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Do you think obese/overweight people should pay more for health insurance?
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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.
And some people are skinny fat... low muscle mass, above average fat, normal, or low overweight BMI...
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No. As someone who has retired from the insurance/financial services industry and sold private and supplemental health insurance this is a slippery slope we cannot go down. Do we really want profit hungry people in business suits determining who is and is not worthy? What is the cut off? Someone with a BMI of 30 who can walk 25 miles or someone with a BMI of 25 who can't even walk 5? Why should the higher BMI pay more when indicators say they are more fit? A person with a normal BMI gets cancer and requires long term treatment. An overweight person needs regular monitoring for BP, lipids, blood glucose but never develops a disease. Who cost more?
There are too many problems with doing something like this. It sounds great in theory to have people who POTENTIALLY may use healthcare more pay more but in practice it becomes very discriminatory.
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crazyycatladyy1 wrote: »lemurcat12 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.1 -
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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.2
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lemurcat12 wrote: »
the ACA made maximum's illegal.6 -
crazyycatladyy1 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
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Been in fitness for 30 years and have studied kinesiology and nutrition
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??3 -
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 nothing2
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Packerjohn 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
The issue with health care in the US is spending per person (from all sources) is doube what it is for the rest of the industrialized world.
Profit is a portion of this but nowhere near all. I believe one of our issues is the amont we spend on end of life care. Most other countries will make an 80 year with a serious illness comfortable and leto them die with no treatment. In the US we spend thousands of dollars for an extra couple of months of life with questionable quality.
I'm in the UK. We most certainly do not leave 80 year olds to die. There are people in their late 80s having surgeries that may extend life for just a few months or a few years. Everyone gets healthcare equally if it's approved by NICE (they control what treatments the NHS will pay for, such as new cancer drugs but it's applied almost universally with a little postcode lottery thrown in).
And these types of conversations terrify me coming from a country with nationalised healthcare. Our doctors don't prescribe medications because they'll get a kickback. They don't meet pharmaceutical salesmen who again, offer incentives to use their medications.
You get treatment based purely on medical need and what is appropriate to the individual. There's no yearly health check (unless you do have private healthcare, which is available if you have the money for it but it feels for the most part, another way to make some money).
Our government are doing their best to privatise our healthcare by stealth by chronically underfunding and then pointing fingers at mismanagement etc in order to do so.
I have chronic health conditions, I will probably be on medication for life. When I see the costs some pay for my medication I know I couldn't afford even a fraction of that. So then what for those people? They cost the country more for being medically unfit for anything than if they were just allowed access to treatment.21 -
So would incentivizing healthy habits be better than penalizing negative ones? Or is that just the same? I used to get a good student discount for car insurance with my parents (we had to bring out report cards in)- it was a nice perk to have for them.
Because here is my problem: we need to be doing "preventative maintenance" and be more proactive about our health. Those of you with animals know, vets start performing routine blood work when animals reach a certain senior age to start monitoring for classic aging disease and treat them in advance- why should we not do the same for ourselves? The reason is, bizarrely, that we are afraid it will be used against us with health insurance premiums. But I would rather know I am, say, pre-diabetic and address it rather than waiting to have eye or circulation problems or something. Just look at the number of people here who have a health condition as a major motivation to lose weight- how do we let it GET to that point in the first place?
If we incentivize being proactive in our health, rather than continuing in the trend of reactivity, maybe it would help. But in the current health insurance climate, it feels we are punished for looking into our health. Which is total crap.9 -
NO ... it's discrimination. Should we charge based on age, nationality or better yet ... lower income individuals since we know it is more expensive to eat healthy?? Absolutely not ... but providing resources to programs that encourage healthier eating and fitness could help.10
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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.4
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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
My employer just started this this year- they will reimburse up to $25 per month if you have a gym membership and go at least 8 time or more per month. I absolutely love it as I belong to a gym that only costs me $30 a month so really I'm only paying $5 for my gym membership. And it's super easy to go 8 times a month as I typically go 6 days a week anyhow. We have to have our gym print out our check in dates and then we turn that into HR and will be reimbursed for each month we go more than 8 times.9 -
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.0 -
NO ... it's discrimination. Should we charge based on age, nationality or better yet ... lower income individuals since we know it is more expensive to eat healthy?? Absolutely not ... but providing resources to programs that encourage healthier eating and fitness could help.
Not all forms of discrimination are bad. Discriminating against bad choices is not a bad thing. Age and nationality aren't choices. Being fat is.13 -
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.4 -
No, as many have said - where do you draw the line? The government is going to demand you control the way you look? Force you to get body scans and tests done? That's a little too big brother for me. If anything, you should be rewarded for being at a healthy weight. Not penalized for being at an unhealthy weight. The reward of cheaper health care would be more motivating to stay healthy. Not to mention it should be a voluntary thing. As you in choose to sign up for a body scan to lower your premiums.
As someone else said, until the healthcare company becomes not for profit, this can never happen.5 -
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.1 -
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.1
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