Discussion: Is obesity a 'pre-existing condition'?
minimyzeme
Posts: 2,708 Member
I've been mulling this question for about a year now, a year after the concept was first introduced to me.
Background: In the summer of 2015, I had a very interesting discussion with a friend I see once a year, most years. At that time, I had lost the better part of 80 pounds. As a cardiac anesthetist (and a very fit one at that) he congratulated me for my weight loss. He also told me it's very rare for people over 50 to lose significant weight and even moreso for us to keep it off. But the other thing he said was what really caught my attention.
He works at a hospital in a large urban area. He very matter-of-factly said that if insurance companies would stop paying for obesity and smoking-related medical issues, health care costs would come down dramatically. He went on to say many patients are admitted to the hospital multiple times for complicated / expensive surgeries. Their problems that are often traced back to the same sources: obesity and/or smoking. His argument was that the ever-rising cost of health care is absolutely related to the fact that insurance companies continue to pay out for what are essentially behavior choices.
So...without meaning to get too political, but wanting to read your thoughts on the topic, I'm curious how you view lifestyle choices in this context. As I have read and heard about the controversy surrounding health insurance coverage to include pre-existing conditions, I'm unable to shake the conversation I had with my friend. It has lead me to concede he has a very good point and that maybe insurers should incentivize better lifestyle choices for a period of time before somehow taking those choices into account via premiums, limited coverage, etc.
Your thoughts?
Background: In the summer of 2015, I had a very interesting discussion with a friend I see once a year, most years. At that time, I had lost the better part of 80 pounds. As a cardiac anesthetist (and a very fit one at that) he congratulated me for my weight loss. He also told me it's very rare for people over 50 to lose significant weight and even moreso for us to keep it off. But the other thing he said was what really caught my attention.
He works at a hospital in a large urban area. He very matter-of-factly said that if insurance companies would stop paying for obesity and smoking-related medical issues, health care costs would come down dramatically. He went on to say many patients are admitted to the hospital multiple times for complicated / expensive surgeries. Their problems that are often traced back to the same sources: obesity and/or smoking. His argument was that the ever-rising cost of health care is absolutely related to the fact that insurance companies continue to pay out for what are essentially behavior choices.
So...without meaning to get too political, but wanting to read your thoughts on the topic, I'm curious how you view lifestyle choices in this context. As I have read and heard about the controversy surrounding health insurance coverage to include pre-existing conditions, I'm unable to shake the conversation I had with my friend. It has lead me to concede he has a very good point and that maybe insurers should incentivize better lifestyle choices for a period of time before somehow taking those choices into account via premiums, limited coverage, etc.
Your thoughts?
1
Replies
-
For many of us that'd be scary. Although I haven't smoked in almost 40 years, that could still be considered. That and my high weight of 335#.0
-
For me Pre-existing came in to play for my hip that needed replacement for years until I was able to take out a supplemental insurance plan which would cover it. Yes my obesity had a part in it making it worse. As for pre-existing for weight loss surgery, the first time for coverage may be important, but you need to take control of your life. I watch the show 600lb life and they wont do the surgery with out being able to lose on your own first. I am actually doing behavior therapy to handle my wife's illness mindfully which is contributing to my stress eating.
So my opinion is pre-existing is good if it is not abused.2 -
Seems to me that we need to work on treating these conditions as a society and not penalize people for them. I'd also add substance abuse to the list.
Several years ago, people were getting discounts on insurance if they lost weight or quit smoking. However, it was really viewed as being penalized if you smoked or were overweight.1 -
Start down that road, next is drinking. Then why should I pay for your skiing injury, or your kid who fell off his skateboard? Now that I think of it, who cares if your kid ever learns to ride a bike?
You think vegans are a pain now? Just get this started.
What if I can maintain a healthy weight but still want to eat sugar?
Start down this road and the "food police" will be at our doors guns drawn.1 -
Boy toughy for sure. In general the idea behind insurance vs just pay as you go is to have shared risk pools. With that in mind I don't want to disenfranchise folks. Everyone has to eat so just say "no" to eating doesn't work and makes it a different category from smoking. We do pay a lot and not just for vanity with an overweight society. True enough. I kinda like what GoRun2 said in the sense of providing some motivation for weight loss but not sure what form that might take. I think some places of employment have this program and it probably saves them a bit on health care costs in some form. We still need shared risk pool or it's not insurance.
Some insurance companies consider you a nonsmoker after not smoking for 1 year. I wouldn't penalize ya Al 40 years later.1 -
Off and on I've had to fight the battle with insurance and weight as a pre-existing condition but more over as a premium increase due to weight even though I may have lost to a standard weight 1, 2 3 years or more prior. Something one has to live with and so it goes. He who has the gold makes the rules.1
-
Thanks for your thoughts; some good and interesting points. The more I think about and what you've commented, the more I think it would be beneficial to develop health-based incentives as motivation (not to mention bringing costs down).
I say all this as someone who was well on his way to starting down the road to needing more and more medical attention, if my blood-related metrics, physical abilities and sleep patterns were any indication. In hindsight, sure, I need to eat but I sure as heck didn't need to eat as much as I was eating. So for me, my choices were likely going to get me in trouble and have me relying more and more on doctors, prescriptions and eventually (probably) procedures.
Where the sweet spot is between preventative (cost-effective) and symptom treatment is, I don't know for sure. What I do know is that much as I hated to admit it, my friend's assertion made me really think about the cost of health care in a whole different way. While I can't personally change that, I can change my own need for it so that's the part I focus on now.0
This discussion has been closed.