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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?
That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.
Except for the fact that the BMI is an outdated and inaccurate POS.
Linux, you magnificent bastard, I read the fucking manual!
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.
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!
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.
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.
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.
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.
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
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
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.
Agreed, & I have a solution.
We should gather every employee in a room & stand them on a table one-by-one, if the majority of the room thinks that person is a fat bastard, that person gets charged more.
Wanna fight ? Bend over, stick your head up your ass, and fight for air.
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?
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)?
World wasn't invented in a day, boy. Simmer down. They'll get to it.
High cholesterol, blood pressure, and glucose, could be valid measurements. Unless, of course, you're genetically predisposed to high cholesterol. The other problem I see with this is it's going to increase promotions for drugs, particularly cholesterol drugs, in a society where taking The Easy Way Out (tm) seems to be a de facto standard.
I think this sets a dangerous precedent. While I agree that people at high risk (of anything) should be charged more for insurance, health has too many variables to be able to accurately measure risk.
Fat percentage, in this case, might be the only possible solution. Anyone got any other suggestions?
Change is inevitable, except from a vending machine -- Robert C. Gallagher
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.
Could we also charge him once per instance on those he has encouraged to take up smoking? I'm pretty sure we could pay down our huge public debt on that.
"Who is the Journal of Quantum Physics going to believe?" --Stephen Hawking
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
Exactly. When I was in college (many moons ago) and weightlifting, I was measured with an 11% body fat (on the low end for "highly athletic") and weighed 205 pounds with a height of 5' 8". According to BMI, that's morbidly obese and I'd have been paying extra. Explain how an athlete who can bench press 400# and leg press 1200# is in extra danger of keeling over dead?
The BMI values are a total load of crapola. I've been checked since, and to get down to my "ideal" BMI would require me to reach a -12% body fat. (That's negative 12% -- also known as dead.)
Life, the Universe, and Everything... in my image.
What about sexually promiscuous employees, or employees that like skydiving or downhill skiing?
Have you read an insurance application lately? Non-commercial pilot, skydiving, rock climbing and other "dangerous" activities are asked about.
As for the rest, I'm sure they'll get to them eventually.
Learning HOW to think is more important than learning WHAT to think.
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.
So all pointy-haired bosses would pay a higher rate regardless of BMI and bodyfat, while the non-bastard fatsos are let off.
Sounds fair to me!
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.
Bosses are exempt, if you have a problem with that you should have majored in Business instead of Programming.
Wanna fight ? Bend over, stick your head up your ass, and fight for air.
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.
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.
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
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
body builders and the like have skewed BMIs, for example.
You better watch out, there may be dogs about . .
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.
Bad form to reply to myself, but in case it isn't clear, I'm fully intending the above to be highly sarcastic. I believe risk averaging is a good idea, and the ideas proposed in this article to be on a pretty steep slippery slope to being sufficiently obviously evil for anyone to recognize it as such.
"Who is the Journal of Quantum Physics going to believe?" --Stephen Hawking
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.
I didn't realize there was so much red meat in cola. Or that fish was a vegetable!
Gamingmuseum.com: Give your 3D accelerator a rest.
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
i don't agree with this at all. the point of insurance is to *distribute risk* across a large pool of people. once you start penalizing on risk factors, you have people with pre-existing conditions, certain genetic markers, etc. becoming "uninsurable", which for many of them means "you go die now".
"uninsurable" is a ridiculous term, IMHO - everyone is "insurable" - you simply give them coverage from the pool. yes, that means your rates go up somewhat - too bad. the important thing is that people are getting covered.
the stunning intrusion into people's personal lives is another issue altogether.
free software, open standards, open file formats, no software patents.
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.
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 . .
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
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.
I'm not very active -- the standard desk jockey, but I have a high metabolism and I *used* to be very active, though it has been nearly a decade since I stopped being actively athletic. That said... I'm 5'11, 185lb but sometimes up to 195lb, that puts me around 25-27 BMI with a blistering 10-14% body fat. Surely, I could lose some weight, I've lost the "6-pack" I had a decade ago, but I'm not over-weight by any stretch of the imagination.
As others have said... BMI is pretty useless. I don't consider myself overweight, and according to my body fat.. I'm between "athletic" and "fit" (which are both below "normal"). Yet, with such a plan, I would have to pay a premium??? Silly.
Most vegetarians are that way because they think it's wrong to eat meat, and killing animals is wrong. Most of them area all OMFG THEY ARE KILLED IN THE MOST VILE WAYS!!!!
What most fail to realize is that the way they are killed in slaughterhouses/by humans is FAR more 'humane' than what they would suffer in the wild from a predator. Most predators will eat the kill while it's still fucking alive as long as it's immobilized. Most slaughterhouses kill the animal instantly, such as at many beef ranches where they use a nailgun with a nail welded to the piston to the forehead of the cow to kill it instantly.
Well, that's the insurance company's goal. The consumer's goal is to distribute cost across a large number of people, not risk.
The insurance company benefits when risk is minimized; the consumer benefits when cost is minimized. What the insurance companies are doing here is trying to further minimize risk at the expense of some of the consumers, which is not compatible with the goal of the insurance consumers because it will increase costs for them.
There are several issues here. One is when a consumer increases risk themselves; for instance, if they choose not to wear a seatbelt, or if their diet consists of fatburgers and coke and nothing else. In this case, the consumer is increasing risk, and one could understand the reluctance of the insurance company towards treating this person the same as one who has a less pathological diet.
But a second, quite different issue is that a person with diabetes or leukemia or breast cancer probably isn't responsible for these things in the sense that their behavior is a key element. So in this case, the tendency of the insurance company to lock them into higher costs (or out of the pool entirely) is less easily excused.
Third, the insurance company wants to make money; as a public company, it actually has an obligation to make money. This can so easily come into conflict with the need of the consumer for the best possible coverage that it may be a defining line where we can use ethics to say that pooling health care costs with an idea of profiting may be inherently unethical.
Fourth, there are people who abuse free-ish health care; I know of some of these myself. I suspect that this is one of the extremes - like people who are quite sick in multiple ways - that a pool just has to accept, just as it accepts people who are inordinately healthy and rarely, if ever, call upon the pool to pay for medical care.
The bottom line, it seems to me, is that we do know that medical care is expensive, we can reduce the citizen's overall need for care into statistical likelihoods that are really pretty well nailed down, and we should probably do exactly that because if we do, everyone will have the care they need and that is a very noble and reasonable goal.
Insurance companies would lose out, but there is no guarantee of any particular job or service niche existing; progress and change are constantly creating and eliminating opportunities. Nothing says that because today, you have a successful corporation selling beanie babies, that everyone is forced from now until the end of time to buy beanie babies. Likewise, the insurance companies have built a great gig for themselves, but if tomorrow, we as a society decide that a not-for-profit national pool that includes everyone who can pay whatever it costs is appropriate, then it is time for them to go find a new business to pursue.
There will always be a group of unemployed / insufficient income people who cannot access such a pool in its most basic form, but then again, our society has a strong tradition of caring for those people. Given that they're a rather small percentage of the overall population, probably the best solution is simply to bite the bullet and fold them in. After all, you never know when you might lose your job, eh?
I've fallen off your lawn, and I can't get up.
"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!
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
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.
I think the continued survival of chickens as we know them depends on their marketability as a food item.
Regardless, it is a stretch to assume that a vegetarian is by default healthier than a one that includes meat. But due to the nature of the thing, somewhere on some vegan web forum vegans are probably complaining about subsidizing health insurance for vegetarians.
"Sacrifice for the good of The State" - The State
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?
No, but as I said above, I'd like to tell them to stop breeding. For the sake of the world, if you have a lifelong illness and are always sick, maybe it's time to change something in your life, move, or stop passing along that genetic makeup that makes you prone to illness. Now is about the time your telling me how much of an ass I am for telling someone not to have kids, but think of what your kids will go through if it is truly a genetics problem? Think of what their life will be like... think of that their children will have to go through. Either man up and accept or start supporting genetic research.
Every time I start to have faith in humanity, I ruin it by driving to work between 7 and 8 am.
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.
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.
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.
MSBPodcast.com The opinions expressed here are my own. If you don't like 'em... Think up your own stuff.
>$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?