In other words, the business is making a business decision to raise rates using a controversial, quasi-medical concept called BMI. They are in effect making a medical decision for everyone without any regard to each person’s actual medical history and condition. You don’t have a problem with that? So if an employee with a BMI of 40 offers a signed medical opinion by their doctor stating said employee is in excellent health, you support the business decision supersedes an actual medical assessment? As I said, woe be a business that goes that route.
I am not ignoring previous comments. I just fail to understand why a blanket business decision has a greater emphasis than a documented medical opinion of one individual. If you care to read more into this than what is stated, the bias remains your own.
BMI is not “junk science”; as explained earlier in detail by treis, the BMI has limits and qualifiers, sure, as do just about any broad measures applied to a population.
Nonetheless, I’m opposed to having overweight and obese people pay more than the small minority of us who are the correct weight, because it really does open that door to umpteen different metrics which could in the long run be invasive to privacy. I mean, I see no reason why people who engage in risky sports or leisure activities should not be paying more than I do. Examples:
Of the people who play golf in my office, 100% of them, yes, 100% of them have had to seek medical treatment for a golf-related injury. Mostly torn/strained ligaments, some needing long-term physical therapy.
People at work have also had hospitalizations due to the corporate softball league games every year - why am I subsidizing a bunch of middle-aged potbellied men acting like they’re 15 and tearing ligaments, tendons, etc.? Don’t tell me it’s helping them physically; these people are drinking a gallon of “Bud Lite” and feasting on Super Supreme pizzas and nachos all night long. Each time one of them cuts themselves drunkenly tripping over a base, BP has to show up to cap the leak from their veins.
So why am I subsidizing them? People may debate whether being overweight is a choice for most (actually, on the SDMB that debate is settled, but as it happens Cecil is doing a column about this in a week to give his opinion…), but surely everyone will agree that golf and softball are in fact choices.
People do a lot of stupid things, they do a lot of unwise things, and they do a lot of just questionable things. While it may make actuarial sense to charge overweight people more, it’s not just a slippery slope, it’s a toboggan run of nitpicks, lawsuits, and unfairness.
I have to admit those two statements in the OP are contradicatory. One says the business is planning to charge extra for health insurance. The other says health insurance costs are unaffected. There is insufficient information to conclude whether or not the extra charge is related to health care costs.
It sounds a lot more fair than the single tax. At least you’ll get charged more for being a risk factor. If you’re single, you get charged a LOT more for being less of a burden.
Bob and steve both make 50k. Bob has no dependents. Insurance is $50 a month, company pays $300 on top of that. Steve has a wife and 3 kids. He pays $300 a month, company pays $600 or $800 or something like that.
Bobs compensation: $4366 a month
Steves compensation: $4866 a month
I’ll pay a modest premium on my tobacco use if I got that extra $500 a month to cover what I’m not costing the company for extra dependents. At least its deserved.
Not group policies. And increasingly not health insurance in general, which is transitioning to no consideration of pre-existing conditions. That’s the way it is going work for health insurance, get over it.
If the point was to charge more to those who would cost more then the company should be charging more to those with a history of high blood pressure, or asthma, or ADD, or even past claims. If you’ve used health services before the odds are you will again, and by that model should pay more. It does not work like that.
The idea is to try to motivate change of something that is within the control of the employee, and for that the issue is indeed how much it is within the employee’s control. Incentivize the easily controllable and that employees can confidently believe they can do.
For smoking success of quitting is 50%. That aint bad. Couple the extra fee (or lack of discount) with covering a smoking cessation program and getting half the discount for attendence only and it makes some sense.
Success at maintaining long term weight loss from morbid obesity is less than 50%, heck less than 5%, but the health benefits accrue even with long term achievement of healthier eating habits and exercise, even if the weight loss is very modest and the employee stays obese. Charge the fee but pay completely for a behavior mod program and have the discount earnable not by getting under BMI of 40 but by documented compliance with the plan. For BMI over 40 what works reliably is bariatric surgery, especially if there is comorbid diabetes. Make sure that a pathway that leads there is other interventions fail is part of your plan. (If your goal is long term health of your employees - short term that may cost the employer more.)
I agree in general with the people arguing that BMI is a poor measure of obesity at the individual level. On the other hand, where the cutoff is a BMI of 40, no employer except maybe Wal*Mart or the US Department of Defense (unlikely, for obvious reasons) is going to have anyone unfairly charged an extra $10, due to simple statistical probability.
Redskins lineman Albert Haynesworth is 6’6", and currently listed at 335 pounds. His BMI is 38.7. Jaguars tailback Maurice Jones-Drew is 5’7" and 208 pounds, and has a BMI of 32. Professional wrestler Mark Callaway (better known as The Undertaker) used to be billed as 325 lbs. and 6’10". His BMI would be 34.
In fact, I have found exactly one person who wasn’t fat but would be subject to the $10 fee: bodybuilder Jay Cutler (not the quarterback), who weighed in for Mr. Olympia 2009 at 274 lbs., and stands 5’9".
Don’t company premiums have a cross section of life styles already figured in?
What about gays? Can they charge them more? How about drug users? Shouldn’t they get family histories and charge more for people who have specific illnesses somewhere in their genetic makeup? Should they check and see who is active and works out regularly? Should they check the neighborhoods of the employees and determine which ones are safer? Should they run their drivers licenses to see who are safer drivers?
The entire point of having a group policy through your employer is that everyone pays the same rate and because you are coming in as a group and spreading the risk amongst a larger amount of people so you all pay less than you would for an individual policy. If an individual policy is written to take weight, smoking, asthma, etc. into account that is all well and good. A group policy by it’s very nature can’t do that. It is written with the concept of lots of people with various issues all being a part of the same plan and all paying the same rate. If you got a group auto insurance plan the exact same thing would happen and you would be rated on the overall driving history of your group and not on yourself as an individual but there are no group auto policies available the way that we as a nation have grouped our health insurance policies.
People who are pissed off that their group insurance rate is paying for health care for the obese are welcome to get an individual policy if they want. That way you are only being rated on your own personal choices and family history. Of course your family history or personal health issues may prevent you from getting a policy at all even if you are in perfect health and you will pay significantly more for that individual policy than you ever would on a group plan through your employer, but at least someone who is obese or chooses to smoke wouldn’t be impacting your insurance costs, right?
In the UK, the National Health Service was formed to give everyone free medical insurance. It was clear from the Second World War, that controlled eating hanits due to rationing, actually made people healthier. So the NHS was a continuation of this, in respect of providing free medical treatment. However since 1945, our lifestyles have generally become more conformtable, and that brings more personal choices. Economic pressures have now caused a re-examination of how free this medical insurance should be. The easy targets are obesity, alcoholism, and drug abuse. There is no excuse for suffering for any of these, but at the same time society can’t just decide which citizens to abandon. Yes, maybe people in these categories should pay extra - where possible. I don’t see it as a go or no-go situation. I pay taxes on lots of services I don’t use, but I’m not about to sit down and work what amount I should really be paying. The ideal society I want to live in, really only exists in my mind, but laterally I can achieve a lot. In private medical insurance, it just isn’t viable to evaluate the costs for each individual, unless they start to form a large grouping. So a general medical insurance is fine with me, just as long as higher needs provide the extra costs from some complimentary source. But above all society has to take care of everyone, however this is achieved. We shouldn’t dismiss people so easily if we don’t agree with their personalities or choices. History is littered with tradgedies based such narrow thinking.
When they started with anti-smoking laws it was just in the office. Then it was restaurants, then bars, then apartments, and now cities are going after parks.
There is no limit to the extent this can be taken. It’s only a matter of time before the process of gene mapping is as fast/cheap as checking sugar levels and then risk assessment will take on new meaning.
I currently avoid companies that behave in this manner. I wouldn’t call it a boycott but more of a reward to companies that don’t treat their employees in this manner.
Yes, initially. Whenever I got quotes for health insurance for my company, the insurance companies took a census of workers and quoted a price. All they knew at this stage was the number, age and sex of the workers and dependents. However, when it came to renewals each year thereafter, the insurance company used the experience of actual claims from my company to set renewal rates.
Hence if a company reduces the size of claims by some measure such as weight-reduction, smoking cessation or other measures, then policy renewal prices will be reduced.
