Get Fit Or Pay Up

As health care costs continue to rise and talk of some sort of reform remains a large part of the upcoming presidential elections, some companies and businesses are taking matters into their own hands. The latest idea is to charge higher health insurance fees to people with less-than-stellar health. Here’s how it works: all plan participants start with the lower costs and are then screened medically. If their scores are found to be lacking, they are assigned to a health coach to help them improve. If the participant decides he doesn’t want to bother, he’s charged more. The details:

“Those who don’t [score well] will be urged to work with a plan-provided health coach to improve their scores. If they don’t take the tests, won’t work with a coach, or slack off on, say, an assigned exercise regimen, they’ll get higher co-pays and deductibles.”

Criteria considered to get the better rates include hitting targets for body mass index, blood pressure, and cholesterol.

So next time you’re sweating out that five-mile run at the gym, motivate yourself to keep going by remembering you’re saving money with every step.

Sweat More, Pay Less [Business Week]


(Photo: Gee-Kay)


Edit Your Comment

  1. lincolnparadox says:

    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.

  2. Fuck Lion says:

    People still use BMI as a valid indicator of health?

  3. GrantGannon says:

    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?

  4. meb says:

    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.

  5. Mariallena says:

    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?

  6. evilhapposai says:

    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.

  7. MattO says:

    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?

  8. @Mariallena: “That too has already happened.”

  9. godai says:


    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?

  10. mantari says:

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

  11. SadSam says:

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

  12. jaya9581 says:

    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.

  13. protest says:

    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?

  14. jaya9581 says:

    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?

  15. lizzybee says:

    @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.

  16. @protest: Probably.

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

  17. evilhapposai says:

    @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.

  18. taney71 says:

    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.

  19. homerjay says:

    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.

  20. evilhapposai says:

    @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.

  21. emt888 says:

    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?

  22. Fuck Lion says:

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

  23. evilhapposai says:

    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.

  24. Geekybiker says:

    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.

  25. FatLynn says:

    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.

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

  27. DojiStar says:

    @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…

  28. ZooGirl says:

    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.

  29. pine22 says:

    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.

  30. csdiego says:

    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.

  31. DrGirlfriend says:

    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.

  32. FatLynn says:

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

  33. AD8BC says:

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

  34. warf0x0r says:

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

  35. oilguy says:

    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?

  36. csdiego says:

    @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.

  37. Xerloq says:

    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.

  38. Dervish says:

    @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?

  39. bobblack says:

    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…

  40. lowlight69 says:

    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…

  41. tcp100 says:

    @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: []).. 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: []).

    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.

  42. phrygian says:

    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.

  43. peggynature says:

    @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.

  44. TechnoDestructo says:

    @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!)

  45. RAREBREED says:



    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…

  46. peggynature says:

    @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?

  47. kimsama says:

    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.

  48. stardeo says:

    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.

  49. SaraAB87 says:

    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…

  50. saltmine says:

    @evilhapposai: First of all, you can usually get a 6″ sandwich from subway for around 3 bucks. I’ve worked on weight loss TV shows and I was astounded at the excuses people made for why they “HAD” to eat McDonald’s. In addition to the “everything else is just too expensive,” here are some of my favorites:
    1) I just don’t have time for anything else!
    My response, then get the salad with low fat dressing.

    2) But you can’t drive and eat a salad!
    My response: then wait until your fat ass isn’t driving, and scarf it down then. Or get the grilled chicken sandwich, for Chris’sakes.

    Second of all, as you should be learning, McDonald’s is NOT cheap. Sure, it’s a couple bucks up front, but you’re going to give yourself higher medical bills and insurance premiums. Not only that, you’re going to need to buy all kinds of machines to save you from a range of respiratory problems. C-PAPs ain’t cheap. Technically, McDonald’s is one of the most expensive meals you can buy. Just make sure to calculate all of the costs, and not that it’s only 39 cents to upsize.

  51. Scuba Steve says:

    High stress caused by work, which makes me pay more, which makes me work longer, which causes more stress.

    The circle of death is complete.

  52. pinkbunnyslippers says:

    So hypothetically speaking, let’s say you’re a 27 yr old who doesn’t drink, hasn’t had a smoke in your life, are a perpetual size 2, work out every day, have no cancer of physical ailments in your family, BUT…you’re crazy as hell. You need to see a shrink 3 days a week. You’re on 4 different mood-altering medications just to make it through the day, and you’ve tried to kill yourself a dozen times. So just because you’re skinny, have great cholesterol, and for all intents and purposes are in PEAK physical condition, you get to pay less for health insurance than someone who may be 20 lbs overweight, a smoker, but as sane as they come? Please someone tell me there is more to this “screening” process than just physical stuff…

    One could argue that one’s mental health isn’t something one can “shape up” – you can’t easily go to the gym and lose the crazy walking on the treadmill. So what happens in those situations???

  53. bohemian says:

    The insurance companies are fostering this idea that we should blame others for their health issues. They want you to adopt the idea that any adverse health issue is always self inflicted. This makes it easier for the Insurance companies to get the enrollees to accept the big brother crap they are trying to do.

    Adverse health issues are not always self inflicted.

    I work out every other day at the gym and work out at home on the other days. I have never smoked and was a competitive athlete in my younger days. I rarely drink and do so in moderation when I do. I eat an extremely healthy diet and rarely eat what is considered the standard American diet. I have an ideal BMI and I am slightly under the standardized weight for my height. But my health is a total mess, none of it my own doing. Healthy people develop medical issues even with healthy habits. Insurance companies want to lump everyone like me in with the fatty that eats McDonalds for every meal and never gets off the couch.
    To save themselves money.

  54. peggynature says:

    @kimsama: Sometimes I believe the point of human societies is to help smooth out the inherent unfairnesses in nature where we can, so that everyone gets a shot at living a decent life. That’s why we don’t just throw imperfect babies out into the forest to be eaten by wolves, why we make public buildings accessible for handicapped people, why we give diabetic people insulin instead of letting them die of hyperglycemia, etc. People who roll snake-eyes in the crap-shoot of health shouldn’t just have to suck it up and expect to mortgage their entire lives, and be happy about that.

    It is true that you can reduce your risk of illness, and since MOST PEOPLE DON’T RELISH THE THOUGHT OF BEING SICK, most people do what they can do reduce their risks, education and access permitting. Trust me, those goddamn annoying sick people aren’t throwing themselves under buses and inhaling asbestos residues just to personally inconvenience the rest of us. There are extenuating factors at work. It’s called the “determinants of health.” Look it up.

    Social Determinants of Health

  55. bohemian says:

    @Stardeo, They tried to foist one of these health coaches on me for asthma I have had my entire life. I know everything there is to know about my condition and know more than some of the doctors. They gave me the same really pushy routine so I quit taking their calls. There was zero benefit for me in this.

    @Pinkbunnyslippers, our health plan developed a super way to deal with weeding out those people with mental health needs. They quit covering anything that even remotely was classified as mental health issues.

  56. peggynature says:

    @taney71: The entire POINT of insurance — insurance of any kind — is to pool resources and spread costs out among many people. There is NO POINT in having insurance if the only people enrolled are those who don’t need it.

    Besides, it is UNETHICAL to deny people access to healthcare. I don’t give a fuck what their condition is.

  57. peggynature says:

    @SaraAB87: Good point, especially since eating disorders have the highest death rate of ANY mental illness.

    And everyone’s worried about an obesity epidemic? I’ll tell y’all what: look at the normal distribution of weight among the population. It’s not a perfect bell curve — it’s shifted to the right. Why? Because, even up to very extremely high weights, people might have ill health, but they are ALIVE. But below a certain weight? Datapoints simply don’t exist because PEOPLE ARE DEAD at those weights.

  58. SaraAB87 says:

    Also when you are not eating you are not healthy, you have to eat something to be healthy. People with eating disorders have many problems, such as teeth falling out and other health issues, not to mention their mental health as well. If you have had an eating disorder you can also have problems for the rest of your life because of the period of time when you were not eating. This will in turn cost the health insurance companies more money, because all these people with eating disorders or who are recovering from them have more problems than someone who is slightly overweight, sane and generallly healthy. Bulimia obviously does damage to your body and your intestines, your teeth can fall out leaving you with huge dental bills after you recover, assuming that you do recover.. There is a reason why eating disorder clinics are overflowing..

    If anything we are breeding a society of children who worry when they gain 5-10lbs becuase they are GROWING. There was a recent article on Jezebel about how being told you are fat as a kid affects you as a person and from having that experience myself as a kid its not pleasent..

    We live in a society where 10 year old kids are expected to carry cell phones, wear high heels and act like adults just to be liked by their peers, the media and images are promoted to them more fiercely than ever, and the media that is promoted to them is thinner is better and that coke stick thin is whats in. Younger kids are also getting into music earlier, which presents another huge image problem, since 99% of the music they listen to is sung by stick thin musicians. The clerks that are seen working in popular clothing stores for young children and teens do not help either… I have never seen a clerk that was even 10lbs overweight working at the stores that would be popular for young people to shop at.

    Imagine if your health insurance company told you you were fat and had to pay extra money because of that even though you were no where near obese or even fat, it could easily make someone fall into depression or an eating disorder. If we keep doing this as a society more and more people will develop eating disorders and it will cost the insurance companies more and more money to treat them.

  59. Smackdown says:

    It boils down to the fact that in part, or at least to some percentage of the population, overweight/obesity is genetic. And it’s ethically repugnant to punish people for being genetically predisposed to illness.

    It’s a slippery slope. While most people who are overweight or obese could lower their weight and thus the risk of illness (and ultimately, health costs for companies), there are other genetic indicators of illness. Should we make certain men pay more because they are hemophiliacs? What about women who have a genetic history of breast cancer?

    Sorry, but it all starts to get a little eugenics-y for my taste.

    Not to mention there is a strong correlation between poverty and obesity, as well as minorities and obesity – see the statistics here.

    Companies would essentially be charging the very people who can least afford it more premiums because our economy favors the corporate lobby and makes it difficult to find affordable, healthy food options.

    We should be focusing on how to empower communities to make smart, affordable choices about how they eat, and feed our children appropriate food, instead of penalizing a group of people, many of whom aren’t “lazy” but poor, or genetically unfortunate.

    This is the government’s fuckup more than it is the fault of fat people. I mean, I’m all for personal responsibility, but at some point, we have to stop coddling agribusiness and corporations like Kraft and start figuring out a way to make healthy choices affordable to the poor.

  60. peggynature says:

    @SaraAB87: The even funnier part is, a lot of eating disorders treatment (especially the long-term treatment that is often required) ISN’T COVERED by most insurers. So, sure, insurers can promote weight-loss willy-nilly — they aren’t the ones who pick up the pieces when it fails.

    Either people gain the weight back (plus more) and aren’t eligible for coverage because of TEH FAT, or they get stuck with a lovely case of anorexia nervosa, or bulimia, or ED-NOS, and can’t get their treatment covered anyway.

    Insurance companies FTW!

  61. ancientsociety says:

    @Smackdown: PRECISELY!

  62. jaya9581 says:

    I think most of you would be surprised at the number of people who truly can’t help being overweight. There’s an alarming number of women, myself included, that have a condition called PCOS – I encourage you all to look it up. Basically it involves how your body processes insulin. Because your body can’t handle the insulin, you gain weight, and it becomes almost impossible in some cases to lose. The unfortunate major problem that comes with PCOS is an inability to get pregnant. Despite the fact that I’ve had all the indicators for this disease since I was about 13 years old, I was not diagnosed and treated for it until I was 24, after 2 years of trying to get pregnant unsuccesfully. In 18 months being treated for my insulin problem, I’ve lost 10 pounds. It’s the only time in my entire life that I’ve ever lost any weight – and I’ve dieted, exercised, and done everything short of bullemia or anorexia to try. But being overweight doesn’t mean I’m unhealthy. I have perfect cholesterol, perfect blood pressure, perfect everything. The only ways I’m “sick” are from allergies and associated asthma, and the PCOS. I can touch my toes without bending my knees – something I bet a lot of you can’t do, and something that continually astounds even my doctors. In most people’s eyes, I’m fat, so therefore I can’t do anything a “healthy” person could do.

    Some people have posted comments that are incredibly rude and insensitive, and I think that the previous commenter got it right when he said that people just plain don’t like fat people. I’m not saying there aren’t people out there who eat to excess and sit on their behinds all day and do nothing about it. Those people should smarten up. But please don’t lump us all into one big category. If you want to comment on this topic, please have a little bit of class and sensitivity, particularly if you want anyone to take what you’re saying seriously.

  63. SaraAB87 says:

    Seems like you can’t win either way… other than to be in PERFECT health. I would venture to say that not too many people are in perfect health, I have had to have 2 surgeries just because of circumstance, it was NOTHING that I caused myself, nor anything that even a family history could cause.

    Being poor is an incessant spiral as well, if you are genuinely poor you won’t be able to afford to eat healthy foods because we all know eating healthy costs more than eating whatever you can afford to put on the plate. In turn this makes health insurance less affordable which makes healthy food even LESS affordable. Its almost like discriminating against the genuinely poor which is bad..

    Again there is no way to win, a person who excercises might also be more prone to injuries such as broken bones or sprains which require hospital visits which cause the insurance companies to have to spend money, and also longterm problems such as arthritis or joint pain or surgeries down the road when you are older which again, causes the insurance companies to have to pay for treatment.

    We should not judge fat people unless you really know that the reason that person is fat is because they sit on a couch all day and eat fast food way too much. There are a variety of reasons for the obesity epidemic, its not just one single cause for everyone. Generalizing the problem is not helping any and its not helping to find a solution for it. Its like we can stop the obesity problem by make companies like kellogs reduce advertising towards children and make Chuck E Cheese take pizza out of their advertisements.. if it was that easy I am sure it would have been done a long time ago.

  64. CumaeanSibyl says:

    @pinkbunnyslippers: A mentally ill person who’s on medications and seeing therapists may cost the company more, but s/he is actually doing the equivalent of the eat-right-exercise-more plan — those treatments are necessary to keep him/her stable, functional, and out of the hospital (being put in the psych ward costs a ton).

    There are a lot of physical disorders, as well, that require prescriptions and regular doctor visits for maintenance, and therefore cost money, but not doing those things would cause far more costly problems down the road.

    The question is, how much are these “health coaches” going to cost? How much money will the insurance companies be spending to pay them, and is that sum less than the medical care that their clients would need without them? I imagine the companies think it is, but the odds are weird sometimes. A person who’s high risk in all the categories might never have to go to the hospital while s/he’s on their plan, with or without the coach.

    I’d also like to know if the companies plan on doing these assessments with all family members who also qualify for the insurance plan. If my husband’s employers called me up one day and said “look, we want you to come in so we can lecture you about your health,” I wouldn’t be at all pleased — but I’m on the plan, too, so I could end up costing them money for my health problems.

  65. dandd says:

    We have really been mislead recently to conclude that being thin is healthy. Weight is not a good indicator of health. Fat people have health problems, but so do thin people.

    This is just one more scam to steal more of your $$$.

  66. matt1978 says:

    I don’t want to pay for your laziness, your “accidents”, your lack of motivation, or anything related. If you don’t like it, quit your job and get your own health insurance, fats.

  67. peggynature says:

    @Smackdown: I’ll go you one further and say that it’s ethically repugnant to punish anyone for a physical condition, genetic or no.

    Even if it could be proven that being fat has significant environmental causes, have you ever met a fat person who WANTED to be fat? Have you ever met a fat person who has never dieted, or otherwise spent years of their lives in a desperate attempt NOT to be fat, or even to be LESS fat? Because those people are goddamn rare, if they exist at all.

    No one wants to be fat, period. Most fat people try everything they can to stop being fat. And it doesn’t work, or else no one WOULD be fat. At the end of it all, people end up fatter, or sick, or both.

    And who do we blame? That’s right, the fat people. Not the diet companies or the drug manufacturers or the doctors who know the treatments don’t work, but push them anyway, or who refuse to treat a fat person for X condition until they lose X amount of weight.

    And we certainly don’t blame the insurance companies for not covering the fat people, oh no. And, even though fat people have difficulty getting insurance coverage, and even though many avoid doctors like the (ahem) PLAGUE because they don’t want to hear the goddamn weight-loss spiel every time they sprain a wrist or catch the flu, WE STILL COMPLAIN THAT THEY ARE DRAINING OUR HEALTHCARE DOLLARS, WHAAA.

    Someone call the whaaaambulance for the thin people. At least they’re covered for the ride.

  68. peggynature says:

    @matt1978: And I don’t want to pay for your obviously debilitating head-injury.

  69. SaraAB87 says:

    @dandd: This couldn’t be more true since the thin person does not get penalized or ridiculed because they eat fast food but as soon as the fat person admits to eating it its ridicule city, despite the fact that its unhealthy to eat it on a regular basis no matter if you are skinny or fat.

  70. Firstborn Dragon says:

    I think it’s going to present problems for some people. I told my parents in all seriousness that if I lived in the US I’d be dead.


    I have medical issues that no one can get to the bottom of. I’m overweight which they say is due to hormones, BUT because of other issues they can’t do the blood tests needed to prove it. But then others say it’s not hormones, it’s a disease. And yet others say it’s neurological. Problem is, they have been running tests on me for YEARS and have yet to find a solution.

    I’ve been stuck on anti-depressants, which now I’m told I shouldn’t have been on. Yet another doctor swears I’m depressed. Others say no, you’re bi-polar.

    I admit I am seriously fucked up, and no one knows what’s wrong or how to handle it. I’ve been to over a dozen diffrent doctors in the last YEAR alone.

    Any hint of getting any needles on me at all for ANY reason causes my blood pressure to shoot out of control. Yet normally my blood pressure is amazing.

    Hell, I KNOW I’m overweight. I’ve lost track of the number of things I’ve tried to loose the weight, but the only option that works is both unhealthy for me, and near impossible to keep up. It was a low carb, high fat diet that actually had me loosing weight. I was limited to what foods I could eat, which given I am already vegetarian I am limited by. But I did not enjoy eatting eggs EVERY morning. Which was the only breakfast food I could eat.

    I got sick of the limited selections of veggies I could eat, NO carbs, NO fruit, NO processed sugars, NO low fat foods. Made even harder by the expectation that I eat lost of meat. And I DON’T EAT MEAT!

    Besides, hardly seems healthy to me when you look at it.

    Bottom line is, to get the lower weight they wanted, (I tried SEVERAL low fat diets that failed for me.) was even more unhealthy in the end then keeping the weight on.

  71. matt1978 says:

    @peggynature: That’s fine with me, hon. Maybe you could put down that glass and get moving, too. Save everybody a little cash.

  72. JiminyChristmas says:

    @phrygian: That’s scary, and quite possibly illegal.

    If the health coach is sharing individually identifiable health information with the employer, it’s a violation of HIPAA (Health Insurance Portability and Accountability Act, which guarantees the privacy of medical records, among other things) and the coach as well as the employer could be in deep s%$t should your brother choose to file a complaint.

    Left uncontrolled, it is clear where this is all headed. Employers figure out who is sick and causing everyone’s premiums to go up, and then fire those people. So, if you’re sick but no so sick you’re protected by disability civil rights laws, say goodbye to your job. Pregnant women, anyone over age 55, say goodbye to your jobs too…you just might be a little too expensive to insure/employ.

  73. azntg says:

    I’m overweight and I consider myself fat, but I get sick much less frequently than people my age who fits the clinical definition of fit (small sample size and personal experience, but I’m no professional statisician).

    And yes, I’m still making attempts to lose weight and get fit, to very little success (because it sucks not being able to run as fast as I used to back in my track days since I’m so damn heavy).

    I’m absolutely against insurance companies basing premiums and copays on health. If anything, they should adjust that based on people who game the system to detrimental level more than people who don’t meet their arbitrary “fitness” criteria.

  74. jamesdenver says:

    My health plan is moving to that direction in ’08. I’m fit, healthy, active and active. However to get the best plan I’m REQUIRED to submit to an “online or phone health coach” if they demand it of me.

    And I already had to fill out a survey with extremely detailed emotional questions which are none of their business. (Just give the most correct answer)

    Here’s the prob: A nurse or “health coach” working for an insurance company does NOT have MY interests in mind. Period. I have a doctor and physician. I’ve been with him for 10 years. I’ll trust his advice for procedures large and small over the “nurse” operating by phone from an insurance company.

    By the way I agree the BMIs are absurd. I’m 155 5’7, bike 80 miles a week and lift weights 2-4 times a week. But because I have muscle and bulk on my chest/shoulders I just BARELY fall under the BMI range.

  75. MikeB says:

    Whats next? Basing health care costs on your family history?

  76. BigNutty says:

    How can your average small business afford to provide employee health care? This is a way to help them afford the cost. It’s either this or no heath benefits for many businesses.

  77. lainykai says:

    Where do they draw the line? Drinking can cause severe medical problems so if you chose to drink in your off time does your premium go up? Same thing goes for smoking. I am not thin but I only go to the doctor once a year for my yearly physical. Far less than my thin smoker friends who go in for bronchitis and respitory infections throughout the year. I understand the need to keep costs down but where does it end?

    We have an incentive program at my company, not penalties. Also we have a doctor on site twice a week that we can see for free. We can even bring our families. This way we get the services we need and it keeps insurance costs down for the company.

  78. mrosedal says:

    The real problem with this is separating fat people who are out of control and fat people who have no control…and what I mean by that is out of control fat people eat way to much and eat everything that is bad for them. So fine penalize these people, but someone noted above of two examples of people who had cholesterol that was clearly genetic. I think there are people who are trying to keep weight in check and never eat Big Macs, but are still overweight.

    In college I knew so many “skinny” people who could pack down so much more food than myself…for sure they overate…and for sure they were not eating any healthier than myself, yet they were “skinnier” than myself.

    I just don’t like penalizing people for health problems they may not be able to control. (ie cholesterol, cancer, obesity, kidney stones, mental problems…keep going the list goes on).

  79. mconfoy says:

    @GrantGannon: As long as that includes the costs of your mental health treatment.

  80. mconfoy says:

    @oilguy: Do you have any scientific evidence to back this up or are you talking through your ass like most of the people out here that spout their nonsense on health?

    Why is it that they can provide better health care in most countries at half the cost? Better as in outcomes — people live longer and children die less often. Tell me where the kids that died of tooth infections because their parents could not afford dental insurance to blame? You people are typical, selfish, think about yourself, only Americans. Time for this country to join the civilized parts of the world that believe the true measure of a societies’ worth is how well it takes care of all its citizens. And what kills me is most people purport to be Christians in this country. In other words, most of those are hypocrits.

  81. mconfoy says:

    @oilguy: And there is zero, i repeat zero evidence, that corn syrup is any worse than sugar. And low carb diets feature higher fat than others and so far, have been shown to be more effective. What I like is evidence that this is all there is to weight gain “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.” There appears to be much evidence now that the problems are much more complex than your simple minded nonsense is spouting. Besides the fact that blood fat is not necessarily associated to weight, especially triglycerides. Never the less, Americans should exercise more. A carrot instead of a stick is the preferred way of achieving that, especially when trying to associate these type of issues to individuals based on measurements that simply may not be a reflection of lifestyle.

  82. spookyooky says:

    So when do they start charging more the older you get? Older people use more health care. Are us young people supposed to support all these baby boomers because they had to go and have long lives? Why should I pay more for my health care because some 60, 70, or 80 year old doesn’t have the good sense to quit working and just go off and die?

    Maybe insurance companies should only insure people who will never use the insurance? Isn’t that a win win for them? People are covered buy once they use it they lose it. Kind of like when a natural disaster hits and then the insurance companies deny claims or just go out of business.

    Health insurance for profit is a scam fellow readers. “Insurance” is paying for something that you hope to never use like car insurance. Hopefully you never have to use it.

    Health insurance in almost every situation will be used. If you give someone $20 and say “you keep this, I may never need the money back but then again there is a likely-hood I may need $100 back” Why would someone do that? Only if they could make sure that you would never come back to them for your 20 bucks.

    In this country we are so paranoid about one all powerful BIG BROTHER that instead we are all too willing to have hundreds, if not thousands of little sisters watching every move we make. It’s time to grow up and realize that in the land of the free and home of the brave , United we stand and devided, we all fall.

  83. chili_dog says:

    @pine22: So if I a slightly fat man with no HBP, non-smoker, non-drinker should be penalized because I have a few extra pounds because I can’t walk or move well due to an accident?

    You people that think being thin is as simple as going to the gym 3 times a week and eating tofu make me sick.

  84. SOhp101 says:

    @chili_dog: Depends on what you mean by few extra pounds. I would hope that the only types of overweight people that would actually get penalized are those who are beyond obese.

  85. Sir Winston Thriller says:

    I’m of two minds about this. My company’s “health” insurance uses such a system. The insurer contracts out the coaching, and they’ve been helpful when CIGNA denied coverage for a prescription drug (Januvia) my Primary Care ordered. After two months of paying for it all out of pocket, the health coaches noticed that I’d both lost weight (about 20 pounds) and lowered my blood glucose. They recommended that CIGNA cover it for six months and then reassess. Still, I have to pay more because I’m still diabetic and overweight (I dropped out of the obese category due to better diabetes control, better eating, and exercise.)

    On the other hand, one coworker ran up over $300,000 in bills because of thyroid cancer, another had a toddler diagnosed with kidney cancer, and yet another had a very serious pregnancy-related issue. They haven’t had a surcharge at all, even though their year-to-date costs are much, much more than mine to the insurer.

    I’ve had to forgo cataract surgery, a colonoscopy, and physical therapy for an exercise related injury because of a very high deductible on our plan. The plan is great if you have something catastrophic happen; not so great if you’re getting older.

  86. @protest: “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?”

    I have a friend, overweight, whose company has a health incentive program. First off, they use BMI as a starting point (which is its purpose, and every medical professional on the PLANET knows its imperfect and that certain categories of people in particular will always be “wrong” on the BMI).

    He and his “health coach” person set goals and they’ve worked on improving his diet and lowering his cholesterol together; info meetings with his health coach are NOT reported to the company. (Which IS NOT THE CASE in many of these programs, and I’d be way leery of a program where your company gets reports on your health.)

    He gets a monthly discount if he meets certain metrics (and there’s a smorgasboard of them to choose from and he gets to pick) — for him, he gets a certain amount of $$ knocked off his insurance every month that he goes to the gym 3 times a week every week of the month. (The gym reports to the company, but only at his request.) Other metrics include seeing a nutritionist X times, or an asthma management specialist, or taking a class on diabetes management, or getting a yearly check-up, or whatever.

    I’d be willing to participate in that kind of plan, largely because they’re rewarding you for education and effort, not for “success” in achieving things that might or might not be within your power, depending on your genetics.

  87. mmcnary says:

    If you get a chance, everyone should check out an episode of Penn and Teller’s Bulls#$t that talks about the ‘obesity epidemic’. One of the points that they make is that the BMI chart was developed aver 100 years ago when people were a lot smaller.


  88. Mariallena says:

    @Rectilinear Propagation:

    Certain airlines like Southwest are charging double to people who take two seats on crowded flights (which is every flight these days), but they don’t have yet a pay-by-the-pound scheme.

    With the price of oil inching into the triple digits and becoming a bigger chunk of the airlines’ costs, it would make perfect sense.

  89. Mariallena says:


    There is no reason why they couldn’t start charging by the pound for tickets sold in the future.

    I weigh about 180 lbs and I don’t see any good reason why I should be subsidising the trips of a 400-lb behemoth that can’t keep his mouth shut.

  90. mike1970789 says:

    The ability to store food in our bodies (make fat) used to be about the most important thing possible for survival. Before technology made it so easy for us to grown more food than we need there were good crop years and bad crop years. During the bad years the people who couldn’t make fat efficiently died off. The ones that could made babies. For hundreds of generations it was a positive genetic trait to be able to make and keep fat. I sometimes wonder if the famines will someday return and all those beautifully efficient food-storing people will be the only ones left when it’s over.

    Anyone who says it’s “easy” for everyone to lose weight is ignoring millions of years of evolution. Look at your mom and dad. Are they tall? Odds are you’ll be too. Are they fat? Same deal.


  91. ogman says:

    I’ve got a better idea; why don’t we just trim the fat profits, made by insurance companies, off of the health care costs? Then we won’t have to pick on certain groups just to make sure the billionaires can still get fat off our dollar.

  92. RagingBoehner says:

    @jaya9581: That’s why Congress passed HIPPA in 1996


  93. Jaysyn was banned for: says:


    A 6″ subway sub is barely more expensive than most fast food fare.

  94. ElizabethD says:

    Damn, this seems capricious. Yes, there are actuarial indicators of lifestyles that put one at higher risk for health issues. But it’s still a crap shoot. As many have pointed out before me, weight and fitness are one piece of the puzzle. Genetics is another biggie — are we going to screen insurance candidates for their parents’ and grandparents’ risk factors too? Do high-res scans on absolutely everyone to see if they have an enlarged heart, like the young marathoner in peak physical shape who dropped dead in New York last week? Snoop around and report on individual drinking habits?

    Slippery slope, what. Let’s nationalize health care and get it over with. Everything else seems big-brotherish, unduly punitive, and a waste of time.

  95. Benstein says:

    The problem with this entire plan is that you are not going to be rewarded for being healthy, you are going to be penalized for being fat. The insurance companies are not going to remain profit neutral, they will just end up making more money.

  96. PlayWithSlurry says:

    What I think a lot of people are alluding to here is the concept of “adverse selection.” Because health insurance companies are prohibited in many states from charging people who get cancer more, they try to compete by dropping the sick or people likely to become sick. Any solution to this problem will have some drawbacks (rationing, bad incentives for innovation, social justice problems).

    The best thing an individual can do is not to begrudge people who are heavy (no one wants to be sick or ugly), but try and exercise and eat healthier as a way of sticking it in the eye of the insurance companies.

  97. smitty1123 says:

    @lincolnparadox: Except nationalized helthcare will screw over people like me who don’t want any health insurance.

  98. brettro82 says:

    The benefits program at my work (a local government health department) has this type of system and, in my opinion, it works really well for everyone. No matter where you rank on the “Wellness Assessment”, you must complete an individual action plan to keep the highest level of coverage. The choices we’re offered are things like tracking your daily food intake or your physical activity over a period of time. It’s all documented in a website that’s designed for the program. I am young and in excellent health but even I am motivated to do a little bit more while in the program.

  99. Geekybiker says:

    When they charged for the obese. I said nothing; after all, I was not obese. When they charged for those who liked dangerous sports, I said nothing; after all, I did not like dangerous sports. When they charged for those with genetic diseases. I said nothing; after all I had no genetic diseases. When they came for me, there was no longer anyone who could protest.

  100. cerbie says:

    @taney71: yet, a private business should be able to put employees in positions that hinder their ability to live healthy? Yeah…

    Health insurance needs major reforming, but so does our collective work ethic (If enough people are not willing to put up with an unhealthy lifestyle, things will be forced to change). If we were working slightly shorter weeks, with businesses more spread out (lower the typical commute time), and insurance paying better for preventative care, we’d be in much better shape, overall.

    However, all of that does not represent any realistic options for most people (I can’t think of a way to write that properly, so don’t go grammar-nazi on me :)).

    @evilhapposai: anyone who can afford to eat at fast food joints regularly can afford to buy good stuff from the likes of Whole Foods. The problem then becomes time and training. How many people that go through the McD’s drive through have an hour or more of their day to cook and clean? How many that might have that time were taught how to make basic meals? I wouldn’t be able to, if I didn’t enjoy it.

    Oilguy obviously doesn’t know anyone who can’t work out because on an injury. They tend to eat far less than those of us who can get around well…but it will probably take physical therapists ($$$) to be able to get them into an exercise regimen that would let them lose the weight.

    As for myself, I wasn’t where I should have been before now, but I’ve gained about 30lb from working. I went from spending 4-6hrs a day on a computer (post-college, pre-job) to spending 7-8, without any useful physical activities around. Then add a little stress, and the fat comes right on. With two more hours a day of spare time, I could lose 50lb and keep it off (time to walk and cook more often).

    I’ve been surprised, even being overweight most of my life, how difficult it is to get the weight off.

    There is no single silver bullet solution, but the health care and health insurance industries could start caring, and both reduce costs and increase profits by doing so. But hey, that would require caring.

  101. There is no single silver bullet solution, but the health care and health insurance industries could start caring, and both reduce costs and increase profits by doing so. But hey, that would require caring.

    @cerbie: Not to mention effort. It’s like those car rental commercials, “What if we didn’t try harder?” Solutions that don’t involve scapegoating are too much work.

  102. Consumerist Moderator - ACAMBRAS says:

    @Eyebrows McGee:
    I like the idea of getting a discount for going to the gym/fitness center a certain number of times per week. That would be an incentive for me. Then, on those days where sheer willpower alone can’t motivate me, wanting to save money will get my ass on the treadmill.

  103. chili_dog says:

    @SOhp101: Well lets see here, according to the Federal height and weight chart, normal weight for being 6’2″ is 143-187#. What a load of crap. That is borderline emaciated and unless the person has “good genes” to allow for that weight, they obviously spend a lot of time in the gym.

    Besides, I’d rather be fat and successful from my work, then thin and a wage slave because I spend 10 hours a week on the treadmill.

  104. chili_dog says:

    On a side note, I say that all of you high risk but healthy people should pay a lot more. I mean come on, runners and their knee replacements should be paying double.

  105. RvLeshrac says:


    I got to see the bill from my PT just to get my knee back to normal after a simple sprain (Worker’s Comp) several years back. Holy hell, was that expensive.

    I’d imagine that these “Health Coaches” and whatnot are costing *FAR* more than they save, but the insurance companies will just use that to raise rates once this takes hold.

    They’ll always find ways to raise rates, it doesn’t matter how much they spend or what they spend money on.

    I’m all for people paying more if they have to go for more expensive care – just like car insurance. You don’t pay more for car insurance because you have slower reflexes than the guy next to you, you pay more if your slower reflexes cause you to rear-end someone. You shouldn’t have to pay higher premiums just because you’re over the average BMI or a smoker, you should pay higher premiums if your weight causes you to have a stroke, or because your smoking causes you to have more hospital visits for bronchitis/infections/etc.

    I’m a smoker, and I very, very rarely choose to head to the hospital. I certainly go to the doctor far less than the “healthy” people I work with who go for a visit every time they have the sniffles. Why should *I* pay to subsidize their hypochondria?

  106. scraejtp says:

    Listening to fat people complain is great.
    I’m with OilGuy, just about anyone can lose weight. Sure everyone is different, and it will take a different amount of food for each person to maintain weight, but everyone could still lose weight.
    It is physically impossible to get away from the fact that if you eat less (energy) than you burn off, you will lose weight. For some people that might only be half a sandwich a day, for others 15 burgers.
    Anyways, I’m all for peoples insurance premiums to reflect their habits. I might pay less because I don’t smoke/drink and am relatively healthy, but I’m sure I’ll pay more for riding a motorcycle. It isn’t a loss of freedom since health care is not a right. You don’t have to give up your information, you can choose not to have health insurance, or start up your own health insurance company and run it how you see fit.