Plan shifts health costs to less fit

[katinmn]

Get healthy, or pay more for health care.
http://twincities.bizjournals.com/twincities/stories/2006/08/14/story2.html?page=1&b=1155528000^1329762

That's the message behind a new health plan being offered to employers in Minnesota by insurer PreferredOne and consultant Aon Risk Services Inc.

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Here's how it would work:

A company would sign up for the plan, then in most cases notify its workers, giving them some time and informational resources to help them shape up their health habits.

Then an independent laboratory would send nurses to the company to evaluate workers' health, placing them in appropriate deductible plans (which cover their health care expenses after the annual deductible is paid).

The plan measures five lifestyle factors: blood pressure, body-mass index, tobacco use, and cholesterol and glucose levels.

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Employees who make unhealthy lifestyle choices (which usually account for a majority of employers' health care costs) would get higher deductibles, possibly as high as $2,500.
more

[Monkeyman]

1. Democratic plan for Health Care

http://www.housedemocrats.gov

[sandnsea]

2. What about alcohol use

The large percentage of ER visits is drug or alcohol related. Some studies show 25-30% of all hospital beds are related to substance abuse. More statistics:

http://www.columbia.edu/cu/record/archives/vol21/vol21_iss19/record2119.17.html

[Trillo]

3. Purpose of insurance is to share costs between

healthy and unhealthy. Today's healthy become tommmorrows' unhealthy. If it doesn't share the cost burden, then insurance fails to live up to its primary purpose. When that happens, then whose purpose does it serve?

Blood pressure is not a lifestyle choice, it goes up as one ages. In fact as I look at the list of risk factors, the only one that appears related 'to choice' is tobacco use, and its addictive nature calls even that 'choice' into some question.

[katinmn]

4. I know marathon runners with high cholesterol

I think this is a bad idea and another example of a market-based system rather than a patient-based system.

[lindisfarne]

5. This is dangerously headed in the direction of using your genetic

make-up against you. Would we endorse charging someone whose DNA predisposes them to having breast cancer more for health insurance? How about someone whose family and genetic history predisposes them to mental illness? Or charging women over 30 more for insurance covering prenatal, delivery, and postnatal care (these women are more likely to have children who have Downs syndrome and other genetic problems).

Insurance is supposed to spread risk across a pool of people. I don't endorse charging more for insurance by age which is a common practice, nor do I endorse charging more based on genetic make-up.

Cholesterol & BMI are not merely a reflection of what you eat: two people eating the exact same foods, at the exact same weight, and with the exact same exercise and stress levels, can have vastly different cholesterol levels.

And, as the Sunday NY Times article made clear, BMI is not simply a reflection of what you eat.
http://www.nytimes.com/2006/08/13/magazine/13obesity.html?ex=1155700800&en=819a7adcfba818e1&ei=5087%0A

"The experience with Janet was an early inkling that traditional ideas about obesity were incomplete. Researchers and public-health officials have long understood that to maintain a given weight, energy in (calories consumed) must equal energy out (calories expended). But then they learned that genes were important, too, and that for some people, like Janet, this formula was tilted in a direction that led to weight gain. Since the discovery of the first obesity gene in 1994, scientists have found about 50 genes involved in obesity. Some of them determine how individuals lay down fat and metabolize energy stores. Others regulate how much people want to eat in the first place, how they know when they’ve had enough and how likely they are to use up calories through activities ranging from fidgeting to running marathons. People like Janet, who can get fat on very little fuel, may be genetically programmed to survive in harsher environments. When the human species got its start, it was an advantage to be efficient. Today, when food is plentiful, it is a hazard.

But even as our understanding of genes and behavior has become more refined, some cases still boggle the mind, like identical twins who eat roughly the same and yet have vastly different weights. Now a third wave of obesity researchers are looking for explanations that don’t fall into the relatively easy ones of genetics, overeating or lack of exercise. They are investigating what might seem to be the unlikeliest of culprits: the microorganisms we encounter every day."

[katinmn]

6. kick