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Do you think obese/overweight people should pay more for health insurance?
Replies
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richardgavel wrote: »This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
And if extreme sports injuries were contributing to total health care spending to the degree obesity related issues are, then that would be a discussion that would be useful to have.
From the CDC web site: The medical care costs of obesity in the United States are high. In 2008 dollars, these costs were estimated to be $147 billion.
We are definitely not finding that skydiving accidents are costing 147 billion dollars a year in health care. If that were the case, skydiving would probably be illegal!4 -
do drug addicts, or alcoholics pay more? It's the same thing. Not all obese people are unhealthy and not all thin people are healthy...
With the power the insurance companies have, it could end up like car insurance, use it once and the price goes up...penalties for breaking a leg, or cutting your arm.1 -
richardgavel wrote: »This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
And if extreme sports injuries were contributing to total health care spending to the degree obesity related issues are, then that would be a discussion that would be useful to have.
From the CDC web site: The medical care costs of obesity in the United States are high. In 2008 dollars, these costs were estimated to be $147 billion.
True. My response was more to the poster I responded too who said we should waive extra costs based on the concept of trying to take care of ones health. The poster I responded to was talking about not charging extra to people with hypertension or diabetes if they were actively trying to improve their health. To me that's not a feasible solution because interpretation of that concept will differ. Obesity does drive costs up, I completely agree and I think some real public health actions need to be taken. Schools cutting PE and selling fast food is an example of what not to do.2 -
heiliskrimsli wrote: »richardgavel wrote: »This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
And if extreme sports injuries were contributing to total health care spending to the degree obesity related issues are, then that would be a discussion that would be useful to have.
From the CDC web site: The medical care costs of obesity in the United States are high. In 2008 dollars, these costs were estimated to be $147 billion.
We are definitely not finding that skydiving accidents are costing 147 billion dollars a year in health care. If that were the case, skydiving would probably be illegal!
The extreme sports listed tend to be fairly expensive--either through the equipment necessary or travel to venues. Does that mean that those who participate in those sports are independently wealthy or just have good jobs with comprehensive insurance so that they are left out estimates of cost of care because it's not through a publicly-funded source? It would be interesting to know if the numbers cited for cost of obesity are all costs, are only those paid by Medicare/Medicaid/ACA-subsidies? And if obesity rates trend upward with reduced socioeconomic status, wouldn't surcharges for obesity just be another tax on the poor?1 -
do drug addicts, or alcoholics pay more? It's the same thing. Not all obese people are unhealthy and not all thin people are healthy...
With the power the insurance companies have, it could end up like car insurance, use it once and the price goes up...penalties for breaking a leg, or cutting your arm.
There is a precedent for smokers to be charged more.1 -
paultireland wrote: »1. Nobody should have to pay more for insurance than someone else.
Even chainsaw jugglers?
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AnninStPaul wrote: »If you aren't caring for your health, you should pay more. If you're diabetic and work with your physician to achieve control, you don't get a surcharge. If you're hypertensive and don't act to reduce your bp - lose weight, exercise, take anti-hypertensives - you get a surcharge.
This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
I don't think it is a slippery slope at all. People who are fit and active enough to routinely engage in sports such as climbing and mountain biking are highly unlikely to be obese. The occasional broken arm which necessitates a couple of x-rays, a cast, or...worst case scenario...an outpatient surgery...will be an insignificant cost compared to the lifetime of expensive drugs, hospitalizations, intensive care units, etc. that obese people are likely to eventually need.
One sports injury will likely cost less to treat (and be a one time event) than a single year's supply of the expensive drugs needed to treat obesity related chronic illnesses.
I am sure any insurance company would GLADLY choose the super active sports participant over the fat person who sits inside their nice and safe home. And they would charge the sporty person much less...which is fair.
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+1heiliskrimsli wrote: »do drug addicts, or alcoholics pay more? It's the same thing. Not all obese people are unhealthy and not all thin people are healthy...
With the power the insurance companies have, it could end up like car insurance, use it once and the price goes up...penalties for breaking a leg, or cutting your arm.
There is a precedent for smokers to be charged more.
The point of obesity's effect on health care is that it dramatically raises the risks of various diseases even if you don't have them yet.
Furthermore the negative effects may not be obvious at first.
You are going to have your work cut out for you if you think to convince me that "Not all obese people are unhealthy".
Diet, blood pressure, cholesterol, shortness of breath walking a flight of stairs, the toll on the joints.
"It makes you more likely to have conditions including:
Heart disease and stroke
High blood pressure
Diabetes
Some cancers
Gallbladder disease and gallstones
Osteoarthritis
Gout
Breathing problems, such as sleep apnea (when a person stops breathing for short episodes during sleep) and asthma"
http://www.webmd.com/diet/obesity/obesity-health-risks#1
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+1heiliskrimsli wrote: »do drug addicts, or alcoholics pay more? It's the same thing. Not all obese people are unhealthy and not all thin people are healthy...
With the power the insurance companies have, it could end up like car insurance, use it once and the price goes up...penalties for breaking a leg, or cutting your arm.
There is a precedent for smokers to be charged more.
The point of being obese is that it dramatically raises the risks of various diseases even if you don't have them yet.
Furthermore the negative effects may not be obvious at first.
You are going to have your work cut out for you if you think to convince me that "Not all obese people are unhealthy".
Diet, blood pressure, cholesterol, shortness of breath walking a flight of stairs, the toll on the joints.
"It makes you more likely to have conditions including:
Heart disease and stroke
High blood pressure
Diabetes
Some cancers
Gallbladder disease and gallstones
Osteoarthritis
Gout
Breathing problems, such as sleep apnea (when a person stops breathing for short episodes during sleep) and asthma"
http://www.webmd.com/diet/obesity/obesity-health-risks#1
I do not disagree with you here in the least. I personally believe that "BMI" is one of the worst bits of BS the medical community has come up with in a long time.stanmann571 wrote: »If it's a fit test, fine... if its a 10 second scan of BMI, then I'm not fine.
Arbitrarily associating fitness with BMI is spurious at best. ~39% of "normal BMI" people are overfat and unfit. over 25% of overweight and Obese BMI are fit and healthy range fat.
BMI was designed to trend populations, not measure individuals.
I am basing my discussion around body fat percentages, not BMI.
Pushing 31% body fat in women and 26% in men is when the proper definition of "obese" starts.
Pro bodybuilders are "obese" if you go by BMI. BMI is crap.
"Healthy ranges of body fat range from between 14-20% for men, a percentage of greater than 25% is considered to be unhealthy and puts the individual at an increased risk of obesity related illness. Healthy ranges for women range between 17-24% where a level of 30% body fat is considered unhealthy and at a level of increased risk." -- https://www.bodybuilding.com/fun/measure_up_body_fat.htm
Please make up your mind.0 -
Where did I contradict myself?stanmann571 wrote: »Please make up your mind.
I explained how I am defining obesity in one post (body fat percentage, not BMI) and why it is bad in another (a list of health issues.)
I have re-read 3 times and I still don't see where the issue is.
If you are taking my stance on body fat to mean that I do NOT think obese people are unhealthy then I have not made myself clear.0 -
This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
For people that participate in risky activities, an assessment by Reuben Feffer is in order:
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Where did I contradict myself?stanmann571 wrote: »Please make up your mind.
I explained how I am defining obesity in one post (body fat percentage, not BMI) and why it is bad in another (a list of health issues.)
I have re-read 3 times and I still don't see where the issue is.
because obese is a BMI term. overweight is a BMI term. They are defined by BMI
If you mean overfat. Say overfat.0 -
stanmann571 wrote: »
Where did I contradict myself?stanmann571 wrote: »Please make up your mind.
I explained how I am defining obesity in one post (body fat percentage, not BMI) and why it is bad in another (a list of health issues.)
I have re-read 3 times and I still don't see where the issue is.
because obese is a BMI term. overweight is a BMI term. They are defined by BMI
If you mean overfat. Say overfat.
No, obese is not a "BMI term" but it was made infamous when they put it on the BMI chart.
Obese is a medical term. I gave the proper medical definition of obesity based on body fat percentages.
Obesity (Etymology of obesity)
From French obésité, which is from Latin obesitas, which means "fatness," and from obesus, which means "something that's eaten itself fat." Roots are from "ob" (which means over) and "edere" which means to eat.
History of obesity
The first people to commonly recognize obesity as a medical condition were the Greeks. Hippocrates recognized it and stated that not only was being overweight a disease, but it also lent itself to the onset of other diseases. Sushruta, an Indian doctor in the 6th century BCE made the connection between obesity, diabetes, and heart failure, and stated that physical work (ie: exercise) would help cure all three diseases. Because of the scarceness of food throughout history, obesity came to be seen as a sign of the wealthy--those who could afford to overeat.
https://www.wyzant.com/resources/lessons/english/etymology/words-mod-obesity4 -
MoiAussi93 wrote: »AnninStPaul wrote: »If you aren't caring for your health, you should pay more. If you're diabetic and work with your physician to achieve control, you don't get a surcharge. If you're hypertensive and don't act to reduce your bp - lose weight, exercise, take anti-hypertensives - you get a surcharge.
This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
I don't think it is a slippery slope at all. People who are fit and active enough to routinely engage in sports such as climbing and mountain biking are highly unlikely to be obese. The occasional broken arm which necessitates a couple of x-rays, a cast, or...worst case scenario...an outpatient surgery...will be an insignificant cost compared to the lifetime of expensive drugs, hospitalizations, intensive care units, etc. that obese people are likely to eventually need.
One sports injury will likely cost less to treat (and be a one time event) than a single year's supply of the expensive drugs needed to treat obesity related chronic illnesses.
I am sure any insurance company would GLADLY choose the super active sports participant over the fat person who sits inside their nice and safe home. And they would charge the sporty person much less...which is fair.
You missed my point. I'm sorry I wasn't clear. You stated that people who already have a health condition such as hypertension or diabetes should have the extra costs waived if they are working on improving their health. I think that's a slippery slope because people who have no condition such as extreme sports athletes who are arguably reckless about their health from an injury standpoint could then be charged extra costs under this mind set. This is what could happen if insurance were NOT based on whether you already have a condition but based on efforts to avoid health risks...which is what you were proposing.
It's got nothing to do with obesity or rates for obese people versus athletes. You were proposing rates based on efforts to avoid health risks INSTEAD of rates based on actual health conditions.
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Hmm.. my point is that I -who work hard to remain physically fit and watch what I eat- do not want to pay for the health care costs associated with someone else being obese.stanmann571 wrote: »Yes, it's shocking, that the people who would suffer under your plan to tax us to supplement your care object.
But somehow you imply it means the overweight people would be supplementing *my* care?
You tried to turn the whole thing around. That isn't how a civilized debate or discussion works.
The whole point of Universal health care is that everyone supplements everyone's care. You look out for your neighbour and your neighbour looks out for you.
How can that be a bad thing?
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Instead of trying to punish people for being overweight and making more money for insurance companies (because if you think you are going to see any of that you are mistaken), why not reward those who are fit, don't smoke, and lead a healthy lifestyle? Oh wait! They do, they get lower premiums!0
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Because if your neighbor is NOT looking out after their own health and are constantly making poor diet choices instead then you have to cover that also.BigDougie1211 wrote: »
Hmm.. my point is that I -who work hard to remain physically fit and watch what I eat- do not want to pay for the health care costs associated with someone else being obese.stanmann571 wrote: »Yes, it's shocking, that the people who would suffer under your plan to tax us to supplement your care object.
But somehow you imply it means the overweight people would be supplementing *my* care?
You tried to turn the whole thing around. That isn't how a civilized debate or discussion works.
The whole point of Universal health care is that everyone supplements everyone's care. You look out for your neighbour and your neighbour looks out for you.
How can that be a bad thing?
How would you feel if every time I crashed my car YOUR car insurance went up?
Your car insurance costs continue to go up even though I have repeatedly been told I need to take a driving course - but I don't.
But again, I am advocating the Japanese system where they pay a additional tax for being too fat so I do not pay for those poor choices.
$147 billion worth of poor diet choices.
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MoiAussi93 wrote: »AnninStPaul wrote: »If you aren't caring for your health, you should pay more. If you're diabetic and work with your physician to achieve control, you don't get a surcharge. If you're hypertensive and don't act to reduce your bp - lose weight, exercise, take anti-hypertensives - you get a surcharge.
This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
I don't think it is a slippery slope at all. People who are fit and active enough to routinely engage in sports such as climbing and mountain biking are highly unlikely to be obese. The occasional broken arm which necessitates a couple of x-rays, a cast, or...worst case scenario...an outpatient surgery...will be an insignificant cost compared to the lifetime of expensive drugs, hospitalizations, intensive care units, etc. that obese people are likely to eventually need.
One sports injury will likely cost less to treat (and be a one time event) than a single year's supply of the expensive drugs needed to treat obesity related chronic illnesses.
I am sure any insurance company would GLADLY choose the super active sports participant over the fat person who sits inside their nice and safe home. And they would charge the sporty person much less...which is fair.
You missed my point. I'm sorry I wasn't clear. You stated that people who already have a health condition such as hypertension or diabetes should have the extra costs waived if they are working on improving their health. I think that's a slippery slope because people who have no condition such as extreme sports athletes who are arguably reckless about their health from an injury standpoint could then be charged extra costs under this mind set. This is what could happen if insurance were NOT based on whether you already have a condition but based on efforts to avoid health risks...which is what you were proposing.
It's got nothing to do with obesity or rates for obese people versus athletes. You were proposing rates based on efforts to avoid health risks INSTEAD of rates based on actual health conditions.
I didn't state that...it was somebody else. The lack of nesting in these threads make it hard to track who is responding to what! Maybe I missed some context to what you wrote because it was part of a previous reply.
My position is simply that obese people should pay more because they are a much higher risk and the payouts involved with them are likely to be MUCH higher than for the occasional minor accident with sporty fit people. Sporty people may have a slightly higher risk of minor injuries...but these injuries are relatively cheap to treat. They will not significantly impact the insurance company's profitability. Their overall risk is much lower because they are much less likely to develop heart disease, diabetes, various cancers, etc.
I think you have to charge based on actual health condition...and obesity is a MAJOR health condition. Maybe we are on the same page.
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stanmann571 wrote: »
Where did I contradict myself?stanmann571 wrote: »Please make up your mind.
I explained how I am defining obesity in one post (body fat percentage, not BMI) and why it is bad in another (a list of health issues.)
I have re-read 3 times and I still don't see where the issue is.
because obese is a BMI term. overweight is a BMI term. They are defined by BMI
If you mean overfat. Say overfat.
No, obese is not a "BMI term" but it was made infamous when they put it on the BMI chart.
Obese is a medical term. I gave the proper medical definition of obesity based on body fat percentages.
Obesity (Etymology of obesity)
From French obésité, which is from Latin obesitas, which means "fatness," and from obesus, which means "something that's eaten itself fat." Roots are from "ob" (which means over) and "edere" which means to eat.
History of obesity
The first people to commonly recognize obesity as a medical condition were the Greeks. Hippocrates recognized it and stated that not only was being overweight a disease, but it also lent itself to the onset of other diseases. Sushruta, an Indian doctor in the 6th century BCE made the connection between obesity, diabetes, and heart failure, and stated that physical work (ie: exercise) would help cure all three diseases. Because of the scarceness of food throughout history, obesity came to be seen as a sign of the wealthy--those who could afford to overeat.
https://www.wyzant.com/resources/lessons/english/etymology/words-mod-obesity
CDC and NHS disagree with you. I'll go with them.
https://www.cdc.gov/obesity/adult/defining.html
http://www.nhs.uk/conditions/Obesity/Pages/Introduction.aspx0 -
AnninStPaul wrote: »If you aren't caring for your health, you should pay more. If you're diabetic and work with your physician to achieve control, you don't get a surcharge. If you're hypertensive and don't act to reduce your bp - lose weight, exercise, take anti-hypertensives - you get a surcharge.
This makes sense but it's a slippery slope. What if "caring for your health" extended to not engaging in extreme sports? Free climbing, wind suit jumping, paragliding, mountaineering, bmx trick riding, downhill mountain bike racing, white water rafting/kayaking, sky diving, etc. One could argue that taking risks of injury and death is not really caring for you health. We could all end up being limited to exercise machines indoors like hamsters.
Free climbing means the rope is only there for protection against a fall, it's not there for "aid" (for use in upward motion, eg with prusiks).
The thing about the slippery slope fallacy is that these are business decisions made by actuaries, using data.
Obesity related illnesses are the #1 expense facing our health care system. They've surpassed smoking related illnesses! Mountaineering related illnesses probably don't make the top million list.
People bring up the slippery slope fallacy as if scorned obese people are going to impose a health tax out of spite.I think that's a slippery slope because people who have no condition such as extreme sports athletes who are arguably reckless about their health from an injury standpoint could then be charged extra costs under this mind set.
It doesn't matter if something is "arguably reckless," it matters that something is demonstrably expensive.7
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