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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."
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.
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.
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.
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.
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.
I agree.
And I think anyone that gets a sun burn or sun tan should pay extra as well.
And anyone that doesn't eat range fed chicken.
And anyone that eats meat.
And anyone that doesn't do exactly what I want.
Because my real purpose is to control them.
She was like chocolate when she drank... semi-sweet at first and then increasingly bitter.
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.
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.
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.
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.
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."
An interesting anagram of "BANACH TARSKI" is "BANACH TARSKI BANACH TARSKI"
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."
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.
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