The Social Complex

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A Blog dedicated to the exploration of height bias and discrimination.



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  • January 10, 2012 11:39 pm

    Cuomo’s ‘short’ cut for fixing Medicaid


    Short people got no reason — to pump up their height on the taxpayer’s dime.

    Gov. Cuomo’s administration is considering eliminating Medicaid funding for hormone-growth treatment provided to kids who have no medical reason to get it.

    The move would save the state $10 million a year for a procedure most private insurers won’t even cover.

    The bottom line: Taxpayers shouldn’t have to foot the medical bill to increase the height of people who are naturally short, officials said.

    “Not medically necessary. Idiopathic short stature is not considered to be a disease,’’ said a Medicaid benefit-review panel co-chaired by state Health Commissioner Dr. Nirav Shah.

    The recommendation notes that private insurance plans do not pay for height issues “caused by heredity and not caused by a diagnosed medical condition.”

    Kids whose growth is stunted by growth-hormone deficiency, a medical condition, would continue to receive hormone injections through Medicaid, the panel said.

    In 2010, 2,593 children received growth-hormone therapy through Medicaid at a cost of $40 million.

    But 30 percent of those kids did not have a documented medical condition, the panel said.

    One study showed it costs $55,634 per child in treatment to grow an inch, and $99,959 for a boost of 1.9 inches over five years.

    “While it may be intuitive that short stature is a handicap and therefore definable as a disease, neither history nor clinical research support this notion,” Arian Rosenbloom, of the University of Florida College of Medicine, wrote in the International Journal of Pediatric Endocrinology.

    [continued at link]

    TSC:  The concepts discussed in this article go beyond the political realm into a moral one.  Is it right for a Government to provide money to families for the purpose of obtaining Human Growth Hormone to “treat” children with idiopathic short stature? 

    As you can probably guess, the answer is “no”. 

    Here are some bullet point arguments as to why this is a bad idea. 

    (All of these arguments assume that HGH is safe and effective)

    • The purpose of making children taller is to achieve social advantage over their peers (as adults), and so the Government should not support it because the pursuit of social advantage is not a medical issue.

    • The purpose of making children taller is to achieve social advantage over their peers (as adults), and so the Government should not support it because Governments should be utilitarian in nature and should not be in the business of “picking winners and losers”.  Under this theory, a Government would have to give growth hormones to all children or give them to no children.  And of course, giving growth hormone to all children is the same as giving growth hormone to no children (and a lot cheaper).

    • By offering Growth Hormone to children, Governments make an implicit statement that height should convey social advantage or social stigma upon its citizens by funding drugs which attempt to “eliminate” short stature.  That is, the government funding of HGH further stigmatizes short stature. 

    • The tax money spent on HGH could better be used to cure illness and relieve human suffering (instead of contributing to human suffering by fostering a kind of ‘height arms race’).  

    Furthermore, just for argument’s sake, I’m not convinced that Governments should even be in the business of paying for HGH when there is an underlying medical condition involved which makes the child shorter than average. 

    Think about it.

    You have two children.  Both are male {-as heightism is a social construct based on gender norms; this is important-}.  Both have a projected adult height of 4’11” tall.  One child is going to be short because of genetics.  The other child is going to be short because of an underlying medical condition.

    Should not these two children be considered similarly situated under the eyes of the law?  Both children will probably be subject to an unusually severe level of height bigotry throughout their lives.  So why is one more worthy of growth hormone than the other?  Why should a government socially advantage one child over another when both children’s terminal height is based on “randomness” on some level.  Shouldn’t the government treat the underlying medical condition, but have no opinion on the height?

    The only difference between these two children is the philosophical fiction that one child was “supposed to be short” (the genetic one) and the other was not “supposed to be short”.  But should a government take that into account?  And why?  Does it matter to society that one short man was “supposed to be short” while the other was not?  No.  They are both equally stigmatized…and so I can’t get my head around why a government should treat these children differently. 

    1. thesocialcomplex posted this