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

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  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
    edited May 2017
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    This is already in place for our insurance. Smokers pay more as well, and staring next year those with bad blood work numbers will also pay more. We'll pay higher premiums for my husband with the new rule next year and I don't have a problem with that-he's a higher risk for needing costly medical care. Getting an insurance policy through the company is optional so if someone doesn't agree with these policies they don't need to participate.

    edit: grammar
  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
    edited May 2017
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    lemurcat12 wrote: »
    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.)

    It's already implemented for our insurance and every October (during open enrollment), employees and their spouses have to go in for mandatory health screenings (if you want insurance through the company). Basic blood work (cholesterol, glucose etc), weight, blood pressure and waist measurements are taken. They run a specific blood test to detect smokers as well. BMI is figured out during this visit.
  • Penthesilea514
    Penthesilea514 Posts: 1,189 Member
    edited May 2017
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    crazyycatladyy1 wrote: »

    It's already implemented for our insurance and every October (during open enrollment), employees and their spouses have to go in for mandatory health screenings (if you want insurance through the company). Basic blood work (cholesterol, glucose etc), weight, blood pressure and waist measurements are taken. They run a specific blood test to detect smokers as well. BMI is figured out during this visit.

    Same at my previous employment through the state- we had state run health insurance for state employees that started rolling out these wellness visits as mandatory- or you get a $500 deductible increase. Next year, if you don't have a doctor's "excuse" then if you test poorly in these metrics, it is a deductible increase. It included all that CrazyCatLady mentioned. I no longer work there, however, and my new insurance doesn't have those requirements at the moment.

    So it is already kind of starting in many places in the US.
  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
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    nevadavis1 wrote: »
    BMI isn't a great measure though, as some people will have a high BMI but low body fat--if they work out a lot. My husband lifts weights for example.

    Do you know what your husband's bmi is? For our insurance-the bmi number is quite high for the penalty (into the obese category).
  • crazyycatladyy1
    crazyycatladyy1 Posts: 156 Member
    edited May 2017
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    Penthesilea514 wrote: »
    crazyycatladyy1 wrote: »

    It's already implemented for our insurance and every October (during open enrollment), employees and their spouses have to go in for mandatory health screenings (if you want insurance through the company). Basic blood work (cholesterol, glucose etc), weight, blood pressure and waist measurements are taken. They run a specific blood test to detect smokers as well. BMI is figured out during this visit.

    Same at my previous employment through the state- we had state run health insurance for state employees that started rolling out these wellness visits as mandatory- or you get a $500 deductible increase. Next year, if you don't have a doctor's "excuse" then if you test poorly in these metrics, it is a deductible increase. It included all that CrazyCatLady mentioned. I no longer work there, however, and my new insurance doesn't have those requirements at the moment.

    So it is already kind of starting in many places in the US.

    Yep, that's exactly how they rolled out the changes-at first there was incentives, then penalties. They gave us plenty of notice though (several years), so none of it was a surprise. They also offer all sorts of resources for those who want help to change things.

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