Firms to charge smokers, obese more for healthcare

I’m kind of wondering how you’ll all feel about this. Do you think you should pay the same for your insurance than those around you that are really living unhealthy lifestyles?

More and more companies are starting to do this and I really don’t think it’s a bad idea. I paid more for my car insurance for YEARS because I smoked. I think now that they’re adding weight, people are more horrified because you have a choice if you smoke and if you “chose” unhealthy lifestyle habits, that’s not your fault??? Right? That’s what “most” people think. I don’t but many do. I think anything you’re trying to quit is hard. You have to give up one habit and gain another. I also really like how they’re offering gym memberships and stop smoking programs.

I don’t feel being a smoker is any different than being overweight and I’ve been both. Quitting smoking is BY FAR the hardest thing I’ve ever had to overcome. Dieting is hard but smoking was much harder for me.

How do you feel? Do you feel if you do everything in your life to be healthy that you should share the cost of group healthcare in the workplace?

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18 Responses to Firms to charge smokers, obese more for healthcare

  1. Sue says:

    I think it would be nice for those that “follow the rules”, whatever they may be, actually got rewarded for it. Your life insurance policies are based on this info and car insurance so why not health insurance? On the flip side, there are those people who do everything right and fit all the correct boxes and columns, but still have heart attacks at age 40 or 50. There are still those that get cancer and have never smoked, drank or did anything else that should increase their risk. So, do you charge them more after they get sick to help cover additional costs, or do you charge everyone the same to offset circumstances like that? It’s a catch 22 I think.

  2. SKL says:

    Honestly, I don’t see a problem with charging more for insurance if the person chooses activities that they know are associated with higher average healthcare costs. It’s like with life insurance, if you are involved in exceptionally dangerous sports / thrill hobbies, you pay a higher premium.

    The whole point of insurance is to spread out the risks of unexpected problems. Like those rare people who have heart attacks at 40 despite having never smoked. That’s different from someone deciding to do something that is proven to have higher average costs.

    I mean, if I had 20 DUIs, would you want my experience to be figured into your car insurance rating?

    Honestly, I feel that there are already too many ways in which the consequences of individual choices are spread among all of us. My insurance bill would be so much lower if the rate recognized that, for example, I’ll never file a claim for illegal drug rehab.

    I am getting a little soft in my old age, but I still have a hard time with the bleedin’ heart logic. It does not make me a mean and selfish person if I think people ought to pay a reasonable price for their choices. I know it’s hard to quit, and I’m sorry about that, but it’s still a choice. If there is no individual accountability, then where’s the incentive to make a better choice, short of getting seriously ill?

    My only caveat is that I am not sure they have really proven that being overweight makes you more of a drain on the healthcare system. I know both sick and well people on both ends of the weight continuum. (Unless they are talking about morbidly obese.) I do think there’s a very clear pattern when it comes to smoking, though.

  3. shanef says:

    I don’t see any problem in charging people more if there overweight or smoke. I talked to my work about discounted health care memberships but our insurance company doesn’t do that. It would be nice if they did. Health insurance shouldn’t be any different than car insurance. If you drive a fast car or a big truck you pay higher rates.

  4. Laura says:

    Ok, full disclosure, I am fat. I have a lot of weight to lose to get to my predetermined “medically healthy” weight. But I have a real problem with this.

    I cannot get health insurance. Period. Neither of us have jobs that offer health insurance. Steve is covered – completely, regardless of pre-existing conditions – by Medicare. I have been to several different insurance companies, and I cannot buy health insurance. No, correction… I can buy a Health Savings Account (HSA), but for that, I have to put up a minimum of $5K before I can even think about getting one.

    I have two major problems with this idea and our health insurance system in general. First, the “weight issue”. I have been “overweight” since I turned about 20. I have also been on a diet of one kind or another since then. On top of that, I’m an emotional eater and am blessed with Binge Eating Disorder. Yes, there have been times when I quit the diet out of frustration, but most of the time I eat right. I exercise, and still, the weight hangs on. I can lose up to about 10 lbs easily, but then it comes to a screeching halt, and doesn’t move. When I have presented any of these issues to any of the doctors who have ever worked with me, I hear “lose 35 lbs, then come and talk to me,” or “cut out more calories and exercise more.” At one point, I was running 3 miles a day, and restricting my calories to 1500/day. For six months straight. I lost 3 lbs during those six months. So the idea that people work, HARD, and can’t lose weight is a very real one. For the record, all of my bloodwork – cholesterol, glucose, triglicerides, etc., have always been either in the “normal limits” range or the “good/excellent” range.

    During much of the time that I was overweight and working like crazy to take it off, Steve was the “perfect weight”, skinny as a rail. But he ate (and still does) entire family sized bags of chips in one sitting. He ate the huge borders of fat on his pork chops and steaks. He didn’t exercise. He smoked a pack a day, and he drank like there was no tomorrow. His cholesterol was off the charts, and other numbers were out of whack, as well. Out of all of those things, the *only* choice he was “punished” for was the smoking, and even then, it wasn’t by much.

    How is that correct? The man was an active alcoholic, ate an awful diet, and never lifted a finger in exercise. I had issues with my weight that I BEGGED for help with, and under these new rules, we would both be paying an extra fee. His would be dropped if he quit smoking.

    Insurance companies base their “overweight” categorization ONLY on BMI and on nothing else. I lost faith in BMI a hundred years ago when it came out that Arnold Schwarzenegger was classified as “obese”… during his active acting years when he was staying in top shape. Why was he classified that way? Because he was so muscular. And yes, I know that he is an extreme example, but it is an excellent illustration about how flawed that marker is. And yet, it is still the “gold standard” in health measurement. Steve has since quit smoking, and he works out. I am still overweight. He can get insurance because his BMI is correct. He still has problems with cholesterol. He still eats huge bags of chips. And aside from going to the gym three days a week, he pretty much leads a sedentary lifestyle. And yet, he is covered, completely. No questions asked. Because it’s Medicare. The irony here is that I pay for him out of my taxes, but I cannot get myself insured.

    • SKL says:

      Interesting point about BMI. I have a kid who is and always has been skinny. I mean, she’s 5 years old and 34 lbs at last weigh-in (after eating all day). She wears shorts that are for kids under 2. The size 3 shorts she has need to be pinned or they will fall right off. She’s skinny, OK? Even taking into account her relatively short height. She also happens to be very athletic.

      But the funny thing is that I plugged her numbers into a BMI calculator when she was about 3 and it put her BMI at like the 85th percentile. What??

      I don’t put much stock in BMI.

      Another twist on this issue is: what are they going to do with the fact that “poor” people are most likely to be heavy and/or smokers?

  5. Laura says:

    My second issue is with the entire health insurance system (not “healthcare”, because we have top-notch health care. We have a problem with the payment system). We have become a group of people who expect that somebody else is going to pay for everything. People complain about a $10 copay because it’s “too much,” but at the same time, they haven’t the first clue what that service costs. They don’t know what their doctor charges for a checkup vs what he actually gets.

    We continue to “need” these huge, full-coverage policies that cost $900/month, but we have no idea what the real cost is… because our companies pay part of that fee and the rest of it is removed from our paychecks, so we don’t really even see it.

    Have you noticed that insurance companies have started making ER Copays higher and higher? $25, $50, etc. Why? To stop people from using them as their regular doctor. If it’s more expensive, they won’t go.

    IF we made a bold move, and got employers and the government completely out of the system, what would happen? I mean, after all the weeping and wailing and gnashing of teeth? When the dust settled, we would likely have a far different program. One which worked very much like the car insurance system. One where we would have a policy that covers things like heart attacks, broken bones and cancer, but where we would pay out of our own pockets for basics like yearly checkups, mammograms, etc. And there’s a good chance that even those prices would come down, because when people actually know how much they’re paying – because they actually have to write the check for it – the costs will move closer to the “reasonable” range. (no more $5 boxes of tissues, for example)

  6. Laura says:

    I know that insurance companies have massive costs to cover. But I also understand that the “market forces” have largely been removed from the medical system. Some would say that’s a good thing – that we should concentrate soley on making people healthy, ignorant of the cost.

    And punishing people because society doesn’t like what they look like is insane. I saw a picture the other day. It was several women standing side by side. One woman looked to be about 300 lbs. Another was about 100. And the rest of the women fell within the range that those two set. And every single one of those women? OLYMPIC GOLD MEDALISTS.

    Our weight is not a single determining factor in how healthy we are. Smoking is. Drinking is. Sitting on your butt all day doing nothing is.

    So instead of punishing people for what very well may be a genetic condition that they can do nothing about, we should find a way to completely overhaul the entire system. And THEN we can start punishing people for lifestyles that we don’t approve of.

  7. Joy says:

    I agree with almost everything you’ve said Laura but I really do wonder why health insurance is so much different than auto or life insurance.

    There should be some kind of a physical you’d have to take and if you were a healthy overweight person then that would show. I have to think of the majority of “overweight” people I know and they are NOT healthy and most eat like there’s no tomorrow. Sorry, it’s true. Look at the rate of diabetes now. Why should I have to pay for that? I feel that is a person’s choice. I hated the steroids I had to take so I went and got healthier and I’m off all but one med and all oxygen is gone too. Had I not lost weight that wouldn’t have happened. I do feel a lot of people could be off medications if they wanted to. I know people who think “oh, a medication can fix that?” Oh good.” That oxygen was so expensive so why should other people have to pay for that when I was the one who ruined my lungs from smoking? I feel it should be up to me.

    I don’t think you should have to step on a scale and your payments should be like that. I do think your doctor would have to be a part of it. Weight is “some” people’s choice.

    • Laura says:

      Agreed. But I think we’re taking the easy route, instead of really looking into the situation. When I applied for all those insurance applications, I noted on the app that they should PLEASE request my bloodwork and recent physical results from my doctor. (I get a physical every year) They never once made that phone call. I notified my doctor’s office before I applied for the policies that they might be calling. They said that it’s the office policy to note every time someone (insurance co, etc) calls and asks for anything in the chart. There was NEVER any record of insurance research. They simply looked at my weight/height ratio and denied me. Repeatedly.

      Yes, for some … I’ll even go on a limb to say most … fat people, it’s all about the lifestyle. but what about those people blessed with a metabolism that can handle all the crap? I know plenty of skinny people who would pass the BMI test, who wouldn’t eat a vegetable if it was the only thing available to them. They exist on fast food, coffee, bags of chips and other crap.

  8. Nikki says:

    I think it’s a great idea. If you are at high risk for health problems because of the choices you have made in your life, you should have to pay more. If you get into accidents, get tickets, you have to pay higher auto insurance. Should be the same concept. It MAY get people to rethink their lifestyle.

    • Nikki says:

      I do not think actual weight should be a determining factor. Over all health and lifestyle should be. But how many people are honest with their doctors? There are so many holes with this issue.

  9. Laura says:

    HAH!!! I found the picture (after a very disturbing hour spent with a seriously twisted wedding dress…..)

    olympic athletes

    Please understand – I don’t blame insurance companies for charging more for “unhealthy” lifestyles. I just don’t happen to think that fat = unhealthy. There are SO many other factors that need to be considered. Cigarettes DO = unhealthy. There is incontrovertible proof of it. But all of the diseases and conditions that are supposedly “caused” by fat – insulin resistance, cancer – have not been conclusively proven. Skinny people get cancer. Jim Fixx, the runner, died of a heart attack. I swear (based on my own personal experience) that insulin resistance can come BEFORE weight gain, and can be a cause of it. But it’s just easier to say “you’re fat, so you’re lazy/unhealthy”

    • shanef says:

      I guess I never looked at it like you Laura. I read all your responses and ” Walter Payton” and ” Tedy Bruschi” came to mind. Tedy was a pro bowl linebacker for the New England Patriots that suffered a stroke at the age of 32, it was very mild but still. Walter Payton who we all know was probably the ” healthiest” guy ever and he died at 45 yrs. old from liver disease. I’m 6’1″ 165 lbs. and I have slightly high blood pressure and I work with a guy that’s 5′ 10″ 280 lbs. and his blood pressure and cholesterol are good. I appear to be really healthy but I’ve always ate garbage, just recently I decided to go on a whole foods plant based diet in hopes to lower my blood pressure because I can’t stand taking meds. But the insurance companies probably base everything on averages and the majority of overweight people are unhealthy– high blood pressure and cholesterol, diabetes, etc. Like Sue said it’s a catch 22 and it’s too hard to determine who’s healthy just by looking at them..

  10. SKL says:

    Whew! Laura, I’m surprised you don’t have much to say about this topic! LOL!

    Well, I think the biggest problem in our payment system is that the doctors’ billed fee is multiple times as high as the fees they negotiate with the insurance companies. Since most people are insured one way or another – and many of the rest don’t frequent doctor offices – the negotiated fees really represent the fair value of the services. But if you’re uninsured, you get billed far, far more. This should be illegal. This forces people to get on expensive all-encompassing insurance plans when all they really need is a stop-loss plan or HSA. That in turn allows insurance companies to charge rates that bear no relation to actual individual risk, and it also allows the government to burden prudent people with the costs of things like drug rehab and STDs.

    I am self-employed, which means that none of my health care costs are hidden from me. Last I checked, I was paying about $10,000 per year for health insurance (plus copays), and I expect that to increase. My girls and I are all healthy by all measures. We don’t hang out at the doctors’ much; years have gone by when not one of us has had a medical expense of any kind. The real cost of our medical care plus stop-loss insurance would be a fraction of what I’m paying. But I keep insurance because if I didn’t, my bill for every routine service would be astronomical (without negotiated discounts). It’s a lose-lose and really needs reform in that respect.

    • Laura says:

      Who, me??? Naaaah….. it’s not a hot-button issue with me AT ALL. Why would you ever think that?????

    • Laura says:

      PS… I’m really glad you put the pricing system into words. I knew all that, but whenever I try to explain it, it gets me tripped up. I don’t know why, it’s just one of those things. So I’m glad you did it. From your lips to Congress’ ears.

  11. mssc54 says:

    Okay then what about fried foods? Soft drinks? Driving a motorcycle? Driving a moped? Riding a bike? Fastfoodaholics?

    But yeh, charge the chimneys more is good with me. Smokers suck.

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