Your baby’s weight and insurance

There's a school of thought that says, "the number don't lie". The assumption is that numbers are facts and facts are always true. So if someone counts the number of times something happens, this gives you a basis from which to estimate the probability of the same thing happening across a population. This is the basis of underwriting for insurance purposes. Teams of highly trained people called actuaries count how many traffic accidents there are. They break it down into the age, make and model of car, the age, gender and profession of the driver, the time of day, the weather conditions, and so on. We happily accept information that, in the first half of 2009, only 16,626 people were killed in crashes, a 7% drop as against the same period last year. We are not surprised when we read this proves that there are 1.15 deaths per 100 million miles driven. The facts are facts and must be true.

Except when we apply the same approach to health insurance, some people get upset. Perhaps it's appropriate to be writing this at Halloween but the same actuaries have been counting the number of people who die from various diseases. For the purposes of this article, one of the main areas of interest has been the question of obesity. There are detailed numbers available across the country showing that people who have a high Body Mass Index (BMI) are more likely than thin people to die of heart disease. The medical evidence proves what are called "comorbidities", i.e. the presence of two or more conditions which, more often than not, suggests a cause and effect at work, or that there's an underlying vulnerability to both conditions. We are not so unhappy to accept a link between drug abuse and mental illness, but mention a possible link between body weight and disease and, suddenly, people are upset. People do not want to hear a link between their lifestyles and the probability of early death.

The reality is that adults with a BMI of 30 and above are either being turned down for health insurance or charged a higher premium. No matter how politically correct it may be to talk about obesity, insurance companies protect themselves by classifying obesity as a pre-existing condition justifying refusal or a premium loading. So welcome to baby Alex, a newcomer to Grand Junction. He's four months old and breast-feeding. He's a happy, bouncing baby weighing in at seventeen pounds. With a length of 25 inches, this puts him in the 99th percentile for the Centers for Disease Control and Prevention's height and weight charts for babies of the same age. So the health insurance company refused coverage. Their cut-off point is the 95 percentile. When you think about it, this is a dramatic piece of news. It seems you are never too young to be overweight. This is not something to be dealt with through an increase in health insurance rates. This is a blank refusal of coverage. At four months, the actuaries have already decided this baby is too big a risk to insure. The parents are naturally upset. Even though their pediatrician has no health concerns, they are talking about putting the baby on the Atkins diet. They may joke but this may be a real sign of change in the health insurance industry. There is no sentimentality here. After all, the numbers don't lie, except the insurers changed their mind when the publicity hit. Alex is now insured. Some good news to end on.