No, smoking is not the same as religion. Get a grip.
Tax dollars…?
Older workers clearly require more medical attention than the younger ones. Should they face a higher premium too due to their age?
Uh… yes?
I am a Benefits Manager at a large corporation. And this is pretty much what we do.
Actually we go further than that. In our plan, the normal insurance copay is 70%. However, if you fill out a Health Risk Assessment and talk to a health coach or participate in our disease management program, you are eligible for an 80% copay.
Non-smokers get a premium discount ($25/month I think).
I’ve worked at companies that also gave discounts for pledging to wear your seatbelt or exercise 3x a week. (Of course these could not be enforced, it was done on the honor system).
Medical costs go up and up every year (10-12% for 2011). Companies have to get as creative as possible to keep the costs affordable for the company and for employees. Providing incentives for employees to make healthy choices is one way to do it.
So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.
Death tends to be prejudiced against age. Don’t hate the playa, hate the game.
It’s not junk science, you just don’t understand how or why it’s used. Let’s start at the top, you posted this link. Starting from #1:
No shit. No one uses the BMI to measure fatness in a person. It is used as a proxy for fatness, and it is a fairly accurate one at that. If I say “someone has a BMI of 35”, no you can’t conclude that they are necessarily fat. But since 99%* of people with a BMI of 35 are fat, it gives you a big honking clue. In this case, I can’t say there is a person with a BMI of 40 who isn’t fat, but I’d be shocked to find one.
*I made this number up
What? This is just bullshit. Ideal weight doesn’t increase linearly with height, so why should we expect the formula to just use height?
No shit. BMI isn’t good for exceptions for the rule, but it is pretty accurate for normal people. No one who uses BMI is not aware of the fact pointed out here. Using it as an argument against BMI is just stupid.
This is just wrong and stupid logically, and ends up repeating the same argument from 3.
I don’t see how this is different from #3, so the answer is the same.
This is just stupid. Anyone with an air of scientific authority uses BMI correctly. As a screening indicator and fairly accurate proxy for fatness. The only people that consider it mathematical snake oil are the ones that don’t understand how and why it is used.
What? This is just retarded. No one suggests that people with 24.9 BMIs are perfectly a-ok and people with 25.0 BMIs are fatties.
No they won’t because no insurance company is retarded enough to put the cut off where “fit individuals with good bone and muscle” will be lumped in with fat people.
Generally speaking they don’t cost a little more, are more difficult to self report, and are less consistent from person to person. It takes a minute to measure and weigh someone, and everyone who performs that test will come up with the same result. Waist size, for example, is more difficult to repeat because not everyone will necessarily measure the waist at the same spot. Especially on fatter people.
It isn’t as though there is a vast BMI conspiracy. BMI is used because it performs its task well, is cheap, and is fast.
Translation: I ran out of semi-legitimate arguments at 9 and had to just make up something.
I took a quick look through the NFL combine results, and I saw 3 out of the several hundred players that had a BMI of 40 or over. The highest being 42.7, and he is most definitely and unequivocally fat. link.
Insurance is based on easily measurable, repeatable, and identifiable numbers, not on expensive, difficult to measure, and not perfectly repeatable numbers. This is why smokers are docked for being smokers without a lung examination. And it’s why old people are docked for being old, and men for being men, and whatever other factor comes into play. There’s nothing wrong with using BMI as another factor, since it has been highly correlated with a plethora of health problems.
I’m not going to say that BMI is a great tool – of course it has very sharp limits – but this guy isn’t even quoting the CDC correctly.
The CDC’s web site says, "Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.
The word “most” is conveniently left out, and the whole mention that it is only a screening tool is not even mentioned.
It’s been said a few times and obviously ignored: A BMI over 40 is seriously fucking fat. We’re not talking about a little pudgy, or the bullshit about Lance Armstrong. We’re talking morbidly obese.
I even doubt many NFL players would fall into this category. But even if a 5’ 11" man was over 290lb of muscle, there is a good chance he’s using substances that are also adversely damaging his health.
In short, BMI works just fine when used to measure morbidly obese.
But on a personal note, women of child bearing years cost waaaaaaay more. Good luck touching that one.
Your idea of insurance is different from mine apparently. To me, insurance is simply a way to avoid the risk of a catastrophic (or at least unpleasant) expense by estimating the risk and paying someone else to assume it.
If you’re wanting to give everyone a consistent rate regardless of the risk to the insurer, well, that’s a social program, not insurance.
Health care coverage started out in this country as plain insurance, but it’s been moving more towards the social program model. At this point it’s still primarily insurance, so you shouldn’t be surprised to hear people saying it’s OK to charge higher-risk people more. That’s just what insurance is.
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Neither smoking nor religion have anything to do with this fee. Smoking and BMI are as arbitrary as religion would be.
Tax dollars…?
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Businesses do not pay taxes on the insurance costs. This is the whole basis of the health insurance business and the company health plans. Tax exemptions decrease tax revenue, and increase the taxes we pay or the debt we owe. The only reason the current system works is that the cost of health insurance for business is not deductible if the benefits are not available to all employees. Before those tax laws were implemented, businesses had been deducting the costs of health care benefits for executives and other privileged employees without offering the benefits to other employees. I haven’t looked into the details of the tax code in over a dozen years, so I don’t know the current details, nor what the recent health care bill has done, but I have little reason to believe it will make this system fair.
I’m not saying I agree with the employer’s policy. I’m just saying that, all things being equal, a skinnier person is statistically more likely to be healthy than a heavier person. A current NFL player that is 6’ and 250 pounds is much more likely to have health problems than if that same player is 6’ and 170 pounds. I guess I could be wrong, but the added weight is almost never a benefit regardless of the fitness of the individual.
All that said, BMI is meant as a statistical tool as far as I know. It is not meant to judge fitness of individuals, but rather populations. For individuals, it serves as a way for a quick estimate of health. If an insurance company wants to charge different rates based on health, BMI is a poor way to measure an individual’s health.
While it sounds silly (because it comes to exactly the same thing), this is the correct solution.
Except that people from the start in this thread were saying that charging more was OK because people could just eat less or stop smoking. Suddenly, when matters people can’t control come up it’s all about risk assessment. As far as I can tell, the real, unspoken standard is “whatever screws the employees the most and costs the employer the least is right, as long as you don’t admit that’s what you are doing”.
BMI isn’t a perfect measurement for muscular people, but it’s not so very much off that the bar being set at 40 is going to unjustly penalize people who are merely fit. I’m a lot heavier than most women with my measurements because a fair amount of my weight is muscle. According to my BMI my body fat is 26.5% and according to Height-to-Waist it’s 20%. The discrepancy isn’t nearly big enough to make me believe that it’s possible for a non-body builder who isn’t legitimately overweight to have a BMI 15 points higher than someone at the same height with a normal BMI.
I wouldn’t be so sure it’s waaaaaaay more. Most women in the US only have two kids and according to this study about the profits to hospitals for c-sections vs natural births, you’re only talking about the hospital making $2,500-5,000 off each woman for two births. I suppose it’s possible that the costs in CA are freakishly low, but I doubt it. And besides, don’t men 18-40 generally have higher rates of injury through various activities like car accidents, fighting, and work accidents than women of the same age range?
Should people should be punished for being younger when buying auto insurance? That’s how the freaking industry works, get over it.
Then people shouldn’t try to justify it by blaming the people having to pay more.
Getting back to the OP if a business is making a pass/fail medical decision based upon non-medical professionals using a controversial and single junk science number, and not familiar with the medical and health conditions of each employee, woe be that business.
So, you’re planning on ignoring the long posts demonstrating your position to be incorrect and just repost the same lame arguments?
treis, you are adding more illogic to Duckster’s statement. The OP made it clear that this is not a medical decision. It is a decision by the business to improve their bottom line by arbitrarily charging employees a fee for nothing of value in return. The companies health insurance costs are unaffected by this fee in any way.