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."

Comments

Mostly OK

[31415926535897]

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.

This is crap

[palladiate]

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.

depends on definitions

[BitterAndDrunk]

I think if you're considering Ronnie Coleman and professional bodybuilders who are walking pharmacies, I agree.

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.

It's NOT health care

[nido]

All good points, but I do take issue with your conclusion:

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. The problem with health care in the United States today is that costs are out of control. This is by design - see 100 Years of Medical Robbery or How The Cost-Plus System Evolved for more on how the AMA lobbied to exterminate the competitors to allopathic medicine.

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'.)

As a licensed insurance agent

[Travoltus]

"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.