Do you think obese/overweight people should pay more for health insurance?

_emma_78

My mom and I were discussing this today and I thought it would be a great topic for this forum, especially with all the politics surrounding health care these days.

So do you think people who are overweight and/or obese should have to pay more?

Do you think this would be a deterrent to gaining weight for people that are not in this category?

Should people with medications/medical conditions that cause weight gain be exempt?

I know that with obamacare/ACA there are wellness programs available, do you think these are all that helpful if you've been to one?

heiliskrimsli

If a smoker can be charged more, so should the overweight and obese.

estherdragonbat

I think it's one more factor that should impact cost, though I have my doubts as to whether it would be a deterrent.

Speaking for myself, I'm an emotional eater and a boredom eater. When I'm feeling stressed and anxious, my instinct is to reach for food. So, what do I think worrying about my insurance premiums is going to do to my anxiety levels? I know exactly what'd go through my head. Note: I'm in Canada, but we still have some medical expenses that aren't covered by our healthcare. "I'll worry about my weight when things calm down. Oh no! How can I afford these higher premiums?" And then I'll make myself a PB&J sandwich to cope. I think you can imagine the rest.

That doesn't mean, btw, that I disagree with the premise that people in higher health-risk categories should have to pay more. It was developing an obesity-related condition that got me here at MFP and losing weight in the first place. But the people who would be deterred from gaining weight by this policy are, I suspect, by-and-large going to be the people who are already mindful of what they eat and trying to avoid gaining. "So, not only do I want to keep wearing last year's bathing suit, but I don't want my premiums to go up!" Do you know how many times my doctor told me to lose weight (and some well-meaning busybodies)? I didn't listen until my health suffered. I honestly don't think the higher premiums would do anything other than annoy me; but not enough to actually do something.

Not sure about the medications/conditions. I mean, it would be nice if it were, but I suspect that insurance companies would point to something we see in these forums: "There are conditions that make weightloss harder. It's still not impossible."

One suggestion. Some years ago, my husband and I bought a house and 5% of the electrical wiring was 'knob-and-tube', which was fine 70 years ago, but not up to the electrical demands of the 21st century. Our home insurance company gave us 6 months to replace it. I would say that if someone falls into a borderline category (Say, 10-30 lbs overweight), they be given a reasonable period to correct the situation before the higher premiums go into effect.

kimothy38

Paying more because of increased health risks is a fact of life I reckon. Certainly doesn't act as a deterrent for me, unfortunately. If I lose weight and keep it off for a year I can get the levy removed. What happens if is slim when they get the insurance and then gets fat? All those years of extra levies the insurance company has missed out on, and then probably refuses to pay out anyway.

_emma_78

One of the cons is that employers could say they don't want to hire people based on weight because of health insurance costs. Many employers do this with smokers already though.

heiliskrimsli

_emma_78 wrote: »

One of the cons is that employers could say they don't want to hire people based on weight because of health insurance costs. Many employers do this with smokers already though.

I don't think that's a con at all.

Carillon_Campanello

Slippery slope IMHO.
1st...smokers.
2nd...obesity.
next????
Genetic predispositions based on DNA.
What you ate for dinner.
How much sleep you get.
How fast you drive your car to work.
What type of activities you do or don't participate in after work hours.

Where does it stop?
Corporations already have the power of PACs pushing corporate agendas.
Do we really want to encourage them to take more power when it comes to how they price health insurance based on varying factors?

"Careful what you wish, you may regret it. Careful what you wish, you just might get it"

And of course it will all be in the name of "saving the company a few bucks" and "controlling skyrocketing insurance costs" which invariably get passed to you anyway. Yes...even the healthy "you" in the form of cost increases that outpace standard of living wage increases.

richardgavel

The point isn't necessarily to encourage overweight people to lose weight, but to get them to shoulder most of their health costs for a result that (in most cases), is due to their own actions. Especially since weight related issues ranks high on health care costs.

chunky_pinup

Nope. You cannot prove a medical condition is due to weight all of the time. Likewise, not all obese people have additional health problems. You can also have weight gain due to a pre-existing medical condition. Then there are those that are medically obese, but BMI is a poor calculating factor for them. This is healthcare discrimination.

_emma_78

chunky_pinup wrote: »

Nope. You cannot prove a medical condition is due to weight all of the time. Likewise, not all obese people have additional health problems. You can also have weight gain due to a pre-existing medical condition. Then there are those that are medically obese, but BMI is a poor calculating factor for them. This is healthcare discrimination.

Just curious if you feel the same way about smokers as well!

Carillon_Campanello

heiliskrimsli wrote: »

_emma_78 wrote: »

One of the cons is that employers could say they don't want to hire people based on weight because of health insurance costs. Many employers do this with smokers already though.

I don't think that's a con at all.

My employer doesn't hire smokers.
They also have a surcharge on insurance premiums to any "grandfathered" smokers that were employees prior to this policy being enacted.

With the % of Americans that are considered obese the backlash would be far and wide (is that a pun...no offense).

I see how this could be construed as a "surcharge" or penalty against employees that are obese. I think the litigation that followed directly after (and likely prior too) would vastly outweigh any cost savings benefits of an "obesity surcharge" on the premiums. When looking at the number of Americans that are obese...It's a pretty big hornets nest to kick and expect little repercussions.

Carillon_Campanello

So I guess my short answer is "no".

KimbersNewLife

Yes and I am obese... there are so many illnesses and issues that stem directly from weight. Excess weight is actually listed as a cause on my medical record. I had heart problems when I had my son. My chart says cause of acute event: obesity as a result of high calorie intake... that is what is listed on my medical record as a fact and yes it is my fault and they are correct I was eating too many calories therefore I was over weight. It is frustrating to me that I caused my own major health event and I haven't fixed it yet. But that's another story. I do not know if a penalty would help people not do this to themselves but it's fair because it can offset some of the insurance costs for society as a whole. If this can be done in every case, when the cause of a medical problem is the direct result of dietary decisions unless the weight is caused by another underlying medical issue in which case that person's doctor should work with them to resolve it.... Since you asked ;-)
Excuse the run-on sentences... I am exhausted LOL

JeromeBarry1

A person would see the insurance bill, get on mfp and lose 20 lb, then sue the provider for discrimination.
Any legal remedy protecting the provider would be overturned.

Overweight and obesity is so quickly and easily changed, in either direction, as to make the implementation of such a pricing mechanism fraught with complexity.

We already have life insurance that charges more for obesity and high blood pressure. The price of it never convinced me to lose weight.

raleighgirl09

Yes, I think that factors of health should be taken into account for all of us, including age. Young trim people who don't smoke and who exercise regularly will use less health care than I will, in general. 53, overweight, former smoker - take some round bits nightly for blood pressure and cholesterol. There are no emotions in these facts, they just are.

Wbaere

In principal I agree, that if your body makeup increases your chances of hypertension, heart disease and diabetes, you should be subject to higher premiums. But shouldn't the premiums really only go up once these issues actually present themselves? Once they do, most people will unfortunately opt for medication, rather than making a lifestyle change that could mitigate the issue. How do you 'reward' the minority that actually does the work to change eating and activity habits?
Also for that matter - how do you measure obesity? If you use BMI, then healthy, athletic/muscular build folks may end up paying more, even though they are far healthier than someone that may be harmfully underweight.

Interbeing

My company provides cash incentives for reaching fitness goals. $160 for a wellness check, then $60 for various goals, up to a maximum of $400. Goals include reaching a workout goal, drinking water, maintaining a minimum number of step average, maintaining BMI within normal range, We were even provided a Fitbit Aria Smart Weigh Scale to automatically upload our weight on a weekly basis and Fitbits to record our steps. Smokers are charged an extra $200 surcharge, so while there is no extra charge for being overweight per se, there is an incentive for getting, and maintaining a minimum fitness level.

pinklife1117

Morbidly obese- hell yes! Only fair since being morbidly obese cause so many health issues over time that are preventable for the most part if you start eating better and moving even a little. Smokers, alcoholics, morbid obese... I worked on a Medicare contract for three years and you would be amazed at all the fat old people who have Dx 250.00 (II)

tomteboda

I say that people who use health care should have to pay more for insurance. Put a 50% increase on your premium for each doctor visit. Another 50% increase for every prescription. 50% if you need lab tests or any scans. It's not fair healthy people pay for sick people.

MoiAussi93

Yes, obesity greatly increases the risk of developing a wide range of expensive diseases. It's fair that overweight/obese people pay more. Smokers pay more for the same reason. This is no different.

maxhan231

By this logic, anyone who does things that are detrimental to their health should be charged extra for health insurance... people who don't get enough exercise, people who eat unhealthy, people who have unsafe sex or many sex partners, people who work in coal mines or with pesticides. You can't pick and choose

Theo166

Cost sharing is appropriate but there should also be consequences for things under your control. If your behavior affects your car insurance, why not health insurance.

Conversely we should also increase price transparency and competition for basic services. Annual check up and blood work should be affordable, even if they treat it like an assembly line to keep the costs low.

I don't put much faith in 'wellness programs' since people mostly know they have problems with their lifestyle. We probably need more PSA type marketing on the benefits of healthy living. We have a marketing problem.

dutchandkiwi

No I don't -
Then smokers should pay more
Oh and people that go skiing (break way more limbs) and those that drive cars (major reason of injury)
The ones that work in high risk industry (oil rigs etc) Chemical industry (cancer risks)
Oh and those that have children when they know heditary diseases run into one of the family? For instance in my family asthma runs in the family (I have it too) should I pay more? Or in my husbands family heditary heart conditions and heditary diabetes 2 (yes there is a genetic link) Should they pay more?
Or the people in Volendam where there is a specific disease local and genetic Yet they insist on procreating Should they pay more?
Or the people that have the audacity to get really old and cannot move anymore? My grandmother had a fall at 72, broke her back, went blind and deaf. Needed increasing care as a result. Should she pay more as she fell over a chair she'd left a little carelessly in the wrong spot? After all she lived until 86.

Where do you stop? So I say no. There are things we cannot control, there are things we can but still do and we all do something that the other considers to be stupid and possibly endangering our own health. We share the burden

I am in favour of programs that help people to get things back under control and to give support where needed/wanted. I am in favour of using tax where food is generally considered to be not that healthy (soda/pop/carbonated sugar waters). But health insurance, no that is not a good incentive

Lounmoun

So do you think people who are overweight and/or obese should have to pay more?
No, I don't think people who are overweight or obese should pay more for health insurance.

Do you think this would be a deterrent to gaining weight for people that are not in this category?
I think it would deter people from getting health care they need if insurance becomes more unaffordable. Trying to punish/threaten people to stay thin is not promoting health IMO.
I think standards would be tightened up so more people would be considered overweight by insurance companies not based on their actual health. I think it would lead to more discrimination of people based on size.


Should people with medications/medical conditions that cause weight gain be exempt?
Why should they? If they are overweight then they have the same increased health risks as a person who got there without medications or medical conditions. How is their fat body exempt if it potentially causes the same health problems?

iofred

smoking is a "touchable" source, so what are you going to base obese on? Weight? BMI? Fat percentage, these are all figures that are either very shadowy/incorrect, or can fluctuate greatly

JeffreyOC

Charging more for obesity would certainly have to lead to charging more to anyone significantly underweight. What measure would be used to figure out who to charge more? BMI is not a healthy measure for everyone, placing people into a box and forcing them to pay money for being outside of that infringes on many areas of life.

TARGET65K

This discussion makes me realise how lucky I am living in Europe.
Loading is not allowed here. If you need medical help its their for you regardless of your situation.

Chef_Barbell

No. Sounds like a slippery slope and where does it stop?

nevadavis1

Should you charge more for someone whose parents had cancer? What if they grew up in foster care (childhood neglect and abuse are associated with a whole host of health issues later in life)? Should their genes be tested and then we charge more for anyone predisposed to any disease?

nevadavis1

Also charging more just means that more overweight and obese people won't get health coverage and will not get preventative care and then won't see a doctor until they wind up in the ER with something life-threatening.

lemurcat12

Theo166 wrote: »

Cost sharing is appropriate but there should also be consequences for things under your control. If your behavior affects your car insurance, why not health insurance.

Problem is that health insurance is nothing like car insurance because it is not freely underwritten because the truth is it's not really insurance. It covers fixed costs and, of course to the extent it covers pre-existing conditions (and can't charge more for them) that's another huge way it's not insurance.

I don't care about this, but I think we need to be honest that it's not really an insurance model and people don't really want the insurance model. (The number of people who would not be able to get insurance or would pay way, way, way more for it if it were actually based on individual underwriting is huge, and this would also probably lead to people not getting medical care -- just like minor accidents often are not reported or other possible claims on insurance forgone in other areas -- to avoid losing/cost increases with insurance. Most don't realize this, because most (or enough, anyway) are protected from this by group employer insurance. They don't connect their own actions to costs.)

Anyway, I'm not opposed to having some kind of surcharge for obesity, but it would be a pain and how does one do it, rely on self reporting? (I'm not sure how the smoking thing works.) Seems to me that it's essentially the same as those wellness programs in reverse (paying less for being normal weight=paying more for being overweight if the total is the same, obviously). But what we realistically cannot and will not have is actual underwriting based on risks.

(I think the political pressure is such that paying more for health insurance also will not happen, and it does open the door to other intrusions -- like in diet? -- that I think most would oppose.)

I don't put much faith in 'wellness programs' since people mostly know they have problems with their lifestyle. We probably need more PSA type marketing on the benefits of healthy living. We have a marketing problem.

I think wellness programs are about exercising, reducing cholesterol, reducing weight. I don't think they work that well, but I do think having specific goals and action steps that have specific shorter term rewards has more potential for changing behavior than reliance on general "I know should lose weight and exercise more and eat better, but it's all overwhelming and I don't really know what to do and will do something someday." There is some evidence that people who change their behaviors often do it as a result of being told that it will have specific health consequences -- this helps with the long-term/short-term reward issue by making it more concrete and short-term. I think such a thing might have been helpful for me (maybe, maybe not), as I knew I should lose weight but put it off in part because I had no feeling of urgency -- my health and tests were always good and I knew it was a risk but kept thinking I could fix it later. (Ultimately it wasn't health but just being disgusted with myself and wanting to be more active and fit and look better that motivated me. I was sick of feeling depressed and miserable every time I bought clothes or someone pulled out a camera.)