Hey, look, a good reason for nationalized health care. We're going to charge you more for being sick.

I'm not one to agree with Michael Moore, but this move by the insurance industry is making me lean toward Flint, Michigan.

People still use BMI as a valid indicator of health?

I love this idea. I take pride in my body and shouldn't have to pay for the obesity epidemic caused by other's desire for a Big Mac. It's not just eating but smoking drinking as well. If you wreck your car you pay higher insurance rates. If you wreck your body shouldn't the same hold true?

My company does this in reverse. Everyone pays a high premium, but if you take an assessment and meet certain standards you get $30 back each month.

I would go further. Airlines should charge fat passengers more.

A good chunk of the airlines' cost is fuel and it takes a lot more fuel to fly a 300-lb body than a 180-lb, so why not charging the 300-lb passenger for the difference?

After all, the Post Office or Fedex charge more for a heavier package, don't they?

Total BS. Government and Employers need to stop playing big brother and let us live our lives as we see fit. Land of the free or hipocracy? There ARE people like myself that are not in the best of shape for other reasons than supersizing everything. I personally have trouble staying fit because of weakness from a series of accidents and metal plates make regular exercise difficult. Not to mention those with eating disorders, thyroid problems, etc. Now with this crap I I would be charged a higher rate when there is absolutely nothing that could be done.

ALL pre-existing conditions need to be banned when signing up for medical insurance and rates should be indiscriminate of age, sex, race, AND physical condition.

i can agree to some degree with this, as those who choose to treat their own bodies like crap are a drain on the system. no on likes seeing the 700 lb woman walking through the mall with a tiny shirt on and her stomach hanging out on an oxygen tank causing my rates to go up, but some people litterally cant help but be overweight. If someone is not in good health and they have to pay more, what about those who have mental problems? is it their fault for having a disability? should they then have to pay more as well?

@Mariallena: "That too has already happened."

Grantgannon,

A car wreck happens. That is a specific event.

This would be more akin to if I don't get my oil changed every 3 month or X amount of miles my rates go up.

This is all about greed. The companys who run the plan want to make more money off of the insurees and the companies who buy plans like these for the employees want the cheaper costs these plans most likely carry for the employer.

I'd be less apprihensive if they explained what happened to the person who was judged "unhealthy" and did work with thier "coach" and produced less then steller results?

Plus what kind of training/regulating do these "coaches" have?

@Freaky Styley: Be careful at the gym. Pack on too much muscle, and the BMI will flag you as 'obese'.

Sure, but limit the work day to 8 hours to provide time and energy to dedicate to healthy eating and working out.

Weight should not be an indicator of overall health. Let's remember that not all overweight people are that way because they eat McDonald's three times a day, despite what mass media would like us all to think. If someone is eating poorly, odds are there are other indicators in their overall health profile, such as blood pressure or cholesterol or a score of other things, that will indicate it.

Let's not penalize all for the actions of some.

i am considering a new job that has this type of thing in their health plan. for me it would save me about 20% in my monthly contribution. you are not enrolled automatically, only those who complete the "assessment" are given the discount.
seems iffy, like if i have to go through all this hassle with taking tests all the time, paperwork and whatnot, it might not be worth the money.
on top of that, i've always had a weird bmi, i would probably be considered slightly overweight by the numbers, but i wear size 8 and most people tell me i'm skinny. does this mean that, as a pretty healthy person, i would have to lose weight just to save a couple bucks?

Also: Banning pre-existing conditions? That's ridiculous. What if you have cancer, and say your company goes out of business. You lose your health insurance. Three months later, you get a new job. Should they deny you health insurance because you had a preexisting condtion and lost your health insurance through no fault of your own?

@jaya9581: I read that a little differently-- I thought the poster was indicating that insurers shouldn't be allowed to deny anyone health insurance for pre-existing conditions.

@protest: Probably.

It's going to make emergency rooms even more crowded when this sort of thing becomes mandatory. I can't wait!

@Lizzybee: thats exactly what I ment. that companies should not be allowed to deny health insurance or charge a different rate because you have a condition. There are some states that it is already illegal to do that in but it needs to be nationwide.

I support these plans. A private business should not have to pay for the bad habits of its employees.

Also, this is the primary reason I don't support universal healthcare. Basically in a universal system the healthy people are paying for the unhealthy ones. That and the government is ordering an individual to do something. Talk about the start of big brother and a facist state.

Everyone makes good points. This isn't exactly like not changing your oil since any damage caused by that is out of pocket. It really is more like a car wreck.

This wouldn't be a bad idea if it were planned out properly, healthy people actually paid less than they do now, people with legitimite conditions were treated different than the stupidly obese or chain smokers, etc. However, I doubt they would actually consider all those things and just lump every fatty into the same catagory.

@Teney71: Just curious how many people are this retarded and brainwashed by the mainstream media that people are only overweight because of their "bad habits"

What is worse is that most of the people that this will affect are lower income in the first place and cannot afford the higher rates.

Even those with bad eating habits cannot always help it. McDonalds is CHEAP not everyone out there can afford to go to a Subway or cook food bought at Whole Foods everyday.

What about people who skydive and ride motorcycles without helmets, and people who don't wear their seatbelts and get tattoos all over their bodies? I should have to pay more than these idiots because I like Burger King?

@mantari: Too late. I am teetering on the edge of overweight and obese :(

Overweight from diet or other condition will be a hard thing to prove one way or another and I see if they try to make acceptions it will be just as hard as someone trying to apply for Social Security. Delayed for months, denials that need appeals, company doctors to do the exams that do not look very hard at patients problems, etc.

If my company gave me 30-45min on company time to work out a couple times a week. Gym provided at the company. I would be alot more likely to work out.

I dont like the idea of penalizing people though. Offer incentive, but through positive reinforcement, not through penalizing people.

My company pays for our memberships at a near-by health club, but if you don't use it, they take it away. Not only do I go because I don't want to pay for my membership, but I am also motivated by taking classes with friends from work.

@SadSam: Companies implementing this will likely expect you to lose weight in just 15 minutes a day three times a week.

@Geekybiker: Why not penalize. If yu get in an accident or get a speeding ticket, your car insurance premiums go up.

Why should health insurance be any different. It costs your company more if they have a lot of claims. A good chunk of those claims are coming from people with unhealthy lifestyles, ie. smokers, overweight people ect...

There are other indicators in this plan besides weight. Cholesterol, for example. I have a friend who works out regularly, eats healthier than anyone else I know, but still has super high cholestorol. It's genetic. I knew a girl who had a heart attack at age 19, the doctor said she had the cholestorol of a 90 year old man who ate bacon and eggs every day of his life. I'm all for fairness, but if that's the case then I think they should let people pay for insurance based on the number of people using it, first. Married couples with no kids pay the same "family" premium as the couple with 12 kids. We ALL subsidize people with big families. Charge people fair amounts based on usage.

i think its fair, but then again im in pretty good shape, so im pretty biased towards that side. i would argue that many overweight people do not choose to make the lifestyle changes necessary in order to be healthier, and perhaps a monetary incentive could motivate them to be healthier. maybe this would force people to be healthier, and that would be a good thing.

insurance companies already do this kind of thing, they just havent had it to this extent i suppose. people who smoke, or have preexisting diseases pay more than people who do not.

This kind of thing makes a slick headline, but I have to wonder how much the insurance companies pay out for diseases caused by overeating and sedentary lifestyles versus what they pay for diseases caused by genetic and environmental factors. I also question the training and credentials these health coaches are going to have. In my experience I know more about nutrition than most clinical nutritionists I've seen, just by virtue of growing up with a mother who has a nutrition degree and keeps up obsessively with new developments in the field. And I have to wonder about the money the insurance are going to be paying the health coaches, money that would be better spent on patient claims.

You know what would save a lot more money? Going to a single-payer system and eliminating the money insurance companies spend on weeding sick people out of their systems and denying claims they should be covering.

This has way too much potential for abuse on the part of insurance companies. Already health insurance is expensive. I'm not so sure that rates would be lowered for those with "better health", but rather prices would continue to rise, and those with the "discount" would still be paying steeply.

And what is "poor health"? Already there are waiting periods that many plans make you meet: if you are sick when you are enrolled, you are penalized for it in the form of little to no coverage for a pre-determined period of time. Would I trust insurance companies, which try to get out of paying every step of the way, with determinging if I am healthy enough to be charged less? How will they determine what's an ailment due to lifestyle choice versus a true condition? They'd have to pore over medical records galore in order to come to such conclusions, using their own experts, which, of course, will make them spend more money and raise your rates so that they can perform this valuable service. I, for example, have high blood pressure, and the cause is yet to be determined. If I happen to fall under my insurance's threshold for "fat", I'll be paying more just because the insurance company said so -- not because my doctor determined that my condition was avoidable.

It's all about squeezing more money from the patient. Even if they have to cloak it under the guise of "we will reward you for not being a fatass." Those who are not fatasses may think that they are exempt from this because they take such good care of themselves, but if it's not one thing, it's another.

@csdiego: Keep in mind that it costs more to treat an obese person than a non-obese person for the same condition.

@lincolnparadox: Good God man. What would they charge Michael Moore to insure him?

@SadSam: Claps, Salutes, and bows to SadSam.

Every time a company considers this kind of thing, fatties everywhere rise up and moan "It's not our fault."

Are you an otherwise able-bodied person who is way overweight? That's *your* fault. Can't exercise because of an injury? It's *still* your fault that you eat more calories than you burn every day.

Weight gain / loss is a simple matter of thermodynamics. Burn as many (or more) calories than you consume, and you maintain or lose weight. Eat more than you burn, and you gain weight.

To read some of these posts, you'd think America was stricken with an epidemic of glandular disorders, cripling injuries, and mental illness. Uh uh. There's an epidemic alright, but it's one of saturated fat, high fructose corn syrup, and sedentary lifestyle.

How about that favorite theme of Consumerist posters, personal responsibilty?

@FatLynn: Maybe that's true. But is it so much more (for the average obese person, not the 700-lb. urban legend) that it justifies the staff time to identify the obese person and develop a pricing plan that charges that person more? That's even before you hire a "health coach" for this person.

I just don't see how it helps the bottom line to spend all that time and money to penalize an obese person, except maybe as a marketing draw for thinner people. It REALLY doesn't further the goal of promoting better health in the plan's subscribers.

At first I tend to agree with the car-insurance analogy; but on further analysis it doesn't hold. Car insurance is catastrophic insurance - it pays for the accidents that happen in your life - not your maintenance. But health insurance, in large part, does pay for maintenance, which is the bulk of the costs.

The big problem with health insurance, which this plan seems to address, is that people who are trying to live a healthy lifestyle are paying, through higher premiums, for the general health (i.e. maintenance) of those who have no desire to live a healthy lifestyle.

I think it's just fine to make individuals pay their own maintenance. If you don't, submit your oil changes to your car insurance agent and watch him laugh you out of his office.

These plans are a good idea. Pair an MSA or HSA with catastrophic health insurance and you're on the right track. My company is offering one next year.

@DrGirlfriend: I totally agree. I like the idea of offering incentives for people to be more contientious of their day-to-day health, but I sure as heck don't trust the insurance companies to administer this in a fair and unbiased way.

People can't get good coverage as it is - what will happen when we open this huge can of worms?

Some Americans have a genetic disposition towards higher blood pressure, higher cholesterol or a higher BMI.

Yes, a large portion of the U.S. could do more to control and/or lower their weight and better their health. But what about people with Thyroid issues? Or deformities? What about breast cancer patients? Should they be charged more because they're by definition "unhealthier" than their coworkers even though they can't do anything about it?

Health Discrimination may soon become a new legal term...

the think the really bothers me about BMI is how it doesn't work. i played college football, i do triathlons today. my BMI says i'm obese, i either run/swim/bike every day. but i have large arms and shoulders.

i understand the companies and insurance both want to save money, but they are going about it the wrong way. why not pay my health club dues? or they could pay my race entry fees. while i think those would have a more positive effect, they'll never do that.

BTW my current employer has two health plans to choose from, one is about $9(US)/mo cheaper but you have to take a "health risk assessment" to qualify for it. the results do not affect your rate, but you must take the assessment. that would be the first step of this process...

@oilguy: And every time an article like this comes up, someone like you pipes up to tell everyone else how "simple" weight loss is. Let me guess, YOU have never had a problem with weight loss? Gee, I wonder why!

The BMI is a joke, so I won't even get into that.. (Yet, everyone, especially the media loves one number they can easily throw out to label EVERYBODY).

However, NOT everybody has the same metabolism. I know people who eat all day and don't move at all, and they don't gain a pound.. Other folks who jog and eat regular meals, and stay fat.

It's not "simple", and the only folks who say it is are people who have never had to deal with it, or have never had people in their family with such problems.

Even the CDC has admitted that its original media-hyped "300,000 people die each year!" study was flawed (Read this: [www.consumerfreedom.com]).. So what does that leave us with?

People don't like fat people.

Yep, that's it, in a nutshell. People like oilguy just don't like looking at fat people. They don't care about health, they really aren't waiting for the pass-through of costs to eventually come to them - they simply think everyone who's not skinny is sitting around shoving cakes in their mouths on a couch with a remote in their hand.

Interesting, when other studies also now claim that it's more unhealthy (especially for women) to be underweight than overweight, and that the psychological factors involved in being overweight can be more unhealthy than the weight itself: [www.news-medical.net]).

I'd never tell someone not to try and lose weight if they're overweight, and everyone should exercise and not eat too much.. But Oilguy, your comment was crass and ill informed. People do get injured, people are poor, people have different genetics, builds, and levels of activity. Expecting a generally sedentary person to get up and jog five miles every day is about as realistic as expecting a marathon runner to sit around and watch TV for a whole weekend. PEOPLE ARE DIFFERENT, and you can't just say "Oh, he's got a 29 BMI, he should pay more."

Even insurance companies do not use the BMI guidelines for health insurance to decide when to charge more. Anthem BC/BS, for example, will charge to a higher tier when a BMI is above 36, not 30. And they're the ones who are banking on it.

The "obesity epidemic" is 50% media phenomenon, 50% socially-induced truth; through issues of poverty, processed foods, and the plain fact that America basically thinks you're offensive to look at if you aren't stick thin.

I was just talking about health coaches with my brother last night. Seems that his work added them to the insurance plans and drastically increased the price of the non-health coach plans. He tried it last year and was horrified that the "health coach" was reporting vitals to his company (age, sex, race, location, health issues) so that it was easy for HR to figure out who was who in small local offices. To top it off, the health coach started making decisions to remove my brother from medicines that he's has been on (legitimately) for years -- going so far as to say lipitor was unnecessary because hereditary high cholesterol is a myth. (Which it's not.)

I'm extremely wary of the health coach trend and thankful that the company I work for has not yet decided to go that route.

@Mariallena: Guess what. The airlines never went into service explicitly selling tickets to people based on how many cubic centimeters and kilograms they take up. They are explicitly in the business of moving people, persons, humans, from point A to point B. These alleged 'humans' come in all shapes and sizes.

@oilguy: The sedentary lifestyle part is easier to get around in some areas than in others. Most of the US is built assuming a sedentary lifestyle, and in such a way as to IMPOSE one. It isn't easy to walk instead of drive, not unless you schedule a lot more time for it. The distances are just too great, even in built-up areas, because OH NO, WE CAN'T HAVE COMMERCE IN A RESIDENTIAL AREA, and EVERYONE just HAS to have a huge yard.

Yeah, losing weight in someplace like San Francisco, or New York, or in Japan or Korea...that just takes trivial dietary changes. Someplace like the suburbs of Phoenix, it can take big ones. (But hey, there's plenty of meth available to help you out!)

@GrantGannon:

Word!

But what happens when they realize athletes get injured more often? Do they get charged more, too, for having a more active lifestyle?

From weight training to soccer to Hapkido over the last umpteen years, I've done some damage to my body...

@MattO: I think you are on the right track. When you start trying to parse out the 'blameless' sick people from those who are 'to blame' for their own suffering, things get ethically tricky. How many people in wheelchairs 'did it to themselves?' How many people with cancer 'did it to themselves?' I'm not sure that's a question I'd want to be asking people. Even though everyone, in some way, contributes to their own health status, no one WANTS to be sick, period.

And we all might try to have a bit more compassion for those who are sick, regardless of who or what we think is to 'blame.' When someone is suffering, I have an awfully hard time feeling sorry for the asshole in the corner who whines about his insurance rates going up.

For the rest of your comment re: being disgusted by a 700 lb woman with an oxygen tank, fuck you. You're probably also disgusted by people in wheelchairs, or who have no hair from chemo. But I guess they're not 'to blame' for being gross?

The thing is, if you work out, eat healthily, and have lucky genetics, you are far far less likely to run up high health costs. In fact, about the only high costs would be catastrophic (say, being in an accident).

On the other hand, if you eat poorly, never exercise, and have unlucky genes, you will be far far more likely to run up high healthcare costs.

So, those who are likely to cost more pay more. This is pretty much the definition of fair.

I know it's not fair to be born with unlucky genetics , but that's not something you can change. You know you'll need to spend more on health care. It's just the luck of the draw (like being born poor instead of being born rich). Since you know you'll be running up high costs, it's fair to pay more.

And if you can make changes, why aren't you? Even a genetic predisposition to obesity isn't determinism -- you just might not see as big of a result, but you'll still get something (and I personally have seen people lose 150+ lbs through just exercising over a period of years). You only live once. I for one think a few hours of exercise a week is totally worth looking and feeling good (and living longer and saving $ on health care). It's annoying and hard to stay motivated, but if you make it a habit (along with eating healthier), it has such immediate and lasting benefits that you'll wonder why you didn't do it sooner.

Health Assessments suck. My employer's chosen insurance provider requires you to take a health assessment and then agree to a follow-up call with a health coach to get a $5 break on your co-pay. Sounds like it could be good, but the health coaches just read off a script, are pushy, and really aren't interested in your health. They are interested in the company's health.

I went from 280lbs to 185lbs. According to my height, I'm still overweight despite my doctor telling me that I'm doing great. I shook off high blood pressure and sleep apnea and the health coaches are still all over me. On the last call I answered from them, the coach actually make me feel bad about myself and my own health implying that I'm not doing enough to stay healthy. I decided then to not answer their calls. I worked out my own health with my doctor, they can, frankly, go to hell.

What about what is going to happen when these insurance companies have to pay for more and more people to get hospitalized for eating disorders because the media and America is ramming it into our heads that being stick coke thin is in. The more a person is told they are fat the more demeaning it is and the more likely they will starve themselves and put themselves into a hospital for an eating disorder, costing the insurance companies even more money. Especially with young people, I know kids who already want to diet at age 9 and 10 and who worry about their weight at those ages, the more younger people are told they are fat, the more it affects them and this will also cause problems for insurance companies in the future as much as the epidemic of childhood obesity is causing insurance companies problems.

A person is not necessarily healthy if they are stick thin...