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Charging the Unhealthy More For Insurance

kdawson posted more than 7 years ago | from the no-carrots-for-you-here's-a-stick dept.

The Almighty Buck 1106

Joe The Dragon sends us a BusinessWeek story, run on Yahoo, about Clarian Health and the new thing they are trying with health insurance coverage for their employees. They are charging unhealthy people more. The article goes into some depth about whether this is a good idea and whether the practice might spread. "In late June, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI, a ratio of height to weight that measures body fat) is over 30. If their cholesterol, blood pressure, and glucose levels are too high, they'll be charged $5 for each standard they don't meet. Ditto if they smoke: Starting next year, they'll be charged another $5 in each check."

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and if you have a slashdot account (5, Funny)

JeanBaptiste (537955) | more than 7 years ago | (#20147539)

thats another 20

Re:and if you have a slashdot account (-1, Offtopic)

Anonymous Coward | more than 7 years ago | (#20147591)

Broody broody bra ha ha!

Re:and if you have a slashdot account (2, Funny)

Hijacked Public (999535) | more than 7 years ago | (#20147617)

On top of the $5 I already paid?

And my BMI is usually just less than 30. Yet my body fat is around 6%, which is kind of at odds with the summary, but pointing out errors in summaries is kind of boring here.

Luckily I'm self employed and pay exorbitant rates regardless.

Re:and if you have a slashdot account (5, Informative)

jguthrie (57467) | more than 7 years ago | (#20147727)

Actually, I don't think it's at odds with the summary, it's just that the BMI is a pretty useless measure of someone's health.

Re:and if you have a slashdot account (2, Interesting)

AKAImBatman (238306) | more than 7 years ago | (#20147943)

I'm more worried about the Cholesterol. Some people have naturally high cholesterol. It doesn't impact their health any, but there's no way they're ever going to come out with a "normal" reading. Are they going to get fined for having "poor health" even when they don't?

Lame idea.

I much prefer the idea my insurance company has. They give you this monopoly money for doing healthy stuff, getting checkups, and generally keeping in good condition. You can later redeem the fake money for real stuff like merchandise and vacations. If only their website didn't suck so badly, I'd have a huge pile of their funny money. :-/

Re:and if you have a slashdot account (2, Funny)

BSAtHome (455370) | more than 7 years ago | (#20147903)

So my lifestyle means that I have to pay for my employment? I love collecting unhealthy habbits.

Where will this madness end? (5, Funny)

Anonymous Coward | more than 7 years ago | (#20147545)

Charging drivers with more accidents higher rates for auto insurance?

Re:Where will this madness end? (4, Insightful)

Tackhead (54550) | more than 7 years ago | (#20147639)

> Charging drivers with more accidents higher rates for auto insurance?

"Exempting highly-skilled workers from having to pay unemployment insurance premiums, and raising premiums on burger flippers."

That's where it'll stop.

What's the problem? (1, Insightful)

0racle (667029) | more than 7 years ago | (#20147551)

You're a higher risk so you pay more, seems like an insurance company at work to me.

Re:What's the problem? (4, Informative)

Captain Splendid (673276) | more than 7 years ago | (#20147587)

Except for the fact that the BMI is an outdated and inaccurate POS.

Re:What's the problem? (5, Funny)

Joebert (946227) | more than 7 years ago | (#20147785)

Agreed, & I have a solution.

We should gather every employee in a room & stand them on a table one-by-one, if the majority of the room thinks that person is a fat bastard, that person gets charged more.

Re:What's the problem? (3, Funny)

internetcommie (945194) | more than 7 years ago | (#20147923)

So all pointy-haired bosses would pay a higher rate regardless of BMI and bodyfat, while the non-bastard fatsos are let off.
Sounds fair to me!

Re:What's the problem? (2)

iron-kurton (891451) | more than 7 years ago | (#20147817)

High cholesterol, blood pressure, and glucose, could be valid measurements. Unless, of course, you're genetically predisposed to high cholesterol. The other problem I see with this is it's going to increase promotions for drugs, particularly cholesterol drugs, in a society where taking The Easy Way Out (tm) seems to be a de facto standard.

I think this sets a dangerous precedent. While I agree that people at high risk (of anything) should be charged more for insurance, health has too many variables to be able to accurately measure risk.

Fat percentage, in this case, might be the only possible solution. Anyone got any other suggestions?

Re:What's the problem? (1)

nehumanuscrede (624750) | more than 7 years ago | (#20147661)

So does it work the other way around ?

Ergo, if you're in perfect health do you get a discount ?

If you prove you ran the last Triathlon do you get a bonus ?

Where do you draw the line ?

If you have a family history of heart disorder or cancer
do you even get benefits at all ?

*grumble*

Re:What's the problem? (1)

CavemanKiwi (559158) | more than 7 years ago | (#20147757)

Already Does kinda. Well My sister who lived in New Hamphire got free gym membership(paid for by her health insurance) if she went 4 times a month.

Insurance companies... (1)

amccaf1 (813772) | more than 7 years ago | (#20147841)

Ergo, if you're in perfect health do you get a discount ?
Yes and no. This is an insurance company. They'll charge you the same, but they'll call it a discount.

Re:What's the problem? (1)

Bartab (233395) | more than 7 years ago | (#20147719)

They should do this in California, so that Governor Schwarzenegger can pay the $10 for his excessive BMI.

Re:What's the problem? (2, Interesting)

Surt (22457) | more than 7 years ago | (#20147837)

Could we also charge him once per instance on those he has encouraged to take up smoking? I'm pretty sure we could pay down our huge public debt on that.

Re:What's the problem? (1)

Fizzl (209397) | more than 7 years ago | (#20147865)

Yeah, but doesn't seem like they would compensate those healthy persons.
Only punish some and fill their pockets (more).

It would look more like car insurance if they would compensate those living healthily intead.

Slow news day? (1)

Aeiri (713218) | more than 7 years ago | (#20147555)

Isn't the entire point of insurance to charge higher for higher risk people, and lower for lower risk people?

Re:Slow news day? (4, Insightful)

MightyMartian (840721) | more than 7 years ago | (#20147673)

The problem here is that it only assesses one kind of risk. What about sexually promiscuous employees, or employees that like skydiving or downhill skiing? What about employees that pop too many aspirin, or employees with physically abusive spouses? What about those employees with genetic predispositions to any number of chronic (read: EXPENSIVE) diseases, who have thus far been lucky enough not to come down with them (so far)?

Re:Slow news day? (4, Funny)

lymond01 (314120) | more than 7 years ago | (#20147811)

What about sexually promiscuous employees, or employees that like skydiving or downhill skiing? What about employees that pop too many aspirin, or employees with physically abusive spouses? What about those employees with genetic predispositions to any number of chronic (read: EXPENSIVE) diseases, who have thus far been lucky enough not to come down with them (so far)?

World wasn't invented in a day, boy. Simmer down. They'll get to it.

Re:Slow news day? (1)

MightyMartian (840721) | more than 7 years ago | (#20147855)

My point is that, as a society, we find it unsavory, if not outright immoral, to let insurance companies run away completely with the notion of risk, particularly in matters of healthcare. If you follow the logic that fat people and smokers are going to cost insurance companies more, then what about people who partake of all manner of activities that increase the insurance companies' exposure to payouts, or who, in fact, through no fault of their own, carry genetic predispositions to hypertension, cancers, and other nasty and potentially expensive diseases.

As with all such things, it makes some sense in principal, but when you get into the nitty-gritty, you find that things aren't always as clearcut as they at first seem.

Re:Slow news day? (3, Informative)

chill (34294) | more than 7 years ago | (#20147901)

What about sexually promiscuous employees, or employees that like skydiving or downhill skiing?

Have you read an insurance application lately? Non-commercial pilot, skydiving, rock climbing and other "dangerous" activities are asked about.

As for the rest, I'm sure they'll get to them eventually.

Re:Slow news day? (1)

rbunker (1003580) | more than 7 years ago | (#20147761)

re. "Isn't the entire point of insurance to charge higher for higher risk people, and lower for lower risk people?"....well, no. That would be a state called "uninsured". The entire point of insurance is to pool risk among many people who will not have a need, and pay for the people who do have the need. Thus homeowner's insurance would not work if only purchased for houses on fire. The fact is that about 7% of the US population suffer from chronic illnesses, and consume around 70% of the health care dollars. So charging people an extra $10 for being overweight is pointless in terms of managing health costs, offensive on too many levels to count, and is live bait for employment law litigators to a greater extent than anything I can remember in recent history. Rick.

Re:Slow news day? (5, Insightful)

AuMatar (183847) | more than 7 years ago | (#20147797)

No, it isn't. The point of insurance is that a certain percentage of a population will get hit. By spreading the financial risk over a large pool of people, each person pays an amount they can afford in case its them.

This is why private insurance is a bad thing- their job isn't to maximize protection, but to maximize profit. Ideally, they would want to insure only the people who don't get sick and none of those that do, to make 100% of that money in profit. In other words, they want to make it a giant scam, taking your money but providing no services. This doesn't stop the others from getting sick, it just forces them to pay through the nose for non-insured rates, or get no health services at all. And since we live in a humane society where we don't let them die on the street, society as a whole pays a higher rate as we pay for them to take up emergency services when things go completely wrong, rather than cheaper, more effective, and less risky preventitve care they'd recieve with insurance.

So no, this is *not* a good thing. This is a perversion that will inflate the pockets of wealthy insurance companies while bankrupting the lower and middle classes. This is why we need to get rid of insurance companies and get government healcare *now*.

Re:Slow news day? (1)

Duhavid (677874) | more than 7 years ago | (#20147897)

Then why have insurance? The medical providers will charge higher
for high risk ( when something happens ), and lower for low risk
( when something doesnt happen ) automatically.

I had always thought that the point of insurance was to spread the
risk of an incident over a large number of people, and over a large
period of time.

Form of Discrimination? (5, Funny)

deadmantyping (827232) | more than 7 years ago | (#20147565)

That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.

Re:Form of Discrimination? (2, Interesting)

SatireWolf (1050450) | more than 7 years ago | (#20147637)

I do believe this is the first positive move to ENCOURAGE people to take care of themselves better ever. The reason Americans are fat is because it's easier, cheaper, and otherwise less time consuming to be a fat ass.

Re:Form of Discrimination? (1)

ajenteks (943860) | more than 7 years ago | (#20147649)

I doubt that obese people would take this move lightly .
Hey, just what are you trying to say?

Re:Form of Discrimination? (1)

scott_karana (841914) | more than 7 years ago | (#20147745)

Do you also find car insurance prices discriminatory? If you get speeding tickets, you pay premiums. Isn't that akin to saying "if you keep your body trim, you're less apt to have health problems"?

Re:Form of Discrimination? (1)

Trauma_Hound1 (336247) | more than 7 years ago | (#20147875)

No I hire a lawyer and beat them, so I don't pay higher premiums. See higher premiums work well don't they?

Re:Form of Discrimination? (0)

Anonymous Coward | more than 7 years ago | (#20147773)

That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.

Indeed. The fatties are so unhealthy they'll be going into cardiac arrest at the shock of it.

Re:Form of Discrimination? (1)

CaptainPatent (1087643) | more than 7 years ago | (#20147927)

That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.
Yeah, pound-for-pound this just seems like a bad idea.
Why should they have to carry a heavier burden?

BMI upside down (1)

methano (519830) | more than 7 years ago | (#20147567)

Seems like you would want your height to weight ratio to be on the high side. Is this to punish the thin people?

Re:BMI upside down (1)

Radon360 (951529) | more than 7 years ago | (#20147803)

Yes, I saw where you were going with your comment.

FWIW, anyway, here's the equation:

English BMI Formula
BMI = ( Weight in Pounds / ( Height in inches ) x ( Height in inches ) ) x 703

Metric BMI Formula
BMI = ( Weight in Kilograms / ( Height in Meters ) x ( Height in Meters ) )

Seems reasonable... (1)

maniac/dev/null (170211) | more than 7 years ago | (#20147575)

Seems reasonable... we charge people with poor driving records more for auto insurance. People who live in flood plains pay more for home insurance. Why shouldn't people at higher risk of health problems pay more for health insurance?

For the record, I'd probably fall at or near the BMI requirement. I know I don't lead a healthy lifestyle, but I don't think I should get a free ride for it either.

Re:Seems reasonable... (2, Insightful)

Hardhead_7 (987030) | more than 7 years ago | (#20147715)

Exactly. And, if they have hereditary conditions (high blood pressure was mentioned in TFA), they should be charged more. Of course, why stop there? Why not pay proportionally more? Of course, that'd price most people with hereditary conditions out of insurance altogether, but that's the free market at work!

And you're dead on, choosing to live in a flood zone is *exactly* like choosing to be born to parents that have hereditary conditions. They should definitely pay the price.

Re:Seems reasonable... (1)

Scottoest (1081663) | more than 7 years ago | (#20147831)

Well, the first thing that comes to mind is that poor drivers, and flood-plain livers choose their fates. Not all obese people, and certainly not all people that fall outside their recommended BMI, have a choice. And what about thin people who smoke a pack a day?

Have you never known a person in your life that, no matter what they do - and whether they eat and live healthy - they never seem to be thin?

I will be shocked if this does not get shot down as discrimination. When it comes to health and body, there are so many variables at play - some of which we have little control over. I obviously understand the sentiment that we should not have to foot the bill for people who actively choose to throw away their health with cigarettes and fast food, but as with most chronic societal problems, advocating programs and lifestyles that stop these problems before they begin makes the most sense.

Then again, I'm Canadian, so I can't really relate. We foot the bill for eachother - from lung cancer, to chemotherapy.

- Scott

Good (0, Flamebait)

NETHED (258016) | more than 7 years ago | (#20147579)

I'm healthy and rarely visit the doctor (thank God). Why should I pay for someone who is overweight and smokes.

Re:Good (2, Insightful)

Nedry57 (951108) | more than 7 years ago | (#20147703)

I agree 100%. I am overweight, and i definitely don't live the healthiest lifestyle (although I have been changing that recently). However, I do not feel that you should have to pay my medical bills. Therefore, I should pay more than you until I get into shape. Anybody who disagrees with this stance is a whiny fatass.

I wouldn't want to pay for others' bad choices, so I don't think anyone should have to pay for mine.

Re:Good (0)

Anonymous Coward | more than 7 years ago | (#20147707)

I'm overweight and smoke, and rarely visit the doctor. Not anymore. Claims for everything!

Notice too you are not getting a discount.

Re:Good (1, Insightful)

Anonymous Coward | more than 7 years ago | (#20147709)

Because they will pay if your ass gets hit by a bus. I guess being healthy doesn't prevent that. All the salads in the world won't stop everything. Self Prick

Re:Good (1)

FinchWorld (845331) | more than 7 years ago | (#20147861)

All the salads in the world won't stop everything

Im not so certain, Im sure if I were to gather all the salad in the world and place it between me, and that bus my mum always told me to wear clean underwear for, Im pretty certain it would stop that.

Granted I've yet to discover a means to survive nuclear holocost with salad, but you know, one day at a time.

Re:Good (5, Insightful)

Surt (22457) | more than 7 years ago | (#20147749)

Maybe we should do away with insurance (averaging) altogether, and just have everyone pay for whatever happens to them.
After all, if you don't have cancer, why should you pay extra for the people who do?

Re:Good (1)

amigabill (146897) | more than 7 years ago | (#20147869)

Because someday when you get old and feeble you'll appreciate all those young healthy people paying for your doctor visits, prescriptions, surgeries, etc.

Memo To Slashdot: (-1, Troll)

Anonymous Coward | more than 7 years ago | (#20147593)

It's called RISK, morons.

  Post some news,

ie. How BushCo is intercepting Taco's e-mail to Saudi hookers or something similar.

not trash.

Have a day.

P.S.: Fuck Bush [whitehouse.org]

BMI?? (2, Insightful)

faloi (738831) | more than 7 years ago | (#20147595)

If they actually just look at the base BMI number, there are going to be some athletic people in great shape paying more for health insurance. And then you get into a dangerous area of penalizing people for some things that are (potentially) out of their control. I smell some lawsuits, and some expansion of what's covered under ADA and EEOC rules...

Re:BMI?? (0, Troll)

tigerhawkvok (1010669) | more than 7 years ago | (#20147695)

A BMI of 30 is obscenely high, and will not affect just healthily athletic people. A standard male should have a BMI under ~15, and a woman under ~18-20 (don't take those numbers as canonical; but they're in the right ballpark). Last time I was measured, I had a BMI of ~11. A BMI of 30 is truly grossly obese.

Re:BMI?? (1)

Bartab (233395) | more than 7 years ago | (#20147805)

Schwarzenegger would be glad to hear that! While he probably lost some weight since, his BMI was once 33.

Re:BMI?? (1)

ArtDent (83554) | more than 7 years ago | (#20147949)

Ummm, no. The range considered normal is 18.5-25.

11 makes Mary-Kate Olsen look healthy. As in, if you were 5'10", your weight would be 76 lbs.

Re:BMI?? (1)

Frumious Wombat (845680) | more than 7 years ago | (#20147737)

They have several indices (as per TFA), which aside from the BMI index, aren't all that expensive. If you're a diabetic smoker with bad cholesterol, you're paying an extra $180/yr. This is far less than my health plan charges me to add my wife, because their one-size-fits-all pricing model says if I'm married, I probably have half a dozen tubercular kids I expect them to support. Whether commercial entities should engage in this sort of social engineering is another question, but not addressed here.

Re:BMI?? (0)

Anonymous Coward | more than 7 years ago | (#20147867)

Some smokers die of cancer early, others live to 100 and die of old age, yet all smokers pay a higher rate. Unfairness in insurance isn't unprecedented. And now it's time to make fatties pay their way. Type 2 diabetes, heart disease, and other often preventable ailments cost this country a fortune. The sooner the gravy train ends the better. Make people pay for their choices.

Is this bad? (3, Insightful)

screensaver400 (652819) | more than 7 years ago | (#20147611)

I'm sorry, but this sounds dead on to me (and my BMI is over 30). If I'm too lazy, or too sick, to keep my BMI down, or if I have preexisting medical conditions that make me much more likely to cost the insurance provider more, I have no problem with being charged more. This is a great incentive to take preventative action, when possible (BMI, smoking, a better diet, etc), and it is a reasonable provision when not possible.

This will lower the insurance for the fit and healthy who never see a doctor (but want the insurance "just in case", and raise the cost for insurance for those who are ill or lazy and go often (I'm speaking in the long run, of course).

Sounds fine to me.

Fine line... (1)

SamP2 (1097897) | more than 7 years ago | (#20147615)

Economically it sure makes sense to the companies that are doing it.

Socially, obviously the healthy people would support this decision, while the unhealthy wouldn't.

Morally I'd draw the line between voluntary and unvoluntary conditions. If you smoke, heck yea, you should be charged more than those who don't... Same thing if you are a couch potato that fails to do even most basic of exercise.

Some diseases, however, are not due to lifestyle choices, and no matter how economically sound in a laissez-fare environment would be charging an unhealthy person more, I just can't get rid of the feeling that it defeats the moral purpose of protection that insurance is supposed to deliver.

Slope Slippery When Wet (5, Insightful)

Hardhead_7 (987030) | more than 7 years ago | (#20147621)

Encouraging Americans to be healthy is great. I don't really have a problem with charging those who smoke more, for instance. But high blood pressure? Come on, that's hereditary. Once you start discriminating against people for their genetic makeup, you're on a slope that is not just slippery, but frictionless.

Re:Slope Slippery When Wet (2, Insightful)

Shimdaddy2 (1110199) | more than 7 years ago | (#20147887)

But there's plenty of precedent for discriminating based on whatever statistics show. For example, the 16 year old boy can't help that he's 16 or a boy, but he still gets charged more for car insurance than 16 year old girls or 56 year old men. Insurance isn't made to be totally fair.

Is that wrong? (1)

SuperKendall (25149) | more than 7 years ago | (#20147937)

But high blood pressure? Come on, that's hereditary.

Why does that matter when it still leads to higher health costs.

You don't like hereditary issues costing more, make sure you genetically edit them out before birth.

And that itself is a slippery slope too - but honestly it makes more sense that people should pay more for insurance they are more likely to use. If they can't afford to do so, that's where government (or ideally private charity) steps in to help take up the slack.

Bad idea (5, Insightful)

mblakeley (1135127) | more than 7 years ago | (#20147627)

This is a horrible idea. The entire point of insurance is that everyone pays a more-or-less baseline amount and some people don't realize any of that value and some people realize more than they put in. Of course, now that Americans expect to realize 100% of any tax or insurance payments, and if even one penny goes to someone else, well, that's socialism! Insurance is inherently socialist. That's why it's called INSURANCE. If you're expected to pay an equal amount to what you receive, you don't really have insurance, you're paying as you go.

Re:Bad idea (1)

ivan256 (17499) | more than 7 years ago | (#20147931)

When you average out the ideas of the general public, it's easy to see how you could come to that mistaken conclusion.

In reality some of our population thinks they deserve to realize 1000% of their payments, and some are happy with 0%, as long as it's 0% of a very tiny amount. Yet other people are up in arms about the first group, and rightfully so.

The best part is that none of those three things are "insurance".

Employment Attourney meet your new clients (2, Informative)

Trauma_Hound1 (336247) | more than 7 years ago | (#20147631)

There will be a lawsuit about this. It's just a matter of when. It looked like it's the employer doing the fining not the insurance company, which I know in my state if an employer holds back any part of your paycheck, you can get back 3 times the amount.

Eh.. some of its okay (1)

Mitsoid (837831) | more than 7 years ago | (#20147633)

Paying extra for smoking.. sure...

but some Cholesterol/Blood pressure is related to genetics.. My diet is closer to a vegetarians then the typical Americans and I have stage 2 high blood pressure, with low cholesterol counts.. I have maybe 2-3 servings of meat per week (FDA servings, not American services)..

I dont mind paying extra for my choices, I do mind paying extra for something I cant change... unless Medications are allowed to reduce BP and avoid the fee

Lifestyle? (0)

Anonymous Coward | more than 7 years ago | (#20147635)

Although I do agree with this policy fully, I think it may be a little bit unfair since it also doesn't take into consideration peoples lifestyles and the risks they present. What if someone is an avid mountain climber or has mental disorders. How about those promiscuous workers that don't bother with contraception. What about alcohol use? They should all be charged more for their level of risk since charging more for risk is what we are talking about.

BMI is BS (2, Informative)

Anonymous Coward | more than 7 years ago | (#20147641)

Regardless of whether you think this is a good idea or not, the BMI is Bullshit!
Really a hospital should know enough to use an accurate measure of body fat, as opposed to this bogus rough appropriation.

from Wiki:
The medical establishment has generally acknowledged some shortcomings of BMI. Because the BMI is dependent only upon net weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly). However, some argue that the error in the BMI is significant and so pervasive that it is not generally useful in evaluation of health. Due to these limitations, body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing.

An analysis of 40 studies involving 250,000 people, heart patients with normal BMIs were at higher risk of death from cardiovascular disease than people whose BMIs put them in the "overweight" range (BMI 25-29.9). Patients who were underweight or severely overweight had an increased risk of death from cardiovascular disease. The implications of this finding can be confounded by the fact that many chronic diseases, such as diabetes, cause weight loss before the eventual death. In light of this, higher death rates among thinner people would be the expected result.

Its unhealthy enough just working there... (2, Insightful)

Simon la Grue (1021753) | more than 7 years ago | (#20147643)

...so next they'll deduct another 20 for just working in a hospital.

How about a discount? (1)

igny (716218) | more than 7 years ago | (#20147651)

I would prefer a discount for healthy people.

I hate BMI (1)

Caceman (682840) | more than 7 years ago | (#20147685)

The problem that I have with this is that BMI is a poor way to measure obesity. I'm 5'11" and currently weigh 260 pounds. Yeah, I'm fat. When I was 18, I was a varsity athlete in soccer, basketball, and track. I weighed 190 pounds. According to BMI, I was overweight. BMI wants me to believe that my target weight is 135-175 pounds. 135 pounds, at 5'11", with a V-shaped torso, is sickening to even think about.

Another thought that just occurred to me is that this might cause the company's premiums to go up. If more employees start taking blood pressure and cholesterol-controlling medication, the insurance company's costs will go up and will be passed on to the company.

Re:I hate BMI (2, Informative)

jnaujok (804613) | more than 7 years ago | (#20147889)

Exactly. When I was in college (many moons ago) and weightlifting, I was measured with an 11% body fat (on the low end for "highly athletic") and weighed 205 pounds with a height of 5' 8". According to BMI, that's morbidly obese and I'd have been paying extra. Explain how an athlete who can bench press 400# and leg press 1200# is in extra danger of keeling over dead?

The BMI values are a total load of crapola. I've been checked since, and to get down to my "ideal" BMI would require me to reach a -12% body fat. (That's negative 12% -- also known as dead.)

Great Idea! (1, Insightful)

carlcmc (322350) | more than 7 years ago | (#20147691)

About time.

It is time to hold people accountable -- for the things under their control.

Why should I subsidize your Big Mac habit and have my health care dollars go to pay for your CABG (coronary artery bypass grafting) because of the heart disease your brought on by overeating and being obese.

The other way of doing this would be rewards. Charge a high rate for everyone. Those who have a BMI < 30 could get a 10 reduction. Perhaps that would be perceived differently.

The end result is the same. People have a monetary incentive to live healthfully.

Before the alarmists beging to cry out "Unfair! Things not under my control!" There are very few scenarios where those proposals would result in people being unfairly penalized. If you are obese, you are at an increased risk for hypertension, diabetes, coronary artery disease etc. Doesn't matter if it was your fault or not. You are still at increased risk.

Why should my money subsidize your smoking habit that will cause lung cancer, bladder cancer, myriads of other cancers and disease?

Re:Great Idea! (1)

Trauma_Hound1 (336247) | more than 7 years ago | (#20147791)

BMI is bullshit, and you're an idiot if you think it is accurate.

Re:Great Idea! (1)

Datasage (214357) | more than 7 years ago | (#20147853)

I don't really have a problem with this idea, but they should be using more accurate measures of health. BMI isn't entirely accurate. Its tries to place everyone on the same standard, but that standard varies from person to person.

But there is also a misconception that everyone who is obese made the choice to be. Which isn't entirely true. Some medical conditions, genetic or otherwise, make it difficult for some people to control weight.

In my opinion, its not a bad idea, but they should be basing the extra costs and rewards on other things. Go regularly to the gym -$10. Eat fast food regularly, +$10.

Re:Great Idea! (0)

Anonymous Coward | more than 7 years ago | (#20147857)

About time.

It is time to hold people accountable -- for the things under their control.

Why should I subsidize your [out of wedlock child bearing] habit and have my health care dollars go to pay for your [prenatal and postnatal care] because of the [pregnancy] brought on by [being a moron]. ....

Before the alarmists beging to cry out "Unfair! Things not under my control!" There are very few scenarios where those proposals would result in people being unfairly penalized. If you are [minority], you are at an increased risk for [unwed pregnancy]. Doesn't matter if it was your fault or not. You are still at increased risk.

Why should my money subsidize your [child rearing habit] that will cause [my money to be 'wasted']?

Re:Great Idea! (0)

Anonymous Coward | more than 7 years ago | (#20147899)

Why should my money subsidize your smoking habit that will cause lung cancer, bladder cancer, myriads of other cancers and disease?

Why should my money subsidize your bad habits? Oh you were mountain bike riding and broke your arm? You owe us $2000, I'm not paying for your stupid mistakes.

Why should the 150% taxes smokers pay subsidize your health care?

Its called personal choice, learn it, love it, live it.

Re:Great Idea! (1)

krgallagher (743575) | more than 7 years ago | (#20147915)

"If you are obese, you are at an increased risk for hypertension, diabetes, coronary artery disease etc. Doesn't matter if it was your fault or not."

I really want to call you an insensitive clod, but I want to make a real point. I am a diabetic. It runs on both sides of my family. I have severe hypertension; 230 / 150 untreated. I get that from my Dad's family. Everyone in his family has died of a stroke. My mothers family all die of heart attacks, but my cholesterol levels are good. Still, I stand a good chance of developing heart disease at some point. My BMI is 21. I weigh the same thing I did when I got out of High School 25 years ago. I do not smoke. Still, these diseases that I have due to genetic predisposition will shorten my life by 10 to 20 years. In addition I spend a considerable part of my budget on medication and doctor visits to manage these chronic conditions. Isn't that punishment enough?

How not to do this (5, Insightful)

onkelonkel (560274) | more than 7 years ago | (#20147699)

I would have expected this to be spun 180 degrees. i.e. Jack the rates up for all and then announce you get a $10 discount for meeting the BMI standard rather than a $10 penalty for failing to meet it. Same outcome, but less likely to piss people off.

Things you have no control over? (1, Insightful)

Anonymous Coward | more than 7 years ago | (#20147705)

I generally don't have a problem with this approach, as long as it's things people have some kind of control over. If you smoke, and the pool of smokers are known to incur more medical expenses, then I have no problem charging the smokers a stupid-fee, so that the rest of us don't have to pay for the extra medical expenses related to their smoking habit.

If on the other hand, you have a genetic/inherited health factor, like diabetes (well, at least one type of diabetes is genetic - I think there is another that is just related to being overweight), which causes your blood sugar to be high/low, you shouldn't be charged extra for that.

Re:Things you have no control over? (1)

Trauma_Hound1 (336247) | more than 7 years ago | (#20147835)

Both types are Genetic as well as diet related.

Re:Things you have no control over? (1)

Major Blud (789630) | more than 7 years ago | (#20147913)

Type 1 Diabetes is the genetic one (at least it's believed to be inherited). I have it, and I wouldn't expect everyone else to have to pay for it. I'd like to think that me or my employer would pay the base fees, and I would be responsible for the copays on insulin, syringes, etc.

Low income people more likely to have health probs (0)

Anonymous Coward | more than 7 years ago | (#20147725)

I believe lower income people generally tend to be fatter than more affluent people, same about smoking, and maybe some other things. So it seems like it will just result in more people being unable to afford health insurance, while saving the already affluent a dollar or two they are likely able to afford anyway.

Not necessarily unwise.. (1)

Improv (2467) | more than 7 years ago | (#20147729)

It seems like a good idea in principle, so long as it focuses on things that people can change in themselves. Unfortunately, public discourse has blurred this distinction, with people who have genetically given urges to eat confusing it, at least in public discourse, with genetically given needs to eat. Smokers and fat people probably have no excuse, while those with issues with blood pressure and the like may not be to blame for their poor health. Shoving people to take care of their health to their ability is probably a good thing though (perhaps something to deal with pro-ana folk too would be prudent)..

Great, but the BMI is not accurate (2, Informative)

cstec (521534) | more than 7 years ago | (#20147731)

Great plan, but defining 'healthy' isn't that simple. The BMI is a good case in point. Very healthy/athletic body types can be surprisingly heavy because muscle weighs more than fat. With serious weightlifting, people's weight goes up even as their pants size drops. With serious exercise, one can easily get their weight into the BMI's "unhealthy zone" while they are simultaneously in the best shape of their lives.

Un-American (2, Insightful)

athloi (1075845) | more than 7 years ago | (#20147735)

America should be like an all-you-can-eat buffet, with one fair price charged for everyone. This variable charge penalizes those who are fat, prone to illness, or require nicotine to calm their neurotic minds. I think it is a variation of "ableism," or a hegemony that assumes all people suffer no disabilities.

http://en.wikipedia.org/wiki/Ableism [wikipedia.org]

No different than insurance companies? (1)

langelgjm (860756) | more than 7 years ago | (#20147741)

These sort of things (smoking, weight, etc.) are taken into consideration if I buy health insurance on my own - I'll either be denied, or have to pay a higher premium. Am I to understand that people on Clarian's company health plan all "paid" the same amount (i.e., Clarian didn't distinguish between its employees when buying coverage)? If this is the case, isn't Clarian basically just doing for its employees what insurance companies do for individual purchasers?

This just for the starters folks, (1)

140Mandak262Jamuna (970587) | more than 7 years ago | (#20147747)

Next year unhealthy people will be forced to eat tofu and yogurt 24/7/365 (they can anything they want on Feb 29 once in four years) till their BMI drops below 25.

Mostly OK (4, Interesting)

31415926535897 (702314) | more than 7 years ago | (#20147753)

I would support a proposal like this with a couple of stipulations:

1. I would want it to lower my (a "healthy" person) premiums, deductibles, out-of-pocket expenses. I'm not trying to sound selfish, but the reason mine were so high to begin with is because of all the unhealthy people. If they're just going to use this to help their own bottom line without helping those that make the health insurance system work (the healthy people, again), then they can shove that plan where the sun don't shine.

2. Don't use BMI. It's a crappy measure. Anyone who lifts weights regularly can easily be considered obese by BMI (even if they're not a "body builder"). I've been over that line my whole life and I'm not fat.

One of the things that I really like about it is that it provides extra incentive for someone to be healthy. Want to save $50 / month? Get in shape, and that will help lower the expenses & burdens of the insurance system for everyone else. It's like taxing a congested road to help clear it up, or taxing emissions to clean up the environment. Sometimes money talks louder than anything.

What about... (1)

gone6713 (807581) | more than 7 years ago | (#20147765)

What about people who live healthy and eat healthy but have a family history of high cholesterol. My mother is one such person, she is taking all the required steps to keep her cholesterol in check, such as diet, exercise and medication, but still has a higher than average cholesterol rating. Should she have her paycheck penalized because of family history? It isn't her choice to have high cholesterol, although some people have it just because of unhealthy lifestyles. Should she be lumped in the same boat as them?

Of course it's a great idea. (1)

haakondahl (893488) | more than 7 years ago | (#20147771)

Without balancing the risk and the premium, it becomes just another program to shift money away from those who succeed into the hands of those who do not.

To eat fruit or not to b that is the real question (1)

voraistos (1128439) | more than 7 years ago | (#20147783)

Its probably good for people who just dont care a bout their health: at least, if they care about their money, now its easier to stop smoking and eat vegetables for them now. However some people are just victims of their health, i dont know much about obesity, but i thought it was DNA related. If thats the case, this move would be completely unfair for them.

Some of this is old news, but biz/corps beware (1)

CodeShark (17400) | more than 7 years ago | (#20147787)

Smokers at our company pay more, and those who participate in wellness programs get a discount. I personally wish they would add an additional charge for those who drink alcoholic beverages and a discount for those who absolutely don't -- such as myself.

But the problem is that employer's aren't supposed to have access to much of an employee's medical or insurance information because otherwise they can discriminate in hiring/firing/promotions etc. based on how much an employee or his/her family is costing on the health insurance group policy. Which means, for example that in my case I might as well file for unemployment now because I have a family member with a disabling illness. And the law prohibits discriminating against me on that basis. So if a person who has an ADA disability gets docked more on their paycheck because the disability messes with their blood sugar level, etc., or if the information crosses the limits set by "HIPAA"?

Well, personally I would hope to be the plaintiff's attorney in that class action suit and that my target defendant business had a great big fat bank account.

fine, as long as... (1)

SolusSD (680489) | more than 7 years ago | (#20147789)

They start charging idiots for having children.

Could get ugly ... (0)

Anonymous Coward | more than 7 years ago | (#20147801)

So we charge fat people more because they get Diabetes more.

So we charge smokers more because the get cancer more.

So far so good. (?)

So we should charge gays more because they get AIDS more?

So we should charge black more because they get gunshots more?

So we should charge young women more because they have expensive babies?

then what's the point of insurance? (5, Insightful)

amigabill (146897) | more than 7 years ago | (#20147833)

I always thought of medical insurance as a socialist concept. Everyone pays into a bucket, and the sick people take out of it when needed. So long as there are more healthy people than sick people, it should work. Even in capitalist implementations of medical insurance schemes.

So if sick people need to pay more than healthy people, what's the point of having insurance? Healthy people then shouldn't need to pay anything, as they aren't costing anyoen anything. And sick people should pay everything, as only they need it. Which completely voids any reason to send any money to the insurance guy. OK, that's going further than this article summary sounded, but if this idea gains any momentum that may be where we end up at.

How about this, as a related idea... Old people should pay more into social security because they use it more. young people should get discounts because they're a long way away from taking it. I bet todays elderly would get all riled up if we tried to make that change, eh?

If this is meant to be motivation to fix things, some things cannot be fixed. I've got high cholesterol. Very high. And very bad ratio of HDL to LDL. I'm relatively young, 31. I've gotten into running, have done a couple relay marathons (split the maraton distance between four runners) and am currently training for a 1/2 marathon. While still bad, my cholesterol measurements were better BEFORE I started running. Now after doing it for a few years, my cholesterol is 20 total points higher and it's time for the pills to fight it. Weird but true. Not sure what my genetics have in mind, but the doctor told me of other patients more athletic than I am trying to become are not able to lower their cholesterol without pills either. No amount of financial motivation can change that, and no amount of financial punishment for testing poorly will help either.

meh (1)

zmollusc (763634) | more than 7 years ago | (#20147847)

Surely, statistically, if you are offered insurance you are unlikely to need it.

Hey an even better Idea (4, Insightful)

John Sokol (109591) | more than 7 years ago | (#20147851)

We could just put all the unhealthy people in gas chambers and kill them.
Oh yea, that was tried in the 1940's and for some reason people didn't like that. (don't flame me, I am being sarcastic.)

For someone who is sick or with a family member who is sick, just keeping a job and earning money is difficult, then add to that charging more health insurance costs, even if they could afford insurance would just push more people over the edge.

Increasing insurance costs would just be a slower, less obvious and more politically correct way to kill them off.

But it would be just as immoral, maybe even more so!

Anyhow Sick-o the movie already points out how screwed the system is.

notice how... (0)

Anonymous Coward | more than 7 years ago | (#20147863)

it doesn't get any cheaper for the healthy people. it's just a quick cash grab to get some extra $$$ from the fatties

This is crap (5, Interesting)

palladiate (1018086) | more than 7 years ago | (#20147911)

They can go screw.

I have a BMI over 30. I used to play baseball. Heartrate? 63. BP? 122/63. Glucose, white cell count, red cell count? Normal. My doctors say I'm perfectly healthy, except for the rare form of cancer.

I truly fear the future where we treat insurance as a personal thing. We invented insurance as a way to spread risk. If we charge you directly for your risk, we are creating no economic benefit. It just means that in the future, I'll have to bear the entire cost of my cancer treatments.

And the healthy? You'll get the privilege to pay a private company to absorb zero risk.

Who pissed in their Wheaties? (0)

Anonymous Coward | more than 7 years ago | (#20147919)

From the article:

BMI, a ratio of height to weight that measures body fat

BMI does not measure body fat. BMI correlates with body fat percentage but there is large variation. In particular, based on BMI, muscular people are going to be judged to be "overweight" or even "obese".

I never did the body building / weightlifting thing but back when I was at top fitness for cross-country ski racing my BMI would still have categorized me as "overweight".

If Clarion Health wanted to be fair and charge people more who are likely to have higher health care costs then the number one factor they should be using is age.

On the other hand, if their goal is to modify their employees behavior then positive incentives would create a much nicer atmosphere. In fact, stress can do major damage to a person's health so if they really want people to be healthy they should be looking at ways to reduce employee stress (and paycheck deductions is not one of them).

The way I see it, there are two fundamental problems with health care in the USA. First, medical school admissions are artificially limited creating an artificial scarcity (monopoly) on medical doctors. Second, the artificial monopolies that are granted to pharmaceutical companies (in the form of patents) allow top management to divert exorbitant amounts of profits to themselves (and also engage in other inefficient management practices).

What it comes down to is that some administrator somewhere at Clarion Health has a lot of anger issues and decided to lash out without any understanding of the fundamental problems facing US health care.

BMI of 45 coming at you (0)

Anonymous Coward | more than 7 years ago | (#20147933)

6ft 235 lbs.

Of course I can bench 400lbs. So, if you say I am fat I can [Arnold accent] crush your puny head like a grape. [/Aronld accent]

Women of course... (4, Insightful)

Bartab (233395) | more than 7 years ago | (#20147947)

Women have higher health costs, what with their frequent specialized doctors care, occasional pregnancies, and longer life span. They should be billed at a higher rate as well.
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