Lack of Height Adds to Growth of Bills

     To quote the Randy Newman song, short people “got little noses and tiny little teeth.” According to the November 13 USA Today, that might be “a disability” – and a costly one at that.

     Reporter Rita Rubin’s big story on little people was about the costs associated with “idiopathic – or unexplained – short stature, or ISS.” The article, headlined “The debate is growing: Is being short a disability?” wasn’t about small stature or even Americans with Disabilities Act claims, it was about big bills – medical bills.

     Joyce Lee, a pediatric endocrinologist at the University of Michigan, explained that billions of dollars are at stake. She told Rubin that the average cost of growth hormone treatments for ISS was $100,000, or more than $50,000 per inch gained – an average of 1.5 inches per patient.

     Although Lee, a child behavioral health expert, questioned the use of growth hormone, the story missed the obvious connection between medical claims for growth hormone and rising medical costs. Growth hormone for all 400,000 Americans falling into the ISS category would have cost $40 billion.

     Just three months before, USA Today expressed great concern about those rising costs in an article entitled: “Could walk-in retail clinics help slow rising health costs? The story focused on strong savings of “about 25% less for MinuteClinic treatments compared with those done at doctors' offices or urgent-care clinics.” A study by PriceWaterhouseCoopers said insurance premiums rose by 8.8 percent from 2004 to 2005.

     The USA Today story led with the parents of smallish Spencer Davies, now 10, whose parents took him to a doctor because of his height at age 2 ½. According to the story, “initial medical tests found nothing that might explain his size, such as growth hormone deficiency,” but that didn’t stop the parents, who asked the doctor to prescribe growth hormone anyhow.

     The insurance company didn’t want to pay for the optional treatment and was forced to do so by an outside review board. That story, wrote Rubin, was typical for parents of 400,000 children who “have a predicted adult height of less than 4-foot-11 for girls and 5-foot-3 for boys.”