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

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Replies

  • tbright1965
    tbright1965 Posts: 852 Member
    Aaron_K123 wrote: »
    We should punish people who actually commit crimes rather than try to decide what factors contribute to crime and then arrest anyone who falls within that demographic regardless of whether or not they have commited a crime. I think phrased like that everyone would agree right? Although the idea that you could stop crime before it happens is appealing the cost of punishing people before they actually transgress is far too high.

    So why is it then okay to try to figure out what factors potentially contribute to obesity and then tax those factors thereby punishing anyone who falls within that demographic regardless of whether or not they are obese? Applying financial pressures to people for what foods they buy in order to intact some sort of misguided social engineering is unethical in my opinion.

    If you want to punish people to discourage obesity then punish the obese and don't try to pretend it is something other than that. Higher insurance rates for the morbidly obese seems like a reasonable way to do that if you want to do that.

    I don't know about punishment. My thoughts were more along the lines of paying for the additional risk presented.

    You know, like if you get a life insurance policy and are asked if you smoke, ride a motorcycle or skydive. You are charged more as you present a greater risk.

    By the same token, if you maintain a a body fat percentage above some scientifically supported percentage, you present more risk. More risk of injury to joints and muscles. More risk of certain diseases such as heart disease, type 2 diabetes, etc.

    I see it more as charging based on the risk presented, not some sort of punishment.

    If you present less risk, shouldn't you enjoy the cost savings?
  • Aaron_K123
    Aaron_K123 Posts: 7,122 Member
    edited June 2018
    tbright1965 wrote: »
    Aaron_K123 wrote: »
    We should punish people who actually commit crimes rather than try to decide what factors contribute to crime and then arrest anyone who falls within that demographic regardless of whether or not they have commited a crime. I think phrased like that everyone would agree right? Although the idea that you could stop crime before it happens is appealing the cost of punishing people before they actually transgress is far too high.

    So why is it then okay to try to figure out what factors potentially contribute to obesity and then tax those factors thereby punishing anyone who falls within that demographic regardless of whether or not they are obese? Applying financial pressures to people for what foods they buy in order to intact some sort of misguided social engineering is unethical in my opinion.

    If you want to punish people to discourage obesity then punish the obese and don't try to pretend it is something other than that. Higher insurance rates for the morbidly obese seems like a reasonable way to do that if you want to do that.

    I don't know about punishment. My thoughts were more along the lines of paying for the additional risk presented.

    You know, like if you get a life insurance policy and are asked if you smoke, ride a motorcycle or skydive. You are charged more as you present a greater risk.

    By the same token, if you maintain a a body fat percentage above some scientifically supported percentage, you present more risk. More risk of injury to joints and muscles. More risk of certain diseases such as heart disease, type 2 diabetes, etc.

    I see it more as charging based on the risk presented, not some sort of punishment.

    If you present less risk, shouldn't you enjoy the cost savings?

    I agree. The issue I was taking was not with the idea of insurance but with the idea of taxing certain types of food because some people feel strongly that they "cause" obesity by being available. ie lets tax bread because bread causes people to be fat.
  • Knokr
    Knokr Posts: 13 Member
    Well first of all I think everyone pays too much for health care. That being said, i think that people who are at a higher risk for health complications should pay more for insurance. But insurers only use BMI to measure weight and that’s not the best indicator of health for many reasons.
  • snowshoe072
    snowshoe072 Posts: 5,146 Member
    Did anyone ever hear the word discrimination? Regardless of your weight or BMI level you are not being equally fair to others instead of berating everyone who does not fit your image why not encourage instead of discourage, its like smoking when you are ready to stop you will, people find a way to pay,the same principal applies here think about it
  • Leslierussell4134
    Leslierussell4134 Posts: 376 Member
    Packerjohn wrote: »
    snowshoe072 wrote: »
    Did anyone ever hear the word discrimination? Regardless of your weight or BMI level you are not being equally fair to others instead of berating everyone who does not fit your image why not encourage instead of discourage, its like smoking when you are ready to stop you will, people find a way to pay,the same principal applies here think about it

    Paying more for insurance when you have a statistically greater likelihood of using the insurance is not discrimination. Is it discrimination when car insurance costs more for a 16 year old male with no accidents/tickets vs a 35 year old male with no accidents/tickets driving the same vehicle and living in the same neighborhood? Of course not, it's the insurance rates reflecting the actuarial likelihood of making a payout.

    Then is it discrimination to assume a black man is guilty of a certain crime, as it statistically correct to state there are more black men incarcerated for crimes at present?
    Statistics are used both for and against any argument you choose, but the reality of both mine and your example is they are both fact. But are they accurate to every individuals situation, of course not.
  • maureenkhilde
    maureenkhilde Posts: 849 Member
    Many different employer Health plans in the United States have the so called Wellness award plans attached to them. Where if you go to the onsite gym, or on their or the medical carrier website and do various challenges in a year. That you get points, that actually equal a discount for the next years premium taken out of your paycheck. Even now as a retiree, I can participate in a former employer to a degree.
    As someone who is a diabetic and working on getting my weight better controlled, I understand where many say heck yes, the fatso's of the world should pay more. But you cannot assume that if someone is 25, non smoker, and trim and fit. That there is not some type of horrid health issue that runs in that persons family that may happen to them. Which in the long run will cost lots more to the insurance company and others than the fat/obese person.

    I know for a fact that Life Insurance companies do charge way more for smokers, and fat/obese people if anything shows up in any of the blood/lipid/bloodpressure tests being out of line. And they can come back every so many years, to try and get a better rate. If they pay for the new exams that the Insurance companies will run, including all the new lab tests. And it is not an every year type of thing. I think they can request every 3 years, because the results need to show that you have achieved the non smoking/new healthy status and held it for two solid years. Based on what your Dr's. sworn statements will be. If that was put or attempted to be put in place for Health Insurance what a nightmare. In large groups like employee plans, it is taken into consideration the way rates are set up and spread out.
  • tbright1965
    tbright1965 Posts: 852 Member
    maureenkhilde wrote: »
    But you cannot assume that if someone is 25, non smoker, and trim and fit. That there is not some type of horrid health issue that runs in that persons family that may happen to them. Which in the long run will cost lots more to the insurance company and others than the fat/obese person.


    But the odds are the 25 year old you describe is less likely to present with a more costly medical event and therefore the risk is lower than the 50 something overweight smoker whose exercise consists of running off at the mouth and jumping to conclusions.

    Therefore it’s not discrimination to charge him more for coverage due to the higher risk presented.

    It’s about risks and they are higher for the 50 something than the 25 year old.

    And I’m a 50 something, but I don’t smoke. ;)
  • janejellyroll
    janejellyroll Posts: 25,763 Member
    Leslierussell4134 wrote: »
    Packerjohn wrote: »
    snowshoe072 wrote: »
    Did anyone ever hear the word discrimination? Regardless of your weight or BMI level you are not being equally fair to others instead of berating everyone who does not fit your image why not encourage instead of discourage, its like smoking when you are ready to stop you will, people find a way to pay,the same principal applies here think about it

    Paying more for insurance when you have a statistically greater likelihood of using the insurance is not discrimination. Is it discrimination when car insurance costs more for a 16 year old male with no accidents/tickets vs a 35 year old male with no accidents/tickets driving the same vehicle and living in the same neighborhood? Of course not, it's the insurance rates reflecting the actuarial likelihood of making a payout.

    Then is it discrimination to assume a black man is guilty of a certain crime, as it statistically correct to state there are more black men incarcerated for crimes at present?
    Statistics are used both for and against any argument you choose, but the reality of both mine and your example is they are both fact. But are they accurate to every individuals situation, of course not.

    There's a big difference between using statistics to determine the groups that are likely to use a greater proportion of health care services and charging more for insurance on that basis and sending an individual to jail for a crime without due process.

    We already use demographic information and past claims to determine rates for car insurance and homeowners insurance. Why is it only unacceptable for health insurance? Or do you advocate that everyone should pay the same rates for auto and homeowner policies too?
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    janejellyroll wrote: »
    Leslierussell4134 wrote: »
    Packerjohn wrote: »
    snowshoe072 wrote: »
    Did anyone ever hear the word discrimination? Regardless of your weight or BMI level you are not being equally fair to others instead of berating everyone who does not fit your image why not encourage instead of discourage, its like smoking when you are ready to stop you will, people find a way to pay,the same principal applies here think about it

    Paying more for insurance when you have a statistically greater likelihood of using the insurance is not discrimination. Is it discrimination when car insurance costs more for a 16 year old male with no accidents/tickets vs a 35 year old male with no accidents/tickets driving the same vehicle and living in the same neighborhood? Of course not, it's the insurance rates reflecting the actuarial likelihood of making a payout.

    Then is it discrimination to assume a black man is guilty of a certain crime, as it statistically correct to state there are more black men incarcerated for crimes at present?
    Statistics are used both for and against any argument you choose, but the reality of both mine and your example is they are both fact. But are they accurate to every individuals situation, of course not.

    There's a big difference between using statistics to determine the groups that are likely to use a greater proportion of health care services and charging more for insurance on that basis and sending an individual to jail for a crime without due process.

    We already use demographic information and past claims to determine rates for car insurance and homeowners insurance. Why is it only unacceptable for health insurance? Or do you advocate that everyone should pay the same rates for auto and homeowner policies too?

    Thank you. I was going to reply with something similar to @Leslierussell4134 .

    If she does think everyone should be paying the same rates for auto insurance, I'd be happy for her to help reduce the cost of my 16 year old son's auto insurance by her paying more.
  • fuzzylop72
    fuzzylop72 Posts: 651 Member
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).
  • snowshoe072
    snowshoe072 Posts: 5,146 Member
    Really ......
  • mburgess458
    mburgess458 Posts: 480 Member
    fuzzylop72 wrote: »
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).

    But paying how much more or less? If you have a history of cancer/MS/diabetes/other serious illness is it okay for your insurance to cost so much that no one could afford it? That might be fair based on expectations of your future health costs, but it can essentially a death sentence. As a society are we okay with that?

    It all comes down to whether access to health care is a right or a privilege. If it is a right (and we are going to stick with the current model of using health insurance) then health insurance has to be affordable for everyone. Obesity is much more controllable than whether or not you get cancer or other serious illnesses, but it is a similar idea.
  • ritzvin
    ritzvin Posts: 2,860 Member
    mburgess458 wrote: »
    fuzzylop72 wrote: »
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).

    But paying how much more or less? If you have a history of cancer/MS/diabetes/other serious illness is it okay for your insurance to cost so much that no one could afford it? That might be fair based on expectations of your future health costs, but it can essentially a death sentence. As a society are we okay with that?

    It all comes down to whether access to health care is a right or a privilege. If it is a right (and we are going to stick with the current model of using health insurance) then health insurance has to be affordable for everyone. Obesity is much more controllable than whether or not you get cancer or other serious illnesses, but it is a similar idea.

    this. In the US in the past, getting diagnosed with a serious illness like cancer while between jobs or underemployed (pretty much no one could afford it back then on their own without it being negotiated down as group coverage like insurance through a job) could essentially be a death sentence. (Some states, like NY, did bridge the gap above medicaid with an insurance exchange - fully subsidized to a point where someone was making a few hundred dollars/mo above qualifying for medicaid; and either partially or non-subsidized (but at least large group coverage pricing rather than individual) for those making more up to $2000ish/mo). Note: there were more technical rules about when and for how long one had to have income qualifying for it, so it would still leave that risky gap there for someone who was laid off from a job (including current graduate students who lost research funding but still had to continue on their research for their degree). COBRA exists for that, but if you were working for a smaller company that largely covered the premium, you quite likely won't have the cash to pay for it (and rent and utilities) for very long (Food, etc could at least be purchased on one of those introductory 0% rate credit cards - but not insurance premiums, rent, or utilities.. In my case, I was extremely lucky - I managed to get a teaching assistant position before having no funding and so my last health insurance was from the state as an employer (state university) rather than the research foundation - my COBRA was only ~$200/mo.. I used it until it ran out (while working part-time as a technician elsewhere) before getting insurance via the Healthy NY exchange).
  • fuzzylop72
    fuzzylop72 Posts: 651 Member
    mburgess458 wrote: »
    fuzzylop72 wrote: »
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).

    But paying how much more or less? If you have a history of cancer/MS/diabetes/other serious illness is it okay for your insurance to cost so much that no one could afford it? That might be fair based on expectations of your future health costs, but it can essentially a death sentence. As a society are we okay with that?

    It all comes down to whether access to health care is a right or a privilege. If it is a right (and we are going to stick with the current model of using health insurance) then health insurance has to be affordable for everyone. Obesity is much more controllable than whether or not you get cancer or other serious illnesses, but it is a similar idea.

    Paying enough to offset the additional insurance risk. Excess of that wouldn't be justified, and less than that is essentially just offloading some of your increased risk to those closer to the center of the risk distribution.
  • mburgess458
    mburgess458 Posts: 480 Member
    edited June 2018
    fuzzylop72 wrote: »
    mburgess458 wrote: »
    fuzzylop72 wrote: »
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).

    But paying how much more or less? If you have a history of cancer/MS/diabetes/other serious illness is it okay for your insurance to cost so much that no one could afford it? That might be fair based on expectations of your future health costs, but it can essentially a death sentence. As a society are we okay with that?

    It all comes down to whether access to health care is a right or a privilege. If it is a right (and we are going to stick with the current model of using health insurance) then health insurance has to be affordable for everyone. Obesity is much more controllable than whether or not you get cancer or other serious illnesses, but it is a similar idea.

    Paying enough to offset the additional insurance risk. Excess of that wouldn't be justified, and less than that is essentially just offloading some of your increased risk to those closer to the center of the risk distribution.

    That’s the point. For some people the amount to offset the additional insurance risk is literally tens of thousands of dollars (or more). Only the rich could afford the “fair” insurance premiums for someone with a bad pre-existing condition. We either let those people die or we offload some of the costs. That’s the decision society has.
  • fishgutzy
    fishgutzy Posts: 2,807 Member
    edited July 2018
    xFunctionalStrengthx wrote: »
    I :

    1) Insurance should be charged by the person. Not by family. For example, why should a family of three pay the exact same premium as a family of eight?

    2) The BMI chart is known to be faulty. Even the modified version for the military is. Therefore, if a person is on the heavier side due to heavy muscle mass, bone density, etc, give them a fitness test that is fair. If they can pass it, give them coverage at the standard rate. No issues if an annual physical shows this is no longer the case.

    1. If you buy your own insurance or have a small business plan, there is a line item premium charge for each family member in the plan. Premium based on age and non smoker. So a family with 6 children will pay more than a family with 2 children. A family with the parents over 50 will pay a lot more than if the parents are under 35.
    My family silver plan costs >$27k, $7300 deductible, $14,700 max out of pocket. And an ER copay so high that it must be intended to ensure more people die instead of going to the ER.

    Insurance companies use NIH guidelines.
    Believe it or not, the NIH ACTUALLY claims that body fat percentage doesn't matter. I had an idiot from NIH tell me that the heart has to soul harder pumping blood through muscle than fat.
    So I asked why the person with lower BFP but same BMR had a lower resting heart rate and blood pressure? No reply.

    To bureaucrats who want to control people, it is necessary to reward skinny couch potatoes and punish the fit.
  • s1im62
    s1im62 Posts: 31,341 Member
    'Insurance' is something that is usually based on risk. If your home is in a location with no fire department, or poor response times, then (other things being equal) your home insurance to cover fire risk is going to be a lot higher than someone whose home is located a block away from a fire station in a major city.

    In most of the world today however, 'Health Insurance' is not structured this way, and that is usually due to the laws that apply in the locality/nation. The reasons given vary, but this is generally based on societal ethics, in which the society believes everyone should be given health care regardless of their income, genetic heritage, and for the most part, bad decisions made in the past.

    At my workplace, health care costs are shared between the company and employee contributions, but there are some rewards to employees who show good-faith efforts toward maintaining or improving health. Employees who participate in the activities get a rebate on a portion of their contributions to the total cost of their coverage.

    Bottom line is that I'm not sure how to address the basic question, given the fact that 'Health Insurance' is not really 'Insurance' these days. On the other hand, I do believe 'reward programs' do help people get/stay healthy, and will lower costs for everyone, so my opinion is that the 'carrot' approach is the better way to go than something that seems like a punishment.
  • wmd1979
    wmd1979 Posts: 469 Member
    mburgess458 wrote: »
    fuzzylop72 wrote: »
    mburgess458 wrote: »
    fuzzylop72 wrote: »
    I'm pretty okay with people at the tails of the risk distribution curve paying more or less than the average (depending on which side they are on).

    But paying how much more or less? If you have a history of cancer/MS/diabetes/other serious illness is it okay for your insurance to cost so much that no one could afford it? That might be fair based on expectations of your future health costs, but it can essentially a death sentence. As a society are we okay with that?

    It all comes down to whether access to health care is a right or a privilege. If it is a right (and we are going to stick with the current model of using health insurance) then health insurance has to be affordable for everyone. Obesity is much more controllable than whether or not you get cancer or other serious illnesses, but it is a similar idea.

    Paying enough to offset the additional insurance risk. Excess of that wouldn't be justified, and less than that is essentially just offloading some of your increased risk to those closer to the center of the risk distribution.

    That’s the point. For some people the amount to offset the additional insurance risk is literally tens of thousands of dollars (or more). Only the rich could afford the “fair” insurance premiums for someone with a bad pre-existing condition. We either let those people die or we offload some of the costs. That’s the decision society has.

    When the risk can be lessened by making better choices then the extra costs should fall to the individual taking those risks. I shouldn't be forced to pay more because my neighbor smokes just as I shouldn't be forced to pay more because my other neighbor is not at a healthy weight. There is such a common misconception that obesity can't be avoided by most people and that is where the problem lies. With the exception of some very rare medical cases, anyone can lose weight. Can certain prescription drugs increase appetite and make the process harder? Of course, but that doesn't make it impossible as a good number of people on here claim. I can feel compassion for someone who is obese and still believe that they should pay for their increased medical risks because they put themselves in that position.
  • Onedaywriter
    Onedaywriter Posts: 326 Member
    So I’ve been running lately to help with my health and weight management. I read earlier that runners have an usually high risk of injury. So would I pay more because I have higher injury risk or less because I’m no longer obese?
    I think it’s ridiculous to charge more.
    People with type 1 diabetes or other child onset illnesses always cost more in medical needs. Should they pay more? Why have insurance at all if it’s going to be pay if you need?
  • Cherimoose
    Cherimoose Posts: 5,208 Member
    This is an ancient thread.
    Onedaywriter wrote: »
    I read earlier that runners have an usually high risk of injury. So would I pay more because I have higher injury risk or less because I’m no longer obese?

    You would pay less because you're no longer obese. The costs of obesity far outweigh the cost of seeing a doctor once because of shin splints or Achilles tendinitis.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    Cherimoose wrote: »
    This is an ancient thread.
    Onedaywriter wrote: »
    I read earlier that runners have an usually high risk of injury. So would I pay more because I have higher injury risk or less because I’m no longer obese?

    You would pay less because you're no longer obese. The costs of obesity far outweigh the cost of seeing a doctor once because of shin splints or Achilles tendinitis.
    I dunno, my running injury was pretty expensive. I don’t have insurance so had to pay up front. It cost me almost as much to diagnose and treat a ruptured Baker’s cyst as my mom’s recent 6 day hospital stay with diabetes related kidney issues. Her whole hospital stay plus surgery and ER fees was 8k roughly. I had ER fees plus ultrasound and labs fo determine I didn’t have a blood clot, surgery guided by ultrasound to drain the cyst, X-rays and associated nonsense because the osteo was determined to do his usual collection of stuff whether I needed it or not, then an MRI “to be sure there’s not an underlying condition causing the Baker’s cyst.” Steroid shots, antibiotics, etc.

    Given that some estimates put 80% of runners being injured every year, maybe they should consider running a pre-existing condition!
  • MargaretYakoda
    MargaretYakoda Posts: 2,994 Member
    edited July 2021
    Cherimoose wrote: »
    This is an ancient thread.
    Onedaywriter wrote: »
    I read earlier that runners have an usually high risk of injury. So would I pay more because I have higher injury risk or less because I’m no longer obese?

    You would pay less because you're no longer obese. The costs of obesity far outweigh the cost of seeing a doctor once because of shin splints or Achilles tendinitis.

    In the US, being obese is classified as a disability if it is caused by an underlying disorder.

    Should every disabled person have to pay more for insurance? Or just the obese people?
    And if so, are you talking about morbidly obese people? Or all overweight people?

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