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

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Replies

  • stanmann571
    stanmann571 Posts: 5,727 Member
    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.


    And some people are skinny fat... low muscle mass, above average fat, normal, or low overweight BMI...
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    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.

    Interesting. I'm used to not having to do anything at all after the initial opt in (which was a form, not anything else). I've gone years without a check-up at times (I am irresponsible about medical stuff, admittedly), so I guess this would prevent people from doing that kind of thing.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    Wattyz wrote: »
    Every insurance has a maximum they pay, right?

    No, they don't. Often there's a deductible before they kick in, but a good policy should not have a maximum.
  • Sp1tfire
    Sp1tfire Posts: 1,120 Member
    edited May 2017
    I can see this being a good idea, but I feel exceptions should be made for those with diagnosed low metabolism. Forgot what its called. . Of course, their medical bills will already be higher to treat that probably.
  • mskimee
    mskimee Posts: 228 Member
    ninerbuff wrote: »
    IMO, until the US healthcare system isn't a FOR PROFIT venture, people will end up spending their retirement income and savings on it. See how much it costs to get hospitalized or how much medication costs for people who need it. It's pretty astounding and outrageous.
    We could pay for ALL AMERICANS healthcare, it's just that our government chooses to spend more of taxes towards the military might instead.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png

    Dd was hospitalized a couple weeks ago and so far we have a $7,000 hospital bill pending. That will probably be for the ER (which in the past has run us around $1,000), and then most likely her one night stay, (since the claim is pending it doesn't have the breakdown available yet for what services it's for).


    I have nothing to add, but I'm not in the US so i'm curious. What if you didn't have the ability to pay the bill for the hospital? Or if you had no insurance? Surly a hospital would still give a critically ill person the same service? I mean, no parent would ever be told "we can save your child as long as you can pay X amount..."

    right??
  • bizgirl26
    bizgirl26 Posts: 1,795 Member
    I do think they should pay more but not if they are overweight , just obese. I do think it is fair but I also feel there should be more incentives offered to motivate people. I have fought for my health benefits to pay for gym memberships but the issue is that they don't know how they would monitor it and it is possible that everyone would sign up and not go . They do offer courses that give me "wellness credits" that I can apply for gym memberships, running shoes , sports equipment etc but I can only accumulate around $ 140 or so a year . Its better than nothing
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    earlnabby wrote: »
    lemurcat12 wrote: »
    Wattyz wrote: »
    Every insurance has a maximum they pay, right?

    No, they don't. Often there's a deductible before they kick in, but a good policy should not have a maximum.

    the ACA made maximum's illegal.

    I know, but who knows what law is going to apply.
  • dmwh142
    dmwh142 Posts: 72 Member
    If this is going to be done at all it should be done in the positive way by rewarding those with healthy habits with a discount. I think that would get a more positive response.
  • BurlzGettingFit
    BurlzGettingFit Posts: 115 Member
    dmwh142 wrote: »
    If this is going to be done at all it should be done in the positive way by rewarding those with healthy habits with a discount. I think that would get a more positive response.

    I agree, we have so many different incentives through work to make better choices and try and be healthier and usually the only people taking advantage of them are the ones who are healthy already.
  • _emma_78
    _emma_78 Posts: 64 Member
    If healthy weight people were to get discounts wouldn't that almost be the same as the rest having to pay more? It's just worded differently but essentially the same thing.

    My health insurance also pays for part of a gym membership, but which gyms they do this for is very selective and often times not worth the 30+min commute.
  • BurlzGettingFit
    BurlzGettingFit Posts: 115 Member
    _emma_78 wrote: »
    If healthy weight people were to get discounts wouldn't that almost be the same as the rest having to pay more? It's just worded differently but essentially the same thing.

    My health insurance also pays for part of a gym membership, but which gyms they do this for is very selective and often times not worth the 30+min commute.

    I don't think so since they wouldn't be raising the amount for anyone, but lowering it through incentives for staying healthy so if you stay at the same amount you'd normally pay that's on you.
  • brittyn3
    brittyn3 Posts: 481 Member
    _emma_78 wrote: »
    If healthy weight people were to get discounts wouldn't that almost be the same as the rest having to pay more? It's just worded differently but essentially the same thing.

    My health insurance also pays for part of a gym membership, but which gyms they do this for is very selective and often times not worth the 30+min commute.

    If health companies really cared about it's subscribers, they would make sure you have all the tools to be healthy. Such as paying for gym memberships, etc.
  • BurlzGettingFit
    BurlzGettingFit Posts: 115 Member
    _emma_78 wrote: »
    If healthy weight people were to get discounts wouldn't that almost be the same as the rest having to pay more? It's just worded differently but essentially the same thing.

    My health insurance also pays for part of a gym membership, but which gyms they do this for is very selective and often times not worth the 30+min commute.

    Out of curiosity do you know why they're selective about which gyms they reimburse for? I'd think a gym you join is a gym to be reimbursed for.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    edited May 2017
    bizgirl26 wrote: »
    I do think they should pay more but not if they are overweight , just obese. I do think it is fair but I also feel there should be more incentives offered to motivate people. I have fought for my health benefits to pay for gym memberships but the issue is that they don't know how they would monitor it and it is possible that everyone would sign up and not go . They do offer courses that give me "wellness credits" that I can apply for gym memberships, running shoes , sports equipment etc but I can only accumulate around $ 140 or so a year . Its better than nothing

    Some divisions of my company did this for a while. It was a cluster *kitten*, not fair and dropped. In our case, to get up to a $30 reimbursement you had to have front desk person at the club sign a form or provide a monthly printout of your check in times. If you went 8 times during the month and provided proof you got the $. Of course now way of telling what anyone did there. Someone spending 20 minutes on an elliptical twice a week was getting a benefit, but someone running 5 miles a day outside was most likely in better shape and got no benefit.
  • ccrdragon
    ccrdragon Posts: 3,374 Member
    zyxst wrote: »
    mskimee wrote: »
    ninerbuff wrote: »
    IMO, until the US healthcare system isn't a FOR PROFIT venture, people will end up spending their retirement income and savings on it. See how much it costs to get hospitalized or how much medication costs for people who need it. It's pretty astounding and outrageous.
    We could pay for ALL AMERICANS healthcare, it's just that our government chooses to spend more of taxes towards the military might instead.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png

    Dd was hospitalized a couple weeks ago and so far we have a $7,000 hospital bill pending. That will probably be for the ER (which in the past has run us around $1,000), and then most likely her one night stay, (since the claim is pending it doesn't have the breakdown available yet for what services it's for).


    I have nothing to add, but I'm not in the US so i'm curious. What if you didn't have the ability to pay the bill for the hospital? Or if you had no insurance? Surly a hospital would still give a critically ill person the same service? I mean, no parent would ever be told "we can save your child as long as you can pay X amount..."

    right??

    It's been a long time since I lived in the U.S. (Iowa), so it may have changed. Emergency care had to be given to anyone regardless of non-payment or non-insurance. The hospital couldn't deny care to someone who came in to the ER for help. You can have your life saved, but get the bill later. It's how many people go bankrupt/broke/homeless/end up on GoFundMe trying to payoff medical bills simply because they wanted to live.

    This is still true - no hospital in the US can deny critical care based on ability to pay.
  • Emily3907
    Emily3907 Posts: 1,461 Member
    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.

    This. All of this.
  • earlnabby
    earlnabby Posts: 8,171 Member
    ccrdragon wrote: »
    zyxst wrote: »
    mskimee wrote: »
    ninerbuff wrote: »
    IMO, until the US healthcare system isn't a FOR PROFIT venture, people will end up spending their retirement income and savings on it. See how much it costs to get hospitalized or how much medication costs for people who need it. It's pretty astounding and outrageous.
    We could pay for ALL AMERICANS healthcare, it's just that our government chooses to spend more of taxes towards the military might instead.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

    9285851.png

    Dd was hospitalized a couple weeks ago and so far we have a $7,000 hospital bill pending. That will probably be for the ER (which in the past has run us around $1,000), and then most likely her one night stay, (since the claim is pending it doesn't have the breakdown available yet for what services it's for).


    I have nothing to add, but I'm not in the US so i'm curious. What if you didn't have the ability to pay the bill for the hospital? Or if you had no insurance? Surly a hospital would still give a critically ill person the same service? I mean, no parent would ever be told "we can save your child as long as you can pay X amount..."

    right??

    It's been a long time since I lived in the U.S. (Iowa), so it may have changed. Emergency care had to be given to anyone regardless of non-payment or non-insurance. The hospital couldn't deny care to someone who came in to the ER for help. You can have your life saved, but get the bill later. It's how many people go bankrupt/broke/homeless/end up on GoFundMe trying to payoff medical bills simply because they wanted to live.

    This is still true - no hospital in the US can deny critical care based on ability to pay.

    Non profit community hospitals cannot turn anyone away based on ability to pay and they have programs you can apply to where they will pay up to 100% of your bills on a sliding scale. "Private" for-profit hospitals cannot turn away emergency cases, but they can turn down other cases if they cannot pay and have no insurance. They will transfer the patient to the closest non-profit hospital.
  • _emma_78
    _emma_78 Posts: 64 Member
    _emma_78 wrote: »
    If healthy weight people were to get discounts wouldn't that almost be the same as the rest having to pay more? It's just worded differently but essentially the same thing.

    My health insurance also pays for part of a gym membership, but which gyms they do this for is very selective and often times not worth the 30+min commute.

    Out of curiosity do you know why they're selective about which gyms they reimburse for? I'd think a gym you join is a gym to be reimbursed for.

    I have no idea. I feel like as long as I can prove I'm a member each month that they should be able to give me 25 dollars a month, but maybe that's wishful thinking hahaha.