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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."
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."
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.
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.
"Exempting highly-skilled workers from having to pay unemployment insurance premiums, and raising premiums on burger flippers."
That's where it'll stop.
...so next they'll deduct another 20 for just working in a hospital.
The problem here is that it only assesses one kind of risk. What about sexually promiscuous employees, or employees that like skydiving or downhill skiing? What about employees that pop too many aspirin, or employees with physically abusive spouses? What about those employees with genetic predispositions to any number of chronic (read: EXPENSIVE) diseases, who have thus far been lucky enough not to come down with them (so far)?
The world's burning. Moped Jesus spotted on I50. Details at 11.
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 agree 100%. I am overweight, and i definitely don't live the healthiest lifestyle (although I have been changing that recently). However, I do not feel that you should have to pay my medical bills. Therefore, I should pay more than you until I get into shape. Anybody who disagrees with this stance is a whiny fatass.
I wouldn't want to pay for others' bad choices, so I don't think anyone should have to pay for mine.
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.
Because they will pay if your ass gets hit by a bus. I guess being healthy doesn't prevent that. All the salads in the world won't stop everything. Self Prick
Exactly. And, if they have hereditary conditions (high blood pressure was mentioned in TFA), they should be charged more. Of course, why stop there? Why not pay proportionally more? Of course, that'd price most people with hereditary conditions out of insurance altogether, but that's the free market at work!
And you're dead on, choosing to live in a flood zone is *exactly* like choosing to be born to parents that have hereditary conditions. They should definitely pay the price.
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
Maybe we should do away with insurance (averaging) altogether, and just have everyone pay for whatever happens to them.
After all, if you don't have cancer, why should you pay extra for the people who do?
"Who is the Journal of Quantum Physics going to believe?" --Stephen Hawking
No, it isn't. The point of insurance is that a certain percentage of a population will get hit. By spreading the financial risk over a large pool of people, each person pays an amount they can afford in case its them.
This is why private insurance is a bad thing- their job isn't to maximize protection, but to maximize profit. Ideally, they would want to insure only the people who don't get sick and none of those that do, to make 100% of that money in profit. In other words, they want to make it a giant scam, taking your money but providing no services. This doesn't stop the others from getting sick, it just forces them to pay through the nose for non-insured rates, or get no health services at all. And since we live in a humane society where we don't let them die on the street, society as a whole pays a higher rate as we pay for them to take up emergency services when things go completely wrong, rather than cheaper, more effective, and less risky preventitve care they'd recieve with insurance.
So no, this is *not* a good thing. This is a perversion that will inflate the pockets of wealthy insurance companies while bankrupting the lower and middle classes. This is why we need to get rid of insurance companies and get government healcare *now*.
I still have more fans than freaks. WTF is wrong with you people?
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.
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
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.
Functionally, the only difference is that you would have to prove that you were healthy do get a discount, but in this case, the burden of proof is on the provider to prove that individuals should qualify pay more.
...because "hacker" sounds way sexier than "code drone."
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.
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
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.
Just look at the pathetic and logically-challenged arguments being used by Republicans to try to keep the expansion of publicly-funded health services at bay. That's what your health insurance premiums are going to.
The world's burning. Moped Jesus spotted on I50. Details at 11.
I follow you, just making a joke. I believe that when filling in insurance forms, there are changes if your family has a history, or if you lead an unhealthy or dangerous lifestyle. One thing you might see to curtail generic rising charges, is selective policies:
I want to be insured for:
1) Accidental injuries incurred by non-dangerous activities (driving, swimming, non-extreme sports)
2) Cancer not directly related to my own activities (colon, prostate, lymph node)
I don't want to be insured for:
1) Extreme sports such as race car driving, motocross, ski jumping.
2) Cancer due to smoking
3) Liver failure due to alcoholic consumption
You start with a flat rate and go up from there.
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
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.
They already have gotten to that. Why do you think your marital status matters? Married couples are usually less sexually promiscuous than single individuals, hence a lower risk and a lower rate.
After 3 days without programming, life becomes meaningless
- The Tao of Programming
Aside from a select few, it's actually a pretty good indicator of people who are overweight. There are a few muscled types who show up as overwieight/obese (I'm one of them) that have very low BF and high muscle mass. But for most of you, if BMI says you are obese, you are obese and need to step away from the cookie.
Buckle your ROFL belt, we're in for some LOLs.
I dunno, body builders with their crazy diets and protein concoctions don't impress me as having the healthiest lifestyle.
http://zero-to-enterprise.blogspot.com/
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 $200). Insurance allows me to spread the risk among other, equally healthy people, so that I can plan my life around it rather than risking bankruptcy.
You're a higher risk so you pay more, seems like an insurance company at work to me.
Part of the obesity epidemic is the 60 hour work weeks that have become the norm, while real earning power has declined for most people. It's not like the company is going to give you the time to be healthy, so the pay cut is simply that and nothing more.
Friends don't help friends install M$ junk.
The problem is that this is GROUP health insurance, not individual health insurance. The insurance company is taking a chance based on the group average. Some will cost more and some less than average. That is how they play the game. So they should not be able to charge more to some people in the group. This is just a way to make more money off of the consumer.
Now if these were individual health plans, then the market should decide. Don't like what company X charges, go to one that charges less. But employees don't have this choice in a group plan, so I'm against it.
Michael
Beware of Sales Reps bearing gifts.
Charge vegetarians less?
More. A vegetarian diet is unnatural and unhealthy. Human beings are omnivores. Giving up meat is about as good for you as giving up vegetables. It totally fucked up my sister's system. Years of deprivation of food we were made to eat took its toll. She still subscribes to the religion, but eats meat now to keep herself healthy and feeling okay.
I'm not a body builder, but I work out regularly. I started last year. My BMI has remained the same (over 30), because neither my height nor weight have changed, but my body fat has dropped from 33% to 16%. I am still classified as obese by the BMI, but am now extremely healthy and well below the average (22%) for my age. BMI tells nothing. Body fat percentage is a better measurement, but you can't get that number from the information on the insurance application form.
Put identity in the browser.
Recent research published in JAMA says that the BMI is not necessarily a reliable predictor of health. Not nearly as reliable as waist circumference, according to the article.
Apparently there are healthy chubby people whose musculature surrounding their vital organs is sound, and skinny people who got that way through diet whose hearts, liver, etc are surrounded by flab.
That still doesn't excuse the idea, embarrassing in the richest nation on earth, that anyone should have to go without medical care from cradle to grave. As far as I'm concerned, if you believe that you, a healthy person, should not be responsible for paying into a system that gives care to a less wealthy unhealthy person, you have a fucked up, un-American world view. You don't have to be a bible believer to know that if you want to pull the heaviest loads, you hook up the strongest horses. That's why the rich pay a greater share of their wealth in taxes (or are supposed to). The dual economic crises of the "sub-prime" credit market and runaway health care are exposing the fundamental weakness in Milton Friedman's theory of the so-called "free market".
Why not have the Fire and Police Dept provide services based on the victim's ability to pay? Because that's not the way we do things in a great, rich nation. So why should health care be any different? We don't allow the Fire or Police Dept to base their service model on profits, so why medicine? We wouldn't suggest that Fire Departments should not save someone from a burning tenement slum because they couldn't afford to properly fire-proof their property, so why suggest that someone who is poor and has become overweight due to a substandard diet should be denied health care?
You are welcome on my lawn.
Insurance rates are about average statistics, not exceptions.
Bodybuilders in particular have a real problem with BMI. My physical trainer's BMI registers as obese, but he is a competition bodybuilder.
In Missouri, physical requirements for their State Troopers had to be revised because some who were bodybuilders couldn't meet their BMI requirements.
Would someone please explain to the 230 lb weightlifter with 6% body fat why he didn't pass his physical.
DISCLAIMER: This post was not checked for speling and grammar- if you complain- you're a whiner
Don't be an idiot.
The demand for medical care is almost infinite. This is not a hypothesis or an ideology, it is an observed fact.
Therefore if you pay for a medical dole using a finite pool of money, there will be rationing. If humans apply good judgement to rationing decisions, the answer will not always be the same. Demagogues will call this unfair: decisions by local democracies will be derided as a ZIP code lottery, professional judgment by doctors will be considered hogging the budget. Therefore rationing decisions will come to be made by flow charts written by a bureaucracy, without regard to economic results, pain, suffering, family disruption, and so forth. Again, this is not a guess or a political position, it is a fact that has been observed every time a medical dole has been tried on a large scale with social "fairness" as its primary goal.
In such a system, in the interests of "fairness", the bureaucracy will become ever larger and more controlling. Eventually it will become both the largest line item on the budget and immersed in its own internal politics. Again, this is an observed fact. One need look no further than the bureaucrat-politician-and-protocolist to doctor-and-nurse ratio of Britain's NHS.
Treating free men as beasts to be harnessed has never worked out well, though it has often been tried, you Stalinist pinhead.
Not when it comes to U.S. health care, they don't. Fully one third of their posh health insurance is paid for by the U.S. Treasury, which funds this enormous give-away entirely by increased taxes on the uninsured. The extra money also drives up health care costs, which is a further burden on the uninsured.
When people like me say everybody should have to personally pay the full cost of their own health care even if they have to die, this is what we're talking about. People like you are simply ignore this point, and whitewash it as "un-American" malice.
And now you are trying to whitewash a strength as a weakness. Free markets work by teaching unbiased object lessons to the participants. The invisible hand does not care whether you are black or white, how good of a nanny your parents could afford, whether you have a strict neighborhood association, or any other claptrap. Sometimes the lessons hurt, but if you want to run you have to expect a few skinned knees. (Remember than the sub-prime mortgage "crisis" amounts to a percent or three of GDP for a single year.)
Have you been living under a rock? Compare the police response in Compton with that in Menlo Park with that in a small Alaska town. Civil services most certainly are based on ability to pay.
Spoken like someone who has never gotten a bill from either a fire department or an ambulance service.
Agreed. BMI doesn't factor in frame size or muscle mass. Why doesn't the employer just require the employee to get a physical, from a licensed doctor, once every 18 months? If the employee is unhealthy, the employee would have to pay more. Simple as that.
And since a physical every 18 months should probably be covered by their insurance anyway, it would be at no cost to the employer or employee.
Anthropic principle: We see the universe the way it is because if it were different we would not be here to see it.
And now you are trying to whitewash a strength as a weakness. Free markets work by teaching unbiased object lessons to the participants. The invisible hand does not care whether you are black or white, how good of a nanny your parents could afford, whether you have a strict neighborhood association, or any other claptrap. Sometimes the lessons hurt, but if you want to run you have to expect a few skinned knees. (Remember than the sub-prime mortgage "crisis" amounts to a percent or three of GDP for a single year.)
For a couple of mod point, please point to a truly free economy. unencumbered by government regulation, government interference or taxes. I bet you the closer to that ideal you get the more corruption and monopolies you see. In fact I bet the closer to that ideal you get the lower the general standard of living is.
"There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy."
That's not far from the truth in the US already. It's in our tax structure, insurance, oh and all the wonderful benefits you'll get screwed out of when you're in the military and unmarried. You're pretty much punished for being single, which really sucks for people who aren't ever going to get married.
:D
Society maintains itself through having kids. It's been observed that family units tend to give kids better starts and are less prone to crime. Thus the society has a vested interest to promote this. If you've made a conscious choice to opt out, then they be wise to push you towards making a greater contribution through higher taxes. Your singledom generally doesn't forward the society. Occasional outlyers exists (Alan Turing etc..). beside the tax credit a family gets does not even make up half of what kids cost. I am single and I don't mind. A $2000 tax credit means a lot to a family but only a new HDTV for me. Society would make the right choice in pushing us toward shaving more kids. Opting out is umm... letting the terrorist win
"There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy."
There is a direct, positive correlation between BMI and cardiovascular disease. Fat people tend to have high BMIs, and they also tend to have heart attacks. STATISTICALLY, a BMI can be a good indicator of whether or not you will have cardiovascular problems, need blood pressure meds, become diabetic, or have a heart attack.
This does not mean you can guess ONE PERSONS risk by BMI, but you can guess that a group of people with BMI >30 will have more health problems than a group with a BMI 24. This is, as a matter of fact, very very useful to an insurance company. They are betting against you getting sick/ having to go to the hospital/ etc., so if you have a low BMI, they will bet more (aka charge you lower premiums) that you'll be ok. On the contrary, if you have a high BMI, they will charge you more, because odds are higher you'll end up in the ER costing them money.
And while BMI is not the most terribly accurate measurement, most people with a BMI over 30 are not in good, or even fair shape. Feel free to rationalize as necessary, but don't get carried away associating yourselves with NFL athletes or pro body builders just because you have a high weight/height ratio. I mean, this is slashdot.. if you are anywhere approaching that kind of physique, you have wandered a long long way to get to this website =)
Send lawyers, guns, and money!
An interesting anagram of "BANACH TARSKI" is "BANACH TARSKI BANACH TARSKI"
yes, it does mean that BMI is not the best one. BMI is a meaningless figure invented in the 19th century that has only marginal meaning in modern healthcare. The only thing a REAL doctor does with an out-of-range BMI is run tests to see if it is meaningless in this case or not, they don't ever use BMI to actually apply health care more advanced than giving generic diet advice that applies to everyone ("eat less sugar, more vegetables and try to get the weight down, OK?".
This is just another example of American "health insurance" companies who are more interested in having some number they can get cheaply to point at and justify why they want to charge some people more money than providing actual, you know, health care. Whether that number is your ZIP code, credit rating, or BMI, it is meaningless to your actual health status, but they're perfectly happy to charge you more or deny you benefits for having the wrong number.
Recursive: Adj. See Recursive.
That being fat also means you are more prone to certain health problems is a different issue altogether.
True, but the links between being overweight and many health problems are well established. I don't think any really reputable source is debating that being overweight -- particularly obese -- isn't unhealthy. Obese people tend to have an increased risk of heart disease, blood clots / strokes, diabetes, etc. The list is pretty long.
Every once in a while you'll hear someone talk about correlation vs causation and obesity -- i.e., whether being obese causes you to be unhealthy, or whether there's some sort of underlying cause which causes both obesity and the other health problems that it's correlated with, but to an insurance company that's irrelevant. They just want to find easily measurable risk factors and indicators; whether the relationship is causative doesn't matter a whit (to them).
"Ladies and gentlemen, my killbot features Lotus Notes and a machine gun. It is the finest available."
If it's guaranteed that one person will get a $100 000 bill, you're right. In health insurance, it's not. It's a 0.1% chance for each person that they'll get a $100 000 bill. If someone has the ability to cut their risk in half, down to to a 0.05% risk, (without increasing anyone else's risk in the process), that will lower the over all cost by $50.
What we're talking about is offering people willing to do that some money. Could pay them $50, thus breaking even. Could pay them $40 and lower everyone's premium by one cent. By paying me $40 to lower my own risk, everyone has saved money, not just me.
Doing such and such changes the cost by $X. This system internalises the externalities, and that's a Very Good Thing. (Clearly we should only be doing this when someone can lower their risk.)
(Yes, the article [or summary--didn't read TFA] talks about charging people for raising their risk instead of paying them to lower it, but it gives exactly the same results, ignoring any psychological reactions to perceived differences and however that will effect behaviour. Economists like to pretend we're perfectly rational beings, but we really aren't. Present it as a carrot instead of a stick and it should work well.)
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.
What does any of that have to do with a free economy? If you go to Somalia, you can buy anything, sell anything, and charge whatever you like (and can get someone to pay).
Being called names or having other countries boycott your product are parts of free markets. In a free market, you don't get to force people to buy your goods or force them to say only nice things about you.
You can buy or sell whatever you like -- 12 year-old boys, stinger missiles, untested medicine, etc. You can perform surgery without any training or worrying that somebody will sue. You don't need insurance to drive a car, or an inspection or registration. there's no building inspector to tell you your slab has to be so far from the curb or so thick, you can build a high-rise out of toothpicks and rent out apartments in it with no smoke alarms. It's a free market, a libertarian paradise.
Recursive: Adj. See Recursive.
You are absolutely right. It's interesting to compare what the French and Americans spend on their healthcare systems. In the US we are spending 16% of our GNP and have 46 million people without any form of insurance (and of those who do have insurance, a lot of it is worthless when it really counts).
In France, however, they are spending 10% of GNP on a system which covers everyone and routinely outperforms what we have in the US.
More FUD to watch out for is the crap about lines and impossible waiting times. I've spent a total of two years in France, including two months in the hospital with a pretty nasty pneumonia. The staff was always courteous and competent. This is at the same time my compatriots were all bashing surrender monkeys and feeling clever.
Slashdot: news from nerds.
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!
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.
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>$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.
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?