to keep giving him whole milk as long as he’s below the 10th percentile for weight – but not longer! Whole milk is the devil!

  128. Wow, that just blows me away. I just had my youngest weighed last month (at 4 months) and she was off the charts for height and weight. So were both of my older kids until the toddler years. Some babies are just big naturally. The state insurance (we use until partner’s new insurance kicks in) covers them and never even blinked about the size.

  129. Aside from the weight issue, this is a giant MATH FAIL. SOMEBODY has to be in the 99th percentile, and the 98th percentile, and the 97th. Every single baby on earth could be a so-called “healthy” weight, and some of those kids are going to be 99th percentile. Jaysus in a jetpack, insurance companies, could you maybe take a statistics class or two?

    Also, I have to wonder: are babies in the lowest 5 percentiles also denied health insurance? Because I’m guessing their health might not be so good.

  130. The latest bit of proof that the medical profession absolutely *must* cease its voluntary enslavement to the BMI. And that at every child must receive free, quality medical care.

  131. Can we touch on the fact that these height & weight charts are old, outdated and just plain old INACCURATE for today’s children and especially breastfed children?

  132. OK, having gotten all the way to the bottom of the much-deserved screaming about this, I see that (at the point I opened this window anyway) no one had directly addressed this little gem in the original article:

    “Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. …Adults who have a body-mass index of 30 and above are turned down because they are considered obese. ”

    Um. NOT MANY??? As a self-employed person with a BMI considerably over 30 (thanks, SSRIs!!), I can’t even consider a divorce from my estranged husband because I simply could not get health insurance (thank goodness we’re not THAT estranged). I am not alone. Googling, I found this handy chart (used to support the OBESITY CRISIS BOOGA BOOGA BOOGA, I’m’ sure), which compares “obesity rates” (over 30 BMI) by country:

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

    Using this criterion, over 30% of the US can therefore be denied health insurance. On what planet is this “not many”???. As of 7/08, the US population was 304,059,724 (from Google’s “public data”). Calculating 30% of that yields 91,217,917.

    That’s right, over 91 MILLION people in the US can be routinely denied health care coverage, for no other reason than that they are fat. Yet Speedie (who seems not so speedy at math, I think) deems this to be “not many are denied coverage.”

    OMFG.

    There are not enough letter’s “O” “M” “F” and “G” on all the face of the planet to express how I am feeling right now.

  133. The worst part is that Medicaid doesn’t count obesity as an eligible disability, and if the family otherwise has the money and insurance, they are again denied coverage from the state.

    I guess the parents could get a divorce and the mother quit her job and the kid could have coverage.

  134. I feel about this the way I felt when I read doctors were suggesting statin drugs for pregnant women whose cholesterol was high. (Pregnant womens’ cholesterol can rise because apparently building an entire person inside your body requires lots of fuel. Who knew? Also statins are specifically contraindicated for pregnant women as are so many other drugs because they might mess up the aforementioned delicate process of building a whole new human being.)

    *headdesk*
    *headdesk*
    *headdesk*
    *headdesk*
    *headdesk*

    But I guess the really important thing right now is to make sure Congress critters still get their big checks from the insurance companies and can still get cushy lobbying jobs when they get thrown out of office for betraying the most basic of Democratic principles – at least based on the behavior of Congress and the White House. Good to know our officials have their eyes on their own prizes. *sigh*

    DRST

  135. When I saw the headline, I thought for sure someone must have hit us with an urban legend, but apparently not. Until now, I’d NEVER heard of a company denying coverage to a baby based on a growth chart. I really didn’t think it would happen. How naive of me, I guess.

    3 of my 4 children were in that greater than 95th percentile area and we never had ANY problems about them being on insurance….but then we have group insurance. I know buying individual policies exposes you to a lot more discrimination, but it never occurred to me that an insurance company could deny a BABY coverage. And based only on percentage on a growth chart? Puleeze. That’s so meaningless.

    However, I’d have to say this is part of a big trend now in obstetrics and pediatrics, obsessing about baby and child size and harassing parents about it. Never thought I’d see the day where they denied a BABY insurance coverage because of it, though.

    I’m glad they relented in their policy, but I know it’s only because of the public relations nightmare they created. What a terrible comment on our healthcare industry.

  136. This whole thing just shows a gross misunderstanding of how growth charts work. They’re used because there is so much variation in size among children and they’re a way you can measure a baby’s growth against hirself

    This is an excellent point. My first child’s pediatrician explained to us that the purpose of the charting wasn’t to see where the kid was in regards to the rest of the population, it was to see where he was with regards to his own previous growth. A smooth growth curve, wherever on the chart it might fall, was good. A sudden jog up or down meant we might want to check some stuff out, especially before age 2 when so much mental and physical development was happening.

  137. Yup…adding to the anecdata, my sister was the prototypical chubby rosy-cheeked baby and toddler, and is now a skinny, wiry-strong adult. I was tiny and sickly because my heart didn’t work (fixed now yay!), and am now an inch taller than my sister and “average” weight. My brother is the one who ended up with the family beanpole genes — none of the men on that side of the family are under 6′ tall — but was a fairly average-sized baby.

  138. You know, I just ran across the story online, and the comments below the story just about drove me nuts. The main comment was asking whether the parents were overweight too, or asking for a picture of the parents. Why is that relevant?

    I guess it drives me nuts because it implies that if the parents are average-sized, it’s okay if the kid is “chubby” because obviously it’s not because they are “overfeeding” him and teaching him “bad” habits.

    But if the parents are fat, then the kid being fat is inexcusable because obviously that means that they are overfeeding him and/or feeding him “bad” foods.

    You just can’t win as a fat parent these days. Augh!

  139. Yeah, kristinc, my kids’ pediatrician said the same thing: the chart is only meaningful in that it provides data about a particular individual which can be used to track growth and look for aberrations in the pattern. My older son has always been 99th for height, but only about 25th for weight. But he has been this way *always*, so it’s not meaningful (and I think I got lucky in that he is tall and skinny, which is an “acceptable” body shape to the doctor). If at his next well visit he were suddenly only 75th for height and 50th for weight (to pull % out of my ass), that would be something to check out, because it would be an aberration. But if those had always been his numbers? Then there isn’t an issue.

    These charts are just like BMI, only topsy-turvy. BMI is only meaningful for populations, not individuals. And baby growth charts are only meaningful for individuals (to check their own progression) and not populations as a whole.

  140. But if the parents are fat, then the kid being fat is inexcusable because obviously that means that they are overfeeding him and/or feeding him “bad” foods.

    I think it’s worse than that. There’s long been a tendency to shame parents with ‘poor genetic material’ for having children. Thing is, once a Thoroughly Bad Idea – in this case, Eugenics – has gained a foothold in pop culture, it never seems to die.

  141. I only mean “lucky” in my comment above to refer to dealing with the doctor. Unfortunately, it’s just easier to deal with medical professionals if your child isn’t considered “fat.” I don’t think it’s lucky one way or the other, personally. It’s just genetics.

  142. My kids were all in the 99th percentile for height and weight since infancy, and all received health care coverage under our policy. This was some years ago, as the youngest is now 11, but the quote really doesn’t seem accurate as to all insurers.

  143. I was shocked when this story was first reported. Fortunately for me, I do have free health care for myself, my husband, and my child. Well, I guess I wouldn’t exactlye say free since my husband is currently risking his life overseas in Iraq. But, we won’t go there or I might bust a blood vessel. My son became ill one month into his life and was hospitalized for a stomach virus. Something that was so simple for an adult to overcome, but which could have killed my child. I am appauled that a family would be denied health care because their child is “fat”, which by the way is a measurment that someone created. Do they expect him to suddenly become ill and lose ten pounds of weight lke my son did to finally qualify for health insurance, which by that point in time may be too late. And it’s flu season, if this baby contracts the H1N1 virus, then who will help him? Who will help a child who can’t help himself. And I wish that some good submaritan halth insurance company would see this story and volunteer free health care to this infant and their family. I mean, I know the economy is not good… but where are people’s morals and empathy? I’m literally disgusted

  144. OK, I need to do some more math explaining here about another reason why this decision is based on total misunderstanding of growth statistics. I’ve spent a while with the CDC growth chart data, because I have another little monster baby, and I like data. (I haven’t had any problems with insurance covering him, BTW, chubby thighs and all.)

    First, 17 lbs is not 99th percentile at 4 months. 99th percentile is 19.4 lbs. (Mine was 18.75 at that age.) I haven’t calculated it (I don’t bother to maintain spreadsheets of data on this chart, for reasons that will become clear in a moment), but I assume that Alex is probably 99th percentile on the weight-for-recumbent-length chart. The reason for that is that most children/babies who are as tall as he is are older, and are therefore less baby-shaped. Babies start out short and chubby, and get (relatively) longer and skinnier for a while. Eventually (around age 3, IIRC), it turns around and their BMI starts increasing.

    As a baby, my daughter was routinely 80th percentile on weight, length, and weight-for-length. (She is now five, and has dropped down to around 50th percentile on the weight, while remaining tall – she’s a little string bean.) You would think that if a child were at about the same percentile on both the weight and the length charts, then they should be around the median for the weight-for-length chart, and if children didn’t change shape as they grew, you would be right. But because most of the data points at a particular length were from children older than my daughter, they tended to be lower weight than her – therefore she was at a high percentile on that measure, too. Once I realized that this was what was going on, I stopped bothering to check that chart – it doesn’t really mean anything. (The BMI-for-age chart is actually more meaningful, since it’s at least based on children that are around the same stage of development, but they don’t publish one for babies.)

  145. That’s really distressing news!
    My son has always been in the 95th percentile for height and weight, but I live in Canaada so I nor my doctor never even thought of it as an issue because we have universal healthcare.
    I couldn’t imagine having someone tell me my perfectly normal looking child couldn’t get health care because of his weight, and I certainly don’t think it would be helpful even if his height was in a lower percentile than his weight.

    I think people are going maniacal in the US in terms of weight- especially if they think they can gain some money from it!

  146. What The Fuck???
    Shit like this makes me so happy that we have insurance companies that are not allowed to refuse coverage.

    Want to hear something Oh So Funny? According to a “percentile-calculater” I just ran, I was above the 97th percentile for both weight and height at birth (I weighed 9,92 lbs and was 23.23 freaking inches long (giant baby!)) So according to their rationale, I was doomed to a live of misery and fatness (because those two always come together, right?

    Well,since I hit the pre-teens, I have been skinny, bordering on underweight. For the past 10 years, my BMI has been somewhere between 17.9 and 19.4. I am currently 25 years old, 6’1 tell and weigh 130lbs. I have been struggling with health issues that are related to being underweight for years (mostly weak constitution and really low blood pressure, plus the related fainting-spells and headaches)

    My siblings were also both above 97th percentile at birth (my 4,25 kilo sister was “little” to me after my 5 kilo brother), and neither one of them is overweight now that they are teenagers.

    So yeah, aside from the total fucked up-ness of refusing anybody healthcare for being fat (or any other pre-existing condition), or for labeling fatness as something that is inherently wrong; it is also pretty dumb to say that big babies simply have to grow into fat adults.

    IT IS JUST NOT TRUE

    Asshats.

  147. I don’t know if the filter/mods will permit me a link, but if anyone would like to turn some of the great, righteous anger on this thread into action, there are sit-ins being held around the country on Thursday against insurance companies that deny care, and a number of ways you can support them.

    http://mobilizeforhealthcare.org/

  148. think it’s worse than that. There’s long been a tendency to shame parents with ‘poor genetic material’ for having children.

    Also, mother-blaming about kids’ nutrition and weight is a very old thing — the fat panic is just the latest iteration. Your grandmothers could tell you about being criticized for having babies who were too small, or how their breastmilk wasn’t “nutritious enough” for them to breastfeed, or how formula was “more scientific”, and let’s not forget the importance of feeding babies on a rigid schedule. Your great-grandmothers could tell you about the class divides of breastfeeding vs wet-nursing, or the mother-blaming over inadequate milk supply (which many of today’s mothers find familiar).

    Granted, nourishing one’s infants is the most basic duty of a parent, so I suppose it’s not all that surprising that mothers have historically been judged by the feeding behaviors and weight of their children. I wish we could get beyond it, but baby-feeding is still the primary front in the Mommy Wars, in one guise or another.

  149. Sigh. When I first found out I was pregnant, I made the comment, “Well, at least it’ll be easy to get the kid health insurance, because how can you have a pre-existing condition of you didn’t pre-exist?”

    I stand corrected.

  150. What the fuck? I had no idea, since I was lucky enough to fall inside the income limits for medicaid, allowing my four mammoth, 99%+ for height and weight daughters access to medical care. It’s truly shocking that low-income babies are encouraged to live such unhealthy lifestyles, snacking on breastmilk every few hours and sleeping half the day!
    Perhaps these little fatties could be put on the Dr. Ferber plan? I’ve heard some parents had great results with his strict feeding schedule, from failure to thrive to death! Wait a minute… those are bad things… aren’t they?
    Well, they could always switch to formula. Formula fed babies tend to be lighter during the first 6 months (and therefore, obviously, healthier – right?)

  151. The figures these percentiles are based on come from artifically-fed babies ie bottle fed & are threfore skewed against healthy breast-fed babies which in my 25 years experience as a Family Doctor, are usually fatter & healthier .
    This is what happens when pen-pushers & bean -counters are put in charge of health care! Common -sense goes out the window !

  152. Well, most of you have probably heard by now, but the family’s insurance company buckled after all the media attention, and they’re now, of course, happy to supply the child full coverage.

    It’s still messed up that they’d tried to deny it at all, but still… I’m sure the parents feel a lot better knowing that even though the health care system is still fucked up, at least their kid will be getting some decent health care, at least until the next loophole pops up.

  153. Sarah B has just given me nightmare fodder: a boardroom full of Michael Scotts running insurance companies. Holy crap.

    Emma B, I think you make an excellent point as well. Anything society can find to berate women over it will use and reuse.

  154. My son was 6 weeks old when he contracted meningitis. From healthy to gravely ill in a matter of days. Babies are indeed fragile.

    My other son was SO FAT AND CHUBBY AND DELIGHTFUL from a steady diet of breastmilk by 4 months old. I wonder if he’d have “failed” the Baby BMI test today.

    This is disgusting. Absolutely disgusting.

  155. I’m the mother of a baby who is in the 0.2% category on the charts. She is absolutely perfect, proportionate, and healthy, and 20 months old now. She is also teeny. Of course I was worried, but my sister pointed out to me that there are babies on ALL parts of the chart. It is a NORMAL distribution. My baby is not even an outlier! Nor is the baby in question. Babies just come in a range of sizes.

    As to denying care for babies. Well. You can’t say anything about that except that it’s wrong.

  156. This is just an extension of the whole ‘fat is totally bad’ issue that’s gotten so out of hand. There are children in the UK, US and Australia who are actually suffering from malnutrition because their parents have them on low fat – no fat milks thinking its healthy, when actually children need a much higher % of fat in their diets than adults.

    This whole obsession with fat and thin is a result of living in cultures that have too much food and money at their disposal and not enough *genuine* life threatening situations to worry about, like will drinking the water kill me today? Its part of our genetic make up to fight life and death issues and now that people from western countries don’t really have them anymore, that need has turned in on other things, like ‘how fat is my big toe?’

  157. God, this is just… ahhhhhhhhhhh

    kristinc, I agree with you and your doctor (and the other commenters who said this) that the point of growth charts is not really to compare one child to other children, but rather to track their, you know, growth. That has some value, even if the charts are still based on statistical averages and some kids will grow differently from others. I mean, we might not have known that something was wrong with me if not for growth charts, but the problem was not that I was off the chart. It was that I used to be on it (well, for height), and everything leveled off because neither my height nor weight increased for 2 years. It didn’t especially help them find the problem until I had my first flare-up, but at least they knew to run some tests and look into it. Giving doctors tools to notice problems is important. Deciding an infant is in a slightly higher-risk category (if that’s even true) just so you can deny them coverage is NOT the point.

  158. “This whole obsession with fat and thin is a result of living in cultures that have too much food and money at their disposal and not enough *genuine* life threatening situations to worry about”

    Yeeeeah… I’m not sure my horrible body image issues are the result of my not having enough stuff to worry about.

    “…to fight life and death issues and now that people from western countries don’t really have them anymore…”

    People from western countries don’t have life and death issues anymore? Or people that you know personally aren’t suffering from life or death issues? Because those aren’t the same thing.

  159. I had [gestational] diabetes in my pregnancy (curiously, absent ANY research I could find, most of the high risk pregnancy specialists were convinced that there is no such thing as early onset GD, only DMII that you succeeded in not getting caught at before). Trying to be allowed to have my baby w/out C-section meant desperately praying he wouldn’t register as ‘too big’ on the weekly ultrasounds. Did you know that researchers consider “macrosomia” (being larger than the 90% percentile) to be a negative outcome/side effect in pregnancy? Perfectly healthy baby, just big, who DOESN’T get stuck (that’s allegedly why they started worrying about macrosomia, since babies who get stuck at the shoulder are more likely to be macrosomic)… still, obviously that’s a CO-MORBIDITY.

    Once he was out, the pediatricians at every appointment were all impressed at how well he was growing and congratulating me on how much he weighed.

    It makes my brain hurt a lot.

    Of course, if he ever gets individual insurance, they can probably deny him coverage when he uses it, on the grounds he didn’t tell them that his mom had GD and therefore he was more likely to be obese and diabetic, based on inferred connections between 3 different correlation studies.

  160. “curiously, absent ANY research I could find, most of the high risk pregnancy specialists were convinced that there is no such thing as early onset GD, only DMII that you succeeded in not getting caught at before”

    Oh my god yes. The best thing I did in my last pregnancy was schedule an early glucose tolerance test, which I passed with flying colors. I then had to take a second one and failed it as spectacularly as I had passed the first, but it at least gave me actual ammunition to tell the diabetes nurse to go piss up a rope when she pulled that one.

  161. Jenne – regarding the medical pregnancy interventions – it’s always an option to say no. I had a child with a serious heart defect which I knew about ahead of time, but after one useless, time-consuming fetal heart monitoring session, I refused to go for any more. I was badgered by a nurse calling me, trying to get me to come in every week, but it didn’t happen. You can always say no, or not go to the appointments they insist on scheduling for you.

    Michelle – I think I understand your point – our society as a whole has some pretty effed up priorities. I know a lot of activists who would agree with you on that one.

  162. Re-reading this, after seeing that the made-into-a-marionette Ralph Lauren model was fired for being “too big,” I’m having a serious “Stop the world! I wanna get off!” day. Will we look back in twenty years and say, “Wow, that FatLand novel was really prophetic”?

  163. Did anybody else see Prof. Amy Farrell on Colbert last night? They talked about this, and also fat-related legislation. Colbert didn’t seem to take it seriously (as that’s his shtick), but Farrel made some great points I enjoyed.

  164. I first saw this story right after my daughter’s two month well-baby (which we had at ten weeks rather than eight, I think). Promptly sent the link out to my family, because it was a major WTF.

    She weighed fourteen and a half pounds, up in those high-nineties percentiles for weight. (Also 24″ length, high nineties percentiles in height.) Every time we bring her in, the pediatrician makes thrilled burbly noises about how heavy she is and tells us she looks fantastic.

    Being in the position of someone with an infant – especially one who’s up there on the charts – right now, the story just broke my goddamn head.

  165. The problem here is not the health insurance industry. It’s the type of policy they have. Individual policies can deny pretty much anything they believe will cost them monies. This type of insurance, rather insure healthy people, the ones who have insurance for “just in case,” than people with possible conditions. That’s how thay make money.

  166. There’s a line in there about how if the girl got treatment and improved, they might cover her. Which is such a presumption of the resources available I’m boggling. I’m not sure what treatment costs would be for “underweight”, nor am I sure that there’s a “fix”, assuming the girl’s naturally small.

  167. My daughter was breastfed and gained a pound a week until she was 3 months old. She doubled her weight in 2 months. She was completely off the growth chart at her checkup.

    Our pediatrician laughed and said, “I see this a lot in breastfed babies. It just means that what she’s drinking is easier for her to digest and she’s getting lots of good nutrition.”

    When I read this story, I thought “way to penalize breastfed babies!!!”

    There are so many things wrong with health care in America… but this has got to be one of the worst things. No child in our country should be uninsured for ANY reason, let alone for being an infant who’s eating well.

  168. Elizabeth, you just sent me into swearing fits.

    Well, YOU didn’t, but that story did.

    Another thing that pisses me off is that the people being interviewed in this article are all claiming that the decision to deny this girl health insurance is insane, because the chances that she contracted HIV are very low. Everyone seems to operate under the assumption that if she did, in fact, have HIV, then denying her coverage would be a perfectly reasonable thing to do.

    Because, ew, yucky… who wants to help sick people? Especially sexually assaulted sick people!

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