Charging the Unhealthy More For Insurance 1106
Joe The Dragon sends us a BusinessWeek story, run on Yahoo, about Clarian Health and the new thing they are trying with health insurance coverage for their employees. They are charging unhealthy people more. The article goes into some depth about whether this is a good idea and whether the practice might spread. "In late June, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI, a ratio of height to weight that measures body fat) is over 30. If their cholesterol, blood pressure, and glucose levels are too high, they'll be charged $5 for each standard they don't meet. Ditto if they smoke: Starting next year, they'll be charged another $5 in each check."
What's the problem? (Score:2, Insightful)
BMI?? (Score:3, Insightful)
Is this bad? (Score:3, Insightful)
This will lower the insurance for the fit and healthy who never see a doctor (but want the insurance "just in case", and raise the cost for insurance for those who are ill or lazy and go often (I'm speaking in the long run, of course).
Sounds fine to me.
Slope Slippery When Wet (Score:5, Insightful)
Bad idea (Score:5, Insightful)
Re:Where will this madness end? (Score:5, Insightful)
"Exempting highly-skilled workers from having to pay unemployment insurance premiums, and raising premiums on burger flippers."
That's where it'll stop.
Its unhealthy enough just working there... (Score:2, Insightful)
Re:Slow news day? (Score:5, Insightful)
Great Idea! (Score:2, Insightful)
It is time to hold people accountable -- for the things under their control.
Why should I subsidize your Big Mac habit and have my health care dollars go to pay for your CABG (coronary artery bypass grafting) because of the heart disease your brought on by overeating and being obese.
The other way of doing this would be rewards. Charge a high rate for everyone. Those who have a BMI < 30 could get a 10 reduction. Perhaps that would be perceived differently.
The end result is the same. People have a monetary incentive to live healthfully.
Before the alarmists beging to cry out "Unfair! Things not under my control!" There are very few scenarios where those proposals would result in people being unfairly penalized. If you are obese, you are at an increased risk for hypertension, diabetes, coronary artery disease etc. Doesn't matter if it was your fault or not. You are still at increased risk.
Why should my money subsidize your smoking habit that will cause lung cancer, bladder cancer, myriads of other cancers and disease?
How not to do this (Score:5, Insightful)
Re:Good (Score:2, Insightful)
I wouldn't want to pay for others' bad choices, so I don't think anyone should have to pay for mine.
Things you have no control over? (Score:1, Insightful)
If on the other hand, you have a genetic/inherited health factor, like diabetes (well, at least one type of diabetes is genetic - I think there is another that is just related to being overweight), which causes your blood sugar to be high/low, you shouldn't be charged extra for that.
Re:Good (Score:1, Insightful)
Re:Seems reasonable... (Score:2, Insightful)
And you're dead on, choosing to live in a flood zone is *exactly* like choosing to be born to parents that have hereditary conditions. They should definitely pay the price.
Un-American (Score:2, Insightful)
http://en.wikipedia.org/wiki/Ableism [wikipedia.org]
Re:Good (Score:5, Insightful)
After all, if you don't have cancer, why should you pay extra for the people who do?
Re:Slow news day? (Score:5, Insightful)
This is why private insurance is a bad thing- their job isn't to maximize protection, but to maximize profit. Ideally, they would want to insure only the people who don't get sick and none of those that do, to make 100% of that money in profit. In other words, they want to make it a giant scam, taking your money but providing no services. This doesn't stop the others from getting sick, it just forces them to pay through the nose for non-insured rates, or get no health services at all. And since we live in a humane society where we don't let them die on the street, society as a whole pays a higher rate as we pay for them to take up emergency services when things go completely wrong, rather than cheaper, more effective, and less risky preventitve care they'd recieve with insurance.
So no, this is *not* a good thing. This is a perversion that will inflate the pockets of wealthy insurance companies while bankrupting the lower and middle classes. This is why we need to get rid of insurance companies and get government healcare *now*.
then what's the point of insurance? (Score:5, Insightful)
So if sick people need to pay more than healthy people, what's the point of having insurance? Healthy people then shouldn't need to pay anything, as they aren't costing anyoen anything. And sick people should pay everything, as only they need it. Which completely voids any reason to send any money to the insurance guy. OK, that's going further than this article summary sounded, but if this idea gains any momentum that may be where we end up at.
How about this, as a related idea... Old people should pay more into social security because they use it more. young people should get discounts because they're a long way away from taking it. I bet todays elderly would get all riled up if we tried to make that change, eh?
If this is meant to be motivation to fix things, some things cannot be fixed. I've got high cholesterol. Very high. And very bad ratio of HDL to LDL. I'm relatively young, 31. I've gotten into running, have done a couple relay marathons (split the maraton distance between four runners) and am currently training for a 1/2 marathon. While still bad, my cholesterol measurements were better BEFORE I started running. Now after doing it for a few years, my cholesterol is 20 total points higher and it's time for the pills to fight it. Weird but true. Not sure what my genetics have in mind, but the doctor told me of other patients more athletic than I am trying to become are not able to lower their cholesterol without pills either. No amount of financial motivation can change that, and no amount of financial punishment for testing poorly will help either.
Hey an even better Idea (Score:5, Insightful)
Oh yea, that was tried in the 1940's and for some reason people didn't like that. (don't flame me, I am being sarcastic.)
For someone who is sick or with a family member who is sick, just keeping a job and earning money is difficult, then add to that charging more health insurance costs, even if they could afford insurance would just push more people over the edge.
Increasing insurance costs would just be a slower, less obvious and more politically correct way to kill them off.
But it would be just as immoral, maybe even more so!
Anyhow Sick-o the movie already points out how screwed the system is.
Re:Slope Slippery When Wet (Score:2, Insightful)
Women of course... (Score:5, Insightful)
Don't listen to his numbers (Score:3, Insightful)
Here's a page giving some BMI weight ranges and a calculator.
http://www.nhlbisupport.com/bmi/ [nhlbisupport.com]
Josh
Re:How about a discount? (Score:3, Insightful)
because averages are good. (Score:2, Insightful)
Also, why the average? It's gambling. In reverse. People make money, we save money. It's a GOOD thing.
Can't see the forest for the trees (Score:5, Insightful)
This is one reason so many companies pound diversity and non-discrimination into their employee's heads over and over. Why? Because it results in the hiring and retention of quality employees. If a quality employee is fired, paid less, harassed, or whatever because of some trivial or irrelevant factor, such as gender, hereditary high blood pressure, race, religion etc., some other, more intelligent employer can pick them up, and they will be making money for somebody them instead of Morons, Inc. It is a colossally stupid business mistake to drive away (or not hire employees) for factors not relevant to your business.
Yes, unhealthy employees drive up health insurance costs for a business. But driving away otherwise perfectly good employees costs a business a heck of a lot more. It is an obvious fact that employees who voluntarily quit are generally those good enough to get paid the same or better elsewhere; otherwise, they would be far less likely to leave to begin with.
SirWired
Re:Bad idea (Score:3, Insightful)
No, that's precisely the opposite of insurance. The "entire point" of insurance is to mitigate uncertainty. The way to do this is to charge according to estimated risk. (Not the same amount as you later receive back -- that is what makes it insurance and not just savings.) To ignore known differences in risk when determining premiums is counterproductive and inefficient, and is not a part of insurance per se. Any voluntary insurance system which charged the same amount for varying risk levels would soon be out of business, because those who find themselves overpaying would stop subsidizing the riskier customers, possibly by starting a competing co-op insurance organization with fairer rates.
Wealth-transfer systems, including risk-blind "insurance", are not sustainable without the use of force.
It's NOT insurance (Score:5, Insightful)
Instead, employer sponsored group health plans are a form of socialized medicine, but implemented under a private feudal system. This system helps keep employees dependent on and loyal to their healthcare lords, the employers.
Since it's not insurance, there's really not much point in trying to charge differential rates within the group plans. If they go too far with it, they'll end up with the same premiums and individual filtering for preexisting conditions associated with individual health insurance. If that happens, the employers would no longer be able to use health plans as a tool to keep their employees pacified, employers no longer find it in their interest to offer group health plans, and the political pressure would quickly build to switch this country over to government-backed health plans like every other developed country on this planet.
Re:Slow news day? (Score:3, Insightful)
Just look at the pathetic and logically-challenged arguments being used by Republicans to try to keep the expansion of publicly-funded health services at bay. That's what your health insurance premiums are going to.
Re:Is this bad? (Score:5, Insightful)
And I think anyone that gets a sun burn or sun tan should pay extra as well.
And anyone that doesn't eat range fed chicken.
And anyone that eats meat.
And anyone that doesn't do exactly what I want.
Because my real purpose is to control them.
Re:Slow news day? (Score:4, Insightful)
I want to be insured for:
1) Accidental injuries incurred by non-dangerous activities (driving, swimming, non-extreme sports)
2) Cancer not directly related to my own activities (colon, prostate, lymph node)
I don't want to be insured for:
1) Extreme sports such as race car driving, motocross, ski jumping.
2) Cancer due to smoking
3) Liver failure due to alcoholic consumption
You start with a flat rate and go up from there.
Re:Slope Slippery When Wet (Score:1, Insightful)
No, that's fat people.
> Once you start discriminating against people for their genetic makeup, you're on a slope that is not just slippery, but frictionless.
Hey, that's business. You're free to start an insurance company which offers discounts for people who eat too much, don't do any exercise etc. I'd be interested to see your business model, though.
BMI subtly skewed (Score:4, Insightful)
The reason is simple -- the square-cube law. Your weight goes up by the cube of your height (so someone 10% taller is probably 30% heavier), while your cross-section only goes up by the square of your height. Waist size goes up linearly. This rule doesn't apply on large changes (you'll need changes in bone structures and musculature, etc.), but it's good enough for the variability you see in adult humans.
If you work out the numbers, you come up with the BMI being 'off' by about the person's height. That means that a 30 BMI for a guy at 5'8" (average height for calculations?) should correspond to approx 33 BMI for somebody who's 6'3" (one in twenty guys under 40?). Likewise for him to get under 30 BMI will be like his shorter peer getting under 27 BMI. Same thing applies on the 40" waist 'rule' -- a 40" waist on somebody 5'8" will be about 44" on somebody 6'3".
So flat fees are going to hit tall guys unreasonably hard... but our short peers still have a far worse deal. They get a false sense of security since their numbers appear to be good.
(The other benefit is that waist isn't the only thing that scales up!)
Re:Good (Score:5, Insightful)
Employer know the employee's medical data?? (Score:2, Insightful)
Re:BMI?? (Score:3, Insightful)
BMI is just height to weight.. it has absolutely nothing to do with your physical fitness or health.. Anybody that is athletic could throw the scale off.. I would not be healthy at 210 pounds (the absolute threshold of becoming overweight by that scale).. i would be anorexic..
Now BMI with a consideration for body fat % would be much more accurate... (and nowaday's I'd pay out the nose since I got the big frame from body-building, and work at a desk all day every day..)
Re:Un-American (Score:3, Insightful)
And I thought that was the problem here.
Re:Slow news day? (Score:3, Insightful)
They already have gotten to that. Why do you think your marital status matters? Married couples are usually less sexually promiscuous than single individuals, hence a lower risk and a lower rate.
Re:What's the problem? (Score:3, Insightful)
i don't agree with this at all. the point of insurance is to *distribute risk* across a large pool of people. once you start penalizing on risk factors, you have people with pre-existing conditions, certain genetic markers, etc. becoming "uninsurable", which for many of them means "you go die now".
"uninsurable" is a ridiculous term, IMHO - everyone is "insurable" - you simply give them coverage from the pool. yes, that means your rates go up somewhat - too bad. the important thing is that people are getting covered.
the stunning intrusion into people's personal lives is another issue altogether.
Re:and if you have a slashdot account (Score:1, Insightful)
Aside from a select few, it's actually a pretty good indicator of people who are overweight. There are a few muscled types who show up as overwieight/obese (I'm one of them) that have very low BF and high muscle mass. But for most of you, if BMI says you are obese, you are obese and need to step away from the cookie.
Re:Mostly OK (Score:5, Insightful)
Re:you're making a joke but (Score:5, Insightful)
Insurance is about distributing risk, not wealth (Score:4, Insightful)
Re:then what's the point of insurance? (Score:5, Insightful)
The concept of medical insurance has been highly perverted. It actually works as insurance if it's only there to protect you from the costs of things like major surgery. But when it's used as a buffer to pay for EVERY medical expense it turns into something that is nothing like insurance, and is a lot like a socialist economy. The reforms, such as the ones being discussed, are attempting to make it more like insurance again. Part of that requires that higher risk people pay more because they're buying more. Just like if your house is located in a flood zone on a fault line you're probably going to pay a lot more for your home insurance than if your house is an underground bunker in Kansas. It doesn't matter if you inherited your house, and so it's not fair because it wasn't your choice. It still costs more if you want the insurance, and it IS fair.
The analogy doesn't fit. Social Security is an income annuity product which Americans must buy. The analogy would be giving working people discounts on their Social Security payments if they were in poor health or charging them extra if they were in good health -- or else increasing a retiree's benefits if they are in poor health or reducing their benefits if they are in good health. With commercially sold annuities you can do this -- get a higher benefit for your money by sending the insurance company your medical records to show a medical condition, like a heart attack or stroke, which implies a shorter life expectancy.
It's not a punishment. Statistically, you are more likely to end up needing open heart surgery at some point compared to someone else just like you without the high cholesterol. The point of insurance is to pay a smaller amount (the premium) to cover the small possibility of requiring a larger amount (the cost of the surgery). If you were twice as likely as the other guy to need the surgery, then the fair price for that insurance would be twice as much as the fair price for the other guy.
Too much work is the problem. (Score:4, Insightful)
You're a higher risk so you pay more, seems like an insurance company at work to me.
Part of the obesity epidemic is the 60 hour work weeks that have become the norm, while real earning power has declined for most people. It's not like the company is going to give you the time to be healthy, so the pay cut is simply that and nothing more.
Re:Where will this madness end? (Score:5, Insightful)
Now if these were individual health plans, then the market should decide. Don't like what company X charges, go to one that charges less. But employees don't have this choice in a group plan, so I'm against it.
Michael
Re:Charge vegetarians less? (Score:1, Insightful)
More. A vegetarian diet is unnatural and unhealthy. Human beings are omnivores. Giving up meat is about as good for you as giving up vegetables. It totally fucked up my sister's system. Years of deprivation of food we were made to eat took its toll. She still subscribes to the religion, but eats meat now to keep herself healthy and feeling okay.
Re:you're making a joke but (Score:5, Insightful)
Re:What's the problem? (Score:3, Insightful)
Well, that's the insurance company's goal. The consumer's goal is to distribute cost across a large number of people, not risk.
The insurance company benefits when risk is minimized; the consumer benefits when cost is minimized. What the insurance companies are doing here is trying to further minimize risk at the expense of some of the consumers, which is not compatible with the goal of the insurance consumers because it will increase costs for them.
There are several issues here. One is when a consumer increases risk themselves; for instance, if they choose not to wear a seatbelt, or if their diet consists of fatburgers and coke and nothing else. In this case, the consumer is increasing risk, and one could understand the reluctance of the insurance company towards treating this person the same as one who has a less pathological diet.
But a second, quite different issue is that a person with diabetes or leukemia or breast cancer probably isn't responsible for these things in the sense that their behavior is a key element. So in this case, the tendency of the insurance company to lock them into higher costs (or out of the pool entirely) is less easily excused.
Third, the insurance company wants to make money; as a public company, it actually has an obligation to make money. This can so easily come into conflict with the need of the consumer for the best possible coverage that it may be a defining line where we can use ethics to say that pooling health care costs with an idea of profiting may be inherently unethical.
Fourth, there are people who abuse free-ish health care; I know of some of these myself. I suspect that this is one of the extremes - like people who are quite sick in multiple ways - that a pool just has to accept, just as it accepts people who are inordinately healthy and rarely, if ever, call upon the pool to pay for medical care.
The bottom line, it seems to me, is that we do know that medical care is expensive, we can reduce the citizen's overall need for care into statistical likelihoods that are really pretty well nailed down, and we should probably do exactly that because if we do, everyone will have the care they need and that is a very noble and reasonable goal.
Insurance companies would lose out, but there is no guarantee of any particular job or service niche existing; progress and change are constantly creating and eliminating opportunities. Nothing says that because today, you have a successful corporation selling beanie babies, that everyone is forced from now until the end of time to buy beanie babies. Likewise, the insurance companies have built a great gig for themselves, but if tomorrow, we as a society decide that a not-for-profit national pool that includes everyone who can pay whatever it costs is appropriate, then it is time for them to go find a new business to pursue.
There will always be a group of unemployed / insufficient income people who cannot access such a pool in its most basic form, but then again, our society has a strong tradition of caring for those people. Given that they're a rather small percentage of the overall population, probably the best solution is simply to bite the bullet and fold them in. After all, you never know when you might lose your job, eh?
Re:and if you have a slashdot account (Score:5, Insightful)
Apparently there are healthy chubby people whose musculature surrounding their vital organs is sound, and skinny people who got that way through diet whose hearts, liver, etc are surrounded by flab.
That still doesn't excuse the idea, embarrassing in the richest nation on earth, that anyone should have to go without medical care from cradle to grave. As far as I'm concerned, if you believe that you, a healthy person, should not be responsible for paying into a system that gives care to a less wealthy unhealthy person, you have a fucked up, un-American world view. You don't have to be a bible believer to know that if you want to pull the heaviest loads, you hook up the strongest horses. That's why the rich pay a greater share of their wealth in taxes (or are supposed to). The dual economic crises of the "sub-prime" credit market and runaway health care are exposing the fundamental weakness in Milton Friedman's theory of the so-called "free market".
Why not have the Fire and Police Dept provide services based on the victim's ability to pay? Because that's not the way we do things in a great, rich nation. So why should health care be any different? We don't allow the Fire or Police Dept to base their service model on profits, so why medicine? We wouldn't suggest that Fire Departments should not save someone from a burning tenement slum because they couldn't afford to properly fire-proof their property, so why suggest that someone who is poor and has become overweight due to a substandard diet should be denied health care?
Re:and if you have a slashdot account (Score:3, Insightful)
Re:and if you have a slashdot account (Score:4, Insightful)
In Missouri, physical requirements for their State Troopers had to be revised because some who were bodybuilders couldn't meet their BMI requirements.
Would someone please explain to the 230 lb weightlifter with 6% body fat why he didn't pass his physical.
Re:Women of course... (Score:1, Insightful)
Re:and if you have a slashdot account (Score:2, Insightful)
Don't be an idiot.
The demand for medical care is almost infinite. This is not a hypothesis or an ideology, it is an observed fact.
Therefore if you pay for a medical dole using a finite pool of money, there will be rationing. If humans apply good judgement to rationing decisions, the answer will not always be the same. Demagogues will call this unfair: decisions by local democracies will be derided as a ZIP code lottery, professional judgment by doctors will be considered hogging the budget. Therefore rationing decisions will come to be made by flow charts written by a bureaucracy, without regard to economic results, pain, suffering, family disruption, and so forth. Again, this is not a guess or a political position, it is a fact that has been observed every time a medical dole has been tried on a large scale with social "fairness" as its primary goal.
In such a system, in the interests of "fairness", the bureaucracy will become ever larger and more controlling. Eventually it will become both the largest line item on the budget and immersed in its own internal politics. Again, this is an observed fact. One need look no further than the bureaucrat-politician-and-protocolist to doctor-and-nurse ratio of Britain's NHS.
Treating free men as beasts to be harnessed has never worked out well, though it has often been tried, you Stalinist pinhead.
Not when it comes to U.S. health care, they don't. Fully one third of their posh health insurance is paid for by the U.S. Treasury, which funds this enormous give-away entirely by increased taxes on the uninsured. The extra money also drives up health care costs, which is a further burden on the uninsured.
When people like me say everybody should have to personally pay the full cost of their own health care even if they have to die, this is what we're talking about. People like you are simply ignore this point, and whitewash it as "un-American" malice.
And now you are trying to whitewash a strength as a weakness. Free markets work by teaching unbiased object lessons to the participants. The invisible hand does not care whether you are black or white, how good of a nanny your parents could afford, whether you have a strict neighborhood association, or any other claptrap. Sometimes the lessons hurt, but if you want to run you have to expect a few skinned knees. (Remember than the sub-prime mortgage "crisis" amounts to a percent or three of GDP for a single year.)
Have you been living under a rock? Compare the police response in Compton with that in Menlo Park with that in a small Alaska town. Civil services most certainly are based on ability to pay.
Spoken like someone who has never gotten a bill from either a fire department or an ambulance service.
Re:It's NOT insurance (Score:2, Insightful)
Re:and if you have a slashdot account (Score:3, Insightful)
Re:and if you have a slashdot account (Score:5, Insightful)
Re:and if you have a slashdot account (Score:3, Insightful)
For a couple of mod point, please point to a truly free economy. unencumbered by government regulation, government interference or taxes. I bet you the closer to that ideal you get the more corruption and monopolies you see. In fact I bet the closer to that ideal you get the lower the general standard of living is.
Re:Where will this madness end? (Score:5, Insightful)
Society maintains itself through having kids. It's been observed that family units tend to give kids better starts and are less prone to crime. Thus the society has a vested interest to promote this. If you've made a conscious choice to opt out, then they be wise to push you towards making a greater contribution through higher taxes. Your singledom generally doesn't forward the society. Occasional outlyers exists (Alan Turing etc..). beside the tax credit a family gets does not even make up half of what kids cost. I am single and I don't mind. A $2000 tax credit means a lot to a family but only a new HDTV for me. Society would make the right choice in pushing us toward shaving more kids. Opting out is umm... letting the terrorist win
Re:and if you have a slashdot account (Score:2, Insightful)
This does not mean you can guess ONE PERSONS risk by BMI, but you can guess that a group of people with BMI >30 will have more health problems than a group with a BMI 24. This is, as a matter of fact, very very useful to an insurance company. They are betting against you getting sick/ having to go to the hospital/ etc., so if you have a low BMI, they will bet more (aka charge you lower premiums) that you'll be ok. On the contrary, if you have a high BMI, they will charge you more, because odds are higher you'll end up in the ER costing them money.
And while BMI is not the most terribly accurate measurement, most people with a BMI over 30 are not in good, or even fair shape. Feel free to rationalize as necessary, but don't get carried away associating yourselves with NFL athletes or pro body builders just because you have a high weight/height ratio. I mean, this is slashdot.. if you are anywhere approaching that kind of physique, you have wandered a long long way to get to this website =)
Re:and if you have a slashdot account (Score:4, Insightful)
Re:and if you have a slashdot account (Score:5, Insightful)
Re:then what's the point of insurance? (Score:2, Insightful)
Higher premiums for risky people: The guy with cancer pays X and the guy with perfect health pays Y < X. The graph is has hills and valleys, but it's fairly flat.
You're question is how anything other than #2 could be better than #1. Don't ignore the middle ground presented by #3. Raising my premiums by fifty dollars a month because I'm at high risk for cancer is an inconvenience, but still a far, far cry from charging me the full millions of dollars for my treatment could end up costing. The question is whether it's better than option #1. I don't know if it is, but I can see how it could be.
If I want to engage in risky behaviour under system #1, my deterrent is that it might end up hurting my health. If I want to engage in risky behaviour under system #3, my deterrent is that it might end up hurting my health and it's certain to hurt me financially. We get the benefit of #2 (if I can afford a slightly higher premium, I can do dangerous stuff and still get health care) and the benefit of #1 (I should some of the financial burden for my choices, thus reducing the burden of people who don't do risky stuff, and reducing the likelihood of me doing risky stuff.
My fear, of course, would be that as we get better at predicting risks, the insurance companies would refine the payments to the point where health insurance premiums match your health costs almost perfectly. At that point, yes, system #2 has become identical to #1. But we're not close to that yet, and a little bit of regulation can keep us from going there at all.
(I know this post is clumsily put together. Sorry.)
Re:and if you have a slashdot account (Score:3, Insightful)
yes, it does mean that BMI is not the best one. BMI is a meaningless figure invented in the 19th century that has only marginal meaning in modern healthcare. The only thing a REAL doctor does with an out-of-range BMI is run tests to see if it is meaningless in this case or not, they don't ever use BMI to actually apply health care more advanced than giving generic diet advice that applies to everyone ("eat less sugar, more vegetables and try to get the weight down, OK?".
This is just another example of American "health insurance" companies who are more interested in having some number they can get cheaply to point at and justify why they want to charge some people more money than providing actual, you know, health care. Whether that number is your ZIP code, credit rating, or BMI, it is meaningless to your actual health status, but they're perfectly happy to charge you more or deny you benefits for having the wrong number.
Re:and if you have a slashdot account (Score:5, Insightful)
True, but the links between being overweight and many health problems are well established. I don't think any really reputable source is debating that being overweight -- particularly obese -- isn't unhealthy. Obese people tend to have an increased risk of heart disease, blood clots / strokes, diabetes, etc. The list is pretty long.
Every once in a while you'll hear someone talk about correlation vs causation and obesity -- i.e., whether being obese causes you to be unhealthy, or whether there's some sort of underlying cause which causes both obesity and the other health problems that it's correlated with, but to an insurance company that's irrelevant. They just want to find easily measurable risk factors and indicators; whether the relationship is causative doesn't matter a whit (to them).
Re:This is not a good idea for anybody (Score:4, Insightful)
If it's guaranteed that one person will get a $100 000 bill, you're right. In health insurance, it's not. It's a 0.1% chance for each person that they'll get a $100 000 bill. If someone has the ability to cut their risk in half, down to to a 0.05% risk, (without increasing anyone else's risk in the process), that will lower the over all cost by $50.
What we're talking about is offering people willing to do that some money. Could pay them $50, thus breaking even. Could pay them $40 and lower everyone's premium by one cent. By paying me $40 to lower my own risk, everyone has saved money, not just me.
Doing such and such changes the cost by $X. This system internalises the externalities, and that's a Very Good Thing. (Clearly we should only be doing this when someone can lower their risk.)
(Yes, the article [or summary--didn't read TFA] talks about charging people for raising their risk instead of paying them to lower it, but it gives exactly the same results, ignoring any psychological reactions to perceived differences and however that will effect behaviour. Economists like to pretend we're perfectly rational beings, but we really aren't. Present it as a carrot instead of a stick and it should work well.)
Missing the point (Score:3, Insightful)
There are many replies here that miss the point. The idea is to punish people who choose to live in an unhealthly way, not people who tend to use the system more for natural reasons (like older people using more social security, or women using health insurance during pregnancy, which other posters have mentioned).
As for my opinion on the matter... I support the penalty to smokers, but it's very difficult to measure obesity. Perhaps some kind of professional evaluation would be better than using BMI or other completely quantitative measures.
Re:and if you have a slashdot account (Score:3, Insightful)
Being called names or having other countries boycott your product are parts of free markets. In a free market, you don't get to force people to buy your goods or force them to say only nice things about you.
You can buy or sell whatever you like -- 12 year-old boys, stinger missiles, untested medicine, etc. You can perform surgery without any training or worrying that somebody will sue. You don't need insurance to drive a car, or an inspection or registration. there's no building inspector to tell you your slab has to be so far from the curb or so thick, you can build a high-rise out of toothpicks and rent out apartments in it with no smoke alarms. It's a free market, a libertarian paradise.
Re:and if you have a slashdot account (Score:5, Insightful)
You are absolutely right. It's interesting to compare what the French and Americans spend on their healthcare systems. In the US we are spending 16% of our GNP and have 46 million people without any form of insurance (and of those who do have insurance, a lot of it is worthless when it really counts).
In France, however, they are spending 10% of GNP [nyu.edu] on a system which covers everyone and routinely outperforms [businessweek.com] what we have in the US.
More FUD to watch out for is the crap about lines and impossible waiting times. I've spent a total of two years in France, including two months in the hospital with a pretty nasty pneumonia. The staff was always courteous and competent. This is at the same time my compatriots were all bashing surrender monkeys and feeling clever.
I like what my company does... (Score:2, Insightful)
I think this is a great idea on the part of my company as it probably helps them cut insurance costs in the long run, as well as supporting the general wellness of employees through the positive reinforcement of free money
Why should I have to lose EVERYTHING? (Score:3, Insightful)
What do you think bankruptcy means?
That you can just get back in your car (oh, that's been repo'ed,) and drive home (sorry, that's been sold out from under you for committing the one sin America does not forgive; being broke,) sit on your couch and watch TV? (sorry, that got sold at a garage sale to empty the place, your house was going on the block.)
Enjoy life in your new luxury cardboard box condominium; you [expletive deleted] and just to make you feel better as a person, remember, you're dying of some horrible and probably excruciatingly painful disease.
And best to you and your family as you take up your new residence below the rail-road trestle.
What an IGNORANT and ILL THOUGHT-OUT response.
Health care insurance is what we SHOULD be paying our taxes for, not blowing shit up and making sure that the rest of the world WANTS us dead.
Re:Hey an even better Idea (Score:3, Insightful)
It's a slippery slope. $20 isn't much for us computer guys, but for someone working at in a retail store or supermarket or some other close to minimum wage job, it can be a lot for someone barely able to make ends meet.
Once they can legally charge more for some individuals, then it can and most likely will increase it. Why not $100 extra, $200, $500,eventually a $1000 extra.
If you earning $10K a month or more this is not much, but many people are earning only $2000 to $3000 per month they are already force to contribute as much as $400 a month to health insurance as it is. My 60 year old Mother is in this boat.
In her case this is even more then her rent, fortunately she is in good health at the moment.
But once this Pandora's box is open, there is no going back and no telling where it will end up.
I had cancer, how much to I get penalized? (Score:3, Insightful)
I understand that there is a connection between personal health choices and the cost of health care but how about things beyond our control?
Worrying about being denied coverage is one of the worst parts of suffering a major medical problem. Even if you survive you might not be able to afford to continue living.
Wait... (Score:3, Insightful)