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

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Replies

  • BigDougie1211
    BigDougie1211 Posts: 3,530 Member
    I can't comment on this with any first hand knowledge really, because I am incredibly lucky to have access to the National Health Service, but I'm wondering something.
    If you drive a faster car, or play football, or ride a motorcycle etc - do these impact your health insurance costs?
    Or, for example, if you live in an area where it's more likely you'll be involved in an altercation?
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    I can't comment on this with any first hand knowledge really, because I am incredibly lucky to have access to the National Health Service, but I'm wondering something.
    If you drive a faster car, or play football, or ride a motorcycle etc - do these impact your health insurance costs?
    Or, for example, if you live in an area where it's more likely you'll be involved in an altercation?

    Yes, driving certain cars, living in certain areas, riding a motorcycle and some risky hobbies can impact your insurance costs.
  • DeficitDuchess
    DeficitDuchess Posts: 3,099 Member
    edited May 2017
    Both no/yes but with, no being; 1st because weight management, isn't common sense & thus until it's a requirement via schools for children/mandated to obtain insurance coverage for adults to, visit with a Registered Dietitian we'd be penalizing anyone for not knowing naturally what someone has; to obtain a college education to know! Once someone receives the knowledge necessary then yes 2nd if, they don't apply it by meeting reasonable weight expectations within; a year! When you know that you've the ability to, control your weight it's your; responsibility to do so! Businesses already charge, extra for; plus sizes because they, use more; fabric & thus it's unfair to expect a clothing manufacturer to, absorb those costs just as it's to; expect the taxpayer to for your health! Of course, the difference between; a business & government's that a business doesn't consider, why you're plus size to; charge you extra but the, government'd/does! However I, don't view it; as a penalty but as, a financial responsibility for; your choices! Obviously if you desire to reside within a larger house than you're able to, currently afford then you must figure how to; afford it upon your own accord! The same should apply to, the choices that lead to'ving a; larger body also!
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    I think people saw my HSA comment and focused on that, but my real point was that catastrophic health care and "everyday" health care are two different animals and should be dealth with differently. When the comment is made that everyone will eventually need health care, I can concede that, but only for the latter. Plenty of people go thru life without actually using catastrophic/accidental care, which does fit the insurance model. But maybe a different type of coverage is needed for stuff like pregnancy, physicals, blood pressure, arthritis, your average non threatening visit, and other regular health care BECAUSE those expenses are going to occur.

    When I get wonky on the issue, I pretty much agree with this, but where it breaks down relates to the development of chronic type illnesses which become increasingly common as one ages (and why we need Medicare, as old people could not be covered with an insurance model).

    One issue is that routine coverage probably could be dealt with through the market and would be responsive to price (although you would still need related catastrophic for things like pregnancy complications). The drawback to this--especially related to this discussion--is that that would tend to DISCOURAGE use of medical care, and we actually want to encourage routine care for preventative effects, including with obesity. If there are interventions that could help with obesity, I'd like them to be made.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited May 2017
    Packerjohn wrote: »
    I can't comment on this with any first hand knowledge really, because I am incredibly lucky to have access to the National Health Service, but I'm wondering something.
    If you drive a faster car, or play football, or ride a motorcycle etc - do these impact your health insurance costs?
    Or, for example, if you live in an area where it's more likely you'll be involved in an altercation?

    Yes, driving certain cars, living in certain areas, riding a motorcycle and some risky hobbies can impact your insurance costs.

    He asked about health insurance. They don't affect health insurance costs, although of course they do affect car insurance costs.

    If we had real underwriting for health insurance, they presumably would, although not for those under the employer model.
  • pinuplove
    pinuplove Posts: 12,874 Member
    lemurcat12 wrote: »
    I think people saw my HSA comment and focused on that, but my real point was that catastrophic health care and "everyday" health care are two different animals and should be dealth with differently. When the comment is made that everyone will eventually need health care, I can concede that, but only for the latter. Plenty of people go thru life without actually using catastrophic/accidental care, which does fit the insurance model. But maybe a different type of coverage is needed for stuff like pregnancy, physicals, blood pressure, arthritis, your average non threatening visit, and other regular health care BECAUSE those expenses are going to occur.

    When I get wonky on the issue, I pretty much agree with this, but where it breaks down relates to the development of chronic type illnesses which become increasingly common as one ages (and why we need Medicare, as old people could not be covered with an insurance model).

    One issue is that routine coverage probably could be dealt with through the market and would be responsive to price (although you would still need related catastrophic for things like pregnancy complications). The drawback to this--especially related to this discussion--is that that would tend to DISCOURAGE use of medical care, and we actually want to encourage routine care for preventative effects, including with obesity. If there are interventions that could help with obesity, I'd like them to be made.

    I agree with the bolded, very much!
  • millcreekr
    millcreekr Posts: 25 Member
    Isn't this a pre-existing condition? I thought with the health care system in place, and even the one the legislature is considering, people with pre-existing conditions would not be penalized. Maybe the soda companies and candy companies and potato chip companies and fast food restaurants should be penalized, how's that for an idea? Maybe they should have to pay a health care tax or something like that (healthy tax?), and then they would pass the cost to the people who buy food there. Put the tax up so high just like the cigarette tax, and maybe some folks would automatically stop eating those foods. Of course, I am speaking "tongue-in-cheek", as this is a preposterous notion to me, but what a great topic for discussion!
  • cppeace
    cppeace Posts: 764 Member
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.
  • NorthCascades
    NorthCascades Posts: 10,970 Member
    millcreekr wrote: »
    Isn't this a pre-existing condition? I thought with the health care system in place, and even the one the legislature is considering, people with pre-existing conditions would not be penalized.

    The legislation that was just repealed was preX friendly. The new legislation replacing it is not.
    millcreekr wrote: »
    Maybe the soda companies and candy companies and potato chip companies and fast food restaurants should be penalized, how's that for an idea?

    That's pretty bad as ideas go. Those companies weren't doing anything illegal. Nobody was forced to go out and buy potato chips and soda. People bought that stuff because they liked it; those companies made that stuff because people wanted it.
  • Leenizi129
    Leenizi129 Posts: 133 Member
    To be politically correct, I will say it is based on circumstances but nothing really is set up to help us in the proper way, it should based on individual circumstances. It is all about the money all the time! Never about really helping the people that need to be helped. They got it all wrong!
  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
    edited May 2017
    cppeace wrote: »
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.

    And you think this is a good idea? To not go in for annual physicals/well checkups, to make sure everything is ok? There's numerous medical conditions that don't have symptoms-for example I was a pre-diabetic and had no clue. My fil is another example-no symptoms at all, went in for a routine physical and found out his blood pressure was so high that he was at very high risk for stroke.

    eta: clarity
  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
    edited May 2017
    Leenizi129 wrote: »
    To be politically correct, I will say it is based on circumstances but nothing really is set up to help us in the proper way, it should based on individual circumstances. It is all about the money all the time! Never about really helping the people that need to be helped. They got it all wrong!

    In what circumstance do you think an insurance company is going to look at someone who has a very high bmi, and not want to charge them more because of the risks that come along with their weight? What individual circumstances do you think would negate this? (genuinely curious).
  • janejellyroll
    janejellyroll Posts: 25,763 Member
    Packerjohn wrote: »
    Packerjohn wrote: »
    One question that should be answered, is an insurance based solution a good methodology for ALL medical costs? If you think about it, home owners insurance, auto insurance, flood insurance, are all based on dealing with unexpected catastrophic events. Maybe another model is needed for more predictable events, such as the savings model like HSAs.

    Sure that is were the high deductable plans and HSA's come in. The challenge is the average American family has less than $1,000 in a savings account:
    https://www.fool.com/investing/2016/09/25/how-much-does-the-average-american-have-in-their-s.aspx

    Have to get people's mindset to save instead Starbucks everyday, the newest iPhone, etc.

    I could skip Starbucks every day for a year (in fact, I guess I did because I never go) and it wouldn't have covered the co-pay we had when my husband accidentally cut his hand last year. We're relatively fortunate with our high deductable plan because we don't use a lot of health care, but it doesn't take much to wipe an account completely out.

    The Starbucks is just an example not to be taken literally. The problem with high deductable plans and HSAs it the savings rate in the US is already so low. Some people could increase their savings rate by reducing spending on luxury items like $5 a cup coffee. Some could not.

    I'm sorry that I took your example too literally. My point is that skipping little luxuries like Starbucks isn't really the solution to health care costs. My husband and I already save much more than the average American family, including what is in our HSA and one (minor) medical event was still a pretty big expense for us. If it was something major like a significant illness or accident . . . Starbucks or skipping a new phone is going to be the answer.

    I'm not saying people shouldn't save money. I think we should and live that value in my own life. But it seems like a savings account is much more useful when it comes to emergencies like car trouble than it is for medical needs. I make all my coffee at home, it isn't going to help me swing chemotherapy bills.

    Don't most HSA accounts go hand in hand with high deductible insurance plans? (we've had several HSA/high deductible combos, including our current one). So after you get your HSA built up, that should cover the cost of the high deductible if someone runs into high medical costs. With your chemo example-the HSA account balance covers the cost of the deductible and then the insurance part kicks in and covers the big medical bills. The kicker is to get the HSA account built up asap and hope nothing big hits until you get that set aside.

    We had our HSA built up pretty nicely until last year, when we had several thousand dollars of dental work happen. So at the time of our dd's accident a few weeks ago our HSA balance was around $400. That, along with new bi-weekly deposits (automatically deducted from dh's paycheck), will cover all the smaller dr. bills coming in but then we'll have to cover the bigger hospital bill oop. As a follow up to my previous posts-the $7,000ish bill has cleared claims and our oop expense will be $2,871. With that amount we've decided to just pay it right away from our regular savings, and not bother with their payment option. The bill breakdown didn't have any crazy surprises (no $50 gauze), and it did include the CT scan as well. My husband and I were actually surprised it wasn't more, considering everything it covered.

    I don't know if most HSA plans are paired with a high deductible, but mine is. We built ours up and it covered the cost of the care for my husband's hand. My point is that just skipping Starbucks or not buying a phone isn't going to allow us to save enough to meet the cost of our deductible.

    This isn't really me bellyaching about my situation -- we're doing fine. That we're doing well is kind of my point. My husband and I are childless, don't have a car payment, live very reasonably, don't have any more student loan payments, and I have a good job. And it's still a consideration for us. For people who aren't in our situation, I'm not sure how practical it is to expect a HSA to bridge the gap.
  • Bry_Fitness70
    Bry_Fitness70 Posts: 2,480 Member
    cppeace wrote: »
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.

    Not going to the doctor frequent enough will be more costly than going too often, if a significant medical condition is not detected and treated early. I know people who are in poor health who have avoided getting physicals for years - all that does is change the nature of the treatment from preventative to reactive, and will end up costing a lot more than having regular periodic checkups.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member

    cppeace wrote: »
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.

    And you think this is a good idea? To not go in for annual physicals/well checkups, to make sure everything is ok? There's numerous medical conditions that don't have symptoms-for example I was a pre-diabetic and had no clue. My fil is another example-no symptoms at all, went in for a routine physical and found out his blood pressure was so high that he was at very high risk for stroke.

    eta: clarity

    Right -- from the point of view of an insurer, it would probably be better to cover someone who gets routine care (which is inexpensive) and thus is more likely to have preventative care that protects against some more expensive costs down the road. But who knows!

    Main expense of medical care has 0 to do with how often you have check-ups, though, or even if you go in to get penicillin because you have strep.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    cppeace wrote: »
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.

    So as obese person who has been lucky you think you should pay less than people who go to the doctor a couple times a year for maybe a check up or a sinus infection, maybe $300 a year. What do you think you should be paying when a big one hits and you rack up a $300k medical bill in a year and the normal weight people you speak of have their $300 for a couple sinus infections?
  • Gisel2015
    Gisel2015 Posts: 4,130 Member
    cppeace wrote: »
    It should be based on your actual health/how much you go to a doctor. I haven't been in 3 years- before that it was only once in 3 years. I've been to a doctor maybe 6 times in 15 years. I'm obese and have been so almost my whole life. I know plenty of "normal" weight people who go 2-6 times a year.

    So you don't get pap smears or breast examinations either, what about testing your blood glucose and BP? There is a high risk for complications for being obese and just because you don't have any problems right now doesn't mean that you will not in the future (hopefully you never will)? Wow, that is too risky.
  • Merrysix
    Merrysix Posts: 336 Member
    The whole point of health insurance is to spread the risk -- the way you do that is have large pools of people, all of who enroll (and are encouraged to do so) by paying reasonable premiums. Once you start dicing and slicing risk pools, then insurance becomes too expensive for vast numbers of premiums, and the whole point of spreading the risk (and reducing the cost) is lost.

    Everybody has different risk factors (as has been pointed out here) -- to set everyone in different risk pools is counterproductive to the whole notion of health insurance. Also, the idea of health insurance (which is why high deductible policies don't make economic sense) is for people to seek health care early before the health condition gets out of control and is very expensive to treat (e.g. Type 2 diabetes) -- causing health insurance to be too expensive is a disincentive for people to get insurance -- then they can't afford preventative health care.

    I studied these things when I got my graduate degree in public health. Most people don't really have an opportunity to learn about health insurance, or health care for that matter. For example, accessibility without affordability means nothing when it comes to getting the health care you need. It has to be both accessible and affordable.

    Finally, there are quite a few studies that show exercise is more important to health than weight, etc., etc.