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

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Replies

  • Clarknt67
    Clarknt67 Posts: 3 Member
    The problem with this idea is it undermines the idea of risk pooling. (Charging smokers does too.) The slippery slope is what about genetic markers that indicate some people are predisposed to cancer? You can slice and dice up the pool a millions ways to penalize people "who should have known better." Red meat eaters? People near toxic waste dump sites?

    Insurance companies introduce these ideas to maximize their profits and minimize their liability to pay out when people actually get sick.
  • stanmann571
    stanmann571 Posts: 5,727 Member
    jdlobb wrote: »
    Bry_Lander wrote: »
    Bry_Lander wrote: »
    jdlobb wrote: »
    Bry_Lander wrote: »
    jdlobb wrote: »
    Bry_Lander wrote: »
    NoxDineen wrote: »
    Nobody should pay for health insurance. Not directly anyway. Single payer system.

    Then brace yourself for single-payer quality.

    gladly

    life-expectancy-at-birth-total-population-oecd-2011.png

    There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.

    and you explain Canada...how?

    Also, as someone who used to live in the UK, their fitness and behavior isn't appreciably different than ours.



    If I were to grant you that socialized healthcare is the sole reason for the increased longevity for the sake of argument - Canada and the UK get an additional 2 years of life. That isn’t a very compelling case for the government to completely take it over.

    It is also much cheaper... and everyone has access to healthcare. The only benefit you can point to for the U.S. system is that some people make a ton of money from it. It isn't cheaper, it isn't better, and it doesn't work at all for millions of Americans. We are fine with "the government completely taking it over" for veterans and the elderly (Medicare) and some poor/disabled people (Medicaid).

    We should either decide between:
    1. We're okay with poor people dying due to not having access to healthcare and stick with a for-profit model or
    2. Go more towards a single payer/Medicare for all system.

    What we have now is no healthcare to many poor people until they are close enough to death that they can go to an ER.

    Veterans are absolutely not "fine" with government healthcare administered by the VA, it has been a disaster and done a disservice to millions of vets - if that is a model for single-payer healthcare, we are in deep trouble if this ever gets implemented.

    I'm a vet, who gets care at the VA, and this is absolutely untrue. The conservative media blows up every little problem with VA healthcare and pretends like the VA is some uniquely bad system.

    It's not.

    Every survey shows that veterans are, on average, highly satisfied with the care they get at the VA, and it consistently rates higher than private hospitals.

    There are numerous studies out there that compare quality of care, patient satisfaction, and health outcomes between private hospitals and VA and they consistently find the VA to be as good or better than private hospitals.

    I've had issues with VA doctors in the past, and I've had issues with private doctors. But as someone who's been regularly going to the VA for care, even though I have good private insurance, I have had a great experience.

    The ONLY problem I have ever had is in getting an initial appointment with a primary care doc when I move to a new city and have to chance clinics. This takes too long, and is a serious problem. HOWEVER, after getting that initial appointment I consistently get fast appointments with specialists, tests, and follow up appointments with the primary care doc. I have experienced the exact same level of service in 4 different cities (Baltimore, New York, Fort Worth, and Dallas).

    I'm not alone. My grandfather has been going to the VA for all his healthcare needs for over 40 years, he refuses to go anywhere else. Every time they move they make sure they're close to a VA facility. I've seen him get visibly enraged watching republicans and those *kitten* stains at "Concerned Veterans" talk *kitten* about the VA on television.

    Regrettably, VA quality varies wildly from region to region and state to state. In some regions/states, VA care is superior to private care. In others, VA care is slightly more dangerous than standing in traffic.
  • shaumom
    shaumom Posts: 1,003 Member
    MKEgal wrote: »
    Anyone whose voluntary actions causes them to cost a health insurance company more should be charged more for their insurance, and maybe care. ...

    Too much weight is caused by eating more than you burn.
    Whether that's because I'm depressed, or on steroids, or just really like Oreos doesn't matter - the cause is eating too much, the result is being overweight.

    This belief is what causes a lot of problems for those who are overweight, and it has as its underlying premise something that, IMHO, ignores the entire reality of limited choice.

    The more negative the consequence of a choice, the more limits there are ON that choice, until it gets to a point where we wouldn't consider it a choice at all. Like, choosing which path to take for your morning jog has little negative consequences, right?. Choosing to, oh, marry the villain who is holding your brother hostage and will kill him if your refuse? Not much choice there.

    If someone complained about the scenery on their jog, we'd probably say, 'why are you complaining? You chose it.'
    But if someone complained about their marriage to the villain, we would not usually say, 'why are you complaining? You chose to marry him.' We'd be more likely to say, so sorry, we know you had no choice but to do what you did.

    The same thing applies to being overweight, in many cases.

    There are medications that cause people to gain weight EVEN IF they do not change their previously fine eating habits. There are medications that create such cravings for certain foods (carbs is one I can think of off hand) that a person can either eat, or feel like they are starving, constantly, every single day. There are injuries and conditions that make it extremely painful to move, which not only make it hard to exercise, but make it hard to COOK, so your only choice is to get all premade food, and good luck getting healthy choices for that with enough calories.

    Not to mention that for some people, they spend most of their worrying, and often money, on the people they care for rather than themselves (I can think of a lot of single parents for this one). If you only have enough money to buy SOME healthy food, who are you gonna give it to, yourself or your kids?

    There are a lot more examples, but treating overweight folks as though all skinny people and all overweight people have had the exact same experiences and the exact same stressors and skills and opportunities affecting their ability to stay in shape, is ignoring the reality of human existence.

    Treating overweight folks as though YOU would do better if you were in THEIR place - which I know this poster of this didn't say, but is rather implied by many of the posts on this issue so far - is both ignorant and rather arrogant as well, I think.

    You literally don't know what it's like for someone else, nor do you know what led to their being overweight. And if you have not HAD any mental illnesses, or taken meds, or been an addict, or lived in poverty...you have no freaking idea how that impacts a person.

    I am not saying that everyone who is overweight did nothing wrong, or had no choice. But the point is, none of us know, looking at someone. We don't know why someone lost a limb, why they are wearing black clothing, why got a perm, OR why they are overweight.

    We don't ACT as though we know why someone lost a limb or are wearing black or got a perm, though. So why do so many of us treat people who are overweight as though we 'know' why they are overweight?
  • ekim2016
    ekim2016 Posts: 1,198 Member
    well if "they" begin charging heavier people more, at least we have the upper edge being here on our journey of losing weight! Imagine a future of charging us by the pound for insurance and air fare too. . .
  • Eden_Goldie
    Eden_Goldie Posts: 283 Member
    edited October 2017
    In England it is the NHS and I believe that those who have medical problems relating to obesity should have to make a higher NI payment because they are at greater risk and type 2 diabetes, for example, is a lifelong medication costing far more than the individual is likely paying in.
  • shaumom
    shaumom Posts: 1,003 Member
    edited October 2017
    jdlobb wrote: »
    hold on. I'm one of the ones here advocating for higher premiums for the obese. This isn't a "you" vs "they" argument. I AM they. I AM obese. My parents ARE obese. Most of my family IS obese.

    This is about math and risk. Not about profits. I don't give a *kitten* about health insurer profits.

    But increasing premiums for the morbidly obese would lower premiums for people with a healthy weight. This would also encourage people to lose weight, thus lowering health care expenses across the economy.

    There are plenty of people in the health care industry making a FORTUNE on obesity, and the fact that insurance has to eat it when it comes to people making poor life choices.

    So no, this isn't YOU vs THEY. This is reality vs mindless idealism.

    I know you want to try and frame this as "fat people did nothing wrong," but that's naive. The percentage of overweight people whose weight is due to things outside their immediate control, is minuscule in comparison to the number of people who have just had a lifetime of *kitten* choices around diet and exercise.

    People like me, who got fat because they made bad decisions, shouldn't get to free ride on the backs of people who made good decisions and gain sympathy or "benefit of the doubt" on the backs of people who have legitimate issues that caused their weight problems.

    Sorry, you're right on the you vs them issue- I get on my high horse sometimes. Mostly you got hit with some of my frustration after having this conversation with someone where it was very much a 'all the fat people in the world are lazy' and then coming on this posting. Myself, I have super skinny people in my family, I have obese people in my family. For both, some of them are the way they are due to their own choices, and some are not.

    However, I truly do not think increasing premiums will in any way help anyone but the insurance company. Sure, they COULD lower premiums if some people with higher risks paid more, and healthy folks paid less. The real question is: would they? And I think idealism mostly comes in thinking that they would.

    The entire history of our insurance companies would contradict that. Because being obese used to be a pre-existing condition. People DID have to pay higher premiums. And it in no way made for lower premiums for anyone else. Premiums were high, coverage was pretty pathetic in many cases, and going BACK to that is not likely to go any better than it did in the past.

    Literally, why would they? The insurance companies, in my experience, very rarely 'eat it' with anything. They make sure WE eat it. If they have to pay legitimate costs because of a horrible accident, or costs because someone made poor life choices, it does not seem to matter to them. Best I can tell, they will make sure that as much of that cost is paid by the people buying insurance, If they can get away with paying no money at all to a patient, without too much negative press, in my experience they absolutely will.

    I used to have to work with medical insurance companies, and frankly, well...if you've ever seen that scene in the children's cartoon, The Incredibles, with the insurance company and their amoral little boss whose whole purpose was to make the shareholders money? That has honest to god been my own experience with them. I'm sure there ARE good people working in many of these companies, and maybe even good companies too, but some of the crap I have seen with them has to be seen to be believed, seriously.

    I never, in any way, expect insurance companies to do anything that will cost them money, and I always expect them to do everything that will make them more. And the only factor that I've seen that keeps them in check is that bad press will cost them a bit of money. So it is literally in THEIR best interest to peddle the idea that WE will pay more money if anyone with ANY increased health risks gets health insurance as easily as healthy folks, and more importantly, that is is entirely out of the insurance company's control that we all pay more money.





    As for 'fat people did nothing.' I don't believe that. I just believe that WE don't know what the situation is for someone else. And I honestly don't know that the majority of people ARE actually doing it due to bad choices, or if it's the other way around. I have no idealistic view on this subject, honestly. I just know there can be many reasons for obesity.

    But here in the USA, while we have a lot of hype that the majority are obese due to their own choices, I don't think we actually have good statistics on the subject. I haven't seen any, anyway. Have you? (And I mean that sincerely, if you've seen studies, I'd love to see them).

    We have a big cultural view of 'you can do anything if you try hard enough.' So admitting that sometimes you can't, that sometimes you will be ugly, or sick, or overweight, or poor, no matter what you do, doesn't play into that national outlook. Which means that if you're overweight, the assumption more often is that a person is solely at fault, with the only factor being poor choices in diet and exercise.

    But just assuming that doesn't make it true (doesn't make it false either. Again, just saying we don't know, is all). I guess, in the end, I see it from the other angle. You said, "People like me, who got fat because they made bad decisions, shouldn't get to free ride on the backs of people who made good decisions and gain sympathy or "benefit of the doubt" on the backs of people who have legitimate issues that caused their weight problems."

    I guess I would say, people who have legitimate issues causing their weight problems shouldn't be penalized because we want to punish people who made bad decisions. Because, going by the history, insurance companies will NOT make any distinction between the two. They'll just charge people more for being obese, period.






  • Cynthia1066
    Cynthia1066 Posts: 21 Member
    No. I happen to believe that EVERYONE regardless of health, personal habits, income, or age should have access to basic healthcare. We need a single payer system like other civilized countries. If anything, barring the obese (or the old, poor, unemployed) from medical attention costs our country more in terms of lost productivity. Not to mention the humanitarian concerns. Look, it's hard enough to be fat. Why punish people further?
  • Cynthia1066
    Cynthia1066 Posts: 21 Member
    People who say that it's unfair that the healthy pay for the sick have no basic understanding of how insurance (and a decent society) works. Trust me, at some point, no one reaches the age of sixty without SOME sort of pre-existing condition.
  • richardgavel
    richardgavel Posts: 1,001 Member
    No. I happen to believe that EVERYONE regardless of health, personal habits, income, or age should have access to basic healthcare. We need a single payer system like other civilized countries. If anything, barring the obese (or the old, poor, unemployed) from medical attention costs our country more in terms of lost productivity. Not to mention the humanitarian concerns. Look, it's hard enough to be fat. Why punish people further?

    What is BASIC health care? The potential cost of services provided by an ACA health plan could be tens or hundreds of thousands of dollars depending on the person's issues.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    shaumom wrote: »
    jdlobb wrote: »
    hold on. I'm one of the ones here advocating for higher premiums for the obese. This isn't a "you" vs "they" argument. I AM they. I AM obese. My parents ARE obese. Most of my family IS obese.

    This is about math and risk. Not about profits. I don't give a *kitten* about health insurer profits.

    But increasing premiums for the morbidly obese would lower premiums for people with a healthy weight. This would also encourage people to lose weight, thus lowering health care expenses across the economy.

    There are plenty of people in the health care industry making a FORTUNE on obesity, and the fact that insurance has to eat it when it comes to people making poor life choices.

    So no, this isn't YOU vs THEY. This is reality vs mindless idealism.

    I know you want to try and frame this as "fat people did nothing wrong," but that's naive. The percentage of overweight people whose weight is due to things outside their immediate control, is minuscule in comparison to the number of people who have just had a lifetime of *kitten* choices around diet and exercise.

    People like me, who got fat because they made bad decisions, shouldn't get to free ride on the backs of people who made good decisions and gain sympathy or "benefit of the doubt" on the backs of people who have legitimate issues that caused their weight problems.



    As for 'fat people did nothing.' I don't believe that. I just believe that WE don't know what the situation is for someone else. And I honestly don't know that the majority of people ARE actually doing it due to bad choices, or if it's the other way around. I have no idealistic view on this subject, honestly. I just know there can be many reasons for obesity.



    "Although there are genetic, behavioral and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat.

    Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, and other diseases and conditions. However, these disorders are rare and, in general, the principal causes of obesity are:

    Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities.
    Unhealthy diet and eating habits. Weight gain is inevitable if you regularly eat more calories than you burn. And most Americans' diets are too high in calories and are full of fast food and high-calorie beverages."


    Source:
    https://www.mayoclinic.org/diseases-conditions/obesity/basics/causes/con-20014834
  • richardgavel
    richardgavel Posts: 1,001 Member
    So do people just not want to penalize individual people by charging them more than the group for insurance? Because at some point, everyone who causes more medical expenses will result in the company they work for being charged more for insurance. At that point, they're being charged more irrespective of how overweight people got that way.
  • andyphin
    andyphin Posts: 38 Member
    I do not agree with charging more for being overweight. Where does that end and why only obese people? What about alcoholics and drug seekers/users? What about anorexics and other eating disorders, why don't they pay more too then? Not to mention the logistics would be a nightmare, at what point are you weighed and what happens when you yo-yo up and down in weight going over and under the threshold? Then there are the numerous exceptions you would have to consider. I have had back surgery twice, I could claim it keeps from being active (and for many people this does). This would create a really big mess for an already stressed health care system.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    andyphin wrote: »
    I do not agree with charging more for being overweight. Where does that end and why only obese people? What about alcoholics and drug seekers/users? What about anorexics and other eating disorders, why don't they pay more too then? Not to mention the logistics would be a nightmare, at what point are you weighed and what happens when you yo-yo up and down in weight going over and under the threshold? Then there are the numerous exceptions you would have to consider. I have had back surgery twice, I could claim it keeps from being active (and for many people this does). This would create a really big mess for an already stressed health care system.


    Eating more calories than you burn causes one to be overweight. Claiming one gained weight due to an orthopedic operation preventing them from being active is really fooling themselves.

    If you can't move as much, eat less. Problem solved.
  • andyphin
    andyphin Posts: 38 Member
    Right... so you won't mind being one of those who waits for 4 years for a hip replacement, I assume.

    Don't confuse the VA system with single payer. No one on medicare has to wait 4 years for a hip replacement.

  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited October 2017
    In theory, the idea behind charging more for obesity/smoking is to provide an incentive for the person to change something that can be changed. That could be applied even in a single payer kind of system.

    In a free insurance market (which we don't have in the US, it's called insurance but doesn't work as insurance), all risk factors would lead to higher prices based on underwriting (or in many cases denial of coverage). For obvious reasons we don't do that (and we have Medicare for old people in large part because of the problems with the insurance model for health care).
  • richardgavel
    richardgavel Posts: 1,001 Member
    andyphin wrote: »
    Right... so you won't mind being one of those who waits for 4 years for a hip replacement, I assume.

    Don't confuse the VA system with single payer. No one on medicare has to wait 4 years for a hip replacement.

    While I don't approve of single payer, I do agree with this statement. VA issues are about the provider of the medical services, not who is paying for them.
  • richardgavel
    richardgavel Posts: 1,001 Member
    andyphin wrote: »
    I do not agree with charging more for being overweight. Where does that end and why only obese people? What about alcoholics and drug seekers/users? What about anorexics and other eating disorders, why don't they pay more too then? Not to mention the logistics would be a nightmare, at what point are you weighed and what happens when you yo-yo up and down in weight going over and under the threshold? Then there are the numerous exceptions you would have to consider. I have had back surgery twice, I could claim it keeps from being active (and for many people this does). This would create a really big mess for an already stressed health care system.

    What about being charged more for auto insurance because of a bad driving record? Or having a car popular among car theives? In my mind, these are very similar circumstances.
  • GettinFitInMN
    GettinFitInMN Posts: 24 Member
    I can appreciate when the right candidates get approved for bypass surgery, however I'm more concerned about the co-workers I have heard talking about LYING on the questionaire just to get approved. Supposedly there are questions that when answered the right way make you a much better candidate for the surgery. Sad. The girl could never get control over her eating and lied to get approved. Gained it all back. So hard on the body to do that too. Surgeries are very expensive and include hospital stays, meds, follow-ups, etc and add to insurance rates going up. Again, I support the right people getting it, not just everybody who is sure it's a quick fix.
  • CaliVeggieGal
    CaliVeggieGal Posts: 10 Member
    It'd be great if it were framed, as some companies/insurance do, as those who are healthier get discounts and incentives. Goals motivate people more than penalties, and it can hard to self-motivate off principles alone, especially because of how easily our biology caves to modern advertising. And yes, as a fit, active vegan who pays a ton of attention to my health and how my diet impacts the environment, I believe there should be rewards for this. We must reform our broken health care and food systems to be based around proper nutrition, exercise, and disease prevention! Money would go to organic farmers and well-trained nutritionists, and otherwise stay in people's pockets, instead of Big Pharmaceuticals and the junk food industry; the environment would be back on the upswing, and people would be happy, healthy, productive, and looking up to proper role models.
  • JMcGee2018
    JMcGee2018 Posts: 275 Member
    I think we should have Medicare for All, and I think that there should be a flat tax % for that health care, and that people who fall within a healthy weight range should get a tax credit for being in that healthy range. That way it doesn't punish overweight/obese people strictly speaking, but does reward those that are healthy. Underweight people would not be able to get this tax credit, either. There could be ranges of tax credit, like obese class II pay the full %, obese class I receive a small tax credit, overweight get a greater tax credit, healthy pay the least with the greatest tax credit, underweight pay the same as overweight, etc. Mandatory yearly physicals if you want to receive any tax credit because that is proof of BMI/weight category.
  • gymprincess1234
    gymprincess1234 Posts: 493 Member
    Yes, the same for smokers, extreme sports, etc. It seems logic from the logistics of health insurance.
  • hud54014
    hud54014 Posts: 3,777 Member
    Assigning premiums based on lifestyle choices that can change at any time for any reason sounds like a pretty big overhead expense to me... and overhead costs are ultimately absorbed by consumers anyway. Sounds like a waste of time and money, but what do I know...
  • JMcGee2018
    JMcGee2018 Posts: 275 Member
    hud54014 wrote: »
    Assigning premiums based on lifestyle choices that can change at any time for any reason sounds like a pretty big overhead expense to me... and overhead costs are ultimately absorbed by consumers anyway. Sounds like a waste of time and money, but what do I know...

    I think a mandatory yearly physical should be put in place, and at that time the doctor can calculate your BMI, which you would then submit as part of your taxes in return for a tax credit if you are in a healthy BMI range or no tax credit (or at least a reduced tax credit) if you are in an unhealthy range.
  • Gisel2015
    Gisel2015 Posts: 4,192 Member
    JMcGee2018 wrote: »
    hud54014 wrote: »
    Assigning premiums based on lifestyle choices that can change at any time for any reason sounds like a pretty big overhead expense to me... and overhead costs are ultimately absorbed by consumers anyway. Sounds like a waste of time and money, but what do I know...

    I think a mandatory yearly physical should be put in place, and at that time the doctor can calculate your BMI, which you would then submit as part of your taxes in return for a tax credit if you are in a healthy BMI range or no tax credit (or at least a reduced tax credit) if you are in an unhealthy range.

    Wishful thinking. The government in the US is limiting tax credits and tax deductions and do you think that Congress will change the tax code again to accommodate for incentives for a healthy BMI? I think NOT!

    Besides, we all know that BMI is a relative measure of fitness. A very fit person doing a lot of exercise and developing a nice muscular physic will weigh more and have a higher BMI that somebody leaner but probably not so healthy. So the ripped guy will pay more while the not so healthy one will be rewarded with a tax refund, credit or what ever? Not a good idea.
  • foreversnafu
    foreversnafu Posts: 29 Member
    JMcGee2018 wrote: »
    I think a mandatory yearly physical should be put in place, and at that time the doctor can calculate your BMI
    >Build muscle
    >Score high BMI
    >Be forced to pay more

    Haha, no thanks.

    Especially when 6'4 at 155 is considered healthy and 6'4 at 205 is considered overweight.
  • Nikion901
    Nikion901 Posts: 2,467 Member
    Only if you make everyone else who has any 'condition' pay more. ...
  • janejellyroll
    janejellyroll Posts: 25,763 Member
    Gisel2015 wrote: »
    JMcGee2018 wrote: »
    hud54014 wrote: »
    Assigning premiums based on lifestyle choices that can change at any time for any reason sounds like a pretty big overhead expense to me... and overhead costs are ultimately absorbed by consumers anyway. Sounds like a waste of time and money, but what do I know...

    I think a mandatory yearly physical should be put in place, and at that time the doctor can calculate your BMI, which you would then submit as part of your taxes in return for a tax credit if you are in a healthy BMI range or no tax credit (or at least a reduced tax credit) if you are in an unhealthy range.

    Wishful thinking. The government in the US is limiting tax credits and tax deductions and do you think that Congress will change the tax code again to accommodate for incentives for a healthy BMI? I think NOT!

    Besides, we all know that BMI is a relative measure of fitness. A very fit person doing a lot of exercise and developing a nice muscular physic will weigh more and have a higher BMI that somebody leaner but probably not so healthy. So the ripped guy will pay more while the not so healthy one will be rewarded with a tax refund, credit or what ever? Not a good idea.

    I am not advocating for a BMI-based tax credit system, but it's likely that the very fit person who has developed a muscular physique and the leaner person who is not so healthy will both fall into the healthy BMI range. BMI being thrown off my muscle is only an issue for more serious bodybuilders, not people who are just fit and developing muscle.