I read a very interesting quote the other day, and it was basically this:
You will spend time and money on your health. Fortunately, you get to choose whether that time and money is spent proactively or reactively.
Man I thought that was brilliant. I think it also segue's perfectly into this article that just came out in Time Magazine a few weeks ago. It basically asks the question "Should smokers and overweight individuals have to pay more for health insurance than their healthier counterparts?"
I think the answer is absolutely YES. I can only give an example on how my company currently handles it since I know those details.
How much more do you think the insurance premium is for a smoker at my company vs. my premium? $7. Smoking has been proven beyond any doubt to be a death sentence but that person will pay only $7 more per paycheck than I will (I don't smoke, by the way).
How much more do you think the insurance premium is for an obese person with Type II diabetes at my company vs. my premium? $0. We pay the exact same amount.
Anyway, it's a great article, so check it out. I have a few quotes and comments on it below as well.
“North Carolina this year became the second state to approve an increase in out-of-pocket expenses for state workers who smoke and don't try to quit or who are morbidly obese and don't try to lose weight.”
On the surface, I think that policy is awesome! I also think it is fair. It doesn’t immediately penalize someone who smokes or who is morbidly obese. It actually gives that person the chance to change those unhealthy habits. They are only penalized if they don’t try to change their situation.
The one counter-argument I have is where are the rewards for those people who not only maintain good health, but actively seek to continuously improve it?
“Nationwide, employee insurance premiums have increased 131% over the past decade, according to the Kaiser Family Foundation. And it's well documented that smoking and obesity are associated with higher medical costs.”
Given that information, why shouldn't smokers and obese people shoulder the majority of the costs?
CONS:
There are a couple of reasons why such programs are hard to administer. First, for the overweight issue, the plans described in the article use the Body Mass Index (BMI) as their determinant. BMI is a number based on a person’s height and weight that attempts to categorize them into one of four categories: Underweight (<18.5), Normal Weight (18.5 – 24.9), Overweight (25 – 29.9), and Obese (>30).
I just ran the numbers on myself (5’11”, 190 lbs.) and my BMI is 26.5. Holy shit! I’m overweight!
BMI can be effective for quickly categorizing a large population with decent accuracy, but at the individual level it just doesn’t cut it. It completely ignores the fact that muscle has a greater density than fat.
I think systems like this should be in place, but there has to be a better way to administer them. It might mean that actual bodyfat testing and blood tests should be run (perhaps at the expense of the individual). I would pay to have those tests done if it would result in savings on my premiums.
"'We're trying to get across to the population that they have to take responsibility for their well-being and engage in more healthy behavior,' says Jack Walker, executive director of the North Carolina State Health Plan."
Are penalties unfair? What if there are no penalties, but only rewards for meeting certain criteria? For example, from the article:
“In 2005 the Safeway supermarket chain implemented a voluntary wellness plan. Employees who take and pass tests for such things as blood pressure and cholesterol levels can reduce their annual insurance premiums by nearly $800.”
Why are drivers penalized for speeding tickets and accidents? Why are homeowners penalized based on what zip code they live in? Simply, it’s because those people represent a higher risk to the insurance company. So why doesn’t the same theory apply to health insurance? Should those people who are more at risk (obese and smokers, for instance) pay a higher premium than those people who are less at risk?
Your thoughts?