Parents of "chunky" infant weigh in on health insurance reform

Frustrated parents of a big infant who is being denied insurance view the system as "absurd."

By Nancy Lofholm
The Denver Post
POSTED: 10/10/2009 01:00:00 AM MDT
UPDATED: 10/10/2009 11:24:59 AM MDT

GRAND JUNCTION — Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.

But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.

Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.

Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."

"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.

By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.

"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

" 'Your baby is too fat,' she told me," Bernie said.

Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."

His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.

At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.

"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."

Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.

The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.

The Langes are counting on the fact that Alex will start shedding pounds when he starts crawling. He is already a kinetic bundle of arm- and leg-waving energy in a baby suit sized for a 9-month-old.

They joked that when he is ready for solid food, they will start him on Slim-Fast.

Meanwhile, they made Alex's plight public on KKCO this week. They plan to appeal Rocky Mountain's denial.

If that doesn't work, they plan to take their case to the Colorado Division of Insurance.

"My gripe is not with Rocky Mountain," Bernie said. "It's with the general state of the health care system."

Nancy Lofholm: 970-256-1957 or nlofholm@denverpost.com

More Collateral Damage from the Siegelman Case – Talking with DOJ Whistleblower, Tamarah Grimes

By Joan Brunwasser
OpEdNews
October 8, 2009

Joan Brunwasser, writer:

The Bush administration is no more. But his legacy lives on in the ongoing wars in Iraq and Afghanistan, massive joblessness, the trashed economy, the transfer of power to the Executive Branch. During Bush's tenure, the Justice Department also became politicized to an unprecedented degree.

One of the most visible among the hundreds of political prosecutions was former Alabama Governor Don Siegelman. A Democrat and the only Alabamian to have served in all four of the top state elected positions, he was a choice target of Karl Rove. After several unsuccessful attempts, Gov. Siegelman was convicted of corruption and sentenced to prison. He is presently out as he awaits his appeal. Ninety-one former US Attorneys of both parties have asked President Obama, AG Holder and DOJ to reexamine Siegelman's case. Andrew Kreig, Roger Shuler, Scott Horton, and Glynn Wilson have done a stellar job covering the Siegelman case. [For more background information, a sampler of their articles can be found at the end of the second part of this interview.]

Tamarah Grimes was a paralegal working with the prosecution in the case against Don Siegelman. She contacted House Judiciary Committee Chairman Conyers and the DOJ about the prosecutorial misconduct of Alabama US Attorney Leura Canary and her team. For her pains, Grimes was chastised, intimidated, and ultimately fired, her reputation trashed. To add insult to injury, she was denied health insurance and they're trying to rescind her unemployment benefits.

This is particularly grievous for Grimes because she was the sole breadwinner in her household and her health insurance policy covered her disabled son. Grimes was terminated just eight days after sending a letter to AG Holder, laying out her concerns about the Siegelman case. Her firing will surely have a stifling effect on any other DOJ employees contemplating similar actions. Unemployed and uninsured, she is on the brink of financial ruin. Tamarah may be bloodied but she is also unbowed. She seeks no one's pity. This is her story

I'm so pleased to welcome you to OpEdNews, Tamarah. Tell our readers how your life has changed since becoming a whistleblower.







In reading the Office of Special Counsel report [that dismissed Grimes's claims of prosecutorial misconduct], I am reminded of the famous children's fable The Emperor's New Clothes by Hans Christian Andersen. Like the prime minister in the story, Interim Special Counsel William E. Reukauf would have you believe that the actions of the Department of Justice are irrefutable – even in the face of e-mail communications which clearly contradict its position – so much so that only the incompetent and unreasonable fail to recognize its merits.

Tamarah Grimes, Whistleblower: Like the emperor, I feel duped by the Office of Special Counsel. Federal employees have access to the Office of Special Counsel's whistleblower's website which prominently features its whistleblower duties. Relying upon the information I obtained from the Office of Special Counsel website, I placed my trust, my career, my entire life and the lives of my family in the hands of the Office of Special Counsel on the premise that whistleblowers are protected from retaliation by federal law. Based upon my personal experience, nothing can be further from the truth.

Continue reading here.

On the Government's Owners

By Glenn Greenwald
Salon.com
SATURDAY OCT. 10, 2009 07:11 EDT

The most revealing political quote of the last year came, in my view, from the second-highest ranking Democratic Senator, Dick Durbin, who told a local radio station in April: "And the banks -- hard to believe in a time when we're facing a banking crisis that many of the banks created -- are still the most powerful lobby on Capitol Hill. And they frankly own the place." The best Congressional floor speech of the last year on the financial crisis was this extraordinarily piercing five-minute revelation from Rep. Marcy Kaptur of Ohio on the Wall Street bailout and how the Congress is subservient to their dictates. And the single most insightful article on the financial crisis was written by former IMF Chief Economist and current MIT Professor Simon Johnson in the May, 2009 issue of The Atlantic, when he argued that "the finance industry has effectively captured our government" and detailed how the U.S. has become very similar to failed emerging-market nations in both its political and economic culture.

All of that came together last night on Bill Moyers' Journal program, as Johnson and Kaptur together discussed the stranglehold which the financial industry exerts over the federal government and how that has produced a jobless recovery in which the only apparent beneficiaries are the bankers and other financial elites who caused the financial crisis in the first place. The discussion began with reference to this Associated Press article from last week, which examined Timothy Geithner's calenders, obtained through a FOIA request. Those documents show that Geithner spends an amazing amount of time on the telephone with the CEOs of Goldman Sachs, Citibank and JP Morgan: "Goldman, Citi and JPMorgan can get Geithner on the phone several times a day if necessary, giving them an unmatched opportunity to influence policy." Other than the President, virtually everyone else -- including leading members of Congress -- are forced to leave messages. Kaptur and Johnson begin by discussing what that signifies in terms of the ongoing financial crisis and how government works.

Continue reading at this link.


CLICK THE PICTURE, WATCH VIDEO, Bill Moyers Journal

Five Myths on Afghanistan

By: Melvin A. Goodman, t r u t h o u t | Op-Ed
Truthout.org
Thursday 08 October 2009

President Barack Obama is entering a crucial decision-making phase on Afghanistan at a time when geopolitical mythology is dominating the debate, the Pentagon is requesting additional forces in Afghanistan.

The military bureaucracy is particularly vulnerable to such mythology. It is unfortunate that the intelligence community has not prepared a National Intelligence Estimate on Afghanistan, which would better inform the White House debate. The military has accepted five major myths with respect to Afghanistan.

Myth #1: Gen. Stanley A. McChrystal, who commands more than 100,000 US and international forces, has endorsed a counterinsurgency strategy that views the Taliban as a collection of armed groups with different political and economic objectives.

Continue reading here.

The RealNEWs: Iran: Beneath the hype

The RealNEWS: Beneath the hype: Is Iran close to nukes? Pt.2

Iraq whistle-blower Greg Thielmann: Military threats may push Iran to restart suspended weapons program



In part two of the presentation delivered to congressional aides and press members separating fact from fiction in the Iran nuclear debate, key Iraq weapons program whistle-blower Greg Thielmann weighs-in. Thielmann, now a senior fellow at the Arms Control Association, gives a primer on the elements needed to build a successful nuclear weaponry program. He then explains how the intelligence consensus over recent years is actually prolonging the time horizon for Iran to develop a useful bomb. Thielmann details that while the intelligence community is of the belief that the Iranian regime is ultimately interested in developing such a weapon, they are not making considerable strides toward such ends. He points out that recent news of Iran's identification of another enrichment site, while possibly a little late, demonstrates compliance with the Non-Proliferation Treaty, and should be viewed as evidence that the regime is not moving any closer to a developed bomb.

CBO Report: 'Tort Reform' Little Effect on Overall Health Care Spending

October 9, 2009

AAJ STATEMENT ON CONGRESSIONAL BUDGET OFFICE FINDINGS ON MALPRACTICE COSTS

The following is a statement from American Association for Justice President Anthony Tarricone:

Washington, DC--“Today’s Congressional Budget Office (CBO) findings reiterate what we’ve always known: that medical malpractice claims have almost no effect on overall health care spending. Along with the CBO’s numbers and countless other academic assessments, the vast majority of empirical evidence suggests that there are only miniscule savings to be found in reforming our nation’s civil justice system.

“Despite claims by tort reformers that the greatest cost of malpractice claims are borne by the public in the form of ‘defensive medicine,’ today’s analysis shows that at most, malpractice reform would provide savings of 0.3 percent in this area. In total, tort reform would provide a paltry 0.5 percent savings, while putting patients at risk.

“Indeed the CBO itself raised concerns that limiting patients’ legal rights could further jeopardize patient safety. In the final paragraph of its analysis, it states ‘recent research has found that tort reform may adversely affect [health] outcomes.’

“According to data from the Centers for Medicare and Medicaid Services and the National Association of Insurance Commissioners, malpractice claims make up just 0.3 percent of total health care costs. And we are confident that after weighing the totality of research on the subject, the public and Congress will see the truth: that limiting patients’ legal rights will do nothing to fix what ails our nation’s health care system.”

Read more statements from leading experts and opinion leaders here.

26Dems Editorial Note: Mainstream media is distorting the truth of the relatively insignificant savings (0.5 percent) by not putting the savings in context that the 0.5 percent figure represents 11 billion dollars which sounds to many people like an astronomical number.

Only the LA Times puts the facts into context. Read the Times story Medical malpractice reform savings would be small, report says

"An analysis by the nonpartisan Congressional Budget Office found the savings -- about 0.5% or $11 billion a year at the current level -- far lower than advocates have estimated."

The Times also features a picture of Sen. Kyl blasting Dems for blocking malpractice reforms.

Elizabeth Warren: "The Middle Class Is Under Terrific Assault"

Voices of Power: Elizabeth Warren on Vanishing TARP Money
Elizabeth Warren, Chairman of the Congressional Oversight Panel talks about the $700 TARP bailout and her concerns about the U.S. economy.

Washington Post
Thursday, October 8, 2009; 5:56 AM

Watch Video




For full transcript click this link.

"Stand and Deliver" LA Garfield High among 12 schools available to outside bidder

Los Angeles Times Blog
September 25, 2009 | 4:31 pm

26Dems editorial note: Putting "failing" schools up for hostile takeover bids by private non-profit and for profit corporations is the next step in a massive effort to reform public schools, already underway in Los Angeles, Chicago and Portland. Public schools are set up for failure as more charter and private schools gobble up a dwindling tax base. According to plan, private corporations are poised to take over the public school system. Privatization means less transparency in governance and financing. Parents are being conditioned and organized at Parent University and Parents Union in Los Angeles to become a part of a "grassroots" astroturf corporate managed and funded campaign to demand a change that will rob them of their power to influence the direction of their child's education. The aims of school privatization are not being discussed in mainstream media. Arizona's public schools have taken a huge budgetary hit this year thanks to corporate friendly Republicans. How long will it be before we see corporate PR managed"tea party" parent groups demanding that "failing" public schools in Arizona be put up on the hostile auction block?

Be sure to read the companion article that follows Say you want a revolution?: Parents Revolution, ‘Astro turf’ organizations and the privatization of public schools'


Garfield High, which became nationally known as the real-life setting for the film “Stand and Deliver,” will be among the first group of local schools eligible for takeover because of persistent academic failure, a high-level district source has told The Times.

Garfield’s selection means that the nation’s second-largest school system will invite bidders — from inside and outside of the district — to run the East Los Angeles campus of 4,600 students. This “request-for-proposal” process could apply to more than 250 schools under a Board of Education resolution passed last month, but the initial set of schools will number 12, sources said.

Included are Jefferson High in Central-Alameda, Lincoln High in Lincoln Heights, Burbank Middle School in Highland Park and Maywood Academy High in the southeast L.A. County city of Maywood.

[UPDATED: In addition to the schools named above, the following schools also are on the list: Gardena High in Gardena, San Pedro High in San Pedro, San Fernando Middle School, Carver Middle School in South Park, Griffith Joyner Elementary in Watts, Hillcrest Elementary in Baldwin Hills/Crenshaw, Hyde Park Elementary in Hyde Park.]

Sources supplied the information on a confidential basis because they did not have permission to disclose it. In an interview Thursday, district Supt. Ramon C. Cortines said he would release the list today, but only after notifying senior officials of the Los Angeles Unified School District.

Garfield High, which for decades has served a largely immigrant population east of downtown, reached its recent high-water mark in the 1980s, when math teacher Jaime Escalante built a famed calculus program that became the subject of a book and subsequent movie. Under his leadership, dozens of students passed the Advanced Placement calculus test every year, a rare feat even at the nation’s elite high school

Last year, only 5% of Garfield students tested as proficient in any math class. The school qualified for possible takeover as one of more than 250 that had consistently failed to meet federal benchmarks and thus was designated as falling into “Program Improvement” status. The board resolution applied to any school with that designation for three or more years.

Cortines later refined the criteria. “Focus” schools, as he called them, would have to meet additional criteria: Less than 21% of students proficient in math or English and schoolwide improvement of less than 10 points on the state’s Academic Performance Index, which is largely based on standardized test scores. In addition, high schools would have a dropout rate greater than 10%.

Garfield qualified easily. Moreover, the school has the lowest rank, 1 of 10, when compared with schools statewide. But that does not make Garfield’s selection noncontroversial or uncontestable.

When compared with schools that serve similar students, Garfield rates a 6 of 10, which puts it in the upper half of state schools by that yardstick. An independently operated charter school, for example, would be eligible for renewal if it achieved a 4 of 10 in this category. Charter schools are exempt from some rules governing traditional schools, including adherence to the district’s union contracts.

Continue reading here.

Say you want a revolution?: Parents Revolution, ‘Astro turf’ organizations and the privatization of public schools

By Danny Well
The Daily Censored: Underreported News and Commentary
October 5, 2009

Overshadowed by two wars, a corporate financed health care debate, economic crisis, swelling unemployment, corporate theft, social unrest and reality TV, a discussion of educational policy is virtually impossible under the current corporate media regime. Unacceptable to most American citizens, the current public educational system is being radically disassembled, state by state, like Legos in a pre-school play room. In its stead is being built a new corporate educational model of non-profit and for-profit educational retail charter chains or outlets that will replace the decaying urban public schools. The public school water bag has burst and the Educational Maintenance Organizations (EMOs) are like kids scrambling for candy under a broken piñata.

For those witnessing the health care or health insurance reform dispute as it is playing out on the national landscape, they won’t be surprised when they begin to see the ‘astro turf’ groups assembled around charter schools emerge, if they haven’t already. This is another reason Arne Duncan, Newt Gingrich and Al Sharpton are riveted on visiting major cities at the end of September for their whirlwind educational restructuring tour to promote educational reform, as they mendaciously refer to it (See Project Censored, They want to be on hand to applaud and cheer on the ‘grass root’ efforts aimed at charterizing a way forward in the Great Race to the Top, the hallmark of Duncan ’s reform efforts.

Continue reading here.
And here is the rest of it.

OPINION: Dems Want GOP, Brewer to help state

by David Lujan, Kyrsten Sinema and Chad Campbell
Arizona Republic
10.6.09

In its Sept. 29 editorial, "Agencies should not be pawns," The Arizona Republic is absolutely right that it's crazy to hurt businesses, taxpayers and homeowners during these tough economic times.
But that's what will happen if the infighting between Republican lawmakers and Republican Gov. Jan Brewer doesn't stop.

A lack of leadership and the failure to complete a budget have left businesses without a functioning Arizona Corporation Commission, which virtually will halt creation of new businesses and jobs for our state.

Arizona's classrooms are bearing the burden of the worst state deficit of our lifetime, while the Department of Revenue lacks enough funding to fully do its job and collect taxes owed to help balance the shortfall.

Homeowners aren't being reimbursed for contractors' defective or incomplete work, the job of the Registrar of Contractors, which also hurts from lack of staff.

Once again, Brewer and Republican lawmakers have failed to employ common sense.

Common sense is for government to meet its end of the deal so businesses can thrive in Arizona and we can jump-start our economy for all families.

Common sense is to pay down our own state debt and put the money to work in areas of government that will rein in more returns and build a stronger Arizona.

Brewer needs to call a special session now to address the Corporation Commission, Department of Revenue and Registrar of Contractor issues and do the hard work of creating a bipartisan solution to our state's open economic wounds.

These agencies shouldn't be a political football in what Brewer and Republicans have turned into a budget game.

Democrats have been ready and willing to work in a bipartisan way for nine months to get the job done and avert a crisis like this, but Republicans have refused. Instead, they chose to fight amongst themselves.

We set aside our differences at the beginning of the year for the greater good of Arizona because we knew that's what it would take turn our economy around.

We are still waiting for Republicans to do the same.

David Lujan is House Democratic leader; Kyrsten Sinema is assistant House Democratic leader; and Chad Campbell is House Democratic whip.

Medical Malpractice Insurers’ Profits Higher Than Nearly All Fortune 500 Companies

By DAPHNE EVIATAR 10/6/09 11:57 AM
Washington Independent

The American Association for Justice — the trial lawyers’ lobby group — has just released an astounding statistic: medical malpractice insurance companies’ average profits are higher than those of 99 percent of Fortune 500 companies.

As the nation remains mired in a debate over health care reform and how to keep down the costs of expanding coverage, AAJ is trying to point out that Republicans claims that medical malpractice lawsuits are one of the big cost drivers is completely misleading. In fact, though malpractice claims and so-called “defensive medicine” does account for a small percentage of unnecessary costs, medical errors and the astronomical profits of malpractice insurers appear to be a bigger part of the problem.

AAJ’s report released today finds that the average profit of medical malpractice insurance companies is higher than 99 percent of all Fortune 500 companies and 35 times higher than the Fortune 500 average for the same time period; and malpractice insurers have seen their profit margins range from 5.9 percent to 74.8 percent, with an average of 31.2 percent. The report also finds that malpractice insurers have publicly overestimated their losses and underestimated their profits in an attempt to suggest the insurance business and medical practice in general faces a crisis that must be resolved by so-called “tort reform” — i.e., making it harder for patients to sue and to collect damages for their injuries.

“Insurance companies are gouging doctors on their premiums to mislead lawmakers,” said American Association for Justice President Anthony Tarricone, managing partner at Kreindler & Kreindler LLP, in a statement released with the report. “And today, injured patients are often left with no avenue to pursue justice, while health care costs continue to skyrocket.”

View CNBC Video below as AAJ weighs in on "Tort Reform" and exposes the myths behind the claims that tort reform will clamp rising costs.




Click here for the American Association of Justice primer on "Medical Negligence" and the role of the civil justice system in the current health care debate.