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Charging the Unhealthy More For Insurance
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."
thats another 20
Charging drivers with more accidents higher rates for auto insurance?
You're a higher risk so you pay more, seems like an insurance company at work to me.
"I use a Mac because I'm just better than you are."
Isn't the entire point of insurance to charge higher for higher risk people, and lower for lower risk people?
That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.
Seems like you would want your height to weight ratio to be on the high side. Is this to punish the thin people?
Seems reasonable... we charge people with poor driving records more for auto insurance. People who live in flood plains pay more for home insurance. Why shouldn't people at higher risk of health problems pay more for health insurance?
For the record, I'd probably fall at or near the BMI requirement. I know I don't lead a healthy lifestyle, but I don't think I should get a free ride for it either.
I'm healthy and rarely visit the doctor (thank God). Why should I pay for someone who is overweight and smokes.
--sig fault--
If they actually just look at the base BMI number, there are going to be some athletic people in great shape paying more for health insurance. And then you get into a dangerous area of penalizing people for some things that are (potentially) out of their control. I smell some lawsuits, and some expansion of what's covered under ADA and EEOC rules...
"It is a miracle that curiosity survives formal education." -Albert Einstein
I'm sorry, but this sounds dead on to me (and my BMI is over 30). If I'm too lazy, or too sick, to keep my BMI down, or if I have preexisting medical conditions that make me much more likely to cost the insurance provider more, I have no problem with being charged more. This is a great incentive to take preventative action, when possible (BMI, smoking, a better diet, etc), and it is a reasonable provision when not possible.
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.
Economically it sure makes sense to the companies that are doing it.
Socially, obviously the healthy people would support this decision, while the unhealthy wouldn't.
Morally I'd draw the line between voluntary and unvoluntary conditions. If you smoke, heck yea, you should be charged more than those who don't... Same thing if you are a couch potato that fails to do even most basic of exercise.
Some diseases, however, are not due to lifestyle choices, and no matter how economically sound in a laissez-fare environment would be charging an unhealthy person more, I just can't get rid of the feeling that it defeats the moral purpose of protection that insurance is supposed to deliver.
Encouraging Americans to be healthy is great. I don't really have a problem with charging those who smoke more, for instance. But high blood pressure? Come on, that's hereditary. Once you start discriminating against people for their genetic makeup, you're on a slope that is not just slippery, but frictionless.
This is a horrible idea. The entire point of insurance is that everyone pays a more-or-less baseline amount and some people don't realize any of that value and some people realize more than they put in. Of course, now that Americans expect to realize 100% of any tax or insurance payments, and if even one penny goes to someone else, well, that's socialism! Insurance is inherently socialist. That's why it's called INSURANCE. If you're expected to pay an equal amount to what you receive, you don't really have insurance, you're paying as you go.
There will be a lawsuit about this. It's just a matter of when. It looked like it's the employer doing the fining not the insurance company, which I know in my state if an employer holds back any part of your paycheck, you can get back 3 times the amount.
Don't Vote for Norm Dicks! http://www.nodicks2008.com Another nutless dirtbag that voted for the FISA bill!
but some Cholesterol/Blood pressure is related to genetics.. My diet is closer to a vegetarians then the typical Americans and I have stage 2 high blood pressure, with low cholesterol counts.. I have maybe 2-3 servings of meat per week (FDA servings, not American services)..
I dont mind paying extra for my choices, I do mind paying extra for something I cant change... unless Medications are allowed to reduce BP and avoid the fee
Although I do agree with this policy fully, I think it may be a little bit unfair since it also doesn't take into consideration peoples lifestyles and the risks they present. What if someone is an avid mountain climber or has mental disorders. How about those promiscuous workers that don't bother with contraception. What about alcohol use? They should all be charged more for their level of risk since charging more for risk is what we are talking about.
Regardless of whether you think this is a good idea or not, the BMI is Bullshit!
Really a hospital should know enough to use an accurate measure of body fat, as opposed to this bogus rough appropriation.
from Wiki:
The medical establishment has generally acknowledged some shortcomings of BMI. Because the BMI is dependent only upon net weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly). However, some argue that the error in the BMI is significant and so pervasive that it is not generally useful in evaluation of health. Due to these limitations, body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing.
An analysis of 40 studies involving 250,000 people, heart patients with normal BMIs were at higher risk of death from cardiovascular disease than people whose BMIs put them in the "overweight" range (BMI 25-29.9). Patients who were underweight or severely overweight had an increased risk of death from cardiovascular disease. The implications of this finding can be confounded by the fact that many chronic diseases, such as diabetes, cause weight loss before the eventual death. In light of this, higher death rates among thinner people would be the expected result.
...so next they'll deduct another 20 for just working in a hospital.
I would prefer a discount for healthy people.
In theory there is no difference between theory and practice. In practice there is. - Yogi Berra
The problem that I have with this is that BMI is a poor way to measure obesity. I'm 5'11" and currently weigh 260 pounds. Yeah, I'm fat. When I was 18, I was a varsity athlete in soccer, basketball, and track. I weighed 190 pounds. According to BMI, I was overweight. BMI wants me to believe that my target weight is 135-175 pounds. 135 pounds, at 5'11", with a V-shaped torso, is sickening to even think about.
Another thought that just occurred to me is that this might cause the company's premiums to go up. If more employees start taking blood pressure and cholesterol-controlling medication, the insurance company's costs will go up and will be passed on to the company.
About time.
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?
I would have expected this to be spun 180 degrees. i.e. Jack the rates up for all and then announce you get a $10 discount for meeting the BMI standard rather than a $10 penalty for failing to meet it. Same outcome, but less likely to piss people off.
None of them can see the clouds; The polished wings don't care.
I generally don't have a problem with this approach, as long as it's things people have some kind of control over. If you smoke, and the pool of smokers are known to incur more medical expenses, then I have no problem charging the smokers a stupid-fee, so that the rest of us don't have to pay for the extra medical expenses related to their smoking habit.
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.
I believe lower income people generally tend to be fatter than more affluent people, same about smoking, and maybe some other things. So it seems like it will just result in more people being unable to afford health insurance, while saving the already affluent a dollar or two they are likely able to afford anyway.
It seems like a good idea in principle, so long as it focuses on things that people can change in themselves. Unfortunately, public discourse has blurred this distinction, with people who have genetically given urges to eat confusing it, at least in public discourse, with genetically given needs to eat. Smokers and fat people probably have no excuse, while those with issues with blood pressure and the like may not be to blame for their poor health. Shoving people to take care of their health to their ability is probably a good thing though (perhaps something to deal with pro-ana folk too would be prudent)..
For every problem, there is at least one solution that is simple, neat, and wrong.
Great plan, but defining 'healthy' isn't that simple. The BMI is a good case in point. Very healthy/athletic body types can be surprisingly heavy because muscle weighs more than fat. With serious weightlifting, people's weight goes up even as their pants size drops. With serious exercise, one can easily get their weight into the BMI's "unhealthy zone" while they are simultaneously in the best shape of their lives.
America should be like an all-you-can-eat buffet, with one fair price charged for everyone. This variable charge penalizes those who are fat, prone to illness, or require nicotine to calm their neurotic minds. I think it is a variation of "ableism," or a hegemony that assumes all people suffer no disabilities.
http://en.wikipedia.org/wiki/Ableism
technical writing / development
These sort of things (smoking, weight, etc.) are taken into consideration if I buy health insurance on my own - I'll either be denied, or have to pay a higher premium. Am I to understand that people on Clarian's company health plan all "paid" the same amount (i.e., Clarian didn't distinguish between its employees when buying coverage)? If this is the case, isn't Clarian basically just doing for its employees what insurance companies do for individual purchasers?
"Anyone who [rips a CD] is probably engaging in copyright infringement." - David O. Carson
Next year unhealthy people will be forced to eat tofu and yogurt 24/7/365 (they can anything they want on Feb 29 once in four years) till their BMI drops below 25.
sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
I would support a proposal like this with a couple of stipulations:
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.
What about people who live healthy and eat healthy but have a family history of high cholesterol. My mother is one such person, she is taking all the required steps to keep her cholesterol in check, such as diet, exercise and medication, but still has a higher than average cholesterol rating. Should she have her paycheck penalized because of family history? It isn't her choice to have high cholesterol, although some people have it just because of unhealthy lifestyles. Should she be lumped in the same boat as them?
Without balancing the risk and the premium, it becomes just another program to shift money away from those who succeed into the hands of those who do not.
Don't trust anyone under thirty.
Its probably good for people who just dont care a bout their health: at least, if they care about their money, now its easier to stop smoking and eat vegetables for them now. However some people are just victims of their health, i dont know much about obesity, but i thought it was DNA related. If thats the case, this move would be completely unfair for them.
Smokers at our company pay more, and those who participate in wellness programs get a discount. I personally wish they would add an additional charge for those who drink alcoholic beverages and a discount for those who absolutely don't -- such as myself.
But the problem is that employer's aren't supposed to have access to much of an employee's medical or insurance information because otherwise they can discriminate in hiring/firing/promotions etc. based on how much an employee or his/her family is costing on the health insurance group policy. Which means, for example that in my case I might as well file for unemployment now because I have a family member with a disabling illness. And the law prohibits discriminating against me on that basis. So if a person who has an ADA disability gets docked more on their paycheck because the disability messes with their blood sugar level, etc., or if the information crosses the limits set by "HIPAA"?
Well, personally I would hope to be the plaintiff's attorney in that class action suit and that my target defendant business had a great big fat bank account.
...Open Source isn't the only answer -- but it's almost always a better value than the alternatives...
They start charging idiots for having children.
So we charge fat people more because they get Diabetes more.
So we charge smokers more because the get cancer more.
So far so good. (?)
So we should charge gays more because they get AIDS more?
So we should charge black more because they get gunshots more?
So we should charge young women more because they have expensive babies?
I always thought of medical insurance as a socialist concept. Everyone pays into a bucket, and the sick people take out of it when needed. So long as there are more healthy people than sick people, it should work. Even in capitalist implementations of medical insurance schemes.
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.
"Flag on the moon. How did it get there?"
Surely, statistically, if you are offered insurance you are unlikely to need it.
They whose government reduces their essential liberties for temporary security, receive neither liberty nor security.
We could just put all the unhealthy people in gas chambers and kill them.
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.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
it doesn't get any cheaper for the healthy people. it's just a quick cash grab to get some extra $$$ from the fatties
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.
From the article:
BMI does not measure body fat. BMI correlates with body fat percentage but there is large variation. In particular, based on BMI, muscular people are going to be judged to be "overweight" or even "obese".
I never did the body building / weightlifting thing but back when I was at top fitness for cross-country ski racing my BMI would still have categorized me as "overweight".
If Clarion Health wanted to be fair and charge people more who are likely to have higher health care costs then the number one factor they should be using is age.
On the other hand, if their goal is to modify their employees behavior then positive incentives would create a much nicer atmosphere. In fact, stress can do major damage to a person's health so if they really want people to be healthy they should be looking at ways to reduce employee stress (and paycheck deductions is not one of them).
The way I see it, there are two fundamental problems with health care in the USA. First, medical school admissions are artificially limited creating an artificial scarcity (monopoly) on medical doctors. Second, the artificial monopolies that are granted to pharmaceutical companies (in the form of patents) allow top management to divert exorbitant amounts of profits to themselves (and also engage in other inefficient management practices).
What it comes down to is that some administrator somewhere at Clarion Health has a lot of anger issues and decided to lash out without any understanding of the fundamental problems facing US health care.
6ft 235 lbs.
Of course I can bench 400lbs. So, if you say I am fat I can [Arnold accent] crush your puny head like a grape. [/Aronld accent]
But high blood pressure? Come on, that's hereditary.
Why does that matter when it still leads to higher health costs.
You don't like hereditary issues costing more, make sure you genetically edit them out before birth.
And that itself is a slippery slope too - but honestly it makes more sense that people should pay more for insurance they are more likely to use. If they can't afford to do so, that's where government (or ideally private charity) steps in to help take up the slack.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Women have higher health costs, what with their frequent specialized doctors care, occasional pregnancies, and longer life span. They should be billed at a higher rate as well.
Any sufficiently advanced technology is indistinguishable from a rigged demo.
At the BMI's he is suggesting, you would be considered underweight. Normal BMI is 18.5-24.9. If he really had a BMI of 11, I'm surprised that he is still alive.
Here's a page giving some BMI weight ranges and a calculator.
http://www.nhlbisupport.com/bmi/
Josh
Open Your Mind. Open Your Source.
Unless this is combined with human judgement and common sense, this is bad. Even with that I think it's highly questionable. BMI doesn't account for how much of your weight is muscle over fat. Someone who lifts weights regularly can be "overweight" according to BMI.
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 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.
Who do you think is more likely to have an unhealthy BMI - a 21 year old guy fresh auto college or a 40 year old woman who just gave birth to her 3rd child and has some knee problems that keep her from exercising? While most obese individuals just need to start walking and lay off McDonald, there are just too many cases which are out of one's control and illegal to discriminate against. For example, both depression and some anti-depression drugs can cause weight gain. Once we move on blood pressure, cholesterol level and glucose levels, it's more likely to be genetic or otherwise randomly striking disease than environmental. Are those morons really going to cut back salary for people who were born with type 1 diabetes?
Besides, the whole point of insurance is to charge an average rate for a wide group of individuals. If instead every one is charged exactly the cost of their medical care, healthy individuals will drop out of the plan and pay out of pocket while unhealthy ones will delay treatment until it's an emergency covered by Medicare. In the long run, this will drive the insurance company out of business as nobody will really benefit from their coverage.
BMI is a very crude measurement. It's chief advantage is that it is an easy measurement to do, which is why it is so popular and well-known. Unfortunately, it can be spectacularly wrong when used to measure muscular people with low body fat - you know, the types that actually use their 24 Hour Fitness membership. I'm one of those, and my BMI suggests I am near overweight (29.1). However, my actual body fat as measured by calipers is just 14% - much less than average (which is about 25% for men and 40% for women in the US). If I gain a few more pounds of muscle (or fat), I will go over 30 BMI, but would still be way below average for percent body fat, and way above average on many other health yardsticks. BMI is pretty useless unless you're already a fat couch potato.
Edith Keeler Must Die
I lost my mother to cancer. She rarely used the hospital but the last ~9 months of her life, we blew through ~900,000 not counting lost wages. My parent's weren't rich.
/geek, not involved in the HIPA world.
Also, why the average? It's gambling. In reverse. People make money, we save money. It's a GOOD thing.
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.
BMI is a horribly flawed index.
Almost every major athlete (certain sports like ribbon twirling aside) has a BMI massively in excess of 30.
It's also based on your height SQUARED. Can any of the learned Slashdot crowd tell me how many physical dimensions the body exists in? For this reason, they've had to lower the recommended range to 18-22 for Asians because their lower average height means that the numbers are completely useless. By the same logic, anyone over the 5'6 or so it assumes for needs to raise their BMI but, of course, it fails to account for that.
For both of those reasons, just about no genuine exercise professionals use BMI. Body fat percentage is a vastly more accurate indicator except that only gets close to being accurate the more points you use, is only particularly accurate if you submerge someone in a water tank and is only completely accurate post-mortem.
To put the joke of BMI in context, we did a 7 point body fat reading and got my body fat percentage. Knock that percentage off from a starting weight of 100% and I end up about 15lbs over a BMI of 25 (the high end of normal). That's right... I need to drop past the 8% minimum body fat range, past the 6% point where brain function becomes affected, past the 0% point where I die, and then lose 15lbs of muscle/skeleton, all to get a BMI of 25 - the high end of what it claims is a healthy range for me.
In a world where any rational thinking has proved I am too tall and have too much basic muscle structure for BMI to have any validity, any company that tried to fine me for failing to live up to a demonstrably unhealthy scale would be facing an immediate lawsuit. The only thing that would be slowing me down would be figuring out if I was suing them for harrassment or for forcing a situation that would outright endanger my health to try and follow.
Before anyone makes the obvious joke, yeah, I'll accept I also go over the 18% recommended male body fat reading and could do with losing weight. It doesn't change the simple fact that BMI is massively flawed and using it to fine employees borders on the criminal.
</rant>
Insurance was a way to calculate and spread risk. Actuaries take into account aggregate risks, and you get to pay a flat fee to absorb any risk covered by the insurance.
However, when you start "tailoring" clients like this, you aren't spreading risk and you aren't providing economic benefit. You are a pivileged monopoly not subject to the will of the market.
Even hardcore conservative economy wonks like me do not like the idea of allowing insurance companies to charge wildly variable rates and deny reasonable coverage. Much of what is OK in health insurance wouldn't fly in life insurance, for example.
This is precisely why privatized health care cannot work. Health insurance companies are in the business of making profit for their shareholders. Profit follows the formula that premiums are greater than payouts. Therefore, maximum profit comes from charging healthy people high premiums but not paying out anything in return.
What should be obvious about this is that healthy people don't need health care (other than minimum preventative checkups). The people who do need health care are not profitable. The more care you need, the more the system shuns you. And we get a system in which the people who need care the most desperately are the least likely to receive such care. I once had a conversation with a professor in college who said to me this: "Prenatal care is the most-needed care of all. Without it, you produce problematic individuals. Yet our system denies prenatal care to tens of millions of women. How can that be a good idea?" The answer is that it's not a good idea, but it is profitable to deny care to them.
Any profit-seeking system of health care will fail to provide the care it is tasked with providing.
Our intelligent designer has never created an animal that we couldn't improve by strapping a bomb to it.
Gattaca here we come!
"Save on post-natal care, genetically screen your unborn child for conditions that may affect your post-natal coverage".
Offer not valid in ND, AK, and HI etc. etc.
My UID is prime!
Okay, giving discounts, bonuses, etc. to say, folks that don't smoke, or something of value for regular exercise, great! But charging for many conditions that are hereditary, and/or difficult to control is stupid, as it just pisses off perfectly good employees, who then may quit because you are nickel and diming them.
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
Really. I work with people who eat powerded sugar donuts with melted butter and a root beer for breakfast every day. They make fun of my oatmeal (then ask me to help carry stuff). Just don't use the f***ing BMI. Use fat percentages, alcohol intake and nicotine intake. I'm 6'1", 190 pounds at 18% BF. Yet the BMI says I'm obese. Riiigght.
Why would you go to a hospital that doesn't understand the difference between lifestyle and genetic predisposition for all of these problems listed, with the exception of smoking. I seriously can't wait for the pending lawsuit.
Don't Vote for Norm Dicks! http://www.nodicks2008.com Another nutless dirtbag that voted for the FISA bill!
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.
To Michael Moore's website, http://www.michaelmoore.com./ The more press given to abuse by insurers and health care companies, the less it is going to happen. I consider this outright abuse. This country punishes the sick and injured. No wonder we are ranked 37th in Healthcare in the Industrialized world. I find it sad that the poorest of the Canadians, Britons, and the French are likely to live longer than the poorest Americans. The blame, lack of access to healthcare and greed from the insurance companies. I submitted this link to michael moore's website. I encourage all to do the same. Clarian should not be able to get away with this; especially being a Methodist hospital system. I thought a fundamental tenet of Christianity was forgiveness. Even Jesus Christ himself said the power to heal is greater than to hurt.
Members who choose to participate will receive $500 discounts toward their deductible for each cholesterol, blood pressure, and BMI level they meet, along with refraining from tobacco use or taking a health risk assessment.
What a scam. They're not even discounting the insurance for those who are healthy and/or go out of their way to meet the standards, they are only giving a discount on the deductible. This is only helping the pocketbooks of the insurance company. It's amazing how corporate decision-makers in HR departments eat this bullcrap up...
'' While most obese individuals just need to start walking and lay off McDonald... ''
Considering how much money is made with products that are supposed to help fat people to get slimmer, and that all these products don't work, I think things might be a bit more difficult than you think.
We laughed at the time. And here it is in action.
http://www.aclu.org/pizza/
It puts the lotion on it's skin, or else it gets the hose again.
Charge vegetarians less?
Charging someone MORE doesn't make sense unless you charge other people LESS. Why should I be penalized for following a healthier lifestyle by paying the same premiums as people who jog less and eat more red meat?
Now, if they'd put it in a chart form, I'd support that. So you could base your lifestyle on the premiums you'd be paying.
Each ounce of red meat, +$0.25
Each ounce of fish, -$0.10
Each mile you jog, -$0.50
Each 12 ounce soda, +$0.25
etc.
I have a really low BMI and great insurance so I'm really getting a kick out of these replies..
That introduces a punitive measure, but also offsets the medical costs associated with supporting these vices.
Engineering is the art of compromise.
What will happen? Will people change their lifestyle and get more healthy? Yeah, sure.
No. They will buy questionable weight-loss pills that drain every drop of liquid from their body so their BMI is below 30. They will swallow whatever necessary to get their blood pressure down and their other values in check, whether that's healthy or killing them, who cares? You'll see a LOT of health related absences in the weeks after the checkup, I promise you that.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
Tax McDonalds and other garbage food producers like we the tobacco industry. Of course the cost will be passed onto the consumer and but then it works more as a disincentive then a penalty. As it is companies are encouraged to bring inexpensive products into the market place without considering the impact on human health (class-action lawsuits aside). If cigarettes kill people how is it that high-fructose corn syrup doesn't? And it's aggressively marketed to you from birth. American is swimming with junk food and we act like it's just people. Ketchup is now in one of the food groups.
Quack, quack.
Where I use to work at, there were penalties if you participated in certain activities such as bungee jumping, riding motorcycle, drove a high performance car (sports). Some states such as Colorado has laws against this known as "lifestyle discrimination". Even with those laws, your manager can still hold that against you without documentation. Performance appraisal is one of the means for them to express their prejudice.
BTW the BMI is subtly skewed against tall people. Ditto the "waist under 40 inches" rule.
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!)
For every complex problem there is an answer that is clear, simple, and wrong. -- H L Mencken
body builders and the like have skewed BMIs, for example.
You better watch out, there may be dogs about . .
I don't really have a problem with charging those who eat more, for instance. But high cholesterol? Come on, that's hereditary.
I don't really have a problem with charging those who drink more, for instance. But diabetes? Come on, that's hereditary.
I don't really have a problem with charging those who use mind altering drugs, for instance. But mental illness? Come on, that's hereditary.
I don't really have a problem with charging those who abuse stimulants. But cardiomyopathy? Come on, that's hereditary.
The point is, there are people who meet every one of the left-hand criteria who cost less than people who meet only one of the right-hand criteria--and there are quite a few people who meet all of the right-hand criteria. Frankly, the people on the left should be charged less for the simple fact that behavior can be changed, heredity cannot.
how in the *hell* are employers able to get and use an employee's medical information in such a way? truly, this is evil.
free software, open standards, open file formats, no software patents.
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.
Engineering is the art of compromise.
They want employees to be fit and trim, because being overweight is unhealthy. Clearly, they acknowledge that being overweight is a medical disability. And they're going to dock their employee's pay over what they acknowledge is a medical disability.
Aside from the obvious Americans with Disabilities Act violations, in most states, docking pay for an illegal purpose is criminal, and rightly so. Whoever signed off on this belongs in prison.
The entire idea of insurance is to spread out the costs over a large number of people, so that those who need medical care can afford it, with help from those who don't. The idea of changing insurance options based on medical need is in conflict with the entire purpose of insurance. Insurance companies have arrived at the point where they literally expect money, as a tax, collected at gunpoint in necessary, in exchange for nothing in return. And they've screwed up the medical industry to the point where even those who don't need much medical care can't afford any without insurance. It's taken them a century to do it, but they've made insurance just another tax.
It's time for some reform. Maybe some old fashioned "water the tree of liberty" kind of reform.
This is possibly OK if people get discounts or refunds for good health scores. Otherwise, it's just another way to rip people off.
I had the privilege of working with an insurance organization (government run) in Canada recently, and I wonder why American health insurance companies don't take the same clue. I keep reading about horrifying health care abuse by your private insurance companies - denying care to those who deserve it and have paid their premiums, etc.
Why not focus on prevention? Here in Canada I notice we pend a *huge* amount of money on prevention education. Free nutrition classes for the overweight, lots and lots of adds on workplace safety and household safety... All of that goes towards reducing your eventual payout, and it's a win-win situation, as opposed to the much less morally justifiable situation of denying patient care once the patient has fallen ill.
And you are supposed to submit to measurements and give your blood for analysis - how often? Once a month? Quarterly? Who is going to pay for processing the results? Presumably, hospital eats the cost, and there go your 200 bucks a year in savings. And if this is a once-a-year deal, that would kind of defeat the purpose: squeak in once, and pig out for the rest of the year; plus another interesting avenue for lawsuits - someone going on a crash no-carbs, no-fat, total purge week-long diet before the check-up, damages his or her stomach/liver/whatever.
I can assure you, the best way to get rid of dragons is to have one of your own.
Health 'insurance' really isn't used for that, though, is it. You don't use your car insurance for routine maintenence, so why should health insurance be different? Shouldn't insurance be used only for cronic illnesses or non-maintenence injuries? In that case wouldn't government programs where the many aid the few be more beneficial to everyone? If you want 'help' with routine maintenence, then pay for supplemental 'insurance' yourself.
I don't agree with everything that was said in Moore's film, but the biggest issue for me is that healthcare is unreasonably expensive, and I believe that is entirely the fault of putting these 'insurance' companies in charge of it all.
Why, oh why does it cost me $75 per visit for 2 minutes of a doctor's time (which he misdiagnoses, so I have to go back several times, paying that fee each time?)
Then there are the drug costs...
I'd much rather take the inflated insurance costs taken out of a paycheck each month myself, and pay for things as needed, but with less costly insurance kicking in should I become ill, require a specialist, or suffer a severe injury requiring surgery.
Um, like didn't these guys get the memo? The Body Mass Index is not an accurate measure of health. Athletes often have very high BMIs because muscle weighs far more than fat per cubic centimeter. I have a BMI of 31. So by their rules I'm fat and unhealthy. The reason my BMI is so high is I do a lot of physical labor every day and have large muscles and dense bones. I have a very low body fat content - I sink, even in ocean water. So in their eager beaver attack on the fat they're going to punish healthy people too. Dumb.
Many folks here are missing the point of the article. Insurance companies charging more, or even refusing to cover, unhealthy and/or high-risk folks is not news; it is in fact quite common in the private (as in, non-group) insurance market. (I'm not saying it isn't a problem, just that it is an entirely separate topic.)
The point of the article, which is news, is an employer charging their employees extra for the based on health risk. This makes not a great deal of sense. The essence of the group policy that employers buy for their employees is that each employee costs the same, and the premium is adjusted up and down year-to-year based on the overall claims history of the group as a whole. Yes, unhealthy employees cost their employer additional dough in premiums, but it could drive away valuable employees while only resulting in some trivial reduction in premiums.
SirWired
Because I'm sure no one's payments, no matter how healthy they are, are going to go down.
I sure don't like paying $4k a year for insurance, that's for sure.
(good post, BTW)
The BMI chart is really an absurd metric if they just go by height to weight ratio. Muscle weighs twice as much as fat, but the BMI treats all weight as equal. Its pretty easy for someone in good shape to receive a score of obese on the BMI.
BMI is garbage- it simply puts height against weight.
I'm a body builder, only about 12% body fat but according to my BMI I am obsese- some hardcore lifters would be considered morbidly obese.
It was developed in the 1800's by a Belgian scientist and does not take into account body composition, body fat percentage or overall health.
If I was subject to this ruling I would be making a hell of a lot of noise- you can't punish a healthy body builder simply because a number based on 19th century mathematics is applied to him (or her) that has no basis on overall health.
CIGNA is my company's health care provider. Three months ago they did a neat little promotion - complete a Health Risk Appraisal survey about your health (diet, exercise, etc) and get a Starbucks gift card ($5 IIRC) and be entered in a drawing to win $50 Amex card. Paranoid as I am, I decided it wasn't worth it.
I have an HSA (not health spending account, those suck) a health SAVINGS account, which is pretax dollars I contribute as well as a partial match by my employer. This account is for paying health bills, via a debit card or provided checks. I have to keep records of my purchases, that are health related. This means I can goto the store buy some advil or a prescription, pay with the debit card making it quite nice. The nifty thing about having the money pre-tax is that what I purchase my dollar goes ~30 further. I do not agree with these people docking people pay, a good way for them to get some exercise as people walk out of the company to another with better benefits...
the smokers who make it to 100 pay a lot more....
every day http://en.wikipedia.org/wiki/Special:Random
Employers can screw themselves if they expect to know by blood pressure, cholesterol, BMI, and any other medical history or details about me. As far as I'm concerned that's a private matter with my doctor. If your employer suddenly decided I had to submit to these kinds of tests, that's a damn good sign they have no respect for you.
AccountKiller
"Hear! Hear!"
http://www.maxineudall.com/2010/02/should-economists-be-sued-for-malpractice.html
I'm pretty sure the OP is thinking about body fat percentage, not BMI. The numbers for women are also fairly low, I thought the recommendation for women of child-bearing age was around 25.
BTW 30% body fat on a guy is not "obscenely high". The person will definitely have a spare tire, but they sadly won't stand out on the streets of most American cities.
For every complex problem there is an answer that is clear, simple, and wrong. -- H L Mencken
Maybe certain poor health indicators related to high stress should be charged to the boss, not the employee. Otherwise, you're double penalizing them for working for a poor boss.
I welcome the suggestion, but to trash your parents that way seems harsh.
I'm sorry to hear about your insurance situation. Those private corps. don't want to insure anyone who has any detectable condition whatsoever. I suppose they're seeing the high triglycerides and then deciding to send you away. [sigh]
On another note, I wish that most anti-cholesterol medications would disappear off the face of the earth.
It's not that I don't think cholesterol shouldn't be lowered when necessary. It's not even that I think it's easy (or always possible) to get it down to desired levels using natural methods alone.
It's that I think many of the anti-cholesterol meds out there are snake oil despite their being "effective."
Ideally, people should be asked to lower their cholesterol for a reason--to fight heart attacks and strokes and such, for instance. So, when I see (judging from the ads) anti-cholesterol medicines that are contraindicated by some of the rational reasons to lower cholesterol, and that do nothing about most of the others because their side effects cancel out the benefits of lowering cholesterol, then I'm wondering why the darn medicines are being prescribed at all, let alone prescribed to everyone and his cat. (I am especially angry at Lipitor for these reasons.)
There is a fine line between recklessness and courage... -- Paul McCartney
At first I thought "this is horrible! what about people who have diseases through no fault of their own (eg, inherited ones)?". Then I saw that two of the examples were to charge smokers and people with high BMI more. The smokers, I can kind of see, but I'd much prefer that they'd phrase it differently; perhaps an (ab)use fee, for not avoiding an activity that has been shown to be detrimental to your health. The BMI thing is probably a bad way to go about charging overweight people "use" fees, since it is really just a silly little formula with no relation to physical fitness (as others have pointed out).
Then I got to thinking a thought that has cropped up in my head a lot recently: insurance companies are the best example of how a "free" market doesn't work for all areas of life. Think about it: the original purpose of insurance was to spread the costs of risk so that society would be a place you would want to live in. These are costs you are going to pay one way or another (as countless privileged classes (such as the French nobility during the French revolution) have discovered). Insurance just makes it so that when someone has a problem, everyone can contribute a little bit to help them out, with the understanding that everyone might need that help from time to time. Insurance as it is now (in the US) is a travesty that not only sometimes runs counter to the original purpose of insurance, but drives up the costs of things insured against, all for the profit of shareholders which probably don't even contribute to the insurance pool. Insurance companies shouldn't be for profit companies, as it severely distorts the intent of insurance.
One other thing: I thought we already charged smokers a "use" fee in the form of taxes on cigarettes; where is that money going and why do we need to charge them even more?
Nathan's blog
People with health issues caused by being overweight (diabetes, high blood pressure, etc.) are already charged higher premiums because of their health issues, that or they get denied coverage completely. There are already mechanisms that take care of this so it seems more like a way to justify a bigger money grab by insurance companies because I highly doubt the savings will be passed on to those of us who are health conscious.
I think the invisible hand of the market has its middle finger extended
--A wise old fart named SC0RN
America. What a fucking mess.
RS
Shoes for Industry. Shoes for the Dead.
Why should my money subsidize your smoking habit that will cause lung cancer, bladder cancer, myriads of other cancers and disease?
Cancel your insurance and start paying cash.
If you won't do that, you have no business complaining because the only reason people purchase insurance is specifically so other people will shoulder their bills--and a rational person wouldn't purchase insurance unless they thought they would get substantially greater benefit than they paid for. So, if you think you're subsidizing anyone else and you think you're never going to be a drain, by all means, drop your coverage.
I agree with you, BMI is not an accurate measurement of health risk. Perhaps I should have said that charging insurance based on perceived health risk is not news.
My post was about the fact that insurance companies charging different rates to different perceived risks is not news. Employers charging different rates to different folks based on perceived risk is.
SirWired
How about a fee for PHBs spouting stupid ideas?
This completely misses the point of employer (or government for that matter) health insurance. Obviously those with higher risks cost more on an individual level and if allowed to follow the market, insurance companies will equalize the risk by making riskier people pay more. The whole idea behind having these big insurance plans funded by employers, the AARP, Unions, or Governments is that you approach an insurance company with a market so big that they can't pass it up but say essentially "take it or leave it at the cost of the average person multiplied by the number of people covered." Because the insurance company is guaranteed a big check, they are willing to spring for it at a lower cost than they would otherwise, and that way people can actually afford insurance. This also prevents the insurance company from dropping you if you suddenly become a greater risk. Ever tried to afford insurance as a bargaining unit of one? It's not pretty. Also, it seems like the idea behind this is at least in part to encourage people to be healthier. But do you honestly think that someone who knows all of the health risks is going to suddenly get healthy because they are being charged extra for their healthcare? After all, with the case of smoking, they are already paying for their habit. It seems to me this is more about healthy people patting themselves on the back. And hey, as long as we're following down that road why not charge women more than men (after all most women go to the doctor more frequently than men) and certainly they should pay more while they are pregnant. Oh, and people with children are much more likely to get sick as their kids bring home diseases from school. Over 50? Your risks are much greater than mine. Are your teeth not straight? Those are going to be some higher dentist bills. And don't get me started on those selfish risk takers the sportsmen, driving up our healthcare costs with all their knee surgeries. Healthcare should be a basic human right, not something we bet on. The whole idea of making it an "insurance" program is simply cruel and, in the long run, makes it more expensive to treat the same number of people since emergency rooms are required to treat people, and doctors and insurance companies waste tons of money fighting with each other over repayments.
Really, do it. I watch co-workers melt butter over powdered sugar donuts and chug a root beer for breakfast. These same people make fun of my oatmeal (then ask for help moving heavy stuff). One of said co-workers is sick for a minimum of four weeks every year, has type II diabetes and probably weighs about 250 to 300 lbs. Nail them for things in their control (news flash: for most people weight is, in fact, in their control). I'd also love to see smokers charged double.
Just don't use the fecking BMI, it's a POS. Use Body Fat %, maybe look at cardiac efficiency. I'm 6'1" and 190 pounds. According to the BMI I'm overweight yet I keep my BF below 20%.
My theory is that they use BMI because people don't like to feel all oooky when they find out their BF numbers are high, so they came out with BMI to gloss over it.
Union Pacific Railroad have declined to hire prospective employees due to the fact that they smoke. The reasoning that i heard is that overall the employees get better health premiums. However; it is my understanding that it only applied to new employees as existing employees who did smoke were not terminated.
In the end discrimination for those posting about that angle on this. I don't believe you can count discrimination on lifestyle choices. Hence why we have discrimination laws against attributes that are not (easily) controllable; i.e. gender, race, age etc. Just to drive the point home lots of establishments (restaurants and even bars) have been known to employ smoking bans; and that wasn't discrimination either.
Before too long, insurance companies are going to start buying all of the data that's been gathered from those grocercy store shopping cards. Don't eat enough vegetables? Raise your rate. Eat too much red meat? Coverage denied because of an undisclosed risk. Orwell was an optimist.
The ugly more for makeup.
The stupid more for an education.
The smelly more for deodorant.
Welcome to America.
one beer a day lowers heart disease risk. I should get that discount. And then multiply it by 6 since I'm six times as healthy as those idiots who only drink one.
You better watch out, there may be dogs about . .
No, insurance is not about socialism. I'm healthy and in my 20s. I don't pay into insurance because I good-heartedly want to subsidize the healthcare of the unhealthy. I do it because I'm not that well off, so paying $200/month with 100% certainty is actually _much_ better for me than not having insurance, but running a half a percent risk per month of getting a $20,000 bill (even though .005*20,000 is only half of $200). Insurance allows me to spread the risk among other, equally healthy people, so that I can plan my life around it rather than risking bankruptcy.
The problem is that there are really three different types of insurance that are all rolled into "health insurance": injury, infection and chronic disorder. That's not an official list, just one I'm making up on the fly. But I think it fits.
Injury is something that is mostly unforeseen. It's about getting hit by a car, falling off a ladder, etc. For the most part, people cluster around the center of the distribution when it comes to likelihood of being injured. Sure, people who are 20 have a different chance than people who are 40, 60, etc. But these factors come in fairly granular chunks like age and sex. Insurance companies already ask questions about high risk activities like profession and sometimes hobbies (like skydiving). Other than that, though, it's really hard to tell which person at the office is more likely to break his arm next weekend.
Then there's the same kind of deal, only with infections. It's hard to tell who will get the flu or pinkeye or tetanus. Yes, medicine is always finding possibilities of genetic predispositions and lifestyle interacting with otherwise "unrelated" health issues. But again, this is fairly granular. We have age, sex, and substance use, but not much more.
Then there are the chronic disorders, for lack of a better term. By this, I mean things you are likely to get due to a genetic predisposition. Like TMJ, Crohn's disease, glaucoma, diabetes, certain types of cancer, etc. Again, there are lifestyle factors that can come into play here. But one of the main areas we are finding more and more information in is how to tell who is at risk simply due to their genes and/or how they spent the earlier years of their life and can't change.
Now, using BMI or even smoking to change premiums for injury is going to be fairly specious. Yes, the 500 lb man is probably at a much higher risk than the 175 lb one no matter what the BMI, but what's the real difference between two individuals within the normal range of weight you see every day, even if it's considered medically obese?
But for the third category, and to some degree the second, we're moving more and more down the path of finding out just how healthy or sickly a person might be AHEAD of time. This runs completely counter to the insurance industry. The insurance industry is about people paying a smaller amount of money to hedge against paying a larger amount of money. To actually work, the large payouts by the insurance company must be balanced by a certain number of people who are healthy enough to get less benefit than they paid for. So if we start putting people in classes where everyone has about the same outcome, rather than the same risk, it's no longer insurance and the whole system falls down.
I would think this is as bad for the insurance companies than for the insured. Because once they start really profiling people and finding those who are the healthiest, that group is not going to want to pay in more than their "fair share" for the insurance. On the other hand, the better you get at charging the class that is going to need large benefits for the actual cost of those benefits, there's no point in that group in having anything other than injury insurance, either. You're actually replacing health insurance for those conditions with a Health Savings Account.
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.
You better watch out, there may be dogs about . .
That sounds expensive
I've got mixed feelings about this, I have no idea what my BMI is but I'm willing to assume it's well over 30, my weight is 100% my own doing OTOH my wife also has a weight problem and eats a relatively low fat diet with 1000-1500 calories daily.
For other issues like cholesterol, blood pressure, glucose, etc., diet doesn't have as much of an impact on those as many people think, for all that I eat terribly (stereotypical American diet) my cholesterol, blood pressure and glucose levels are all well within "normal" ranges. My father on the other hand exercises regularly (rides his bike to work for Pete's sake) eats extremely healthily (almost no fat, lots of hardcore vegetables, very little processed foods, etc. and his cholesterol and blood pressure are high enough that he's on medication for them (if that doesn't qualify as "not fair" I don't know what does).
I am not sure if this will work but one thing Government could do is give a tax credit for gym and/or club memberships which promote activity.
Mind you... that's a theory totally depending on whether or not someone wants a zero-sum dollar benefit (let alone the health benefits).
(1st sig) If this were a snappy sig, you'd be reading it right now. (2nd sig) I'm a karma whore. >Insert FUD here
First they came for the smokers,
I did not speak out,
Because I did not smoke.
Then they came for the Big Mac eaters,
I did not speak out,
Because I ate at Subway.
Then they came for the beer drinkers,
I did not speak out,
Because I did not drink beer.
When they came for the people who breathed in polluted air,
There was no one to speak for me,
Because the rest of L.A. were already taken.
"Flag on the moon. How did it get there?"
Can you say litigation-pie.
:)
Does it or does it not violate the Disabilities Act?
Is it a reasonable accomidation to charge extra only for the extra cost?
Is high colesteral a 'disability'? Is it now?
I would love to charge by the hour working that stuff out.
at least in the US, there's two types of private health care: group plans and individual plans. a group plan is generally bought by an employer, union, or other type of organization, with a discounted fixed (in the sense that every member pays the same per person on their insurance) per-member cost that reflects the bulk number of plans that will be sold. an individual plan is sold to individuals/families, and the cost is based solely on the lifestyle choices, family medical history, and current medical issues of the individual/family purchasing the plan.
the problem here is that, regardless of the health of your employees, health insurance is going to continue to cost more. 40 obese employees out of 100 total employees paying $10 a month more isn't going to stop the increased costs next year when prices jump another $14-$18 a month per employee (which is fairly low compared to last years average of 7.7% increase). mind you, as a large number of employers offer full or partial medical coverage, not everyone sees these increases if their company/organization eats the cost, but I assure you that they happen across the board regardless of insurance company or individual health.
while I don't personally have an issue with what clarian is doing, I urge healthy people to understand that this is in no way benefiting them. people backing it purely because they believe this will benefit them need to speak with their human resources department or medical insurance agent. the only people that benefit from this would be a) employers who offer partial medical coverage, b) any insurance company that starts doing this, and c) any truly unhealthy people that use this as a means to achieve better health.
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, 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 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'.)
Learn the rules so you know how to break them properly.
www.teslabox.com
Instead of just messing with employees over health criteria why not deduct from investors' stock earnings as well? After all, health is important at every level, not just for the working folk.
Your argument doesn't appeal to any person X who believe that just because a person Y has it hard it is X's job to help Y. Your ethics might be different, but now we come to the question of whether social ethics is something that a "free" country can establish. Remember that the government's power is derived from their capacity to commit violence towards non-complying. If you break laws (even tax laws), theoretically, you go to jail.
It would be nice of that hypothetical X to help out Y. But government forcing all X's to help all such Y's can no longer purport to be a government of a free nation. Maybe you'd rather be comfortable than free. There is actually a strong argument that most people would. But this nation is established on the opposite premise.
Any guest worker system is indistinguishable from indentured servitude.
No, but I've heard of one case in Durham. It only stopped when the 4 were able to run the guy out of town along with anyone supporting him.
Twitter supports and protects racists - by smearing their critics with the "Hate Speech" label.
I had an large argument with a co-worker over this who was pissed I smoked (at the time, since quit)
He fully supported jacking the premiums for unhealthy lifestyles, etc...
Then he proceeded to rack up massive bills from MRI scans, physical therapy, and eventual surgery for blowing out his knee halfway through a marathon.
* We dance where angels fear to tread *
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.
Friends don't help friends install M$ junk.
This is a great incentive to take preventative action, when possible (BMI, smoking, a better diet, etc), and it is a reasonable provision when not possible.
It's not kind of incentive at all, if the company does not give you time to take action.
This will lower the insurance for the fit and healthy who never see a doctor
If you don't go see the doctor when something is wrong, you are going to cost everyone more. It's also a good idea to get yearly checkups and talk to your doctor about what's really healthy. This spots problems early, while they are easy to fix, and corrects misinformation that big food and others deal out every day. Once upon a time, companies used to pay for such checkups, often bringing doctors to the employees or having a doctor on staff, and many insurance companies still encourage these visits.
If you think insurance companies pass on savings, you are dreaming. It's kind of like Communist China - the boomers worked hard and put their money into a system that was supposed to look after them. Now that they are old, the system is shown to be bankrupt and a fraud form the beginning.
Friends don't help friends install M$ junk.
I watched a Dukes of Hazzard episode today (Season 3, "Along Came A Duke") where Boss Hogg has a line in which he says he needs to cut down his weight at least 20%, otherwise his insurance company will raise the value greatly. That's in 1981, 26 years ago.
I think it's an logical concept. Do you want to eat cheeseburgers and coke all day? fine, but you put a burden on the health system. Same with smoking, drinking etc.
The real issue is where do all the insurance money go. We pay millions for insurance each year, but we don't see a health care system that reflects that amount of money.
The idea of penalizing people who don't take care of thier bodies is a good one, but its not really possible given the difficulty and hereditary implications (as many people pointed out). Though I do agree things like smoking can definately be penalized. Better yet, screen for all illegal drugs too.
People are inherently lazy. Obesity has reached epidemic proportions.
Maybe we can have the health system institute health care cost reductions for people passing standardized health classes and/or workout classes every year. Encourage people to be educated about good health living by reducing their health care costs. This will justify the discount at the same time because it will improve the average health of people.
I like this idea. As long as these incentives are based on chosen behaviors over which a person has control and not genetic predispositions which you can't do anything about, here here.
Now about you parents: I know you love your kids. That's great, you really should. Those little buggers sure are expensive though, aren't they? So expensive in fact that a lot of my money goes to support programs for your kids.
I know that this is supposed to be an investment, because your little darlings will eventually become productive members of society whose value outweighs the tax dollars I "gave" to your spawn. There are some of you whose kids will turn into time-wasting, no-good, Slashdot-reading drains on society whose sedentary and antisocial lifestyles will cause at least as much in the way of social problems as their efforts will offset.
So here's the deal. If you choose to have kids and they turn out to be sociopaths, felons, bad drivers, or celebrities than all future earnings of both you and your kids will be garnished in full. If you chose not to add to the strain on our resources by not spawning your own genetic material, major tax break. (Alternately, we each get a chance to whack your screaming-on-the-airplane kid without getting arrested.)
These tax breaks will apply doubly to adoptive and foster parents.
There is nothing discriminating about this. If you are costing the system more and there are steps you can take to prevent it, then you can pay for that privilege. This is the same with car insurance, same with medical coverage, you want the privilege to be a high risk group, well you should pay for it. I'm surprised that this hasn't happened sooner with smokers. Now I don't think something like a genetic disorder or a disability should be treated this way. There was nothing you could do to prevent that and or bad things happen.
I'm getting charged extra for high BP caused by workplace stress from the company that's charging me extra. Whee!
That so many weight lifters read slashdot! I am sure if you are a legit weight lifter and your BMI is over 30 you can get a doctor to check you out and give you the green light. It is about seeing the doctor. The BMI is easy because all you need is a scale and a tape measure and about 10 seconds. It is easier to understand that body fat calculations. 30 is pretty high for 90% of the population so I think it is a good place to start. Cancer is expensive, so is medication to control cholesterol, blood pressure, and glucose levels, if they can keep my premiums down by raising high risk (by choice) people than that is fine by me.
Half of writing history is hiding the truth.
I agree with it...only the smokers need to pay 5 dollars of all their co-workers too..Second hand kills...I don't see any discrimination and my BMI is something like 50-60...Smaller bodies=smaller food budget and smaller clothes budget...they save in the long run...
Why do we need insurance at all?
Because healthcare costs are too high.
WHY are healthcare costs so high?
Could we just design a solution that would guarantee affordable healthcare costs to all the population, while still providing free service to people who need it (eg homeless, unemployed, very poor)?
If healthcare was affordable, insurance would not be needed at all.
How is this any different than say the automobile insurance industry. They don't charge everyone the same. So why haven't people who are being charged more because they were involved in an accident, or have teenagers driving suing the automobile insurance industry for discrimination. If I can get cheaper insurance because I choose not to smoke, eat a healthy vegan diet and exercise, why shouldn't I get a cheaper rate.
"I bow to no man" - Riddick
While this is indeed a form of "discrimination", or "selection", this is not illegal discrimination.
Discrimination against the obese is legal. It's legally no different than discrimination against the stupid, or discrimination against the rude.
Frankly, I'm not even entirely sure there's anything wrong with it, either. We're (U.S.) a very fat society. Nearly all of us need to lose weight, and a significant number need to lose a lot of weight. A general societal more against fatness might help.
The only "fat" people who should be protected against weight related discrimination are those who have no hope of a cure (genetic disease, or crippling mental disorder). For the rest of us; lose weight! We're fat, we waste a vast number of government and private dollars on obesity related diseases, and there's no good reason for this other than our complacency.
Get over it; being fat is no different than being messy, and no different from having poor hygiene. These are the small challenges in life we need to overcome.
WhiteWolf666 an exBush supporter. All you new-school,compassionate,save the children Republicans can rot in hell
As a healthy person I HATE having to pay any insurance at all. So generally I prefer to pay less if I am not seeing a doctor. Plus, our media and the Democrats are brainwashing Americans to be hypochondriacs. Making healthcare a greater issue than it really is (only about 13% of adults dont have health insurance of some kind). And face it. The more we hype up going to the doctor and magic-pill-solutions, the greater demand for drugs, the higher the price. If we didnt buy the drugs and refrained from needless trips to the doctor, the price or medical care would drop. There are other factors too. Americans - especially union and government employees - like pay raises and benefits and high wages regardless of their personal productivity. That means researchers, doctors, nurses, technicians etc all want to be paid $100k+ annually. The only person who can pay that wage is the patient. The alternative. The whole point of having group insurance through the employer is to share the cost. So maybe it should be a tiered cost for employees: the basic coverage is the same for all - with those on regular care and prescriptions paying more for those extra services. There needs to be a distinction between "insurance" and what we really have "medical care memberships". Insurance is for the emergencies, the unexpected. There are no surprises when you hire fat, alcoholic, smoker, allergenic, out of shape employees. They are going to be at the doctors office the first day their medical coverage kicks in. And will go to the doctor on a monthly or weekly regular basis. They should pay more. *I am overweight and I realize that reducing my weight will reduce my need for health care. Maybe we should just charge fat people more. They are going to be the ones on cholesterol pills, heart medicines and surgery, diabetes, etc
Yes...but where does it end? If your family has a history of heart disease or cancer then should you pay more? Also while 99.9+% of obesity is caused by overeating and/or lack of exercise there are rare cases where it is not. Should they be penalized?
It is one thing for this type of selective criteria where there is universal public health care and insurance is there to either expand coverage, reduce wait times or improve hospital accommodation. It is different in the US where you either have health insurance, are extremely wealthy or just have to live without healthcare.
Seriously. Just the social stigma of being fat is more than enough inducement. If everyone had a choice about being fat, independent of all other considerations, almost no one would be fat. These little extra charges smack of smug moralizing, and absolutely do blame the victims.
Accidents aren't always the fault of one or more of the drivers involved. Some roads and intersections have significantly more accidents because they're bad. Maybe too narrow, have things blocking the view at critical points, poorly graded, rutted slippery pavement, etc.
Let's charge accident victims by weight! More weight means more gas used by the ambulance, bigger stronger and more costly stretchers, having to bring along more strong backs. Let's throw in some extra charges for excessively tall people too, for forcing the rest of us to spend more money making doorways and ceilings higher, stretchers longer... Tall people wouldn't be so tall if their parents had carefully regulated their diet during childhood so their growth would be stunted. It's not like something couldn't have been done! Too long for the hospital bed? Chop their legs short!
Intellectual Property is a monopolistic, selfish, and defective concept. It is "tyranny over the mind of man"
Do any of these products force the owner to exercise and eat meals appropriate in calories and composition? I bet 90% of obese would achieve healthy weight in a rehab-type environment, provided they later follow the same regimen at home. For the remaining minority, the problem is truly genetic and must be addressed with drugs and possibly surgery. The thing is, there are millions of genetically obese in US and job discrimination against all these people is not the answer.
Anyone?
Anyone?
I cannot believe we are leaving the running of our health care system to these corporate blood sucking leeches. This is just another reason that we need a Federal run health care system that benefits everyone equally, rich or poor. I personally am willing to pay the taxes. Health Care corporations are just getting out of control. Next we will hear shit like, "Oh, were sorry sir, but you've had six heart attacks and two hernias in the past three years, we have to drop you from our coverage now.". Kinda like Car Insurance and too many speeding tickets. It needs to stop. It should have been done back in the 50's at least. Then all the major bugs and problems would have been worked out by now. When will we get put collective heads out of our asses and get this done?
Here's a thing. Instead of punishing people for their unhealthy workaholic lifestyles, why don't they ensure that people's workloads are such that they don't have to spend their life in a cubicle, with no time to get of their fat ass. Why don't they provide fresh fruit in the break room, subsidised gym memberships, discounted massages - even training. Things that encourage a healthy lifestyle.
My employer does a lot of these things, because they recognise that the issue for them is not just stopping people from getting sick, but keeping them. If they are healthy and happy, they will stay. If not, at the very least they will be absent a lot and at worst they may leave or die.
It's no use punishing people for an unhealthy lifestyle if they don't know how or don't have the means to have a healthy one. You can't punish someone for his high blood pressure and high weight, if his job keeps him sitting on a chair for ten hours a day. Adjust his workload a bit so he can relax with his family and get that blood pressure down, or go to the gym and lose some of that weight.
There are friendlier ways of achieving these ends on a population wide basis than fining people.
If my call is important, why am I talking to a recording?
Why shouldn't an employee get a discount if his/her genes do not predispose them to cancer, AIDS, Alzheimer, etc?
Man will never be free until the last king is strangled with the entrails of the last priest. --Denis Diderot
"By that logic, no insurers would ever pay out. Thus, they would eventually have no customers so they would go out of business."
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.
--- Grow a pair, liberals... stop letting the Republicans bully you!
On a more serious note driving and health insurance are rather different. With driving you can always choose to not drive if you have a bad driving record and the insurance premium is too high. Do you really want to tell people with a bad health record that they should just choose not to live?
Like Psoriasis?
Sounds like America fucking Americans once again. Enjoy the country, we built it this way.
Companies much of the responsibilities for health issues. They put people in stressful environments, overwork them to the point where all they have time for food wise is fast food or break rooms loaded with unhealthy drinks and snacks. If companies want to solve the health crisis and some of the escalating medical costs, they should start by cleaning up their own acts. Provide more time off, hire more people to spread the work out, don't box their employees into deadlines or metrics that cause people's stress levels to go up, replace office snacks with healthy alternatives, etc. The options are out there; they just need to become more people orientated rather than labor exploiting.
*It's not what you can do for the Dark Side but what the Dark Side can do for you!*
Remember, people that are underweight are also unhealthy. And why the hell would someone stand for them charging you more if you go to the gym regularly and are 1 pt. over the BMI limit, even though your body fat percentage is comfortably within a safe range?
The BMI is a piece of shit instrument that has been outdated by body fat indecies, and even then, is often abused by focusing on one end of the spectrum instead of both ends.
My employer-sponsored insurance premiums keep going up every year because our claims as a group are so high. We are a small company, so every dollar makes a big difference. As it is, the company only pays 40% of our premiums. Instead of punishing all of us, only those who are using more should have to pay increased premiums.
Just as with auto-insurance, I see no problem with increasing premiums for "bad" health. Insuring unhealthy people is not good for insurance companies or healthy people. Health insurance is exactly that, insurance. It was designed as an exception, not a rule. You pay a set premium and the insurance companies bets that you will stay healthy and not need to use it....just like auto insurance companies are betting that you won't get into an accident.
Getting a speeding ticket or other type of violation is an indicator that you may be at increased risk for an accident, thus your premium goes up. Why should it not be the same if you're becoming a fat slob who will have a heart attack, requiring complicated and expensive surgery. I'd be willing to drop my employer-based insurance pay full-fare premiums with an insurance companies that did proper health screening.
The bottom line is that if you are 50% more likely to file an insurance claim, you should be paying a higher premium that I am. I would have no problem paying more as well. It's call personal responsibility.
Just to play the devil's advocate about your second point, and please don't take it too harshly: how about taking responsibility for your own life? You're not the employer's serf tied to the land. You _can_ look for another job, you know. If a job is crap and ruining your health in the long run, well, maybe it's your responsibility to take care of your own health after all.
And the employer isn't your father, nor has any other responsibility or particular interest in your wellbeing. His job is to make more money for the investors, in a nutshell. No more, no less. Sure, in an ideal world that would involve realizing that more tired employees make more mistakes, that turnover and sick days do impact the bottomline, and that even the immune system goes downhill under extreme fatigue and stress. He might even expected to be humane. But in the end, there isn't any written or unwritten law that he must take care of you more than you take care of yourself.
Basically, I don't think that "but I'm addicted to instant gratification via buying overpriced useless crap, so I can't afford to quit" or "but I'm too scared of change, so I'll stay here and get fucked up the ass" should be any more excuses than "but I'm too proud to use a condom" or "I'm too lazy to brush my teeth" are. If it comes back to bite you in the ass, the first one to blame is yourself. It's _your_ choice that ruined your health: in this case, the choice to put up with those unreasonable demands for so many years.
You can't just throw your hands in the air, be passive, and expect someone else to come and fix your life and make you work sane hours and exercise. Your own life isn't a spectator sport, where you just lean back, grab a beer and blame someone else at the end if it wasn't a good game.
If a job has that bad an impact on your health, if it's eating that much time that you barely have the time to get home and flop into bed and not do much else for yourself (not even exercise half an hour), then you just shouldn't be doing it. God knows there are plenty of other choices that aren't half that bad. At any rate it's _your_ choice whether you want to do it or not.
If the boss is kind and humane enough to care about you too, kudos to him, but that's extra. It's not him who should be the main person concerned with your wellbeing. You're the first on the list of people who should care about yourself, he's very much near the end of that list.
Again, don't take that too harshly, because I've been in that mental trap myself too. "Oooh, I can't let the boss down, plus I bet he'll be so proud of me if I finish that program within a hideously unrealistic deadline. I bet he'll be soo impressed that I work 12 hours a day." It took a very rude awakening to realize that it doesn't quite work that way. So I'm fairly sympathetic to people who still are in that trap. But nevertheless, it's still _you_ to claw your way out of that trap, not someone else's responsibility to come and save you.
It's RL. There is no deus ex machina to force a happy ending. There is no fairy godmother that turns Cinderellas into princesses. There is no hunter that comes at just the right time and saves Little Red Riding Hood from her own stupidity. You make your choices, and live with them. If you let yourself be pushed into Cinderella role, you stay Cinderella for ever.
A polar bear is a cartesian bear after a coordinate transform.
Why do you assume that obesity is not a genetric disorder?
Would it be fair if we also decided that gay people should stop being gay (much likely to get AIDS that costs millions to treat).
Or black people should bleach their skin etc. (because black males are x5 times more likely to get shot than whites)
Or poor people should stop being poor...
Obama likes poor people so much, he wants to make more of them.
"The concept of penalizing for poor health is not well accepted, and a lot of employees would react badly to it,"
You know, this sounds like another attempt to squeeze less out of benefits while still paying a higher premium. Health care is in poor shape in the US, and although a witch hunt against "offenders" (smoking, fat, whatever) sounds like a logical step, all it's going to do is breed contempt and garner hate. People who are fat, know they're fat. A lot have tried to slim down only to find it all comes back all too quickly. Some people are fat because of depression and/or genetics; pretty complex problem. Nicotine is addictive just like coke and alcohol and some people are more susceptible to it than others. I think they should look to positive reinforcement in the form of sponsoring programs for good mental heath, hygiene and life skills. If people choose to participate, they get a break on their premiums. If they do not choose to participate, their insurance rates stay the same. In the long run, you'll have a majority of healthier, happier people that are a lot more fun to work who are on less medication, and less likely to indulge in things that are not in the interest of good self care. Hopefully, people learn how to take better care of themselves and this results in fewer claims. Sadly, a witch hunt will be much easier and appealing to people.
boycott slashdot February 10th - 17th check out: altSlashdot.org
The extra video clips at the end of the movie "Super Size Me" hit the nail right on the head. They show a community where the citizens really value quality Physical Education. They have Video Games like Dance Dance revolution, motor cycle racing games that make you pedal, as well as other key changes to the curriculum that allow people who aren't star athletes to experience success. The real problem here is with our culture. PE teachers have gotten a bad rap. When I was a kid, coaches with no child training background going into to Teaching PE. The kids who didn't know how to use their motor skills yet, would screw up and the kids who's parents put them in little league would laugh at them and the "Coach" PE teacher would do the same. Properly trained PE teachers are specialists and have Masters Degrees and understand that in order for kids to exercise and stick with it over a lifetime, they need to experience success. If you don't do it this way, you do it the way that most of America does it, then you get the overweight kids who don't experience success and sit on the fence and the kids that don't need the training are making the problem worse picking on the kids that can't or won't try physical activity. You can solve the problem by trying to spend all the money on drugs, and you'll see TV as we have it to day where diet pills are everywhere. You can solve the problem by dumping tons of money into health care where we try to patch up all the overweight disorders people have. Then you'll get random things like this Topic where people say, "WOW we are spending billions on health insurance to pay for this problem, maybe we should pass it on to the people who contribute to the problem." That's not really a solution either. The real solution is to get the kids young let them experience success exercising, show them the way to take care of their bodies, and hire specialized PE teachers who are not going to be considered the Lowest of the Low after Math, Reading, Science, Social studies, etc. We need to get rid of the notion: "After we teach the kids all these other subjects, and if they haven't died of a heart attack, then we teach them Physical Education." In my city, Middle Schools have kids doing PE every other day. They think teaching a middle schooler French, is just as important as teaching them Physical Education and how to take care of their body. That notion has to change if we are going stop seeing thread topics about overweight people getting charged for being overweight through health insurance. -Jeff
Health insurance companies should merge with fast food companies and cigarette companies. Then they can make a lot of money from tempting people and then make more money when they have problems.
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.
Yes, he chooses where he works. But when he's already in bad health because he's been paying too much attention to an unreasonable employer, he'll have this problem:
The health insurance of all the other employers likely won't cover pre-existing conditions at all. He'll only be covered for the conditions caused by his current employer if he stays with his current employer.
Catch-22.
There is a fine line between recklessness and courage... -- Paul McCartney
The way I see it unhealthy people are most likely costing me money. If everyone paid the same amount rates would go up so everyone could help get 900 lb Joe Sixpack a hover-round so he doesn't have to be bothered with such difficult tasks as walking, and "moving". If I watch my weight, wash my hands before I eat, don't smoke, and don't engage in dangerous activities, then I should get a break. Its like someone mentioned above, insurance companies raise rates on people who get tickets BECAUSE THEIR A HIGHER RISK. Their going to have more wrecks and cost more money. Insurance companies should have the right to do this and the government needs to stay out of it. I think it will also help lower the percentage of obese people in this nation if they end up paying out the ass to keep their insurance. Maybe they'll stop and think before they down those 25 McDonald's cheeseburgers. I for one am sick and tired of having to pay for the medical care of people who don't even try to keep themselves out of the hospitals. I may seem insensitive but my compassion for people who leech off of my hard earned money ran out a LONG time ago. /rant.
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?
That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
You never thought that experience from Obfuscated C contests would be a good thing, did you?
Have you been touched by his noodly appendage?
At least, for the medium-sized company that I own, we're paying some very special premiums on our group plan -- and, yes, it is an employer-sponsored group plan -- due to a couple of specified pre-existing conditions among our employees. Perhaps big corporations have a different setup, but it's costing us buckets of extra money.
And you'd better believe that if these conditions were self-inflicted (none of them are) due to smoking or what I'll call "voluntary obesity", I'd be more than happy to pass these extra insurance costs along to employees who were less healthy due to their own ongoing choices.
(Posting anonymously because this isn't information we need associated with me or my company)
especially when it comes to health needs!
Where did you get this "we are equals" nonsense? The only time we are equals is when it comes to opportunity in the eyes of law. Thats it. Everywhere else we are definitely unequal. ESPECIALLY at work. Thats why we have systems of varying pay scales, authority, seniority, access level, clearance...
Why on earth should I pay for your needs and wants? Paying for you makes me less able to provide for myself. If you really think we are equals on all these levels then you are nothing else but a communist.
In a land where there are enough laws that every one is at one point or another forced to break a law either knowing or unknowing, or depending upon interpretation, then it's really a matter of selective prosecution, or persecution.
t m
d _States
Have you looked around lately, or do you just believe everything reported on Fox News?
http://www.aztlan.net/lapd_attack_on_immigrants.h
One of the most respected UniVision reporters was intentionally shot at by police with rubber bullets for reporting the news.
Where did you get the idea that we are Free, we started to loose that 40 years ago, GWB is just finishing the job.
You have obviously never traveled globally?
Considering the current state of affairs, Hell yea I'd settle for comfortable at this point. I am even nervous about posting this, and getting a knock on the door late at night and never to be seen or heard from again.
Compared with other countries, the United States has among the highest incarceration rates in the world. More people are behind bars in the United States than any other country, according to available official figures. As of 2006, a record 7 million people were behind bars, on probation or on parole. The United States has 5% of the world's population and 25% of the world's incarcerated population.
From http://en.wikipedia.org/wiki/Prisons_in_the_Unite
Any these are only the ones reported, we have no idea how many are in secret prisons, or how many are being torchered.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
Brilliant idea. Thanks for very interesting article. Keep up the good work. Greetings
Tomasz Gorski
f.
you people are content with using minimum wages, professional organisations, max weekly work hours, weekend holidays, yearly paid vacation days, retirement, security and all that.
these are ALL socialist concepts. annoyed ? well you should be. these were not around at the period 1750-1850 when full fledged capitalism was driving the industrial revolution. people were working from 6-7 to 21 at night and having only a short stint off on sunday mass in a weekday. no retirement no security no defined working hours and no other crap.
wake up to the fact that there needs to be socialist elements in a society for the machine which we call the society to function well. sometimes you americans speak like you have still not been able to come over MacCarthyism.
aaah - im not a socialist. but i know every stuff has their useful place and put them there in practice.
Read radical news here
Thank you!
and Amen and Hallelujah!
It's fine to charge people more for health insurance if they want to indulge in behavior that is obviously unhealthy. If people are chain smokers, obese, too lazy to exercise, drug users, heavy drinkers, or have lots of sex partners, they SHOULD pay...so the rest of us don't have to pay for their bad decisions. What would be wrong, though, would be for people to have to pay more for insurance due to things they have no control over, such as genetically-based diseases, or birth defects or things like that.
Interesting theory: The immorality of charging risk-based health insurance premiums is equal to or greater than that of exterminating people in gas chambers. And your a fan of Michael Moore films too... well, there's a shocker!
File individual lawsuits that have seperate merits so that the turds can't get them lumped under a class action. Do it under state law or under the Americans with Disabilities act and screw with them until they buckle.
This is what national hellcare would be.
I'd go on a Vegan diet but the delivery time from Vega is too long. --brownkitty
I lift 4x a week. Swim 2 miles twice a week. Mountain bike for fun. I have 13.2% body fat (have a hard time pinching anything other than my butt cheek).
For the years of hard work to get to this level of fitness, I get to pay extra health insurance premiums.
Great.
I am very small, utmostly microscopic.
This was an idea I had a long time ago (I'm not professing to have invented the idea). I think people who intentionally harm their body should be penalized and health conscious individuals such as myself shouldn't be forced to subsidize and ultimately condone their lifestyle. Obviously congenital and hereditary health issues should be treated and not penalized in anyway but if you smoke, use meth, choose not to exercise or do anything else that is obviously detrimental to your health then you should not impact the premiums of other individuals. This is one of the reasons I'm against national healthcare. Why should I pay for others to abuse their body? My two cents!
I'm sure everyone here knows Claria/Gator... Seems to me that some office head at Clarian had some perfectly benign addware installed and gotten some of Clarias morals in the bargain.
Just a thought!
Charging people different premiums based on pre-existing conditions? ...
I think that plan has a name, too.
Oh, you're a guy - sorry, males are more prone to risky behaviors - $5 extra per month
Oh, you have the BRCA1 gene (beast cancer) - sorry about your luck - $20 more/month.
How far can that go? A better plan is just to pay skinny people more
Don't be too smug about your good health. As you get older, your body will betray you.
Mea navis aericumbens anguillis abundat
The group thing has been tried, and we've seen the outcome. Part of the problem with a shared risk pool is that there is much less accountability. If people were made to bear more of the true cost associated with the choices they make (which they are prefectly free to make), I dare see we'd be looking at a different landscape in many respects.
Funny, I had fairly recently written an article paralleling insurance companies to investing in stocks. Though, admittedly, my article is a bit wordy with extended metaphors, and may not be my best writing, it does explain why someone that is unhealthy would be required to pay higher premiums.
Here's a poignant excerpt from the article:
"When an insurance company sets an insurance rate on a 17 year old at a 50% premium above what an average driver pays, it does so because the 17 year old has a profile of high risk. If that 17 year old doesn't get into a car accident, the insurance company makes 50% more money on the 17 year old than it does on the average of all other drivers combined. In other words, to an insurance company, a 17 year old is nothing more than a speculative small cap stock! The impact is profound if you consider the outcome if the insurance company doesn't adjust its rates based on a driver's risk. Simply put, if the insurance company treats the 17 year old as part of the average statistic they will not be compensated for taking on additional risk."
The rest of the article can be found here: http://greenarrowinvestments.com/theory.aspx
I think insurance companies are double dipping into this, partially due to frivolous lawsuits. If people stopped suing doctors for malpractice (specifically those cases where the end result was inevitable) and doctors being more careful not to do malpractice (mistakes such as leaving foreign instruments inside of people during surgery, incorrect prescriptions, etc.), then overall costs would be cheaper.
Value of life is decreasing yet the cost of insurance is increasing... what gives.
Then that leads to the issue of overpriced drugs... as well as those recreational drugs people try to get as prescription, and those quality of life drugs that could be worked around (with doctors stopping prescriptions for them if it's not essential.)
At first I bristled at this idea, particularly since the BMI is total bunk and not an accurate/conistent indicator of anything. Then I reconsidered; this is not about incentive to be healthy, it is managed risk. All the insurance industry is doing here is going more granular with their risk assessments for their customers. Regardless of what causes conditions like high blood pressure, diabetes, etc, they are still risk factors that incur healthcare costs with greater frequency and amplitude. Insurance is not about fairness, it is all about individual risk. I don't agree that the BMI is a good indicator of risk (too flawed to be a consistent indicator of "obesity"), but the other health conditions are.
The spooky thing here is what if we extend this demographic probability risk logic to more benign risk indicators like height, race, and gender? I'd bet there are stats out there that could be interpreted to indicate less risk for a 5'4" white woman than for a 6'3" black man; does that make it okay to charge the the latter more for the same health insurance? Either you are managing risk based on probability data or you aren't. Anything else is just a tax on hot-button health issues.
Ultimately this is the insurance companies' prerogative. The bastards.
Just realize that not all discrimination is teh evil.
It's one thing to discriminate against people for something that they can help (smoking, etc.)
It's not the same as racist or sexist discrimination (i.e. something that the person has no control over).
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
Sorry, I don't watch Fox News. From what all the ways I hear it being demonized, I am guessing that this is a stab at saying that I am biased. I simply stated a philosophical position. Freedom is a goal. It is the stated goal of this country. Perhaps we are doing poorly at moving towards that (never fully attainable) goal. But as long as it is our stated objective, your argument for moving away from it simply is not in line with the indicated objectives. As such it is pointless.
Any guest worker system is indistinguishable from indentured servitude.
your view on this generally depends on which side of the fence you are on. People with good health are sick of subsidizing the medical bills incurred by the unhealthy, and the unhealthy are looking for as much monetary assistance as possible, due to the high cost of medical care.
I fall into the former category, and as such I am (currently) all for the "make the sicklies pay more" concept so my bill goes down. I have been to the doctor five times in my life, for the same issue every time. (I get a sinus infection about every 4 yrs) I have never checked into a hospital for any reason. I wonder how many thousands of dollars me and my employers have pumped into the system to keep YOU healthy?
Now next week I could be diagnosed with cancer, and then I will of course perform a staight 180 on the issue I'm sure. Anyone that denies following this simple common sense explanation of their behavior needs to do some self-examination.
The insurance companies can either flat-rate it, or set their rates according to risk. Risk is common in most other areas of insurance. Your auto insurance rates are closely tied to the statistics of the area in which your vehicle is registered. If I were to move from out here in the sticks into say, Detroit, I would expect to pay more for auto insurance. If I develop diabetes I expect the same thing to happen to my medical insurance. Not saying I would like either of these turn of events, but I do expect it, and it's probably the right thing to be done.
I work for the Department of Redundancy Department.
Why in the name of all that is holy do we rely on insurance to provide routine health care? The whole idea of is to pool risk of unlikely events. Routine health care should not be "unlikely."
Is there competition in the insurance industry? If they're all using the same actuarial tables (and it's likely they are, since the info is so easy to get and correlate nowadays), then how can rates differ by substantial margins? The question to ask in this context is if those extra charges mentioned in the article are commensurate with actuarial risk, which would be fair, or if they're based on a ruse that will fly under the radar of regulators, if regulation even exists. Maybe that's a facade too. The Michael Moore film, Sicko, makes me wonder if there is any legitimacy to the insurance industry. They should be as tightly controlled as a state lottery.
I shudder to think that Jonathan Swift might have been modded "+5, Insightful" had he posted his work on slashdot
I have come to find the more something it touted the less likely it is to be true.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
Try Nation Healtcare, America. Stop letting the insurance companies and the pharmaceuticals run the country. You can afford it, especially if you get rid of that expensive-ass war over in the Middle East. But if you're really THAT much of a tight wad, how about legalizing recreational drugs and taxing them? Not only would you then have better health but also less crime!
"He who can destroy a thing, controls a thing." --Paul Atreides, Dune
the BMI standard has been shown time and time again to be a flawed system. vitals such as blood pressure, liver function and body fat are far better measures of a persons health.
If you mod me down, I will become more powerful than you can imagine....
I can understand charging smoker more, or someone doing extreme sports.
Christian beliefs are to help the sick and needy. Even though I am not a Christian, most of modern society has been shaped by it, and it has worked better then those societies that don't help the sick and needy like Hindu's for example.
Also it's not someone fault if they have a genetic disease or catch some infection or cancer for example where the person sick didn't do anything to create his condition. Even being overweight isn't something that most people can actively control and is mostly cause by stress and our modern crappy processed food. Both are direct side effects of the way our society is going.
If someone fall on the side walk, do you just step over them; or stop to help them?
What about if someone is being attacked by someone, lets say a women being beaten by her boyfriend. Do you just ignore it.
Or an accident on the side of the road, would you stop to help? Well why should that help end after the ambulance take them away?
Now we should charge the injured person more for insurance while he is sick and out of work?
What if they as a result are disabled?
What if that person was you injured and having medical problems?
Should be force you to sell your house to pay the bills, and put you out on the street?
I can't tell you how many times I have stepped up to the plate to help people, from 2 days ago being first on site after a wreck on the highway to call 911 and rush to help the injured.
To going as far as confronting someone waving a gun and disarming them.
There is even one well talked about on slashdot at debconf6 where 10 guys rushed Jonathan Walther to attack him and I step in front and stopped them.
I have also helped homeless people get there lives back together.
If you want freedom, then someone must step up and make sure the weak are not trampled, that is what freedom is about at it's core, protecting the weak from the powerful. Freedom from tyranny, oppression, injustice. It's the reason for a Bill of Right.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
BMI is a completely useless "index". It's similar to comparing a car's safety via a mass/gas mileage rating.
The cesspool just got a check and balance.
That it is not in the health insurance company's best interest for employees to know how likely they are to get sick.
If people knew their relative risk, only those likely to get sick would bother buying health insurance. At which point, the whole basis of affordable health insurance would go out the window.
By charging extra fees for the "unhealthy" indicators, this company is basically telling those who don't get charged that they don't need health insurance. At which point those people will begin to ask themselves, "Why should I be paying money for health insurance, when my healthcare bills are less than my premiums, and even the insurance co. thinks I'm not likely to get sick?"
The society for a thought-free internet welcomes you.
How much more can corporate America stick it to the little guy? The worker whose paycheck has already been screwed into the ground with outsourcing to India and the pay scale for every other working class job has been stomped into oblivion by the scourge of the illegal aliens willing to work for peanuts. Let's kick the American worker in the nuts one more time, all in the name of greedy profiteers who reward fat cat CEOs with million dollar performance bonuses. I wonder if the guy in the suit and his fat wife will get hit with a surcharge out of every paycheck? I doubt it!
Health insurance isn't socialism.
It's gambling.
flamebait? Oh boy!
Not everyone is born healthy and not everyone can be treated as easily. Some races, families, etc. are predisposed with certain conditions based on ancestral genetics.
Just because people are "healthy" does not mean that they will cost less for insurance, what happens if they hit their head and turn up in a coma. Same thing can be said of people who are considered unhealthy - I have seen many of report of some 100 year old man or woman who attests their long life was in part to smoking regularly.
And while good physical health can be measured, what about mental health? What if the person is built like a Olympian but has the instincts of a lemming?
Thinking of physical/mental attributes and employability I know many great people who excel despite their health problems Steven Hawking and FDR come immediately to mind.
And how much would they tag on to Helen Keller if she were getting such insurance???
Lets face it Insurance companies aren't in it for helping people and they aren't in it for helping the businesses they sell insurance to, they are in it for profit. If they can get away with taking a profit over a little bit more human suffering (again and again) then they will do it to satisfy their corporate mandate to be profitable.
"Enjoy what you're doing! If it becomes drudgery, you're doing it wrong!" - Jim Butterfield
As a former Republican, I share your bitterness and your cynicism.
What you have just described are Risk Pools, and I think it's a very fair way to do health insurance.
Consider auto insurance. If you have a perfect driving record, you go into a pool with other drivers who also have perfect driving records. You each pay the same low premium and share risk.
On the other hand, if you choose to drive like a maniac and get tickets and at-fault collisions all the time, you'll be yanked out of the perfect record pool and placed into a pool of other dangerous drivers. You'll all pay the same high premium and share risk.
I think it's totally fair to do medical insurance that way. As someone who is healthy and makes healthy choices, why should I be placed in the same risk pool with a sedentary smoker who eats Doritos and McDonalds all day long? I'm willing to share risk with people who at least attempt to take care of their bodies. But why should I have to share risk with people who intentionally harm themselves?
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
Why should I be in the same risk pool as a sedentary smoker who sits around and eats Doritos and McDonalds all day?
I'm willing to share risk with people who at least make an attempt to take care of themselves, but I am not willing to share risks with people who make no such attempt.
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
Traditionally, it just hasn't been seen until it was too late. You think if they have one kidney for five recipients, there isn't a selection committee to decide who is most "worthy"?
I took a graduate medical ethics class some years ago which included touring the wards of a major medical center that most people would perhaps as well skip. Reviewed the case of a man who had smoked his lungs out and was being kept alive on a machine at several hundred dollars/day. Imagine the horror of being perfectly sentient and having people tell you that they're really sorry but they're going to have to shut you off because it just isn't practical for anybody to spend several hundred dollars/day to keep you alive indefinitely. A few extra dollars/month might give smokers something to think about when it could still matter. If not, it'll at least pay for a few days on a machine while they try to get straight with their priest or psychologist instead of going out freaking.
(Government healthcare would be even worse),
Who is Clarian Health?
Its a non-profit funded by the Methodist Church. And the healthcare policy is a very ironic decision coming from the Methodists.
My step-father, who I admired very much and liked to smoke cigarettes and drink a glass of Whiskey everyday, was a Methodist priest. He died of bone/jaw cancer at the age of 55. The cancer wasn't because of the cigarettes, it was becuase of the lung damage he recieved while he was a carpenter. My step-father was a master carpenter and he built three Methodist churches in North Carolina. A graduate with a Masters from Duke, he became a priest and quit because he didn't feel like the Methodist church was doing enough for the poor. He carried a gun, loved my mother very much, and taught me how to do things myself (he wounldn't pay for things I could be taught how to do). When he died he was the regional supervisor for the Florida Department of Child welfare services (now called DCF). His funeral in Florida was attended by over a 1000 people. His second funeral in North Carolina was attended by 30 people who remembered him as thier priest. Neither funeral service was attended by Methodist officials. One of last conversations I had with him is that he regretted the Kemo. It did nothing for the bone cancer and all he wanted before he died is to eat a big steak.I named my son after him.
I have nothing against the Methodist church or Christians in general, but sometimes they can be extreme.
I'd like to know why the Methodist church stops at smokers and people who to like to eat? Lets add some more to their list.
1) Your a carpenter who builds churches. Add $1000 for the bone cancer you will get 30 years later.
2) Your gay. Add $200 for aids vaccine and rectal recovery surgery.
3) You drink more than two drinks a week? Add $20 for liver treatment.
4) You mountain bike on the weekend? Add $20 for broken bones.
5) Your a pot smoker? Add $40 because your not paying the tobacco tax and you have the same problems as cigarette smokers.
6) You drink coffee? Add $10 or $20 this week because we don't know which "coffee is bad" study is correct this week.
7) You go to the beach? Add $10 for skin cancer treatment.
8) etc, etc, etc. It will never stop.
Its called personal responsibilty and choice people. We each have the right to choose what is right and wrong for ourselves. Not the church, not the government, not your neighbor. People are different. I can eat Big Macs for week and not gain a pound. My wife eats one an her ass gets bigger (And I like big asses). Different strokes for different folks.
For this company to regulate their employees behavior is no different than the evangelicals trying to regulate your spiritual choices. How is Clarian Health going to manage the employees off time? Spy on them? Thats not what Jesus preached.
As a healthy person, if I worked at Clarian Health I would quit and walk out (I know that we be hard for for most employees). Until I found a new job, I would sit in front of thier offices everyday on a lawnchair with a Cigar, Beer, Big Mac, Fireworks, Coffee, and cook a big fat juicy steak on a grill (Steak is bad for you, it clogs your fun veins). I'd have a big poster next to me that reads "Jesus Loves Me".
Im posting anonymous for obvious reasons.
Enjoy,
I run a lot (~70 miles per week) and I eat healthy food. I never go to the doctor, but I pay the same as everyone else. Of course, some people just like me have dropped dead of a freak heart attack. The point is that I consciously make decisions that make it less likely that I will need healthcare services. Someone that does not exercise, smokes and eats at McDonalds every day, is probably, statistically more likely to need healthcare.
It's simply unfair that I have to pay the same into the community bucket. I'm paying with my good habits. I pay with the time it takes to run (although I enjoy it). I pay with the additional money it takes to eat good food (although I think it makes me feel better). Why should I have to pay the same into the bucket as someone more likely to take out of the bucket? As a practical matter of fairness, I believe I should not pay more to people that are more likely to take out of the bucket because of their genetics. Some things I believe to be personal decisions, but it's difficult to completely untangle personal choice from genetics.
I think the burden rate has actually decreased since 2000 due to the Bush administration tax cuts, but that's arguably an artificial decrease since it was more than made up for by deficit financing that will have to be paid off later.
A rather fascinating analysis of tax burden rates as a function of income is available here: http://www.truthandpolitics.org/tax-burden-pechma
"Ladies and gentlemen, my killbot features Lotus Notes and a machine gun. It is the finest available."
I'm type 1 diabetic with a bmi of 23.8. I'm active, healthy and eat a very controlled diet.
I already pay more to stay alive because I require supplies (needles, lancets, insulin, test strips, etc.). While my blood glucose is more well managed than most morbidly obese people, I shouldn't have to pay my _insurance_ company more money because of a chronic, genetic illness outside of my control. While it may give some people some morbid satisfaction that sick people are being punished, all this does is make insurance companies rich.
Health care problems aren't caused by people that have health insurance (healthy or not). The problem is people that don't have health insurance that get treated anyway because emergency rooms can't turn patience away (and they shouldn't).
Unified health care where everyone is covered (and then pays a premium for better services) means that my insurance isn't paying $200 for a bag of electrolytes so the hospital can pay for the five people that got those same fluids for free.
Perhaps you don't realize that liberty is not being touted to you. Perhaps you just don't realize that the other side is simply saying "no, you can't have the world owe you a cookie if it comes at the expense of my freedom." No one is saying that you have to choose to be free. We are just saying that we are choosing to be free. And if you attack our freedom, don't expect us to give it up without a fight.
Any guest worker system is indistinguishable from indentured servitude.
Now I have a real excuse. It will pay for itself, if I get the right games ...
So long as we mouth the platitudes, reality can go hang, I suppose.
The only freedom being promoted in America these days is the freedom for rich people to get richer, and the freedom of the poor to fight with all the desperation and ingenuity they can muster for the crumbs that fall from the table.
Freedom from want? Freedom from fear? Archaic niceties we can no longer afford, not when they interfere with freedom to profit.
You want the truthiness? You can't handle the truthiness!
Just pay the $10 and enjoy another BigMac. Diet food tastes like #@&!%* , and probably is.
Table-ized A.I.
Thanks for playing.
"Ladies and gentlemen, my killbot features Lotus Notes and a machine gun. It is the finest available."
The world does not owe you a cookie. If you have the "dough" to make one, make one. If you don't, think of a way to make the dough. If you think your neighbor must share his dough because he has it, you'll create a society where people will be much less likely to create innovative ways of making cookie dough. So there'll be less dough to go around. Less people will have cookies. Oh, and anyone who is creative enough to find a new way of making cookie dough deserves a huge windfall from that for himself and his family. That's economics. If you take your neighbors cookies dough because you need it, you'll be steeling it. It doesn't matter if you do it with the knife in the middle of the night, an act of Congress in the middle of the day, or a gun in the middle of a highway. That's ethics.
Any guest worker system is indistinguishable from indentured servitude.
... the health care insurance available to Clarian Health Partners is provided by M-Plan, a Clarian subsidiary.
Clearly, in the 21st century the notion of an insurance company -- especially a corporate health insurance company -- providing insurance for a population consisting of an employer's employees, and spreading the risk across that employee population, has gone by the wayside in favor of milking not only the customers, but the employees for profits to support the corporate owners.
And Clarian Health Partners is not a publicly-owned company.
I am 30 years old. I am 6ft tall and weigh 278lbs.
my BMI is 35.
My heart is exceptionally healthy.
My cholesterol is 160.
My blood pressure is 120/80.
My glucose level is 110 on average.
I don't smoke.
I exercise 3 times a week at a gym. (cardio and strength)
Charging me more is just plain unethical.
I already pay more for my clothes.
This is tantamount to a "fat tax".
How can your employer get access to your medical records?
Don't they know that everyone is different? These "standards" may not fit every person.
Charge the smokers more.
They're using their grammar skills there.
But it's not, it's only the unhealthy lifestyle. And yes, they should demand more for people with unhealthy lifestyles. The medical systems (especially in Europe) are bogged down under the cost of those that profit of it.
... shouldn't have to pay over $100/week for a 80/20 insurance policy unlike the people that do drugs, smoke, drink, have STD's and because of that are poor and then get help from several federal and local instances so that they get almost free 90/10 insurance.
In the US however, the insurances have added more to the cost, but don't take anything off for those that live healthy or don't get sick often. They are actually PROFITING grossly from the situation unlike state-supported insurance in other countries where there is just a big pot of money for everybody to profit from in case they get sick. I don't care that a company makes a good profit, but to go over people's bodies (literally) to do so and/or try to weasel out whenever they have to pay up is just wrong in my opinion.
They have to be fair, people like me that drink moderately, never get sick, don't smoke, never even broken a bone, thin, no extra cholesterol
Custom electronics and digital signage for your business: www.evcircuits.com
www.term4sale.com Isn't affiliated with any particular insurance company and has the rates for (almost) all the companies in North America. You can see how much you are paying compared to current prices....
for one single reason: Michael Moore does not make documentary films.
You'd be well-advised to avoid mentioning his films in any fact-based discussion, lest your argument will be completely discounted.
Some people are genetically predisposed to obesity. Granted, there are those who make poor choices by eating fatty foods, but I have met several individuals whom have struggled to lose weight even while eating sensibly. For some, their only resort was gastric-bypass surgery.
> And if you attack our freedom
I am not, I am pointing out that there has been an attack on our freedom for many years and people don't seem to be to notice it.
If you know history, and you see what's been happening in these past 5 years, you should be concerned, and possible terrified.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
The higher the pressure, the more you need to donate.
If you can't donate, consider getting a pressure relief valve installed. When the pressure gets too high, the blood spurts out. You could hide the valve by getting it installed in some oriface like your nose or butt. People would think you're just having a nosebleed or whatever, but really you're letting off the excess pressure. Installing the valve in your mouth might be even better, as it would allow easy servicing and let you recover the iron. If your problem is severe though, you'll just have to install the valve in your juglar artery and try not to squirt people. An overflow tank, like the ones cars use for radiator fluid, might solve the squirting problem.
Everyone starts life as a kid. As a kid, you benefit. We all do.
Some single/childless people wish to eliminate the benefits toward kids. They say this as adults, knowing that society can't retroactively take back the benefits which were given to them in years past. Well that just isn't fair. Other people helped you; as an adult it is your turn to help others.
You might cost more because of all the injuries you get. Somebody with lots of muscle is probably into extreme sports. I bet you climb up skyscrapers with your bare hands, wrestle alligators, and commute to work by running in fastest lane on the interstate.
Fat people and smokers aren't just unhealthy (unhealthier ?) people, they choose to be unhealthy. There is a difference. In turn it's their choice to take more from their insurance companies.
What this is proposing is to have them (forcably) choose to give more to the insurance companies to balance it out for those that choose to be healthier and only use health insurance for unavoidable problems.
Sounds fair to me.
In my eyes, it's a bit like insuring against using using the fire-services.
You're putting your health in the hands of large corporations, who clearly have your best interests at heart. Wait until the insurance companies can get access to your genetic information...the people worst off truly will suffer then.
Being healthy is a basic human right I always thought, and even if it's not you suffering now, there will come a day when you'll need the system to help you, which if it's private enterprise, would make me feel terribly nervous.
throw new NoSignatureException();
Dunno. If they're fat enough we can probably make a net contribution to the power grid. Especially if we use a treadmill attached to a generator to tire them out before we gas them.
Disease prevention? Not really; look at the measurements they'll be using to determine who gets charged more. Lots of pseudo science, carefully written to appeal to the Oprah generation. Meanwhile, behind the smoke and mirrors a HR director pockets a nice bonus for this loss prevention idea.
What would be very informative would be to see if the selective "insurance" surcharges are applied to the upper management / executive staff. I've got a hunch that they're exempt...
I am 100% in favor of a insurance surcharge for people that have blatantly unhealthy habbits. Today people that are unhealthy drive up the costs for us all. If a person smokes or is a alcholic we should have a 70% insurance surcharge or more. If a person is overweight they should take steps to reduce their weight or face fines. For many people weight is problem, but for others it is just laziness and bad eating habbits.
Insurance companies want to raise more money and (almost) no mention about "Sicko" the latest film from Michael Moore?
Well here it goes: http://en.wikipedia.org/wiki/Sicko_(film)
I've seen the movie. Best Michael Moore film ever.
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.
But no-one needs private health insurance, so no-one need be "fined". At least not in civilised countries. Every other insurance policy has its rates set taking risk into account, whether it be my home contents cover, or insurance for kayaking holidays.
So you're a buff skydiver or martial artist, and I'm a couch potato. I share your risk of broken bones and you share my risk of heart disease. Why should our employer get $10/paycheck from me but not from you?
What's next - your employer will fine you for skateboarding? Accounting clerks will pay lower premiums than forklift operators in the same firm?
This is a divisive, cherry-picking ploy of insurers. Don't stand for it!
http://www.billstclair.com/DoingFreedom/000623/df. 0600.fa.lipidleggin.html
Insurance companies just want more money, it has nothing to do with better coverage or reducing *your* costs.
There are some things a person CAN do to improve their health. There are other things that they CANNOT do. Blood pressure, cholesterol levels, and body mass are NOT things we can change by will alone. People that have high blood pressure can sometimes get this under control with drugs and diet. Cholesterol is harder to control, but can respond to drugs and diet as well. Loosing weight requires a life style change, and if your genes are just 'wrong' NOTHING you do will change a thing. Insurance MUST cover treatments for cholesterol and blood pressure, not deny coverage based on it!
(COUNTER-PRODUCTIVE MAN!). About the ONLY thing that would be fair would be charging smokers more for coverage, THAT is something that you can control. To be fair, the insurance should cover treatment for aid in quiting (at 100%) for a period long enough for the average person to quit.
Gives a very good synopsis of UK healthcare. Complaining about the NHS can be something of a sport over here for the papers, but it is actually far better than most people give it credit for and I'm glad we have it.
- wake up at 6:30
- 7:30-6:00 pm i'm at work SITTING. I'm over worked and therefor can't take my two 15 minute breaks, and i bearly have time to either go get lunch or to eat what i make in the morning.
- 6-7pm is driving bad home in worse traffic than before.
- 7+ i'm on CALL should anything happen. I have a wife and no children. I do on the other hand have in-laws with kids who ge dropped off every so often.
- 7-7:30pm is dinner.
- 7:30-8:30 pm is daily chores, Washing clothing, dishs, mowing grass, cleaning house (to keep healthier of course)
Now let's look at health standards. Certain criteria SHOULD be kept, and if they are going to set rules, they will KEEP adding rules until all the "healthy guidelines" are met (this list was created and set after talking with 4 doctors and after a year worth of research)
Since the insurance companies are being "unbiased" and "generalized" to fit the average person... here is the "average" health criteria list.
1. Minimum of 8 hours of sleep for full body recovery. No less.
2. Do not eat 3 hours before going to sleep.
3. Drink a minimum amount of water according to the following equation: (Bodyweight (in pounds) / 2) oz. of water. 200lbs? 100oz of water MINUMUM
4. Do not exercise rigerously for more than 1.5-2 hours in a day. The body needs recovery time. Instead, workout for no less than 30 minutes a day, a minimum of 3-4 times a week if you are already "healthy". For overweight people should workout for about an hour ever 3-4 days (not super heavy workouts either), perferably 4 days.
5. Do no workout within 2 hours of going to sleep as you have to much adrenaline and will cause sleep issue
6. Eat smaller portions, and eat about 5 times a day.
7. Have at least an hour of "Down Time" or "Personal Time" where you can do something you really enjoy every day for psychological health. (this is more like hobbies than just sitting around and being bored watching tv).
Summary:
- Working out every day would not give me time to meet: #7. If I do pass #7, and I goto gym after work, I fail #5, if I only go Saturday and Sunday, I fail #4.
- Gym membership in my area costs about 1000$ a year. They close at 10-11pm. They open at 6am. I cannot go in the morning, and I cannot go after work. The gym membership is not supplied by my workplace either. Money is an issue there.
- I'm not allowed to eat at my computer, or drink around it. I fail #6 due to being overworked ( I was told I wasn't even alowed to take my vacation days all in a row).
- I have to go to sleep at 10pm to meet #1. This makes me fail many of the things if I go workout.
- If i DO go to the gym AND want to spend time with my wife, then i fail #1 because i goto sleep at 11 (under 8 hours of sleep)
The only way for all these criteria to be met, is if my job cuts back on the work I have to do (Hahahahahah), let me take 40 minute breaks Daily (or 3 times a week) to do exercise (be it jogging, running, biking etc... of course, those are all health risks on their own... so technically we would need to constantly buy new shoes and we'd only be able to walk in a circle else we'd be a health risk) (that's 5 minutes before and after to change / get to the workout place and 30 minutes to workout) ... ... that means that i can't have kids because i don't have time for it?? Oh wait! I get to pay more because i don't have kids!!! YIPPY!!
In other words, the company would have to make us work less to be healthier (because that's their overall plan of course! they want us all healthy and happy!)... else they would get more money. Welcome to capitalism where they make it near impossible to meet guidelines and criteria to NOT have to pay more money... then make you pay more money and smile while doing so claiming it's u're fault. They're fuck you over to fuck you over. The only way to win in this situation for me is to give up any family time that I already almost don't have, else I have to pay more money? And pretty much
But dammit, the *whole frigging point* of insurance is to pool risk! Insurance is a method of pooling risk among individuals and over time, as a means of managing cashflow. If insurers are allowed to differentiate too extensively between customers on the basis of the risk posed, then eventually there becomes no point in having insurance at all -- you might as well just put the money in savings or investments instead.
Next they'll consider the likelihood of your offspring being healthy - do the parents carry genes for inherited diseases? What are the odds that a child will have a genetic disease? They can refuse to allow to cover your offspring if you and your spouse aren't genetically 'fit'.
A scary world, indeed.
Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
I don't think we should be subsidizing unhealthy habits (like peanut butter and banana sandwiches after a whole rack of Kansas City ribs, [in my best Elvis imitation "Thank you, thank you very much" :-])
...)
That said, the determination of risky behavior becomes a problem.
If someone has a risk factor for something s/he has no control over, like coming from a family with a lot of cancer deaths, (or multiple sclerosis, or lupus, or polycystic kidneys, or ALS, or
Mind its better than the current insurance situation where they just don't pay.
Right off the bat, they refuse the expense. You have to prove that they owe you anything. Ever read your policy? Not the one you signed, the one that they mention that they can change at any time, the one that's in effect when you ate the trichinosis special.
You have to get pre-authorization for an ambulance ride (Like, you're supposed to know that the meal at this restaurant is going to give you food poisoning? But the place has [had] three stars!)
Health insurance for profit is the biggest sham you're dying from. (But America doesn't care about its citizens.)
MSBPodcast.com The opinions expressed here are my own. If you don't like 'em... Think up your own stuff.
"According to this BMI calculator 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."
Well, I am also 6'2", and I've got to say that if 190-195 is what you consider skinny, then you must be a tall endomorph - because I know I'm an ectomorph, and I'm trying to reach 185 right now. I wouldn't argue that you're big and strong, but 40" sounds like you're pretty stocky.
In my case, I spent most of my life at 145 lbs., and I was a beanpole. And I was on the cusp of being unhealthily thin. I could fight off disease, but sometimes not that well. It took an illness that dropped me to 127 - which is a VERY scary place to be - that made me decide to finally gain some weight. Now, I'm sitting at 175, and while my target is 185, I'm healthy enough that my nutritionist, who doesn't even look at BMI, isn't all that sure I need another ten pounds. I still look quite lean, but I'm fairly strong, I've got decent stamina, and I've got around 30% body fat. And, because of my genetics, I will always put on or drop weight in a way that makes me look lean.
So, I doubt that 180-185 is unhealthily thin for somebody who is 6'2" - and that's coming from somebody who has been unhealthily thin for real.
Robert B. Marks
Author, Demonsbane in Diablo Archive
I had the chance to ask a Department of Labor representitive about these "wellness" plans. By regulation, the cost can't be more then 20% different between a "good health" and a "bad health" person. So, the cost per paycheck to the employee for medical insurance has to be 125. The employer portion does not count. So, if a single person is paying at least $3,250 per year on medical insurance (ASSUMPTION: paycheck every two weeks), then this is legal. If not, then the company can have issues. I pay $2,080 for my wife and I. This also can apply to the out of pocket costs of the employees. If the company puts all the good health people on 90/10 and the bad health people on 70/30, the potential difference for a 70/30 can be greater then 20%, making the plan illegal.
What the nice lady told me though is that they are waiting for an age discrimination lawsuit. This is because peoples' health scores get worse as they age, so it can be discriminatory for such plans. The DOL is actually waiting for this to hit the courts. A good lawyer could make a nice chunk off of this.
In God we trust, all others require data.
LaDainian Tomlinson - 31.7
Donovan McNabb - 30.8
Priest Holmes - 31.5
Jamal Lewis - 34.2
Ray Lewis - 33.0
Mike Alstott - 32.7
Brian Urlacher - 31.4
This will result in a demonstration of applied evolution. After a generation, maybe less, there will only be "healthy" people working in jobs that do this.
If this is wide spread then eventually only skinny/anorexic people will exist. All those that don't conform to the "ideal" body standard will be pushed out of society and either will perish as a group or will be forced underground.
I welcome our new Morlock overlords!
So where excatly, does this stop. I was born with disolcated hips, which is inheritable, and now have artificial hips on both sides. Here in mother fucking switzerland, which btw, is more capitalistic than the USA, my medical insurance had a clause which specifically stated that nothing to do with my hips would be paid by them. The hip operations were finally paid for by charity, because I just don't have that kind of money. Not only that, but one of the operations was botched and I was unable to sue for malpractice. One of the conditions of having the operations.
That was 12 years ago. Since then, Switzerland has joined civilisation and it is no longer permissible for insurances here to exclude hereditary diseases. Thank god (or your favourite other diety)
So when I read stuff like this, my blood pressure goes through the roof, my collesterol turns into fatty gel, my blood sugar turns astronomic, my BMI goes over 90 and I want to smoke a carton of cigarettes, I get so angry.
I want to know if they will stop with these unhealthy and possibly hereditary conditions, or if they will then possibly start to try and slip in other clauses like skin-colour, any illnesses whatsoever etc?
They pay a nice little one time bonus to non-smokers, and have a bunch of little health programs that pay off to your flexible spending if you complete them. These programs include things like participating in diet monitoring and improvement programs as well as passing little health tests and the like.
:)
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
Eek!
Smoking is or at least before they became addicted, was a choice.
Most "fat" people didn't decide ever to be fat. Much is from the bad diet pushed on us in our supermarkets and on TV, combined with lack of education about how to eat.
Also Stress is a major factor for weight gain, high blood pressure and for high cholesterol, heart disease, detached retinas, diabetes, varicose veins, blood clots and many many other problems.
Stress is something that most people don't know how to control in the USA, it starts in childhood at school here and continues later in life.
Especially for the middle class is put under more and more pressure just to try to maintain a decedent life style.
I am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
You're answer tells me that you are a total ignoramous.
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.
MSBPodcast.com The opinions expressed here are my own. If you don't like 'em... Think up your own stuff.
Mass is almost the cube of animal's size, not the square. So the quadratic BMI law is generally only valid for average height people. This screws children and big athletes.
The Sick-O movie points out a small percentage of cases and makes them look like the norm. How many people do you know that went through those scenarios, honestly? No system is perfect and he is just spinning it to be useful propaganda for his liberal agenda.
How is it difficult to keep a job if a family member is sick? Yes it may be emotional, but it isn't difficult to keep a job. Seriously, is an addition $5-20 extra per month really that significant? Health Insurance is a protection mechanism, that is what insurance is. Car insurance is higher if you are more of a risk, that is the nature of insurance. Would you mind if your car insurance was higher, but the same as everyone else just because others are higher risk? I am not saying that genetic conditions should necessarily count towards higher premiums, but some things, yes absolutely.
Confucius say: "Man who associates with smarter men than himself is smarter than the men he associates with."
Percentage of GDP spent, as well as some indication of quality, would be useful. But it doesn't explain why there is a difference, or what to do about it. When I've seen numbers given, most countries (UK, Canada, etc) were about $3000/person/year, and the US was about $6000/person/year. (Ok, not exactly a percentage of GDP, but GDP per capita isn't _that_ different amongst the mentioned countries) What that doesn't explain is _why_ the difference.
For example, the numbers above were quoted in a NYT editorial advocating socialized health care ("hey, look, they pay half what we do!"). However, the article then went on to mention a study saying that if California had socialized medicine, their costs would be about 5% lower than they are now. Which, if the study is right, suggests that making socialized healthcare is not the answer - it just doesn't explain away the cost differential.
A more recent NYT editorial suggested that more of the difference may be in what we pay doctors - they claimed that UK doctors make about $60k-$120k annually, and that US doctors make $120k-$200k (for generalists) or $200k-$400k (for specialists). There are a number of complications here - we're not told how much the state pays to subsidize medical school, or whether the doctor's pay is net after the costs of running a practice. Or, for that matter, how much of our medical costs are traceable to doctor's salary. (Nor is it necessarily arguing whether a doctor deserves a particular salary - just whether it explains the cost differential). The same article furthermore claimed that prescription prices average 30-60% higher in the US than in Canada or the UK.
It's also not clear to me what would happen to prices for prescriptions if the US adopted a national drug insurance policy like Canada. I suspect that the US pays a disproportionate share of R&D costs, because we have so far refused to collectively bargain with the drug companies for better prices. If the US did shift to such a model, prices would fall in the US but would have to rise in Canada and the UK to compensate.
Anyways, it seems complicated, and I've never seen a thorough economic picture of the whole system - just empty rhetoric.
Maybe now people will quit being fat-ass smokers and start taking care of themselves. Why is it fair in the least for the healthiest people to be forced to pay for the health care of irresponsible people?
This is no different than charging smokers more for life insurance. If you engage in irresponsible behavior, you deserve to pay for it.
I can already see the future where the movie Gattaca comes true but in a totally different way. We will all just be pidgin holed into our genetonomical cast.
Folks who are uninsurable on their own can get insurance if their risk is spread out among a larger group. The company subsidises the insurance for the unhealthy.
Getting the uninsurable out of the group by discouraging their participation reduces the employer's premiums and shifts the burden to the employee.
This is no different from any other cost savings measure that your friendly HR department implements in the "new improved company healthcare plan".
The justification presented for this decrease in compensation is that the employee is sinful (fat, smoker, high cholesterol, drinker, etc.), and therefore unworthy of the compensation offered to more morally upright employees.
It's not a new story--just one that needs to be recognized for what it is.
"Reality is that which, when you stop believing in it, it doesn't go away." - Philip K. Dick
to the insurance company I'm sure. It does not make sense socially.
I think skinny/healthy people should get a healthcare credit. Then, as with pollution limits, those people should be able to sell their credits to rich, unhealthy people. It's a source or income for starving people! It's the perfect free-market solution!
Lisa: "Look, Dad, I made fish sticks. They're burned on the outside, but they're frozen on the inside, so it balances out."
Listen, Ms. Rand. It's been well over a decade since I last thought you had anything remotely interesting to say. Kindly shove off, go back to writing your self-indulgent, fictionalized treatises about the inherent superiority of the capitalist nobility. Or being dead. Or whatever the hell you're doing these days.
You want the truthiness? You can't handle the truthiness!
I am 5'10" and weigh 220lb that gives me a BMI of 31.6 or obese. I may be over weight somewhat, but obese I am not. I am also not a body builder. However I am active, play sports several times a week and work out. I am also not a sports professional. According to the BMI, the average "ideal" weight for someone that is 5'10" is 150lb. I would consider myself unhealthy at that weight. When I was 18 I was in damn good shape and 180lb and I had not filled out yet totally then. My optimal weight as I see it would probably be in the realm of about 190-195lb (depending on how much muscle I wish to try and maintain, 210lb I think would still be fine if I wanted to do the work to maintain that), which according to BMI is very overweight (still approaching obesity). Bottem line is BMI makes too many assumptions to be anywhere close to being correct. It doesn't consider natural body type or fitness level at all. I have a buddy that is in extremely good shape, but he is also very short and stocky, according to BMI he is also very overweight. I also have a friend that trains as a mixed martial artist. He is probably about 5'10 and 230lb and the guy is massive and strong. He isn't a body builder and doesn't take supplements, nor is he a pro sports professional, however is trains an awful lot yet I am sure he would be amused to find out that he is obese as well... (lets just say I wouldn't want to be the one to tell him).
We are going to start charging the stupid more for education.
It is remarkable to see hundreds of response comments where the author takes no personal responsibility for their own unhealthy life choices and expects all the rest of us to pay for the long term damage they cause to their own body. Rather, we get nit picking about BMI 30 vs 32, weight lifting (for Christ's sakes!), and rejection of the known facts that fat people, after a few years delay, get lots and lots of chronic, expensive diseases. So pick a measure of "being fat", go for it, and revise it with new facts.
Wake up. Take responsibility for your own heavy eating and lack of exercise.
>$5-20 extra per month really that significant?
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 am always doing that which I can not do, in order that I may learn how to do it. - Pablo Picasso
I'm in general good health but I had cancer four years ago. Am I even allowed into this Brave New World of health insurance? If smoking is worth that much per check isn't having been personally visited by The Big C worth even more?
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.
A visit to the doctor is 21 EUR. That's before insurance. You just pay 1 EUR in the end.
In socialist cheese eating surrender monkey land, 28 Mbps DSL is less 30 EUR a month.
Thing is, in socialist cheese eating surrender monkey land, we don't spend trillions committing war crimes. Well, not yet, Bush-cock sucking Sarkozy might fix that soon.
So auto insurance companies can get away with charging more for bad driving habits, but people are bitching that they're being charged more for being unhealthy? When did personal responsibility go out the window?
But back to the topic, why should unhealthy people be paying the same insurance rates as healthy people? Why am I subsidizing the health care of the sick?
That's risk-based pricing, as applied to insurance. Now, the argument is that risk-based insurance prices are appropriate for some things, but not for others. For things over which the insured has control, there isn't really much of an objection: you can choose to drive more carefully, you can choose to buy a safer car, etc. (It's nowhere near black and white, though: being a male between ages 16 and 25 is not something you choose.)
On the other hand, risk-based pricing becomes very unfair when people are penalized for things that they have no control over. Plenty of medical conditions are things that people cannot reasonably be expected to be able to opt out of, like congenital diseases. (Though again, there are exceptions and gray areas: it is arguably fair to charge smokers more for health insurance.)
Are you adequate?
The point of insurance is to cover unexpected catastrophes. I buy insurance on my car because if I get into an accident I could be facing huge costs. I don't use that insurance to cover the costs of fuel, oil changes, or car washes. True "insurance" has a premium based on actuarial tables which predict the likelihood of a payout having to be made, and is cheaper if you are unlikely to need a payout. For example, if I am statistically more likely to get into an accident, I pay more for car insurance. This is how "insurance" works. On the other hand, "Socialism" provides benefits to everyone regardless of their ability to pay, and doesn't charge more for higher risk users. Socialism is different from insurance in that insurance seeks to maximize profit, while socialism simply seeks to distribute costs. Simple distribution of costs is NOT insurance.
Atanamis
Because it's much better for the society that way.
Obama likes poor people so much, he wants to make more of them.
BMI = teh stupid.
d &cmd=Retrieve&dopt=AbstractPlus&list_uids=16920472 &query_hl=1&itool=pubmed_DocSum
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubme
Study showing that people "overweight" BMI 25-29 actually had a LOWER rate of cardio disease than leaner people.
"INTERPRETATION: The better outcomes for cardiovascular and total mortality seen in the overweight and mildly obese groups could not be explained by adjustment for confounding factors. These findings could be explained by the lack of discriminatory power of BMI to differentiate between body fat and lean mass."
-Styopa
Big old hairy difference -- so obvious I am surprised at the question...
Sleeping pills, ADHD, and prescription pain killers are all controlled -- by a medical provider, and usages closely monitored because all of those are "schedule" prescriptions
You, me or anyone (of legal age) can go out and buy and drink enough alcohol to bring about (for example) 2003's statistics for drunk-driving related fatalities (17,013) and injuries (over 500,000) are published by the NHTSA are well known.
I have yet to read a significant nationwide study on how many people are killed by drivers who are under the adverse influence of an ADHD med (theoretically more alert people would cause less accidents), sleeping pills (sleeping people don't cause too many accidents), or pain killer induced accidents. (a larger number to be sure and quantifiable -- I just don't have any data at my fingertips)
...Open Source isn't the only answer -- but it's almost always a better value than the alternatives...
Two reasons:
Are you adequate?
Some projections show the global population to eventually stablize around 15-16 billions.
Would we really be a 'greater' civilization with more people?
More people clearly would destroy more animal habitats.
What's the additional good that comes out of that?
Charge more for unhealthy?
Why not give refunds for those who are healthy. It is the same thing, but a much more positive and effective incentive. Didn't anyone read "How to win friends and influence people"?
Telling people, "You're bad. BAD!" doesn't exactly make people want to be on your side.
(-1: Post disagrees with my already-settled worldview) is not a valid mod option.
You're making a big financial mistake there: you're thinking about investments in terms of uncertain future returns, without accounting for risk. Whatever return you receive for those investments, if they don't fail, is nothing more and nothing less than the payment you receive for bearing the risk that they will fail. Insurance works the other way around: when you take out an insurance policy, you pay another party so that they will bear some risk that would otherwise be yours.
What you propose is to increase the amount of risk you bear, by bearing your healthcare expenditure risks and the oversized risks of an emerging market. This is the opposite of what insurance is supposed to do for you.
You're also forgetting some basic financial and investment advice: the reason you keep a liquid emergency fund, and buy insurance to cover your personal risks, is so that you don't have to pull money from your investments in the case of a personal disaster. I.e., you pay out money to neutralize risks that don't pay, so as to guarantee continuity of exposure to the risks that do pay.
Are you adequate?
If you really think your risk is only half a percent per month, then you would be much better off investing that $200/month. Even with a normal savings account making 4.5% interest, you could get the $20,000 required in seven years; get a good mutual fund or GIC making 8.5% and you're golden in just over six years. If your risk is only 0.5% per month, you've got about 16 years before you're likely to need insurance. Insurance companies make money by investing your money, so why not just invest it yourself? Yes, this exposes you to risk in the short term; that's what insurance provides, short term comfort. In the long term, you're better off investing. Some combination of cheaper insurance and investing is probably your best bet; gradually lower the amount of insurance you buy as your savings account grows.
Or hell, go one step further and charge fruitarians less. After all, they claim it makes them healthier.
Funny, I though the definition of vegetarian was that they ate only plant based life. Besides, some might argue that you should be charged more for eating fish, since the levels of mercury in fish have been rising.
Except that jogging is hard on the joints, and those are very costly to replace. Perhaps you meant exercise that was less high-impact, such as bicycling or swimming?
Nathan's blog
I just used this (http://www.nhlbisupport.com/bmi/) BMI calculator and my BMI is 26. I workout daily and my abs are just barely showing, in other words I'm pretty fit, but not a professional athlete. By this BMI calculator, I'm overweight. What a fucking joke. BMI = Bullshiting Moron Indicator.
You, me or anyone (of legal age) can go out and buy and drink enough alcohol to bring about (for example) 2003's statistics [wikipedia.org] for drunk-driving related fatalities (17,013) and injuries (over 500,000) are published by the NHTSA [wikipedia.org] are well known.
Oh well, some of these accidents would have happened anyway. After all, people who drink recklessly also tend to drive recklessly, even when not drunk. But fair enough, irresponsible drinking causes lots of accidents, violence and health problems. Does that mean that billions of humans who enjoy a glass or two should be penalized?
I pay $286 a month for insurance on an individual policy--after being rated up 10% (15%?) for pre-existing conditions. It's about to increase by 5.8%. I'll be paying $10 for generics, and $30 or $60 for brand names, and pay $50 on a hospital visit. OTOH, I have a $5,000/person, $10,000 family deductible--so I just got hit for $1800 on an ER visit (that turned out to be an insidious false alarm).
.) and the negotiated rates (the uninsured are in a bad way in Vegas!), which this plan does.
I put $560/month into the HSA (deductible above the line on the 1040), and can pay from that. When the balance is above $2k, I can put it into vanguard funds within the HSA until it is needed. I have a mastercard debit card to access the checking balance, and can also reimburse myself from the account (oddly, I can even do this at an ATM, though there is a service charge).
What I really wanted from the plan was catastrophic coverage (one of the pre-existing conditions was a partial epilepsy, which had a 70% chance of going away--but if it didn't . .
hawk
I hate to point this out to you, but when you have something happen that causes that $20,000 bill, you now are one of the unhealthy people that people are now "good-heartedly subsidizing". That's your INSURANCE.
You wouldn't want to catch pneumonia (or antibiotic resistant tuberculosis) from that bum on the corner who can't afford 'healthy/employed people" insurance. He probably could infect 2000 people a day...
You have a vested interest in that bum's good health. "other equally healthy people" aren't necessarily healthy tomorrow, and no amount of good genetics or low BMI will prevent that.
The Public's health is everyones concern.
F X=0:1:9999 F D=2:1 Q:((X>2)&(X#D=0)!((D>X/2)&(X'=1))) I D>(X/2) W:$X>75 ! W X,?$X+5-$l(X) Q
So since I won't fall under any of those items do they subtract ~$50 total from each paycheck since I am less likely to need health care?
Those who can, do.
Health insurance, not life insurance! :)
Great! You don't like Ayn Rand. Stating that is not exactly the same as producing a coherent counter argument.
Any guest worker system is indistinguishable from indentured servitude.
Well, we need to tap-out their bank accounts first.
First, we'll make them fat, by including high-fructose corn-syrup in just about everything they eat, to really fuck up their metabolism. That way, if they try to diet, their metabolism will slow down more, and they'll get tired, and they won't be able to exercise, and they won't burn those calories, and they'll stay fat. If they exercise, they'll just get hungrier, and eat more, so they'll stay fat.
Next, let's make them feel self-conscious about being fat, by bombarding them with all kinds of studies, advertisements, and media images. (And charge them more for insurance too).
Then, when they go get liposuction, we render the fat to make fancy boutique soaps, and sell it back to them at boutique prices.
Then we'll hook them up to the treadmill and gas them.
These are my friends, See how they glisten. See this one shine, how he smiles in the light.
Most people see a fat person and assume that it is a problem with their self-control. It's not always the case. Many are on diets and exercise regularly. Many can trace their weight problem to a real medical condition.
I had problems with my weight thru out my life. It wasn't until a few years ago that I found out why. I have an intolerance to wheat. If I cut wheat out of my diet, I lose weight. If I add it back in, I gain weight. It's that simple.*
The idea of charging people more for health insurance because of some phony metrics is sad. One of the major problems with health care in the USA is that the health industry doesn't promote preventative medicine. They wait until something becomes catastrophic before they do anything.
----
*for me.
Which is exactly why would this is a bad metric for insurance decisions, since the patients are penalized for each individual test they fail. BMI is, at best, the initial screening to do more tests - that makes it a bad total metric for healthy weight.
As they say in the trade - "Quick, Cheap, Good - Pick Any Two"
Prolly not. Bit I'm sure CodeShark, like myself, wouldn't mind if those who don't drink at all were mildly rewarded.
Never mind if that height-weight ratio is possible, never mind how he'd look if he were 5'11" and 133lb., and never mind what common sense says:
Does the BMI chart claim that this combo is in its normal range?
If it does, it's severely flawed and needs to be scrapped before any more celebrity femmes aim for those figures. (I know, it's not normal range for them, but the camera adds ten pounds...)
There is a fine line between recklessness and courage... -- Paul McCartney
And believing in God is a symptom of a lack of education, or a rejection of it.
You misunderstand. That wasn't my counterargument. That was me saying that I think you're a complete nutjob who isn't worth arguing with. The implication is that no counterargument will be forthcoming.
You want the truthiness? You can't handle the truthiness!
Really? A nut job? I outlined an argument (albeit rather abstractly) for not wanting to support your needs. You gave some blurb about a pulp fiction writer (who may or may not agree with me) being bad. When did we get to the point where people like you feel comfortable calling people like me nut jobs?
Any guest worker system is indistinguishable from indentured servitude.
>> Really? A nut job?
Too true.
>> I outlined an argument (albeit rather abstractly) for not wanting to support your needs.
Yes, you were mercifully brief. But within that short ramble, you outlined the following principles:
1) Taxation is theft.
2) Social programs are theft.
3) It is a simple economic fact that the material benefits of innovation go to the innovators themselves.
4) Hard work is always rewarded with a good life, opportunities for advancement are ample.
4b) Therefore the poor are entirely to blame for their own circumstances.
4c) Therefore, the system that rewards "winners" so well has absolutely zero responsibility to the "losers".
5) "stealing" is spelled with two 'e's.
The first two points make you a libertarian nutjob. Three and four make you either deluded or simply uncompassionate.
The fifth point is not as entirely gratuitous as it seems, since the original point of this thread was that it would gain me nothing to try and reply to you.
>> You gave some blurb about a pulp fiction writer (who may or may not agree with me) being bad.
A pulp fiction writer who -- whether you're aware of it or not -- did more to popularize the whole "Mine, mine, mine!" philosophy than a million slashdotters pitching semi-coherent cookie dough analogies could ever dream of doing. Bow before her dessicated corpse, padwan, and beg her rotted bones for forgiveness for not giving Rand her due. Then she may give you the strength to become a tenth the selfish, arrogant blowhard that she was.
>> When did we get to the point where people like you feel comfortable calling people like me nut jobs?
For me, the moment came when I realized that "people like you" are generally people who want the world to be as vicious and selfish a place as possible. You want the world to be a cutthroat, dog-eat-dog, because secretly you fantasize that in such a world you'd be the fastest knife, the biggest dog. Only then would the world finally recognize the inherent superiority of people like yourself, and stop lavishing your hard-earned money on welfare for the "undeserving."
You want the truthiness? You can't handle the truthiness!
This is all fine and good except that it revolves on the premise that bureaucrats are capable of acting as surrogate parents -- taking care of those in need and wisely redistributing resources in such a way as to minimize unhappiness. History tells that any such attempt leads to a merciless totalitarian state sooner or later. They stifle true innovation -- the innovation that comes out of the need to create those temporary solutions that usually become permanent out of necessity. They stifle them because the bureaucrats are too remote from the problems at hand to understand their solutions. But this is all moot. We can discuss whether it is more ethical to be selfish or charitable until we are blue in the face. But this is a choice of a personal philosophy. Proposing that the government (again, the people with guns who have no means to enforce their decisions other than with the threat of violence) forces everyone to become charitable takes the choice of personal philosophy away from all individuals. FYI, I've read Ayn Rand. I stand by the statement that she is a pulp writer. She made both logical and factual mistakes in the analysis she presented. The fact that she inspired multitudes to become selfish-as-a-knee-jerk-reaction-to-having-libertie s-taken-away does not change this. I'll leave you with Aristotle's "Beware of a man who means well." Because everything is allowed to him who means well. Feel free to correct my spelling further. That always adds strength to an Internet argument.
Any guest worker system is indistinguishable from indentured servitude.
This is why I don't want to engage you in a meaningful way. You claim that social programs lead inevitably to totalitarianism is yet-to-be-proven at best. I could name a dozen countries which -- in my mind, at least -- have both stronger social programs and a more vibrant democracy than the U.S. has. The U.S. seems far closer to your ideals than, say, France, but if you ask me, the U.S. is closer to slipping into totalitarianism.
The idea that innovation can only thrive under pure capitalism is bunk.
The idea that government is a solely coercive institution is bunk, and inconsistent as well unless you're a true anarchist.
I'm bored with debating these things with people like you, people who can blithely spout falsehoods like, "History tells that any such attempt leads to a merciless totalitarian state sooner or later." The only thing I think I have to learn from you is how to effectively rebut people like you, and I'd like to think I have better things to do.
>>> Because everything is allowed to him who means well.
Lookin' at you, Dubya.
No, it's a good point, but one that ought to apply equally to capitalist or bureaucrat.
You want the truthiness? You can't handle the truthiness!
Lookin' at you, Dubya.
I don't remember claiming to be a Bush supporter. Nor do I think that Bush has worked to reduce the size of the government. As a matter of fact, he has worked to expand the power and the reach of the federal government. So you are kind of proving my point there.
The idea that innovation can only thrive under pure capitalism is bunk.
Yep. It most certainly is. Innovation (as all other progress, or to be even more general any successful human activity) is an iterative process alternating between planned and ad hoc. Some times planning can foresee most problems that would otherwise need to be resolved ad hoc. Most of the time it does not. My claim was not that a bureaucracy cannot facilitate innovation. It was that it cannot facilitate the ad hoc part of the process (and usually works to suppress it). Further, I never even stated that innovation cannot exist in the absence of capitalism. That would be absurd. My claim was that leaving the task of problem solving in the hands of bureaucrats rather than allowing it to slip in the hands of those concerned with their own self-interest hinders the ad hoc part of the process. This, by the way, is evident by definition. Bureaucracies plan and administer according to preset plans. Thereby, they remove the flexibility often necessary to accomplish tasks at hand. In other words, innovation in absence of self-interest would be severely hindered, but it would not stop.
I'm bored with debating these things with people like you, people who can blithely spout falsehoods like, "History tells that any such attempt leads to a merciless totalitarian state sooner or later." The only thing I think I have to learn from you is how to effectively rebut people like you, and I'd like to think I have better things to do.
You have not actually rebutted my arguments. You've spewed insults and pointed out where my arguments were incomplete. You have not shown a single time that my assumption was wrong or that a conclusion that I made from of my assumptions did not logically follow. Better luck practicing!
The idea that government is a solely coercive institution is bunk, and inconsistent as well unless you're a true anarchist.
Interesting. But logically inconsistent. Anarchy itself is a logically inconsistent believe that human beings can live in a society in which no rules of behavior are established. So to claim that something is logically inconsistent unless it comes out of a logical inconsistency is well... interesting.
The U.S. seems far closer to your ideals than, say, France, but if you ask me, the U.S. is closer to slipping into totalitarianism.
Since you are still in academia, you might notice the deluge of French expatriates around you. The number of researchers that cannot find the funding in either public or private sector in France and are forced to come to the U.S. (despite the fact that they know what American attitudes towards the French are) is telling. It is telling of the fact that in the name of your beloved egalitarianism France could not handle supporting the pace of innovation (that would have kept the researchers at home) that it could otherwise. But this is only evidence of the fact that the claim that capitalism promotes innovation is not bunk. Considering that the French are not allowed work more than 35 hours/week legally I would hardly call them a more free nation. You can argue all you want that a person should not have to strive to succeed in order to survive, but can we, please, agree that a person should be allowed to strive to succeed?
And now that I decided to finally address everything you've said previously in as much expanse as one evening's blog will allow. Back to your previous posts:
1) Taxation is theft.
2) Social programs are theft.
Taxation with the sole purpose of redistributi
Any guest worker system is indistinguishable from indentured servitude.
...Therefore, it has to be taken from those who have the resources to dispense it. Before you tell me again that these people will not shortly fall into the trap of allowing themselves to command greater and greater power over the people who allowed them to govern, tell me why not? If they could bring themselves to act as despots towards one group of people, why not all people?
And lastly, our arguments don't have an actual effect. We are only 2 votes in each election in which millions vote. The only effect that this argument can produce is to establish a correct label for the system whose victims we may or may not become. I just hope that at some point that label will be "free" rather than "nice".
Any guest worker system is indistinguishable from indentured servitude.
>> You have not actually rebutted my arguments. You've spewed insults and pointed out where my arguments were incomplete. You have not shown a single time that my assumption was wrong or that a conclusion that I made from of my assumptions did not logically follow. Better luck practicing!
You say these things as though they were a bug, not a feature. If I thought I might convince you, or learn from you, I might try. I don't, so I haven't, and I won't.
You want the truthiness? You can't handle the truthiness!
Thanks! Since you've offered nothing but insults in the face of logical arguments I will make the most obvious assumption that a logical argument cannot be forthcoming (at least, your claims to the contrary notwithstanding, not from you). As such I take insults as indications of frustration. Or to put it bluntly I don't believe you when you claim that you are choosing not to disagree with me coherently because you can. I am confident it is because you cannot master a counter argument. I'll take it as the best indication that you agree even though you don't want to. Thanks again.
Any guest worker system is indistinguishable from indentured servitude.
You are entirely free to draw whatever conclusions you like.
You want the truthiness? You can't handle the truthiness!
Ummm, I wouldn't be too quick to claim that we don't have law enforcement which is focused on, and motivated by, revenue models.
Every since the mid-'80s when the U.S. feds passed the "RICO" statutes (seizure and forfeiture laws) there have been serious concerns about the focus by many police agencies on maximizing their share of the seizure pie.
Before discounting this post as wholly irrelevant to the topic of medical care let's also keep in mind that keeping marijuana illegal keeps the pill pusher oligarchy (think Prozac) intact.