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."
and if you have a slashdot account (Score:5, Funny)
Re: (Score:3, Funny)
And my BMI is usually just less than 30. Yet my body fat is around 6%, which is kind of at odds with the summary, but pointing out errors in summaries is kind of boring here.
Luckily I'm self employed and pay exorbitant rates regardless.
Re:and if you have a slashdot account (Score:5, Informative)
Re:and if you have a slashdot account (Score:5, Funny)
Agreed. My BMI is 57, and I feel just fine thank you very much.
Now help a brotha out...I can't reach the remote and I can't get up off the couch. Could you change it to channel 114 and pass the Doritos?
you're making a joke but (Score:3, Informative)
Re:you're making a joke but (Score:5, Insightful)
depends on definitions (Score:5, Interesting)
If you're talking about regulars at T-Nation, or other natural body builders, I'd say you're wrong. There are people who manipulate their intakes, know everything (EVERYTHING!) about their diets, and keep meticulous workout and diet logs. They tend to be pretty damn healthy. If a bit obsessive compulsive. ;)
I'm not one of them but I play one on TV.
Re:you're making a joke but (Score:5, Insightful)
Re:you're making a joke but (Score:5, Funny)
Re:and if you have a slashdot account (Score:5, Informative)
Re:and if you have a slashdot account (Score:5, Funny)
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Cast OUT those DEMONS! Can I get an AMEN?!?
Louder! The LORD can't HEAR you!
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: (Score:3, Insightful)
Re:and if you have a slashdot account (Score:5, Insightful)
Re:and if you have a slashdot account (Score:4, Interesting)
Here's examples without going into bodybuilders.
A 5'11" guy is "normal" if he weighs 133lbs. If you add 40lbs of pure fat, he's still "normal". If the 5'11" guy is athletic and has a lean body mass of 155lbs and has 15% bodyfat, he's overweight.
In case you haven't noticed, women tend to be built differently than guys too.
The place I work has started things like this. Besides smoking ($25 a paycheck), they've gone the opposite route and "reward" employees who have a "healthier" lifestyle. Same difference, but it makes a little better PR.
Re:and if you have a slashdot account (Score:4, Funny)
Re: (Score:3, Informative)
Re:and if you have a slashdot account (Score:4, Insightful)
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: (Score:3, Interesting)
Lame idea.
I much prefer the idea my insurance company has. They give you this monopoly money for doing healthy stuff, getting checkups, and generally keeping in good condition. You can later redeem the fake money for real stuff like merchandi
Re:and if you have a slashdot account (Score:5, Informative)
You need to worry about triglycerides too. I'm predisposed to very high levels...as high as 1200+ in the past....down to 540 these days....started on meds again and working out to try to get them under 200.
The reason I state this? I can't GET freakin' insurance.....unless you are working for someone else in a group plan, you can't get anyone to insure you. I have no other problems, BP is good, etc. I can more than afford to pay for insurance, but, I cannot get anyone reputible to sell it to me.
I didn't realize it would be so tough to get it at any price.
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Re:and if you have a slashdot account (Score:5, Informative)
I can't GET freakin' insurance...
You should check if your state has a state risk pool.
I am also self employed, and since I got sick once years ago I also
was not insurable through individual policies. A state risk pool gives people
like me coverage when nobody else will.
It's a little screwy because it is still a private insurer (at
least in the state of Texas) that is contracted by the state.
The premiums are set at double the average, so the private insurer
makes loads of cash (and the tax payers don't take a hit), but at least I have insurance.
The deductible is high, but I do get the negotiated rates
which are usually 1/3 to 1/2 of what the uninsured are charged.
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Re:and if you have a slashdot account (Score:4, Interesting)
Anecdote #1: January of 2001, I developed appendicitis. I got an urgent appointment to see a GP (General Practitioner, "regular family doctor") at my local GP clinic. They took a bit of a history, quick manual exam of my abdomen, found the telltale "rebound pain" and immediately referred me to hospital. As my mum had taken me to the docs in the first place, she drove me to the hospital and generally did all the thinking for me.
Arrived at hospital, went to the MAU ward (Medical Assessment Unit - for GP referrals, as opposed to Accident&Emergency which = "the ER"). I threw up I think 15 times in total (I kept count purely by the number of little press-board "kidney dishes" I got through!) before they managed to hit me with a strong enough anti-emetic to stop that. I had been scheduled to be the last surgery of the evening but I got "bumped" because a major emergency case came in - so they stuck me with some sweet sweet morphine to enable me to sleep. (Oh, and they put me on IV fluids as soon as they'd managed to stop the puking. Pissing like a racehorse when you know you've not been drinking that much is one of the weirdest body-things ever!)
Come the morning, I got my surgery spot and swapped my appendix for a nifty well-stitched abdominal wound. I believe I had another day or two in hospital to keep an eye on me (check the wound was starting to heal and that the main symptoms were clearing, I guess). I did that recovery time in a single-sex part of the ward (but not a private room - they're not the norm in the NHS).
*Up-front* cost of all of the above: Nothing. No itemised bill, listing every dish I puked in and every injection I received. At the point I needed it, the care was there, it was entirely adequate, and the only concerns I had were boredom and recovery. Of course we know this isn't free, it gets paid for by the comparatively high levels of taxes on things. Also, the local Health Authorities in different areas sometimes differ in terms of what sort of treatments they will pay for (not offering certain very-expensive drugs on a purely cost-benefit basis, causing the so-called "postcode lottery" effect).
The thing a great deal of Americans seem not to know about the UK setup: There IS private, pay-for healthcare over here *as well* as the NHS. For less-urgent stuff, waiting lists on the NHS can be significantly bothersome - it can potentially take many weeks to get something done. There are some private hospitals around, and some consultants only do NHS work part-time and also see private patients. To pay for this, you can take out private health insurance which will hopefully pay for that sort of thing.
Anecdote #2: When I was 16, there were some concerns about potential blood-sugar weirdness - so my GP suggested I have an Extended Glucose Tolerance Test done (eat nothing for 12 hours, go to hospital and drink a glass of sugar-syrup and then give blood/urine samples over the course of a few hours - checking for sugar spike/crash stuff). It would've taken quite a few weeks to get that sorted under the NHS, but my dad had extra private cover at the time (it's not uncommon for it to be offered by employers) which covered family too - so my NHS GP referred me to a local BUPA private hospital, where the test was booked and done much more quickly (and I had a really nice private room, hotel-quality). Upfront cost: Whatever the "excess" was on my dad's medical insurance - in the region of 50GBP I think.
Anecdote #3: Turned out, one of my good friends I made at university has a peanut allergy. His first ever proper reaction (not "choke and collapse", but certainly "go very blotchy and itchy") won him a nice ride in an ambulance and spending the evening in Accident & Emergency. I went along for the ride and to keep him company. Direct cost of ambulance: Nothing. Number of times ambulance crew mentioned money: Zer
Re:and if you have a slashdot account (Score:5, Insightful)
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.
Re:and if you have a slashdot account (Score:4, Interesting)
We may have problems with our 30yr old system but bankruptcy/death from health-care and medicine costs are not amoung them.
Disclaimer: Even though I would "save money" I refuse to take out the extra private cover (it DOES NOT give you better medical care but it will pay for a private room or silicone tits). I willingly pay the extra 1% since I know it goes to health care for someone less fortunate and not some fat-cat's profit margin. The system saved my son's life in the 80's, at the time I was classified as "working poor" and it certainly saved my family from bankruptcy.
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:4, Funny)
Since the number of those requesting medical care is most definitely finite I'm not sure how you arrive at infinite demand. Because you insist it is an "observed fact", I have decided to stop reading your post. I suspect you may have need for mental medical care.
Re:and if you have a slashdot account (Score:4, Interesting)
Or you could look at the US Medicare system, which is almost an order of magnitude more efficient than any private health insurer in the entire country.
Anyone who thinks that having a single system could possibly generate MORE bureaucracy than our existing private health care system has obviously never worked in health care.
There are approximately 18 billion different private insurance programs in the US, each of which has arbitrary rules that serve no purpose other than to deny coverage to the most patients possible (what, your doctors didn't read all 14,372 pages of our plan's guidelines before performing the emergency surgery? sorry, not our fault you used a 6mm staple instead of a 5mm when closing the incision -- we're not paying for the procedure! Plus we're canceling the patient's coverage.)
Re:and if you have a slashdot account (Score:4, Interesting)
U.S. Medicare efficient? It rations mercilessly, pays so little that many people cannot get care even though it is "free", and spends money in isolation from personal economic consequences. The doctor contracts also have a Mob provision that makes it very hard to leave the Medicare "family" once you do a job for them.
And anyone who thinks they know bureaucratic red tape has never worked with government agencies that have a statutory monopoly. Single payer would be like getting health care from the Immigration and Naturalization Service.
Incidentally, one of the big problems with the existing system is that the GOVERNMENT only pays for a third of your insurance if it comes from an employer. Competition is drastically curtailed because important business relationships cannot be quickly changed. For many people, changing spouses is easier and cheaper than changing health insurance underwriters. Yet another reason to abolish that antique law.
Where will this madness end? (Score:5, Funny)
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.
Re:Where will this madness end? (Score:5, Funny)
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: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:5, Funny)
Re: (Score:3)
Regardless, it is a stretch to assume that a vegetarian is by default healthier than a one that includes meat. But due to the nature of the thing, somewhere on some vegan web forum vegans are probably complaining about subsidizing health insurance for vegetarians.
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Form of Discrimination? (Score:5, Funny)
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BMI?? (Score:3, 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
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BMI is well known for being grossly off in predicting disease for tall or muscular people, and if you're both, that's the worst.
I used
http://www.nhlbisupport.com/bmi/bmicalc.htm [nhlbisupport.com]
which gives me the same BMI number as every other calculator I've seen.
Re: (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 consideratio
Re:BMI?? (Score:4, Interesting)
I'm 5ft 8in tall and 200 lbs. According to this site [nhlbisupport.com], that gives me a BMI of 30.4
On the other hand, my chest is 44 inches, my waist is 37 inches (for the pervs that are salivating: I'm a guy. For the remaining pervs still salivating: I'm hetero. For the woman salivating: I'm single). I regularly bike (50 to 100 miles per week @ 15+ mph in preparation for a 60 mile charity ride this fall), run (I can run 2 miles in just over 17 minutes) and weight lift. Last time I got my cholesterol checked, my doctor mentioned that it might be too low (!).
Am I "grossly obese"?
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.
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.
Slope Slippery When Wet (Score:5, Insightful)
Bad idea (Score:5, Insightful)
Re: (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 pre
How not to do this (Score:5, Insightful)
Re:How not to do this (Score:5, Informative)
Punitive measures will backfire (Score:3, Interesting)
Punitive measures will backfire due to human nature. If you're paying the extra $10 for being 5 pounds overweight you are likely to think: Oh well, I'm paying to be fat so I may as well get 20 pounds overweight.
Mostly OK (Score:5, Interesting)
1. I would want it to lower my (a "healthy" person) premiums, deductibles, out-of-pocket expenses. I'm not trying to sound selfish, but the reason mine were so high to begin with is because of all the unhealthy people. If they're just going to use this to help their own bottom line without helping those that make the health insurance system work (the healthy people, again), then they can shove that plan where the sun don't shine.
2. Don't use BMI. It's a crappy measure. Anyone who lifts weights regularly can easily be considered obese by BMI (even if they're not a "body builder"). I've been over that line my whole life and I'm not fat.
One of the things that I really like about it is that it provides extra incentive for someone to be healthy. Want to save $50 / month? Get in shape, and that will help lower the expenses & burdens of the insurance system for everyone else. It's like taxing a congested road to help clear it up, or taxing emissions to clean up the environment. Sometimes money talks louder than anything.
Re:Mostly OK (Score:5, Insightful)
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.
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.
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.
This is crap (Score:5, Interesting)
They can go screw.
I have a BMI over 30. I used to play baseball. Heartrate? 63. BP? 122/63. Glucose, white cell count, red cell count? Normal. My doctors say I'm perfectly healthy, except for the rare form of cancer.
I truly fear the future where we treat insurance as a personal thing. We invented insurance as a way to spread risk. If we charge you directly for your risk, we are creating no economic benefit. It just means that in the future, I'll have to bear the entire cost of my cancer treatments.
And the healthy? You'll get the privilege to pay a private company to absorb zero risk.
Women of course... (Score:5, Insightful)
Bad idea.... BMI is flawed (Score:3, Interesting)
For example I'm 6'2" and 280 lbs. I've got some fat on me, I won't argue that. I also work out daily, deadlift 350+lbs, and can run a 6 minute mile (although I wish I hadn't after I do). I'm going to be generous and say 30% bodyfat, which I think is a good bit above reality. That's 84 lbs of fat. Losing 20% (56 lbs) to put me at 10% bodyfat, which is fairly low for anyone other than professional bodybuilders (and those guys who go way lower are being arguably just as unhealthy) leaves me at 224 lbs. According to this BMI calculator [nhlbisupport.com] I'm still way overweight and nearly obese and am currently ridiculously obese in my 40" waist jeans. According to that I should weigh 145 to 195 lbs. 145 lbs? Talk about unhealthy for someone who's 6'2". My Junior year in high school I weight 190-195. I was skinny. Not muscled, not ripped, skinny. Not unhealthy thin, but I would say more than 5-10lbs less than that would have been unhealthy.
How about a better idea? If you go to the doctor all the fucking time you pay more.
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
This is not a good idea for anybody (Score:5, Informative)
The whole point of insurance is to spread the costs around. Not risks, costs. Let's take an example. Suppose there's a group of 1000 people, and in any given year one of them's going to get hit with a $100,000 bill. None of them can afford that large hit, but all of them can afford to pay $100 per year. So they start a pool, each paying in their $100 with the understanding that the pool will cover the entire bill for whichever of them gets unlucky that year. Sure, the other 999 have to pay even if they don't get hit that year, but they also avoid the even higher expense of preparing to handle that big bill and the worrying over what'll happen if they get unlucky before they've saved up enough to handle it.
Now, suppose the guy running the pool for everybody decides there's an awful lot of money floating around in the pool. He could, he thinks, work out which person'll be the unlucky one that year. If he can, then he can charge that person the full $100,000 that year. That'll cover the pay-out and leave the other $99,900 in the pool for him to play with. Yes, this is the extreme case, but it's what the insurance companies here want to do taken to it's logical conclusion.
But wait a minute. If I'm a member of the pool, the whole reason I'm paying my $100 every year is so I won't get hit with the high bill if my number happens to come up that year. If I'm going to get hit with that huge bill anyway, why am I paying in? I'm not getting any protection from it, I'd be better off with that extra $100 every year to spend myself. The more it moves towards that extreme case, the less reason I have to pay into the pool. And even at the near end, the more people decide to pull out of the pool the more the guy running it has to charge those who're left, which makes it less attractive for them to remain in the pool, which means more people will pull out. And when there's nobody left, who will the guy running the pool get his money from? Oops.
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.)
Re:What's the problem? (Score:5, Informative)
Re:What's the problem? (Score:5, Funny)
We should gather every employee in a room & stand them on a table one-by-one, if the majority of the room thinks that person is a fat bastard, that person gets charged more.
Great idea! (Score:5, Funny)
We should gather every employee in a room & stand them on a table one-by-one...
Yeah! We could hire people the same way. Let different departments bid on them. Make them take their shirts off and show their teeth so you know they're nice and healthy. And, just for their safety and protection, we might want to chain them together, so they don't get scared and fall off the table. And maybe a small but tasteful whip, strictly to make sure things move along and people don't waste all day bidding on new employees. And make them sing worker songs, because people really like that. Swiiiing low, sweet cub-i-cle wor-ker...headed for the break room at niiiiiine. That's my favorite.
Dang, it seems so obvious. Why hasn't anyone thought of that before?
Re: (Score:3, Funny)
Bosses are exempt, if you have a problem with that you should have majored in Business instead of Programming.
I knew that would come in handy.... (Score:5, Funny)
Re: (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 - every
Re: (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 in
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.
It's NOT health care (Score:5, Interesting)
Someone asked me about Michael Moore's Sicko today, and I said that while he had some good points, he missed the problem entirely. If the medical industry was like the auto industry, it'd be like ignoring your car until the brakes failed and you ran into a brick wall, or never changing the oil until the engine needed replacing. Auto bodywork == expensive, brakes == cheap; replacing the engine == expensive, regular oil changes == cheap.
Americans would be a whole lot healthier (and health care expenses a whole lot lower) if health care was about prevention. (Mammograms & prostate exams, et al, are NOT prevention - they're screening for conventional treatments). The basics of human health haven't changed in thousands of years. The body requires certain levels of essential nutrients (some bodies need more of a nutrient than others due to genetic variation - some sailors were resistant to scurvy, for example). These nutrients need to be effectively assimilated through the digestive system, and the waste products of the body's metabolic processes need to be efficiently disposed of. The body requires clear air, clean water, sunlight (to synthesize Vitamin D), essential fatty acids [nutru.com], etc. If any of these are missing, or are not available in the required amounts, illness will invariably result.
Dr. Harold Reilly's Handbook for Health Through Drugless Therapy [amazon.com] covers the basics pretty well.
(it's not 'health care' because the system waits until a person gets sick, then it performs highly profitable 'disease-care'.)
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A ball player's life expectancy in the nineteenth century was about sixty years. For Love, for Money, for Real Money: Life Expectancy Among 19th Century Baseball Players [wwu.edu]
There is scarcely need to screen the gene
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.
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Re:Slow news day? (Score:5, Insightful)
Re:Slow news day? (Score:5, Funny)
World wasn't invented in a day, boy. Simmer down. They'll get to it.
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:Slow news day? (Score:4, Informative)
Have you read an insurance application lately? Non-commercial pilot, skydiving, rock climbing and other "dangerous" activities are asked about.
As for the rest, I'm sure they'll get to them eventually.
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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: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*.
As a licensed insurance agent (Score:5, Interesting)
I can most credibly say that insurance companies would LOVE to not pay out. They try to avoid paying out all the time. This is part of why people absolutely hate insurance and why state regulators are coming down so hard on them all the time.
All corporations would like to not make good on their obligations if they can get away with it. It's the inherent nature of capitalism.
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That was the historical purpose of insurance companies. The purpose now is to collect vast amounts of money, try to fuck over anybody that tries to get some payout on what they've been paying into, and to spend millions lobbying politicians in Washington to keep a system that is failing a whole helluva lot of people from being disturbed by any notion of wid
Re:Good (Score:5, Insightful)
After all, if you don't have cancer, why should you pay extra for the people who do?
Re:Good (Score:5, Insightful)
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The BMI values are a total load of crapola. I've been checked since, and to get down to my "ideal" BMI would require me to reach a -12% body
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As others have said... BMI is pretty useless. I don't consider myse
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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!)
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And I thought that was the problem here.
Re: (Score:3, Interesting)
That's the American way.
Many years ago military officers had trouble getting various types of car and home insurance because they were deemed more "at risk" than other occupations. They formed USAA, which to this day has some of the lowest insurance rates going.