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)

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?

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.

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.

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.

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.

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