I object to a tool being used for a purpose to which it is ill-suited.
I won’t post the most recent letter because it is chock full of personal information but if you saw it, it would be very clear this is based on my personal medical information. No, it’s not a “statistical population”, it’s about what screening tests I’ve had and when (dates included), vaccinations (my most recent tdap in 2008, for example), my on-going allergies and asthma, and other items I don’t care to discuss on this forum.
Yes, it is. That’s why I want insurance companies to stop doing things like that.
Nobody wants to be part of a marketing campaign. Companies that run them do it to improve their bottom line, not because they think you’ll like it. It would be a lot better to let health agencies do all the marketing of food too, but McDonalds is going to keep running marketing campaigns because it’s good for them. Don’t think of your health insurer as any better or different than McDonalds. They would never encourage you to take advantage of a covered service unless they believed it would save them money, in aggregate.
There is if you tell 100,000 fat people for every 1 body builder. Even if the lean body builder is too stupid to ignore the advice, the net benefit to the insurer is still there.
It’s a really good idea from their perspective. It even looks like they care about their customers to the intersection of people for whom 1) it is good advice and 2) don’t realize it’s nakedly self serving.
Four mailed fliers and two phone calls to “encourage” me to get a procedure that could provoke a medical emergency, land me in the hospital, or worse case even kill me (well, that might save them money if it happens quickly) is not saving them money, it’s mindlessly going down a checklist and triggering bothering to a point just short of harassment because their algorithm isn’t set up to note people for whom something like a flu shot is contra-indicated due to a history of life-threatening complications.
If it was just “get a mammogram” or “get a pap smear” or “it’s time for a colonoscopy” your argument would hold water but because whatever mechanism is in play causes them to recommend something absolutely not good for me despite obvious access to my medical records indicates that this is, at best, badly done. Nor am I the only person I know of who has encountered such things.
Fuzzy D, at BMIs in the “overweight” range, especially at 26 and 27, they are aiming at a whole mess of people who may not be body builders but who do not have unhealthy amounts of fat (along with a fair number who do). This is not BMI of 30 plus which misidentifies very few. The studies are somewhat mixed but the statistical “sweet spot” for lowest mortality risk is, depending on the study, somewhere between 23 and 27 (the population most likely to more commonly have the most healthy balance of muscle mass and fat and behaviors/health status associated with better outcomes). They are also targeting a huge number of people, an overwhelming majority of them, while still missing some with unhealthy amounts of fat in unhealthy locations and poor diet/nutrition, whose BMIs are under 25.
That said I am still fairly sure that the flier is not based on anyone reviewing your chart Broomstick even though it has a whole messa personalized information in it. Insurance companies can (of course) get access to your chart but there is significant effort (staff time) involved and typically is only done when looking to justify (or deny) a particular claim. What they have easily available for these “outreach programs” is claims data and they autopopulate mailings and calls out of those datasets, yes according to the algorithms:
"Dear [First Name Last Name],
We at InsuranceCorp care about your health. People like you with [Conditions A, D, T, and V, codes entered that are searched for] are advised to have [Screenings and preventative care that basic guidelines advise unless contraindications exist matched to the conditions].
We see you have already had your [screenings and preventative care items above that have been entered in as codes] done, which is excellent, and would like to encourage you to have [those not coded for] done as well as soon as possible.
We have [matching program(s)] available to support you in meeting your health goals. Please consider taking advantage of them!
InsuranceCorp. Your health is our concern!"
Not sure that they have these programs set up to look for the listed matched contraindications to [Screenings and preventative care that basic guidelines advise unless contraindications exist matched to the conditions] but even if so they will only find them if they are entered in as claim codes that identify them as such (which is often not done so well, even though it is clearly marked as part of your medical chart) and the numbers will be much smaller than the numbers of those correctly identified as members of the targeted populations. Annoying you with an inappropriate flu vaccine reminder (which will not be inappropriately acted upon) is from their population management perspective a small cost compared to what they believe they can gain as benefit.
Yes, they are not doing this. They SHOULD do that. If they can automate the rest of it they should be able to automate that part, too.
And it’s not just polite encouragement - it’s “you won’t get your X% rebate on premiums if you don’t get Y done” even if Y is contra-indicated. As I mentioned, this sometimes takes the form of phone calls. The phone call people DO have access to my medical chart, I know this because I asked one of those nice people if my flu shot allergy was in my records or not and she said yes, it was - oh, that makes this whole phone call ridiculous, doesn’t it? Yes, it does.
So, basically, if I get a shot that may hospitalize me I can get a rebate on my premiums, but if I don’t I won’t. So I wind up paying more than someone else because I can’t conform to some pre-determined algorithm. Really, they should reward me for NOT getting a flu shot, because that saves them money and me trouble.
Another factor is that my insurance is subsidized by my state due to my current low income and that seems to make people feel entitled to dictate things to me (see any thread about food stamps and what poor people should and shouldn’t be eating to satisfy the better off). Maybe that’s a factor with the intrusiveness.
Anyhow - getting back to the obesity question and away from yours truly - weight loss and how it should be done is something to be worked out between patient and doctor, not dictated by the insurance company. Someone might need to ideally lose 30 pounds but there might be more pressing matters they need to deal with first. Achieving actual long-term weight loss is not easy and a patient may need multiple attempts with multiple approaches before succeeding on any level. Some people who are of normal weight but low lean body mass might benefit from a program to put on muscle rather than concentrating on diet.
Of course, I’m a silly advocate of optimizing health, not just waiting around for an acute illness.
That, and I think the issues surrounding the overweight - spare tire weight in the OP’s terms - and the truly obese are very different. If you’re 20 pounds over ideal you should be working on diet and exercise, possibly stress control (that’s often a factor in over-eating) or whatever triggers excess consumption. If you’re 200 pounds overweight then surgery starts to become an option to consider, but you’d never do that for a mere 20 pounds. In that sense, yes, it’s a two-tier problem but the dividing line isn’t sharp, one category does shade into another.