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Do you think obese/overweight people should pay more for health insurance?
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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.2 -
'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.1 -
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.
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The only reason you're paying more for insurance is because the government decided to get involed and they have the anal touch, everything they lay hands on turns to shite. For those willing to throw obese people under the bus, don't worry, the government will get to you soon enough and brand something you're doing as an "unhealthy lifestyle".7
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Yes, they should. Just like health insurance companies can charge people more for smoking.5
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From a purely insurance perspective yes, higher risk means higher premium, that's how all other forms of insurance works.
With that said, I think there is a larger question of how do we ensure everyone has access to affordable healthcare. Many nations have chosen to have a national healthcare system, which I would not classify as insurance you pay taxes and your taxes entitle you to access. To me this is more similar to the taxes that go to roads, and public education. In the US we do not have national healthcare, instead we do rely on actual insurance to provide that access to healthcare, and so I think the question is trickier, and full of a lot more ethical questions then how the average auto or property insurance rates are calculated when weighing risk. Yes obese individuals are at higher risk, so are smokers, drinks, drug users of any kind, extreme athletes, Older women who choose to get pregnant, and I am sure a bunch of other life choices a person can make or not make that would mean they are at a higher then average risk for health conditions. Health insurance is already very high in a lot of cases, if we impose higher premiums for higher risk situations, we may inadvertently price out people who really need healthcare.
I think rather than talking about insurance premiums, for me the question is how to we make healthcare accessible to everyone. IMO healthcare is a basic human need and I think we could find a way to make sure its available to everyone.5 -
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?4 -
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.
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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.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.
Given that some estimates put 80% of runners being injured every year, maybe they should consider running a pre-existing condition!
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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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rheddmobile wrote: »
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.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.
Given that some estimates put 80% of runners being injured every year, maybe they should consider running a pre-existing condition!
Your mom's 6 day hospital stay for kidney issues that included a surgery didn't cost $8k, that was her out of pocket. Total bill was probably closer to $200k+ and insurance picked up most of it.
Orthopedic injuries from exercise are generally lower cost if they happen and help prevent 6 figure hospitalizations from obesity related issues.0 -
MargaretYakoda wrote: »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?
Obesity is a lifestyle choice in most cases as opposed to something the individual has no choice over. Big difference IMO.2 -
Wow. This thread is toxic. Obesity is NOT always a choice. I’ve been “overweight” according to BMI my whole life and I did NOT choose it. I was overweight DESPITE a healthy lifestyle of eating well and being relatively active. Bodies come in all shapes and sizes and lots of people are naturally bigger and it’s GENETIC and NOT a choice. BMI is a crappy system that doesn’t take muscle mass into account. Lots of “overweight” people with high muscle mass and an active lifestyle are perfectly healthy despite being labeled as “overweight” by BMI. Plus size women already face SO much discrimination in the workplace and we don’t get equal representation in the media and now you guys want to add on even more discrimination? What is wrong with you people? I’ve only been on this forum a few weeks but as someone who identifies as plus size I have felt so much negativity towards me here. Stuff like this is really triggering for me and I am feeling SO pissed right now!4
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Wow. This thread is toxic. Obesity is NOT always a choice. I’ve been “overweight” according to BMI my whole life and I did NOT choose it. I was overweight DESPITE a healthy lifestyle of eating well and being relatively active. Bodies come in all shapes and sizes and lots of people are naturally bigger and it’s GENETIC and NOT a choice. BMI is a crappy system that doesn’t take muscle mass into account. Lots of “overweight” people with high muscle mass and an active lifestyle are perfectly healthy despite being labeled as “overweight” by BMI. Plus size women already face SO much discrimination in the workplace and we don’t get equal representation in the media and now you guys want to add on even more discrimination? What is wrong with you people? I’ve only been on this forum a few weeks but as someone who identifies as plus size I have felt so much negativity towards me here. Stuff like this is really triggering for me and I am feeling SO pissed right now!
Welcome - I'm sorry this thread is upsetting to you, but the "debate" area tends to be more freewheeling when it comes to discussing topics like this. You may find areas like "Support" to be more useful for you.
When people say obesity is a choice, what they are usually saying is that obesity is the result of daily, regular choices. It's not that there is a belief that people wake up and say "I'd like to be fat." The particular situation of a lot of people here is that we were overweight and we've realized the role that our choices played in that. It's not that we weren't eating well and being active (many of us were eating well and being active), it's that our choices resulted in us consuming more calories than our body needed. Our current environment makes it incredibly easy for people to do that . . . but we still have choices over how we interact with our environment.
I personally found this realization to be empowering. I understand that's not the way it feels for everyone.10 -
Wow. This thread is toxic. Obesity is NOT always a choice. I’ve been “overweight” according to BMI my whole life and I did NOT choose it. I was overweight DESPITE a healthy lifestyle of eating well and being relatively active. Bodies come in all shapes and sizes and lots of people are naturally bigger and it’s GENETIC and NOT a choice. BMI is a crappy system that doesn’t take muscle mass into account. Lots of “overweight” people with high muscle mass and an active lifestyle are perfectly healthy despite being labeled as “overweight” by BMI. Plus size women already face SO much discrimination in the workplace and we don’t get equal representation in the media and now you guys want to add on even more discrimination? What is wrong with you people? I’ve only been on this forum a few weeks but as someone who identifies as plus size I have felt so much negativity towards me here. Stuff like this is really triggering for me and I am feeling SO pissed right now!
Sorry if you are feeling triggered. Does it trigger you that obesity is the second leading cause of preventable death in the US? If not it should: https://www.wvdhhr.org/bph/oehp/obesity/mortality.htm
It's nothing personal, just facts and data.
I would have no problem and would encourage basing any sort of obesity related insurance surcharge for obesity on bodyfat measurement via DEAX scan, etc as opposed to strictly BMI.
Fact is though in the vast majority of cases if someone is obese based on BMI they will be obese on measures of bodyfat such as a DEXA scan.
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I think that something everyone misses in the whole “obesity costs health care money” is that we will all die eventually. Toward the end of life, health care costs often skyrocket.
So, if obesity were “cured” (imaginary of course) then ten or twenty years from now health care costs would skyrocket for all the non obese people just being old.
My mom is nowhere near obese (never was) but 95 (in fact we need to help her gain weight). In the past 8 months she broke her right hip once and her left hip twice. The costs for surgery and rehab without insurance (she’s well insured) would have been astounding.
Should mom pay more because she’s more likely to need medical care?
I was obese for 30 years and with the exception of an inguinal hernia (hereditary) never saw a doctor. I know I was just lucky but would it have been fair to charge me more?
Health insurance is not like car Insurance. We will all need health care at some point but many of us will never have a serious car accident.5 -
Her out of pocket was zero. It’s good to be an elderly widow of a military officer in the US. That is the stated total cost, Tricare said they would have covered up to 24k, but the bill was 8. I know, I was shocked too.Theoldguy1 wrote: »rheddmobile wrote: »
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.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.
Given that some estimates put 80% of runners being injured every year, maybe they should consider running a pre-existing condition!
Your mom's 6 day hospital stay for kidney issues that included a surgery didn't cost $8k, that was her out of pocket. Total bill was probably closer to $200k+ and insurance picked up most of it.
Orthopedic injuries from exercise are generally lower cost if they happen and help prevent 6 figure hospitalizations from obesity related issues.
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Wow. This thread is toxic. Obesity is NOT always a choice. I’ve been “overweight” according to BMI my whole life and I did NOT choose it. I was overweight DESPITE a healthy lifestyle of eating well and being relatively active. Bodies come in all shapes and sizes and lots of people are naturally bigger and it’s GENETIC and NOT a choice. BMI is a crappy system that doesn’t take muscle mass into account. Lots of “overweight” people with high muscle mass and an active lifestyle are perfectly healthy despite being labeled as “overweight” by BMI. Plus size women already face SO much discrimination in the workplace and we don’t get equal representation in the media and now you guys want to add on even more discrimination? What is wrong with you people? I’ve only been on this forum a few weeks but as someone who identifies as plus size I have felt so much negativity towards me here. Stuff like this is really triggering for me and I am feeling SO pissed right now!
Eating well apparently means something unique to you. To me it means eating the correct number of calories to maintain a normal BMI. Doing that, or not, is indeed a choice. There are no people who can maintain an overweight BMI despite not eating. If there were, NASA would be contacting them to solve to the problem of how to ship enough food to Mars to sustain astronauts on a manned flight.
Approximately 10% of people fall into the “overweight” category despite not being over fat. Most of them are athletes.
In other posts you have claimed that because most people in America are overweight or obese, the BMI defined as “normal” should be changed. I recently read a good example of why that is a false use of statistics. What is the average number of arms a human being has? Some people have fewer than two, while almost no one has three or more, so the average is less than two. Does that mean that I, with my two arms, have an abnormally large number of arms?4 -
rheddmobile wrote: »
Her out of pocket was zero. It’s good to be an elderly widow of a military officer in the US. That is the stated total cost, Tricare said they would have covered up to 24k, but the bill was 8. I know, I was shocked too.Theoldguy1 wrote: »rheddmobile wrote: »
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.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.
Given that some estimates put 80% of runners being injured every year, maybe they should consider running a pre-existing condition!
Your mom's 6 day hospital stay for kidney issues that included a surgery didn't cost $8k, that was her out of pocket. Total bill was probably closer to $200k+ and insurance picked up most of it.
Orthopedic injuries from exercise are generally lower cost if they happen and help prevent 6 figure hospitalizations from obesity related issues.
That is super strange. I had outpatient rotator cuff surgery a few years ago and the discounted price my insurance was charged was $12k, insurance paid $9k we had to pay $3k.0 -
No, because it would promote weight stigma, and to solve obesity problems we should first solve the parallel problems of weight stigma.My mom and I were discussing this today and I thought it would be a great topic for this forum, especially with all the politics surrounding health care these days.
So do you think people who are overweight and/or obese should have to pay more?
Do you think this would be a deterrent to gaining weight for people that are not in this category?
Should people with medications/medical conditions that cause weight gain be exempt?
I know that with obamacare/ACA there are wellness programs available, do you think these are all that helpful if you've been to one?
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