Employer To Obese Employees: Shape Up Or Pay Up

[Contrary1]

Can anybody guess where this one is headed?

Indiana Company Charging Employers Who Smoke, Are Obese


"...Indiana has the fourth-highest level of obesity and the second-highest smoking rate. One employer is fighting the skyrocketing cost of health insurance by charging its least healthy workers a penalty.

Starting in 2009, Clarian Health Partners -- the Indiana hospital chain with 26,000 employees -- will start screening workers and docking paychecks $5 if you smoke, $10 if your body mass index is too high, and $5 for high cholesterol, high blood sugar and high blood pressure.

"The population of Indiana is one of the un-healthiest populations in the country,” said Dr.Robert Goulet of Clarian Health. "The ultimate goal is not to collect more money, the ultimate goal is create a healthier population.”

More: http://www.nbc5.com/health/13866692/detail.html?dl=headlineclick

[hobbit709]

1. Will the same rules apply to management?

Somehow I expect the bosses to have a different set of rules.

[Madspirit]

42. Excellent Point!!...n/t

[Crayson]

220. And PERCENTUAL !! 5$ means nothing to a manager

[Kookaburra]

2. Oh good grief

I smell a class action lawsuit brewing -- a big one.

[ceile]

11. HIPAA and ADA lawyers are going to have a field day w/this. n/t

[alarimer]

58. Exactly. It is illegal for your employer to have access to your medical records

Which is the only way they could learn your cholesterol numbers. I can't imagine anyone volunteering that information, along with weight and the other things.

[GOTV]

215. They wouldn't need to have access....

... The company can just offer discounts to anyone willing to voluntarily submit to medical tests to prove a certain level of fitness.

[Crayson]

221. They are screening them themselves

I understand they put their employees through medical checkups ?

[elehhhhna]

146. Plus it's plain old vanilla flavored WAGE DISRIMINATION. n/t

Too bad we have no Constitution, etc. anymore to protect us.

[JitterbugPerfume]

3. Good ole bright red Indiana

my home sweet home

[AwakeAtLast]

136. Yup, the land of Bushbot Mitch Daniels

When is the tarring and feathering party? I've got all my broomsticks soaking in oil! :evilgrin:

[jody]

4. People routinely pay higher auto insurance rates if they have a bad driving record, why not pay more

for bad physical fitness records?

[Zywiec]

7. Uh oh, now you've done it!!!

:popcorn:

[Contrary1]

8. Not talking about insurance premiums here...

This would be docking the employee's paycheck.

[havocmom]

13. Yep. Businesses looking to set precedent for legalizing theft of services.

Indentured servitude is just around the corner for most American workers. Already here for too many in questionable legal status-land.

[jody]

16. IMO we are talking about insurance premiums for health care. Those are paid directly or indirectly

by employees.

If people intentionally engage in unsafe practices, why should others covered by the same insurance program bear that extra cost?

Do you object if your auto insurance premiums are lower because you have a clean driving record or perhaps your children have excellent academic records?

[nascar55]

18. Not the same

it is going against the disabilities act. Obesity is a disability. There will be law suites. Driving is a privilege, You need a job to live. Heath care should be a right not a privilege.

[jody]

22. The disabilities act can be changed like any law. Obesity may be a disability but clearly some

people are obese because of their choice of life style.

Why should those who make the right decision pay for the sins of those who make the wrong decision?

[Madspirit]

48. SIN of obesity!!!!!!!!!!!!!!!!

You should be ashamed. The actual PURPOSE of insurance companies is supposed to be to help people in their times of need. That is a joke with most insurance companies but still, it is the supposed purpose.

Obesity is NEVER a choice. Why in the fucking hell would someone choose to be out of breath and at risk for many diseases. I am quite slim myself but have a couple of morbidly obese friends. They fight this continually. They have fought it their entire lives. One of them just turned 40 and had already had heart attacks before she even got out of her thirties. You call that choice? It's a compulsion; sometimes genetic; it is overwhelming. Why don't you read at medical sites, the AMA or APA, for instance. Obesity is most certainly not a choice. Is this same insurance company offering to help them deal with the obesity or just docking their fucking pay?

Give me a break from your judgments. They are shameful.
Lee

[jody]

55. "Obesity is NEVER a choice." Then why are there so many success stories of people who have changed

their life style and reduced their weight to normal ranges?

Are you saying those stories are not true?

[Madspirit]

56. RARELY happens with the morbidly obese...

I'm not talking chubby. I'm talking morbidly obese.

THAT is never a choice. Doesn't mean people cannot deal with the issue with help. I am bipolar. That is not a choice. I take meds and go to a shrink to deal with it. That helps. Still doesn't make it a choice.

Lee

[jody]

62. The OP quoted "Obese Employees" so you want to change the issue to "morbidly obese"? OK but that's

another issue. :shrug:

[Madspirit]

64. Is there a difference? n/t

[jody]

67. See the definitions below from Wikipedia

Obesity

The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:
•	A BMI less than 18.5 is underweight
•	A BMI of 18.5–24.9 is normal weight
•	A BMI of 25.0–29.9 is overweight
•	A BMI of 30.0–39.9 is obese
•	A BMI of 40.0 or higher is severely (or morbidly) obese
•	A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity.

[Madspirit]

69. Thanks. I am talking about all the obese...n/t

[jody]

75. Then I believe many people with a BMI of 30.0–39.9, i.e. obese, are so because of their choice of

life style.

IMO those people should pay a premium for health insurance if studies show that their weight is positively correlated with increased health risk.

[Madspirit]

105. ...and I think you are TOTALLY wrong

I do not think it's a choice because who the hell would choose it.

Plus, it's just bogus. Are they going to charge their employees who engage in other high risk behavior? Speeding in their automobile, drugs, drinking, sky diving, scuba diving, roller skating, bicycle riding, driving in a car..EVER.

..and is this going to apply to the bosses too? ...and is anyone at the head of that insurance company a fat person?

This is just another way to shaft the working person.

Lee

[jody]

114. You do know that I only have to produce one case to refute "you are TOTALLY wrong".

You'll find more than one success story at obesity success

Have a nice evening. :hi:

[Madspirit]

121. That doesn't prove anything

I never said obese people cannot become Not obese. I said it is not just a choice. That doesn't mean they cannot choose to fight the devil. It means it is extremely difficult and often takes more wherewithal than some have and often takes doctor help, etc. A lot of diseases can be fought. It IS a disability. ...and this is a way to screw the workers.

...and are they going to charge the other high risk takers and is this going to apply to the bosses? Answer these two questions.
Lee

[jody]

124. If obese people choose to loose weight and succeed, then how can you claim that's not a choice? n/t

[Madspirit]

127. ...because we're not all clones

Everyone does not have the same wherewithal. You can't just bootstrap yourself up from an illness. It takes help and support and some people just do not have that within them. Some people lick cancer. Some don't. Some are able to keep their mental illnesses in check with meds; some are not able to. We are not all cutouts from the same mold.

...and as I thought, you did not answer my two questions. Of course, I expected that. I am not going to engage with you any more. I have no idea why you call yourself a liberal or a progressive. You clearly are not. ...and I've been told by some friends here to watch out for you. So adios. Go defend anti-worker policies. Go defend big insurance companies. Go be a rutting happy little pig because there is obviously more than one kind.

Lee

[jody]

I said "many people" are obese because of a life style choice, not 100% as you say. n/t

[Madspirit]

131. ANSWER THE TWO FUCKING QUESTIONS I ASKED

Are they going to penalize all high risk behavior?

Will this apply to the bosses too?

You are now persona non grata...

Bye.

Lee

[jody]

133. And you have a nice evening also. n/t

[Madspirit]

135. I knew you wouldn't ..lalala...I knew you wouldn't..lalala...I knew you wouldn't

This was all just a guise to trash the workers. :woohoo: I knew you wouldn't answer the questions..... :rofl:


:woohoo: :rofl:


Lee

[AnotherGreenWorld]

151. Obesity is not the same as getting cancer,

MS, ALS, or any other serious disease. People who get cancer, MS, etc. didn't make lifestyle choices that caused their diseases. (Smokers who get lung cancer are an exception.) What's more when they are diagnosed with their disease, someone with MS cannot make a lifestyle choice to stop having MS. And successfully beating cancer has nothing to do with wherewithal. That is one thing that really annoys me: When people say person X was so strong because they beat cancer. Well, what about person Y who didn't beat cancer? Was she weak? No.

But someone who is obese can say, hey, you know what, if I don't eat so much, workout a little more, or just walk more frequently, which is good for the environment, I can get back to a healthy weight.

[proudmoddemo]

155. Wrong--We Don't Know

Lifestyle choices may be responsible for cancer, autoimmune diseases, and other types of diseases. We know that smoking causes lung cancer. But some people don't smoke and still get it. We know that there's a gene that leads to Crohn's (what I have), but we don't know why some people carry the gene and never develop active diseases. Theories ranging from treated water to a lack of exposure to cow shit as infants try to explain the difference.

We know that there are genes that predispose people towards being obese. We know that there are genetic diseases (diabetes) that can cause people to be obese. We know that there are medical treatments (steroids) that lead to obesity. But we don't know why some people with a genetic predisposition to obesity are not obese, and others without one end up being obese.

Other factors, and genetic illnesses, (depression, etc) can also lead to obesity.

And person A that beat cancer was strong. Saying that doesn't imply that person B who didn't beat cancer was weak. that's a faulty understanding of the English language.

[AnotherGreenWorld]

175. We don't know what causes autoimmune diseases, though.

Even if there were life style choices that caused autoimmune diseases, we don't know them. So people can't change their life accordingly. But there are life style choices obese people make. We know them. They have a choice.

Maybe, as an aside, it has to do with the polluted environment we in industrialized countries live in: autoimmune diseases are much more prevalent in industrialized countries.

Also, beating cancer isn't contingent upon a person's will. You don't will yourself to beating it. That's retarded.

[Contrary1]

166. Many people that get cancer did indeed make lifestyle choices that can cause it...

Breast cancer has a definite link to obesity.
High fat intake increases the chance of developing colon cancer.
A high fat diet may also increase the chances of developing prostate cancer
Hepatitis C virus and Cirrhosis are major causes of liver cancer in the US.
HPV has been linked to cervical cancer.

For many cancers, there is a lifestyle choice that may increase the odds of developing it.

[AnotherGreenWorld]

177. Yeah...

But it's still not the same as obesity. A 5 year old kid who gets brain cancer did nothing to bring that on. A 5 year old who weighs 200lbs had irresponsible parents who didn't teach him the value of eating healthy and exercising. It's still not his fault, I would say, but it's within his parents' control.

[pookieblue]

167. I one of those with MS

However, as I said in a previous post, I also have hypothyroidism on top of the MS. With the hypothyroidism comes trouble with weight as well as a list of other things. Add to that, the three rounds of IV Steriods I had to do and the AD's I have been on..well I have gained alot of weight.

Despite watching what I eat, getting exercise, etc, the weight was not coming off. My Neuro tested my Thyroid levels and that is when we found out about the hypothyroidism.

I am now being treated for that and the MS. but despite that, the weight loss is slow.

It's not always a matter of "choice". many factors play a role in a person's weight. To look at me, one would not think "oh she has a disease." No most people would assume that I was just one the "lazy ones" who eats too much.

according to this article

"Research reported on in February of 2000 estimated that as many as 10 million Americans -- the majority of them women -- have undiagnosed thyroid disease. Most of this is in the form of hypothyroidism -- an underactive thyroid."
http://thyroid.about.com/cs/publicawareness/a/oprah_3.htm

hypothyroidsim can cause your cholesterol levels go up. I know this, because at one time, my LDL's (Bad) were through the roof, where as the rest of my cholesterol levels were normal. despite what I was eating, despite the meds I was taking for the cholesterol, despite the exercise. Once I started the treatment for the thyroid. My LDL level dropped back to normal levels.

[AnotherGreenWorld]

180. It's not always a matter of choice. But for most people it is.

Someone who has an autoimmune disease like MS might have to take IV steroids or drugs like prednisone that cause an increased appetite. It's completely understandable to gain weight under those conditions.

But most Americans don't have such health problems. The major health problem most Americans have is their obesity which they can control. You didn't control getting MS. It just happened.

[pookieblue]

190. but to look at me...

one would not know that I have MS and hypothryodism.

All one would see is that I'm overweight and think that I just eat too much.
They don't know that I watch what I eat (have to..not just for the weight..but some stuff like red meat, is not good for someone w/MS), I walk as much as I can (Some days it's two miles...some days it's four..some day's I it's 1/2 a mile). I do what I can.

So my point is, how will the company know it's my condition that causes the weight problems. They would have to go into my medical records. Which I think should be between the patient and their doctor only. While I am open with my health, and luck to work for a boss who is very understanding. Some people want to keep their health problems private.



btw sort of off subject. the "roids didn't make me hungry. it was the opposite. I got very sick on them and could barely eat anything. But I still gained weight.

[AnotherGreenWorld]

197. Yeah, I agree.

I don't think companies should be able to look at a person's medical records. I'm not arguing in favor of the OP. I just think obesity is a little different from a real disease.

[pookieblue]

208. I think that

obesity can be a symptom of a disease (depression for one). Or a side effect of living with one (not being able to exercise, having to take meds that make you gain weight).

No one has the right to judge a person really. They don't know what that person.

The only one who should be concerned about a person's weight, really are the person and their doctors. Since they are the ones that know the real deal. Not the person who see them walking down the street.

as I said, no one can look at me and see that I have MS or Hypothyrodism. All they would see is an overweight person and ASSume that I was just some fat lazy woman who ate too much.

[Madspirit]

211. Not True

There are most certainly genetic links to obesity. It really irks me when people say that isn't true.

So I guess we're just going to have to be irked. I would never say "someone is so strong because they beat cancer." MY MOM DIED OF LUNG CANCER. I never blame the victim. I just think you are dismissing obesity because you find it unattractive and offputting, not because what you say is based in any science. Almost all doctors and scientists now say there is a genetic link or other physical problems, almost always, when talking about morbid obesity. YOU stop blaming the victim.

Even if it was "in their heads" which most don't think, well, the head is a part of the body and mental illnesses ARE illnesses. You can no more bootstrap your way well from a mental illness than you can from CANCER.

Lee

[GOTV]

216. Is Smoking a choice?

[AZBlue]

138. Who do you think you are? Are you a doctor?

Stop sharing your bigotry and hate with us - keep it to yourself!

[BlackVelvet04]

73. I once had a BMI of about 7 and

cholesterol levels in the 70's which was unhealthy (I weighed 88 lbs)....should I have been charged, too? Being extremely under weight is probably more dangerous health wise than being over weight.

[jody]

77. In your special case, it is unlikely that your underweight condition is a life style choice. n/t

[BlackVelvet04]

87. and you would know that how??????? n/t

[jody]

91. I don't "know that". I said "unlikely" which was clearly a conjecture on my part. n/t

[BlackVelvet04]

94. Why do you think it's unlikely?

Actually it was a lifestyle choice. I managed a karaoke company and besides working I would dance for hours at the bars every night. I was also going to the gym and all of the physical activity caused me to go into hyper metabolism.

[jody]

98. "conjecture" "A statement, an opinion, or a conclusion based on guesswork" n/t

[BlackVelvet04]

99. I know what the word means.....

I just think there is an assumption that too thin people can't help it and obese people can.

[jody]

101. If you know the definition of the words I use, why do you ask a question? n/t

[BlackVelvet04]

108. I wondered what caused you to think it was unlikely that

it wasn't a lifestyle choice.

[freeplessinseattle]

113. nice dodge. how about "presumptous"?

you knew nothing about her lifestyle, but concluded based on no other info that being underweight in this instance was probably not a "choice", which really illuminates your bias.

doubtful you are familiar with the dynamics of anorexia and bulimia, but many sufferers do feel as if they have no choice but to engage in their compulsive behavior, and many are livig a nightmare, and are actively trying to overcome the unhealthy behavior. Based on my own personal experience with anorexia, family and friends tend to think that it simply a matter of making a choice to eat normally, but it is so much more complex than that, and frustrating as hell to the one experiencing the problem. I can imagine that being obese has similar characteristics, and as a matter of fact I ended up being recommended to an overeater's anon. 12 step group bc there was little support available at the time (about 20 years ago).

[CreekDog]

147. Jody, frequently the disabled are obese because disabilities prevent

Needed exercise.

Try running on a treadmill with just 1 leg.
Try swimming with a 15,000 prothesis that cannot get wet
Try walking for exercise with a bad back

Also, people should be paid for their work, not their health. If they are doing a better job than a skinny person, they should be paid more and vice versa.

[jody]

168. The OP was about "skyrocketing cost of health insurance" not wages or salary for work. n/t

[CreekDog]

173. But the deduction comes from wages

It doesn't change the cost of health insurance.

[jody]

176. You said "people should be paid for their work, not their health" I agree but the issue is who

should pay for health insurance.

If an employee makes a lifestyle decision to increase their health risk, then IMO that employee should pay for the associated increase in health cost. Do you agree?

[CreekDog]

182. No I don't agree for 2 good reasons

It's too complex and impossible to do fairly and accurately (your life is nothing but choices!)

Second is that so many people can't pay for health care regardless of whether they can afford their own costs or the "average" for an individual in the USA. Thus, unless we deny those that cannot pay, we are not going to save you any money for "choices" because the system is paying for those choices anyway.

And in an average company health plan, probably the majority of those covered are not actual employees, but dependents. The employee could be healthy, their spouse, or kids could be making "bad" choices. Where does it stop and is it realistic to ferret out all this? If you stop short, then you are not recouping costs in any realistic way so that your vaunted concept of people "paying for" their lifestyle choices is not accomplished, not even partially.

You just refuse to concede that a concept that is logical can be totally impossible to implement. That's why I'm saying don't do it.

[jody]

184. You can disagree but if you have health, life, or property insurance you already

participate in contracts that reward or penalize you for lifestyle decisions you make.

[CreekDog]

187. Now you aren't even reading my posts

I didn't dispute the other types of insurance except for health insurance.

And my health insurance contract doesn't change based on my lifestyle choices, I am a federal employee in the largest group health insurance company in the nation. My premium is decided on something like 1 million people's group coverage and in the year prior.

Your assertion as it applies to my health insurance is simply wrong.

[jody]

191. OK, so you feed at the government trough but you are a special case that in no way disapproves

my assertion that some employers offer health insurance benefits to employees in which lifestyle choices affect the cost paid by employees.

[CreekDog]

192. I work for my benefits, how is it different than yours?

And my benefits cost less because I'm in such a large group and further, I pay 28% of my premiums and I pay all my dental and vision out of pocket because for them federal employees get no employer based coverage.

[CreekDog]

195. by the way, you just maligned the largest workforce in the country

Federal employees who work for your country to provide needed services calling them feeders at a trough.

Many of them are readers and you unfairly maligned them. I think that the rules state that broad brush characterizations that are derogatory such as the one you made are against the rules here. Do you agree?

[jody]

199. How do you know whether or not I am an employee of a federal agency? n/t

[CreekDog]

200. I said you maligned, I didn't say who you work for

Why is it feeding at the federal trough?

[jody]

201. You do know don't you that the federal government enforces strict obesity std. on some agencies? n/t

[CreekDog]

202. for job-related issues, not to change health care costs

and federal employees are charged the same premiums for the same plans regardless of their weight, cholesterol level and thankfully, preexisting conditions.

Why are you bringing up red herrings? You keep wanting to say that costs for health insurance vary according to choices, but the example you gave has no effect on health insurance premium to the employee. So what was the point?

[jody]

203. I've proved my original point that some employers charge employees more for their health care

benefits if the employee makes certain lifestyle choices that increase the employees health risk.

I've enjoyed the exchange, so have a nice day.

Goodbye :hi:

[CreekDog]

204. feeding at the federal trough? you never answered

but you admit that your last post about weight limits is not related to health insurance?

a non answer will be considered agreement. Thank you.

[Contrary1]

212. I don't see where he proved any point either. n/t

[AnotherGreenWorld]

110. And if it's something you can't do anything about,

why isn't Africa filled with obese people?

Why are the abjectly poor--not middle-class people who think they're poor--never obese?

[jody]

115. I don't know, do you? n/t

[AnotherGreenWorld]

150. When you don't eat more calories than your body uses,,

you don't get fat.

[LeftishBrit]

205. One can do something about lots of health problems!

I have Crohns disease (a form of inflammatory bowel disease), which for the most part I am lucky to be able to keep under control through a combination of medication and diet. This doesn't make Crohns disease a sin, or mean that those people with the same disease, who don't respond to treatment as well as I do, should be blamed for it.

People with diabetes can control their condition, but not cure it, through insulin and diet.

People with asthma can control their condition through inhalers, medication, and lifestyle changes to reduce their exposure to allergies.

One should not be fatalistic about illness and assume there is nothing to be done about it; but at the same time it rarely helps to equate illness, or even poor health habits, with sin.

Ordinary self-indulgence can make one overweight, but to be truly obese you usually need either physical or psychological health problems in addition.

In any case, this should not even be relevant. Employers pay you for doing a job. They don't, or shouldn't, have control over your lifestyle - even if it is 'sinful'. That is invasion of privacy.

[jody]

206. Agree "Employers pay you for doing a job" but the issue is the cost of health insurance. Why should

an employee who makes lifestyle choices that increase her/his health risk be subsidized by the other employees?

For example, if an employee chooses to smoke, a practice that most medical research concludes increases health risk, should he/she pay an added amount because her/his health risk is higher than other employees?

[LeftishBrit]

213. First of all, I believe in universal, equally administered health-care

I do not think that people's salaries should depend on their lifestyle choices.

A better idea is a sales tax at source on obviously unhealthy items such as cigarettes and certain junk foods. In Britain at least, cigarettes are highly taxed, so that smokers do indirectly end up paying more (in taxes) for the health service.

[jody]

214. Higher sales taxes on items associated with unhealthy lifestyle choices, e.g. smoking, shifts part

of the added cost of health care to the individual under a universal health care system.

Under the U.S. system of employer provided health care the same result is achieved by charging employees an extra amount if they smoke.

In both instances, smokers pay an additional amount if they make an unhealthy lifestyle decision to smoke.

Medical research shows that some people are obese because they make an unhealthy lifestyle decision to overeat.

How would you ensure employees who overeat pay an additional amount if they make an unhealthy lifestyle decision to overeat?

Higher taxes on food, unlike higher taxes on cigarettes, would target all employees not just those who overeat since minimum eating is essential for life and minimum smoking is not essential for life.

[LeftishBrit]

219. You can't and shouldn't tax food...

you might tax OBVIOUSLY very unhealthy foods; and subsidize healthy ones. At present it is cheaper to eat unhealthily than healthily, which is unfortunate.

But this is all getting a bit off the main point. What right do employers have to reward and punish people for their lifestyles? Where does it end? Should people get lower wages if they fail to look carefully before crossing the road; if they don't sleep enough; if they sunbathe too much; etc.? How can this be established without monstrous invasion of privacy? And what is next? Underpaying people if they have pre-existing health problems, or a genetic make-up that could put them at higher risk for certain conditions? That would make just as much sense with regard to the costs of health insurance.

Which is worse? To 'subsidize other people's lifestyles' through somewhat increased taxes or insurance, or to have your employers entitled to monitor your actions and personal health situation? I would say the latter. Also, if the monitoring is to be done effectively, it will probably prove quite expensive, so you'll end up paying for *that*.

[grace0418]

63. Based on that logic, couldn't someone in a wheelchair because they tried to imitate Jackass

fall into that category then? Who gets to make the differentiation between those who have made wrong decisions and those who are "truly" disabled? How do they do it and where do they draw the line?

[jody]

74. At present such decisions are made in the market place for insurance. If an insurance company offers

a particular group policy with various healthy life style premiums and that policy is attractive to employers/employees, they get a share of the insurance market.

Of course government can step in and pass laws that prohibit practices such as the one we are discussing.

In one sense, the issue is whether health insurance costs are spread equally among employees or whether employees with certain conditions are charged more or less for their insurance.

I return to my special case example, should you pay the same for health insurance as a fellow employee who chain smokes cigarettes?

Going from that special case to other health conditions takes us into a gray area. One discriminator may be whether or not the condition is subject to a person's choice.

Given the potential for medical genetics in the 21st century, the future looks tumultuous.

[Luminous Animal]

83. Insurance is supposed to spread risk.

Yes, I should pay the same whether or not I smoke, drive, skydive, have unprotected sex, drink to excess, race motorcycles, have children, work in a coal mine, ingest illegal drugs, ingest legal drugs, live in a building that is riddled with lead, fight fires, do combat duty, eat food that I am allergic to, handle fireworks, am a trapeze artist, play football, or engage in one or more of the the hundreds of thousands of risky behaviors that normal human beings engage in everyday.

[jody]

85. You forgot building a house in New Orleans and the sarcasm tag. n/t

[Luminous Animal]

96. I am not being sarcastic.

And your attitude is, quite frankly, pissing me off. I am also a proponent of "socialized" building insurance. People, in general, didn't build houses in New Orleans just for the hell of it. They built houses because that is where commerce developed. And funny things about humans, they tend to want to live in somewhat proximity to where they can make a living.

[jody]

97. And you have a nice evening also.

Goodbye, :hi:

[Luminous Animal]

104. I will have a nice evening

I'm going out to engage in some risky behavior. That is, I will do what I do most Friday nights. I will walk with my husband the 2 blocks to my corner bar (I hope I don't get hit by a car in the crosswalks - it happens often in this part of town)and I will drink 2 martinis and then several comparis and sodas. I will get tipsy, no doubt, and thus heighten the risk of getting hit by a car on the walk home. Not only that, I will increase my risk by walking home without my husband (he likes to stay at the bar longer than I). Jeesh, I hope my insurance company or my employer isn't inclined to do a spreadsheet about my private weekend activities.

[iverglas]

117. hee hee

Me, I'll be sitting safely at home on my chesterfield, eating cooked from scratch veggies and lean chicken with carefully counted carbs (diabetic in the house), drinking only water, climbing no stairs ... and smoking my head off.

I wonder which one of us will pop her clogs first?

A friendlier wave from this direction!

:hi:

[Luminous Animal]

120. Nice! A wave right back at you!

Enjoy the smokes!

:hi:

[Occulus]

162. Yeah, I held off the first time, but now that you've used that line TWICE,

welcome to my ignore list.

Reason: astonishing condescension combined with intentional obtuseness.

[jody]

169. And you have a nice day. n/t

[GOTV]

217. You bring up what I always thought was an interesting dilema....

... I sympathize with people with healthy lifestyles who feel they should get a break since they are working to keep their healthcare costs down. We would like people to stop smoking, eat better and exercise to keep the nation's total healthcare costs down and financial incetives to do so make some sense to me.

But, at what point does it cease to be insurance and start to be everyone for themselves again. At one point we didn't know that smoking was a major cause of cancer, and we didn't understand the effects of certain dietary choices. As we learn more and more, we are more able to predict who will have higher healthcare costs and who will likely have lower healthcare costs over a lifetime.

However, imaging the logical end to this progression. Suppose science could predict accurately what each person's healthcare costs will be. Suppose doctors could say you will die in relative health but your friend will die of cancer complicated by diabetes (let's say that this disease would not be caused by personal behavior). Your healthcare costs over the remainder of your life will be $60,000 but your friend's healthcare costs will be $400,000.

What now? Do you and your friend both pay $230,000 over the rest of your life to cover both your healthcare costs? You know, spread out the cost? That made more sense when you didn't know which of you would life their whole life in relative good health and who would get an expensive disease.

I can't see many healthy people, once they knew that they would only use a relatively small slice of the healthcare pie, being willing to pay MORE than they will cost for insurance.

We're not there, and we may never be there. But we've moved, and will continue to move, in that direction.

Is insurance spreading the cost around or is it protecting against the unknown?

[jody]

218. "Is insurance spreading the cost around or is it protecting against the unknown?" Good question.

It seems there are at least three alternate states.

One is where people make life style decisions that increase or decrease their health risk, e.g. smoking or not smoking. I can understand why people who decide to reduce their health risk by making good lifestyle decisions would object to paying the added cost of health care generated by people who make lifestyle decisions that increase their health risk.

Another possible group is people who have a gene that makes them at risk for a known medical problem. The growth of Genetic Medicine means that more of us will be identified with one or more genetic markers associated with a predisposition for medical problems. IMO this group presents interesting moral options for society regarding who pays for health care.

A third condition is protecting us from the unknown by spreading health costs among those not in the previous two groups. I hope that most people would not object to spreading the cost of health care equally among all members in this group since based on the unknown condition means all are equally at risk.

[LeftishBrit]

230. One further point...

It's not at all clear that people who lead unhealthy lifestyles incur higher health costs in the long run than those who lead healthy lifestyles. People who lead healthy lifestyles usually live longer than those who don't, and those who live longer get old, and older people usually incur higher health costs than younger people.

A, who smokes, overeats and drinks too much alcohol may incur higher health costs at the age of 50 than B who leads a healthy lifestyle; but by the age of 90, B is the one who is much more likely to be still alive and needing all the health care that older people usually do.

I am very much in favour of people living healthily and increasing their life expectancy - but it doesn't necessarily cut health costs over the life-span.

[BlackVelvet04]

72. Same reason I have to pay

property taxes for other people's children to go to school. Why should I have to pay for other's life style choices?

[jody]

80. But one can argue that you benefit from educating the children of others since their contributions

to society are shared by most/many/all members of society.

I'm not sure how you or I benefit from paying for the health insurance of a third party who chain smokes cigarettes.

[BlackVelvet04]

86. I could also argue that smokers pay a lot of taxes on

cigarettes that benefit society. Those who eat out a lot pay a lot of taxes as well.

I don't see over populating the earth as benefiting me or society so why should I pay for the education of children I see no need for? And pregnancy can cause long term health problems so let's charge an extra fee for anyone who gets pregnant. Let's also find out if everyone is using condoms when they have sex and charge them if they aren't....it's dangerous you know.

[jody]

92. I don't have answers to your questions and neither do any of the experts who pontificate about this

issue.

Thanks for the exchange, :hi:

[peacebaby3]

144. Maybe some of the people who are overweight or smoke are doing

good things for the world? How about an overweight nurse who works with Hospice patients? Would she be worth keeping around? How about a guy that smokes, but works for indigent defense? Is his life worth anything? How about the obese woman who works for the homeless? Do you think that you or many others benefit from the things these people do? You do because a chain is only as strong as its weakest link.

[Zywiec]

23. Does the ADA clearly cover obesity?

I don't think it does.

[nascar55]

31. Yes

It is a listing by the ADA.

[Zywiec]

36. I think they only list morbid obesity as a disability

not people who are just overweight or obese.

[nascar55]

40. I think

it is a BMI over 40. The point is how do they know that skinny person is healthy? A far as blood sugars they say any thing over 100 fasting is high now. They keep moving the gold post. I remember a blood sager over 140 fasting was borderline. Also will they be checking HA1C ( blood sugars over 3 months avg) For example my morning fasting my be 130 but my a1c may be 5.9 that is normal.

[jody]

47. I love your use of "moving the gold post" cause every time a standard is tightened it increases

the sale of drugs to treat that particular condition, e.g. blood pressure moved from 130/85 to 120/70.

Before long everyone will have one or more conditions that fail to meet a medical standard and we'll all be on prescription medications.

[nascar55]

50. You got it

They move the gold post to keep you on the meds.

[alarimer]

59. How would the employer know your BMI anyway?

They have no right to that information. None. I can't imagine anyone volunteering it. If you go to the doctor for whatever reason, your records are private and not to be shared with your employer without your permission.

[nascar55]

68. You

will have to wight in every 6 months and if your BMI is over 30 you pay the 10 bucks a week. I am assuming a doctor will do the 6 month exam. It seems like it will coast more in the long run.

[Arkansas Granny]

19. The article doesn't mention insurance premiums. It clearly

states that the company will be docking wages.

"...will start screening workers and docking paychecks $5 if you smoke, $10 if your body mass index is too high, and $5 for high cholesterol, high blood sugar and high blood pressure."

[nascar55]

21. Yes

My flat I am a diabetic and not over wight?

[jody]

25. The article says "One employer is fighting the skyrocketing cost of health insurance by charging its

least healthy workers a penalty."

"health insurance" is paid for by insurance premiums. :shrug:

[nascar55]

28. Than don't

Cover them at all. you cant pick and chose.

[jody]

41. Sure you can pick and choose and I expect some of the causes, e.g. smoking, will be a no-brainer and

others very difficult. In the end some people will be unsatisfied but that's true of most insurance programs.

[nascar55]

45. Fine

Why fine someone? Just dont cover them. What if you are not on your employeers heath ins. will you still have pay the 10 bucks a week if your overwight?

[jody]

52. "dont cover them"? Why not don't hire them but that would probably violate some law. I can just see

a lawsuit over someone not being hired because they smoked tobacco, a legal drug.

[Contrary1]

24. Not all conditions mentioned in the article are the result

of engaging in unsafe practices. Will they make an exception in these cases?

I am on more than one prescription drug where weight gain and a rise in blood pressure are known side effects.

[jody]

29. I agree with you. IMO employers have a tenable position iff the unhealthy act is a personal

choice of life style by the employee.

[AZBlue]

137. "intentionally engage in unsafe practices"??

You have a lot to learn about obesity, high cholesterol and the like. Try educating yourself before posting inane comments again.

[Heywood J]

209. Nope, we're not.

will start screening workers and docking paychecks

The word "insurance" wasn't there. It's good, old-fashioned wage-docking - taking money that has already been earned.

[Wickerman]

12. Can't one experience health problems and still be in reasonably good shape?

I mean, isn't it conceivable that a guy experience a health incident that is commonly associated with those out of shape while he himself is someone who is physically fit?

One size doesn't fit all in anything; fitness is no exception.

Not to put a point on it, but how are you, btw? Haven't been in a thread with you for a while and it's good to see you. :hi:

[jody]

17. I understand and agree. I recently had a heart attack even though a recent physical found me in

excellent health. My life style was healthy and I exercised more than perhaps 90% in my age group.

I was talking about those people who engage in personal choice things like smoking, etc. that have been shown to cause many illnesses.

[nascar55]

14. Okay

How about if someone has cancer why not dock there pay? Or if a woman wants to have a child, how bout docking her pay? Maybe if you have a heart attack and it coast the employer higher coast for heath care, why not dock your pay because of your heat condition. Were the hell do you stop at?

[jody]

20. I agree special cases can be given for both sides of this discussion. Still there are some

life-style choices that raise health costs, e.g. smoking, and I don't see why non-smokers should pay for the added health costs generated by smokers.

I know that's a special case but it does illustrate the problem of fairly apportioning health costs.

[nascar55]

26. Smoking

is not the same as being a diabetic are having high cholesterol and being overweight. If it were just for smoking than they may be okay....but when you start docking pay because someone is sick or has a disability than you will be sued as they should be.

[jody]

44. I agree with the special case you give. IMO extra costs should be charged to those who make choices

to engage in unhealthy life styles.

[BlackVelvet04]

76. That's the same argument used by those

who don't want to have to pay for welfare or aid for dependent children.

[jody]

84. Agree and it's a contentious position. One position asserts we support such programs but we must

find a way to help women from bearing children when they have little prospect of supporting them.

For example, my neighbors have one child, now in college, because they believed that their two incomes were adequate to raise and educate only one child. They object to having their taxes go to support children born to mothers who will never be able support and educate their children.

[BlackVelvet04]

95. Maybe you want a society where society tells everyone how to live

to save money but it's a damn miserable existence trying to please society all the time. There are many, many dangerous things in life that people engage in on a daily basis and picking and choosing which of those is more unacceptable is nothing but an exercise in self righteousness.

[jody]

100. IMO you've missed my point. I've said in this thread that I believe each person should bear

the costs of their particular choice of life style.

[BlackVelvet04]

109. But it doesn't work that way.....

I do have to pay for children to go to school when I don't have children. We could require all parents to home school and save me the money. We are always paying for things others choose to do.

[jody]

112. Per your #95 Do "you want a society where society tells everyone how to live" n/t

[BlackVelvet04]

116. I'm not the one advocating for it.....

even though I could argue that I have as much reason to as those who are advocating for this fee in the name of health and money.

[jody]

118. Then what point are you trying to make if any? n/t

[BlackVelvet04]

119. You obviously wouldn't understand no matter what.....

have a nice night.

[jody]

125. And you have a nice evening also. n/t

[CreekDog]

148. So obesity is a choice of lifestyle? Is Anorexia Nervosa a lifestyle choice?

You don't know what you are talking about. You just think you do.

[jody]

171. You should google "obesity lifestyle" and read reports on the issue. For example, the first hit said

Despite the cold facts —64.5 percent of American adults are overweight, 30.5 percent are obese, and 4.7 percent are morbidly obese — a new survey from Thomson Medstat found that more than four out of five Americans characterized their eating habits as either “very healthy” or “somewhat healthy.”

* * * * * * * * *

Conclusion
‘Sometimes’ is a very dangerous word
While very few respondents in any of the BMI categories consistently ate super-sized fast foods for the majority of their meals, snacked recklessly, or even characterized their eating habits as poor, several high risk behaviors have combined to become part of the average American’s weekly routine. Through a combination of occasional fast food meals, moderate snacking, not quite enough exercise and the belief that these habits are “somewhat healthy,” Americans are rationalizing themselves into ever-expanding waistlines.

[CreekDog]

159. there is no way to figure that out

You could have someone who moves to LA but otherwise lives a healthy lifestyle. They get lung cancer from the air pollution. Is that a lifestyle choice?

This is so tangled that it will take more administrators than the insurance industry has now to figure out what to charge everybody and how much of it will turn out to be genetics anyway?

This is a monumental waste of time.

Your fantasy world where we can calculate how much excess health care our choices cause us to use is truly a fantasy. The only easy way to do it would be to do a slipshod job rife with innacuracies. For instance, some people have very high cholesterol levels despite a very good diet and some people, like me, have perfect cholesterol despite a fairly bad diet.

[jody]

172. But some companies already charge employees extra if they make life style decisions that could raise

the cost of health insurance provided through the employer, e.g. smoking. :shrug:

Many people support banning smoking in public places because they believe second-hand smoke can increase the health risk of non-smokers.

In other words, non-smokers refuse to pay for the life-style decision of smokers where the payment by non-smokers is increased health risk.

[CreekDog]

178. That's a surcharge, but you have no idea if it fully covers extra costs

or is an overcharge to the smoker.

Smoking is one of the most clear cut examples of this, but the explanation by one variable goes down rapidly after that.

I'm saying that if you actually can charge accurately that you will wind up saving nobody money because the amount to determine how much each person really should pay requires so much effort, research and analysis (which must be constantly updated) that it will cost more than you could ever save anybody.

You don't take care of your health to save money, you do it to have a better life.

Not everything is valued properly or easily by the market system, health care is one of those that hasn't been able to provide monetary rewards/penalties for good behavior. Good people get paralyzed by car accidents caused by someone else, thin people die of cancer, championship runners die of heart attacks, obese people can live long lives, etc.

What we know are generalizations. If you don't smoke, you probably will live longer, ditto for being a good BMI, ditto for eating right, etc.

What we cannot do well at all is figure out how much each of those things amounts to monetarily. That's the point.

You want this nice little system where everybody pays for their own "stuff". Health care just doesn't work like that and in fact, our system spends more providing less care because it tries to get everybody to pay for their own "stuff", so there are all kinds of actuarials, research and underwriting with insurance but since these people get care anyway, you the insured, prudent person end up paying inflated costs anyway.

So, you could charge the smoker more, but your health care costs are probably higher because the local hospital has to recoup what they don't get paid for anyway, the smoker who is insured is probably having less effect on your premium.

The problem is that your concept is so logical, but absolutely impractical and hopeless when carried out.

So give it up already. Come up with a scheme that figures out how to charge road taxes based on use of cars, gas, etc. Now, there's a place you could actually have costs reflect choices. Health care, no way to the extent you want to.

[jody]

183. But a surcharge is an added cost charged to a targeted individual. In this case it's to people who

make lifestyle decisions that increase their health risk.

You plead "So give it up already."

Sorry but IMO society is never going to agree to completely subsidize the health, life, or property insurance for those who make lifestyle decisions that increase their risk.

[CreekDog]

189. I don't plead give up already because it's impossible

Trying to do the impossible can be a good thing depending upon the result.

But what do you get for this? So, you charge $250 per year for instance for someone to smoke? That's helping?! It's not. What's the benefit? A small savings for you for making a decision that is potentially life saving and a small charge for someone who may be cutting a decade of their life?

If you actually charged the smoker for the risk they are taking, they might not be able to afford the coverage, and then you would have to pay for them anyway because everybody needs healthcare regardless of whether they can pay or not.

That's my point is that your concept simply falls apart in application and worse, doesn't get us anywhere, it doesn't cover more people or make the payment fairer or more possible in any significant way.

[jody]

194. You say "your concept simply falls apart in application". It's not MY CONCEPT, it's the contract

between insurers and employers that try to reduce the total cost of health care.

One technique is to charge people more for making lifestyle decisions that benefit them but otherwise the cost of those decisions would be born by all employees.

[CreekDog]

157. Jody, there is no good way to solve the problem you raise

The cure is worse than the disease so to speak.

The only way to assure that taxes don't support people who cannot on their own support their children is one or more of the following:

1) income based test required for reproduction
2) forced abortions or forced adoptions where income is not great enough to care for the child
3) no support of the child whatsoever even if the child starves, goes homeless or without in other important ways

If the income tax were high enough so that the needy can be taken care of, yet those who pay taxes could afford those taxes, this need not be a terrible thing.

[CreekDog]

156. But you support the apportioning of health care costs

That you find so problematic.

And those charged extra would seem to exclude yourself by the way.

[jody]

170. I believe people who make a personal decision to raise their risk of requiring health care should

pay more for their insurance. Do you agree?

[CreekDog]

174. No I don't agree because it's impossible to quantify well or fairly

With a lot of choices in life, I'm willing to grant different costs for different choices, but health care has too many variables and many of those are often but not always out of the control of the individual.

[jody]

181. But most life and health insurance policies adjust premiums based on whether the insured engages in

risky lifestyle choices, e.g. smoking, skydiving.

[CreekDog]

185. Yes, life insurance policies do

Health insurance policies are simply not offered to those with those characteristics anymore.

If you smoke, you simply don't get insurance. That's how the market is handling this. The problem is that the market is saying, if you had cancer 10 years ago (even if not related to a lifestyle choice), then you don't get insurance either).

This is a bad idea and it's screwing things up.

Health rewards/penalties should be marketed in terms of better health and longer lives. Those are general rewards to aim at. The monetary equation applied to the individual is simply not working because we believe everyone should get care regardless of ability to pay.

So, we are paying for poor choices, but we are saving money for good choices. How much? Who knows and to some extent who cares. I prefer to know how much longer people are living and in how much better health they are in than what precisely it costs.

[jody]

188. So people who make bad lifestyle decisions pay the ultimate cost of being denied insurance. That

proves my point.

[CreekDog]

193. But they aren't denied healthcare or arent' supposed to be

And this is where it gets complicated, in employer based coverage, if I'm health but my wife smokes, should I be denied coverage because of her choice?

You don't seem to believe in universal healthcare.

[pookieblue]

207. Insurance isn't only being denied to those

who "make poor lifestyle choices."

I was told by three different doctors that I would not be able to private insurance because I have MS. And if I could, it would cost way too much for too little of a benefit.

So not only are those who make "poor lifestyle choices" are being 'punished' its other who by no fault of their own being punished. I think that SiCKO covered this on how insurance denies coverage to people.


If we go by your ideas, we would be throwing out the baby with the bathwater. Too many people would get hurt by this.

as I said, I am having to fight a weight battle because of the meds I have to take (IV Steriods) and the fact I have another disease HypoThyroidsim. Weight will always be a battle with me, as will living with MS. It's my life now.

But too look at me, one would only see an overweight woman and think "She's lazy, she eats too much".

I know, what the deal is. I watch what I eat, I work out when I can..do what I can. I will never be a runner. I have given up on being a size 6 again. But I am thrilled I am able to walk at least the two miles. I know I am lucky, because there are others with MS who can't even walk across a parking lot.


Also my doctors know what the deal is. that is all who should be worried about my weight, besides me. No one else has the right to judge me. No one!! Not you, not my boss, not some bean counter within the company. No one.

I would be docked (Fined) ten dollars a week for being overweight. When I already high copays for meds that I need very much. ($200 copay for my MS Med). I have to see my MS doctor at least four times a year, if I am doing well. If I end up having a flare, I would have to see her more. I would have to do another round of IV Steriods.

I am also having to see another doctor for my hypothyroidsim. More meds, more doctor visits.

I am already being "punished" enough, don't you think, without a company docking my paycheck ten dollars a week for being overweight? basically I would be punished for being sick. Golly gee, great company to work for.

[The Straight Story]

33. Actually, people with good driving records can pay more than those with bad ones

If your credit rating is low, you pay more even with a good record or a perfect record like mine - no accidents or tickets ever.

[nascar55]

37. How about

If you have bad credit you eat more so that may make you fat so you need to pay your employer $12.50 a week just in case you do get fat and you credit is bad...oh did I mention that already? Man whats next? Lets see how bout if you eat at McDonald's that you have to pay a fat tax.

[The Straight Story]

49. Give it all tiime...sadly we will become puritan society, even without using religion :) (nt)

[Sapere aude]

71. Your health insurance is not based on your health.

Usually there is a rate for the employee and additional costs for dependents.

The people who weigh more don't pay more nor does the employer.

[jody]

89. Sorry but there are health insurance policies that are based on health conditions. Chief among them

is being denied health insurance because of preexisting conditions.

[Sapere aude]

93. An employer doen't pay more for you because you smoke or are over weight.

That's what we are talking about.

[jody]

102. Sorry but there are company health insurance policies where costs are based on whether employees

smoke, etc.

[iverglas]

111. jody sees things as they are

and says "sorry". (jody's very sorry, you can be sure. Especially when he's being insufferably rude, which is most of the time. You're very very sorry to be insufferably rude, aren't you, jody? But you just have to be when people dare to question the way things are.)

Bobby Kennedy (he was one o' them Democrats, right?) saw things as they never were, and said "why not?"
Some people see things as they are and say why? I dream things that never were and say why not?

Who the fuck would care that it is legal, and common, in the US, to deny health insurance because of pre-existing conditions? It's despicable and anti-human and not practised in civilized parts of the world.

What decent person would use this despicable and anti-human practice to argue for yet another despicable anti-human practice -- stealing the wages an employee has earned, for wholly arbitrary reasons?

Well, I guess the answer is obvious.

[AZBlue]

139. Oh yeah, he's a very very very sorry person.

And exactly who the "ignore" button was created for! I just can't figure out how he's lasted this long on DU. Tr*lls usually get kicked off a lot faster than this.

[mondo joe]

152. Um, it's more complicated than that.

Rates are determined by several factors. If the employer is large enough, the insurer may look at utilization for the pool of employees. If utilization is high, they will often charge more. What leads to high utilization? Several factors - which I'd guess would correlate with obesity.

[DeSwiss]

223. Because being a bad driver isn't in your genes....

...obesity often is or at least can be. And along with the other stresses that business places upon families in our society -- to the point where we no longer eat healthy -- well, whose fault is that? Everyone wants accountability for everyone else, except those in power.

And on this same point, where does this intrusion into our lives end? What's next access to our DNA profiles to screen out people who'll later develop diseases???

[napi21]

5. It's debatable about the smoking issue, but high cholesterol????

HC is mostly due to heridity and although people can slightly lower it via diet, the only way I know of to lower it into the acceptable range is via drugs what will just cost more in insurance payments!

In many cases, the same thing applies to overweight people. It's a RARE instance when someone has thin parents and is overweight.

[Commie Pinko Dirtbag]

6. There's no way in hell this can be legal. NO fucking way.

Giving bonuses conditional to losing weight? Fine. But cutting pay? CAN they even DO that?

[Initech]

9. Here's an idea! Why don't they just sponsor physical fitness programs?

One of the main ways to get overweight is to sit at a desk job all day eating shit, so why don't companies do that? That would be a better idea.

[lvx35]

15. Exactly! Oh, because they would have to PAY for that rather than CHARGING for that?

All these problems are easy so solve, if you are willing to take on the roots of the problems, big fast food, big tobacco etc. Everybody loves to blame the individual, but nobody wants to blame the guy with the billion dollar advertizing machine dedicated to selling the individual poison. The person who's selling poison should be at least as accountable as the person who freaking swallows it.

[Initech]

51. Yeah, really. God forbid a company should have to dip into its precious profits...

Let alone help their employees. That would make America a better place.

[Heywood J]

210. Exactly.

I think you've hit the nail on the head. Helping their employees would require spending a dime or two on subsidizing a gym membership (for example), or better health-care for doctor consultations.

Then they couldn't pull $10 from every paycheck, to steal from the mouths and rent-checks of their employees. How do you expect a company to survive in this day and age if they can't exploit their employees?

[BlackVelvet04]

79. Big tobacco has paid millions of dollars

and what happened to it?

[iverglas]

10. universal single public payer health care

Keeps the corporations out of the kitchens of the nation. And out of various other aspects of individuals' private lives they might be tempted to stick their noses into.

Of course, some workers' rights legislation seems like it might help too ...


A Canadian approach, to compare and contrast

http://www.hc-sc.gc.ca/hl-vs/pubs/tobac-tabac/cessation-renoncement/section-7_e.html

Smoking Cessation in the Workplace - A Guide to Helping Your Employees Quit Smoking

http://www.hc-sc.gc.ca/hl-vs/pubs/tobac-tabac/cessation-renoncement/section-2_e.html#2

The WHY, WHO and WHAT of Quitting Smoking in the Workplace

The basic workplace smoking cessation approaches include:

Comprehensive - This approach involves offering programs and activities at the workplace. Employees can then access the supports on-site, and often during work hours.

Facilitated - This approach involves working with outside agencies to deliver programs and activities off-site, and providing self-help materials.

Education and Information - Providing employees with information including self-help materials. Refer to Section V: Tools for Employers and Others Who Promote Health in the Workplace for a detailed comparison of the various approaches, including the pros and cons identified with each.

Nary a mention of billing the employees. I can only imagine what would happen in Canada, let alone, oh, France, if an employer pulled shit like this ...

[M0rpheus]

27. Damn that Robert Goulet!!!

You lack energy in the afternoon at your office, and that's when singer Robert Goulet comes in and messes things up: screws up your office, knocks things over, causes havoc. The only way to get rid of him is to eat a handful of Emerald Nuts and you'll get your energy back. Until tomorrow, when Goulet returns.

http://www.tvsquad.com/2007/02/04/emerald-nuts-robert-goulet/

I would think that a bunch of medical providers could come up with something better than fining people.

[bamacrat]

34. Mmmmm Emerald nuts...

Goulet strikes too often.

[Scout]

30. so if you don't smoke, have a "correct" BMI, blood sugar and blood

pressure are normal but you're a raving alcoholic, drug addict, wife beater/child abuser (injuries cost $) or any number of OTHER things that can cause poor health and/or absenteeism then you're golden!

Those who are actually EDUCATED about health know that BMI is shit! Many professional athletes are morbidly obese according to their BMI.

I hope everyone who works for this hospital chain QUITS and works elsewhere. I don't know about other jobs, but I have heard nurses are in short supply these days.

Also, I'd be willing to bet that people with CHILDREN cost the insurance company a lot more than I do (I'm fat but have excellent cholesterol, good blood pressure and I don't smoke).

[nascar55]

32. Great Points

[DaveJ]

38. Excellent points. Also...

Frequency of doctor/hospital visits is not necessarily a factor of smoking or weight.

My guess is that smokers and overweight people probably are less likely to go, because they know they'll be chastised. I understand wanting to encourage people to quit their bad habits, but screwing it to them financially isn't the way.

[JustABozoOnThisBus]

35. I'd have just traded one fine for another

I quit smoking about 10 years ago, so I would save $5.

But then I gained weight, so I would lose $10.

Dang.

:rofl:

[nascar55]

39. Thats sad but

so dam funny:rofl:

[CreekDog]

160. your "lifestyle choices" cost you $5

Were you supposed to keep smoking, because on balance, your choice is more costly than if you had kept smoking.

That's the problem with this...

IT'S NONSENSE.

[BlooInBloo]

43. Just so I understand - is everybody's outrage (a) about the fact of the matter...

... do obese folks cost a company more than non-obese folks? Or is everybody's outrage rather (b) EVEN IF obese folks cost a company more, obese folks should have their wallets dinged for it.

I'm just not sure which part the outrage is on.

[nascar55]

46. They are not

Only targeting obese people but people with high blood sugars. As I posted before my morning fasting blood suger may be 130 but my a1c may be 5.9 over 3 months. 100 is the cut off for fasting blood sugars now and 6.0 is cutoff for a1c.

[DaveJ]

53. I'm outraged it's just another chipping away at our freedoms

And that people always accept it if someone waves a dollar bill and say it's just about money.

[Madspirit]

54. Hi Bloo

Both. I am not sure I believe they cost the companies so much. People engage in all sorts of high risk behaviors. Are they going to dock people who speed? Who skydive? Are they going to test for drugs and alcohol because both those CAN cause problems. It is arbitrary and I am not sure even valid.

...and even if it was, the company should eat it. (no pun intended...)

Lee

[BlooInBloo]

57. Lil of column A, lil of column B. lol! Fair 'nuff.

EDIT: Hi!! :) :hi:

[Nevernose]

140. I'm on the "EVEN IF" side

What about smokers?
What about those who drive in automobiles that aren't aren't as safe?
What about those who participate in contact sports?
What about those who were hired before or after a specific date?
What about those with preexisting conditions?
What about those who exercise too much, i.e. "sports" medicine cases?"
What about those who practice unsafe sex?
What about those who hang out in unsafe neighborhoods?

This list could go on forever. EVERYBODY is deserving of health care. Period.

[CreekDog]

161. What if you live in Alabama, don't hurricanes hit there?

I think Jody has convinced me and I now support charging the hell out of those folks for their geographic "lifestyle choice".

[Raejeanowl]

60. Headed to Hell in a Handbasket, I Hope

Ridiculous. They need to reward the "superfit" with incentives. Or at least recognize good habits and progress. Go on a diet and get to your ideal weight, or quit and stay quit of cigarettes, complete a marathon: get a week off. Keep your blood pressure, blood sugar, cholesterol in check for two months, clock 200 miles on your bike or pedometer, get a day off (apologies if these aren't realistic benchmarks, but you get the idea).

I can tell you, for example, that people with IBD can become "obese" from prednisone. Dock them for having TREATMENT for an autoimmunize disease? Dock smokers who gain weight after quitting? Duh? Do they also plan to penalize unsafe sex, alcohol use, recipients of speeding tickets and other unsafe behaviors/habits?

I hope the whole dastardly plan crashes and they're swamped in litigation.

[Luminous Animal]

70. RE: reward or punishment.

The workplace has no business rewarding or punishing anyone for personal activity that has no repercussions on a persons ability to do their job.

Absolutely none.

They already ensnare us in 100s of ways that limit our free agency and they will succeed on this front, as well. Nobody gives a shit about fat people or smokers. Who is next?

[Raejeanowl]

81. Speak for Yourself

If you personally don't give a shit about "fat people," smokers, or whoever else you think you're superior to but can't name because it would probably cause a greater backlash, you can speak only for yourself.

As for the workplace issue, please tell me how being ill, hungover, in withdrawal, sluggish, or absent/late frequently due to illness, etc. couldn't possibly impact on one's ability to do their job?

If you think you're a free agent, then you need to be equally mindful about "at will" employment.

[Luminous Animal]

90. I have no clue as to what your point is.

My beef is not with fat people or smokers but with the tyranny of the corporation. When I say, "nobody cares, etc. etc.", I am talking about society at large who seem to derive some personal satisfaction of marginalizing some subsets of society. Currently, it is fashionable for the mob to target smokers and the obese. Once they are sufficiently under the thumb of corporate and government control, it will be yet another subset of society.

As for your ill, hungover, withdrawal, sluggish, absent/late scenarios... why yes, each and every one of these may be actionable offenses, but the company in question is not making a claim that individual employees regularly are NOT doing their job.

[CreekDog]

163. They should pay people based on their work/job and performance at it

If they want to encourage good health, they could provide discounts on the health insurance if you maintain a good weight, avoid smoking or whatever flavor of the month they want to encourage. But the default rate should be the same for everybody and should not be punitive.

And wages are supposed to reflect the value of the work being done, not the BMI of the person doing it. Sheesh. And to think capitalists are supporting this idea.

[eridani]

61. My self-insured company abandoned "healthy lifestyle" discounts on health insurance--

--because it didn't save them any money.

[Luminous Animal]

65. What the hell has happened to our dignity as human beings!!!

This is outrageous. We are allowing corporations to treat us like children. Why is "the bottom line" more important than being a human being with all our complexities both good and bad?

The marketplace spends a buttload of money to appeal to our weaknesses. For the past several decades it has spent buttloads of money brainwashing and ensnaring ourselves and our children to engage in risky behavior. Now that they have succeeded they want us to pay for their success!!

It is depressing to me that any human being, let alone anyone on DU, would acquiesce to this tyranny.

[bbgrunt]

179. I agree with your posts entirely--but I would say

they are treating us as farm animals rather than children.

[SmokingJacket]

66. An insurance agency should be able to do this, but not an employer.

The employer should only have a say over your work performance. If your health affects it, that's different.

[Deja Q]

78. Thanks to offshoring and a handful of other prevalent negative factors,

adding this otherwise good idea into the mix may not give the intended effect.

Being healthy is a damn good thing and I know I have excess weight to lose, but is the ultimate phrase in all this that we need to have faith in a better future and just work to get in shape for it now?

If so, I'm hip. But it's still a big leap of faith.

[superkia]

82. How can anyone defend this at all?

Do we really want companies controlling more of our lives? Well you have children so your blood pressure is probably higher or you deal with your children screaming in the car, you might be more likely to wreck, so theres another surcharge hmm what else. Well I mountain bike on the weekends which can be somewhat dangerous, I should have to pay for that too. How about my job pays me a surcharge because the floor in the kitchen is dangerously slippery, yes they have insurance but they should have to pay me because I may get hurt? I bite my nails sometimes so I guess I owe my work money for that too, when would it stop if we let it start? We would eventually be charged for anything we wanted to do that may cause higher medical bills, I thought we pay our high insurance premiums for that?

Lets work to change our society so people can make a living so maybe they can eat better or have the time to go to a gym or exercise.I know way too many people that run from one job, throw fast food down their throat as fast as they can, so they can run to their next job. I think this will punish people that are less fortunate before it does people with money. Hey thats new in this country.

I'm no doctor but don't they say that obesity is a symptom of something else, lets say depression? I just don't like that some people are raised in very different situations than others and its not always as easy as get up off your lazy ass and pull yourself up by your boot straps.Insurance companies are making a killing and so are the companies we work for so lets not help them rape us anymore than they are! Maybe give us free health care, more money in peoples pockets so maybe they can be like the wealthy and afford to spend more time with their children, cooking a healthy dinner, instead of hoping to have time to get them something thrown together or better yet letting them eat what they can because your working your second job.

[BlackVelvet04]

88. How can anyone defend this?

They are self righteous pains in the ass, that's how.

[Madspirit]

106. So succinct and yet accurate to a tee! I agree...n/t

[bread_and_roses]

153. add ill-informed and full of Libertarian shit and you got it in one. (n/t)

[OwnedByFerrets]

103. Yes, and my lawyer will be telling you to prove its not

genetic, you fucks.

[LuckyTheDog]

107. Great

Now they can work me so hard that I end up grabbing fast fod or vending machine fare most days. And when I gai weight, they can charge me for it?

[Luminous Animal]

126. Why not? Banks do it.

Companies automatically deposit your check for which the bank charges a fee. If your employee uses another bank other than the company one, they charge yet even more. Some companies don't even do they but load up a bank atm card with your pay check. Then the bank charges fees to your account so you have to pay to access your own money. They close down your local branch so you have to pay at the atm machine to access your own money. They double dip if you don't access their own machines, leading to absolutely no protest when banks merge because who doesn't want more Wells Fargo Banks if it means saving $1.95 at the atm machine. They charge your corner store a fee to process your debit purchases. Who in turn charges you.

[LuckyTheDog]

158. What does any of that

Have to do with health insurance?

[iverglas]

122. you know what is truly bizarre (and indefensible) about this particular case?

One employer is fighting the skyrocketing cost of health insurance by charging its least healthy workers a penalty.

Starting in 2009, Clarian Health Partners -- the Indiana hospital chain with 26,000 employees -- will start screening workers and docking paychecks ...

It's a HOSPITAL CHAIN with 26,000 employees.

Who the hell is it paying for health insurance for those employees ... and why??

[Ilsa]

123. Sometimes people have undiagnosed pituitary tumors and other

endocrine problems that haven't been discovered by their doctors. If they are going to charge them more, then they better give them diagnostic health care first to see if it is a metabolic or endocrine problem.

[Ellen Forradalom]

129. Polycystic ovarian syndrome can cause obesity

That sure as hell is not a lifestyle choice.

[Ilsa]

142. And PCOS can affect alot of other things, like fertility, lactation, etc. nt

[pookieblue]

143. Right

One of the meds I had to take for my MS, ended up hurting my thyroid. Making it hard to lose the weight, that I had gained from the three rounds of IV Steroids I had to take. (ms related).

since starting new meds, I have lost weight. but it's a slow process. and it is not easy. and if I ever have to do the 'Roids again... some of the weight will come back.


also, another note, steroids can cause your blood sugars go up.

and your thyroid levels can cause your cholesterol to go up as well.

[Manifestor_of_Light]

145. Low thyroid is a much missed diagnosis.

Women are told they are just depressed when they are tired and what they need is thyroid. I've been on Armour thyroid since I was 11 years old.

A few years ago, I went to a diet doctor and was on vitamins, supplements and a strict 500 calarie a day diet. I exercised too.

So how much weight did I lose in a year? About 10 pounds. How many more did I need to lose? About forty. One day I had to skip breakfast and go in for a blood test and realized I was having a low blood sugar attack, and starving to death. So I stopped going. It was a waste of money going to a diet doctor.

So if that company wants to help me lose weight, they damn better pay for liposuction. That's the only way I'll lose what I need to lose. It won't just be cosmetic either, it will help my health, cholesterol and BP probably.

Those people have never heard of "metabolic syndrome" or "syndrome X" which is quite common in America. It is a group of factors contributing to obesity that are not understood.

A good website: www.stopthethyroidmadness.com

[Ellen Forradalom]

128. It is possible to be overweight and have all other health indicators normal

There is such a thing as a fit fat person.

If an employee is obese, he or she should qualify for extra support to deal with the weight problem. Not be shamed and have their pay docked.

[GOPisEvil]

130. Why not take the positive route and reward healthy behavior?

Instead, this company takes the negative route.

[ProudToBeBlueInRhody]

132. Great idea

But I bet that would be ultimately be considered discriminatory in some way as well.

[proudmoddemo]

149. It ultimately would be discrimnatory

Our health system is already discriminatory. This plan is a farce by a naive moron that is upset over the costs of his health insurance premiums rising. The people that he wants to dock the wages of already pay more for health care: they visit the doctor more often and take more prescription drugs. So they already are charged more to get care than the "healthy people" he wants to work for him.

Even among the healthy people, there's diseases that can strike at any time. I'm very thin, and I'd been pretty healthy (aside from the sporadic flu, cut and broken bone as a kid) all my life. I got sick at 25. I have Crohn's Disease. I'm already virtually unemployable because of my disease--there are ways around the HIPAA laws for employers. But if I get a job, perhaps they can discriminate against me because I somehow didn't take care of myself, and it's "really my fault" that I got sick. That's the logic of this crap--even though I have a genetic disease.

Heck, the next step is genetic testing, and docking the wages of those with "bad genes." This is a violation of the 13th amendment of the constitution--not even the HIPAA or ADA laws (though it violated them too). If followed to its logical conclusion, it'd create a class of "unhealthy" slaves.

So he can dock his employees all he wants. But the reality is that already happens. When they have to pay a $70 co-pay for prescription drugs, their budget gets blown to pieces.

If he really wants to do something about the high cost of health care, he'd support a single payer. What is happening now is that insurance companies are issuing routine denials of payment--denials they know to be wrong--in the hopes that sick, tired, and depressed patients won't fight them. The doctors and hospitals get stuck with the bills, and everybody else's fees have to go up. Fixing that is the first step in fixing health care. After that, we need to insure the uninsured. They use ERs as GP clinics because they have no choice, and they basically always leave the hospital stuck with the bill. Again, that causes the fees for everybody else to go up. Increased fees mean higher insurance premiums (which also mean a higher profits if they're successful at shirking they're responsibilities).

Address that problem, and you'll have stopped medical inflation in America. Dock wages or pay bonuses based on health, and you've only created an underclass at your company and in the country.

[Luminous Animal]

134. As I pointed out above...

Corporations have no business penalizing or rewarding private behavior.

Corporations are undemocratic fictional entities.

[Nevernose]

141. I blame gays and pregnant women for high insurance costs

Gay men have a statistically higher chance of getting HIV than white women, don't they? Why shouldn't they be penalized for that?

And having a baby is a choice, isn't it? That's a drain on the company for 18 years + 9 months, so why shouldn't we be able to penalize a women with children (or men for that matter)?

In the richest nation in the history of mankind -- a nation that would make Caesar weep and Pharaoh blush with envy -- Universal Health Care is a RIGHT, not a privilege.

[davsand]

154. Medical Privacy rights are gonna get eviscerated by this kind of stuff.

I think we all can concede that most people would prefer NOT to be overweight, addicted to nicotine, caffeine, or any other substance, or ill in any way. If you take all that out of the discussion, there is one really creepy aspect of this whole thing and that is the loss of privacy.

Simply put, I sure as hell do not think that my employer has ANY right to my medical information in ANY form. Even if they pay 100% of my medical insurance for my entire family--I still don't think that they have any right to know my personal medical information. This really crosses a line.

IF they wanted to provide some benefit to people who choose to voluntarily report this kind of stuff, maybe it would creep me out a bit less--I dunno. I do see a positive to encouraging healthy lifestyles for employees, but I think that right to medical privacy is an absolute that simply is not to be messed with.

You'd THINK a hospital chain would have a better grasp of medical privacy issues...


Laura

[mondo joe]

164. Would people be opposed to an insurance discount bonus for employees who take

part in planned wellness activities?

Say the insurer offered several wellness programs, with personalized wellness goals so no matter where you fell on any one matter (like weight), you'd get the discount just for participating and making improvements?

[bbgrunt]

196. yes. Just like I object to special benefits for people who have

children. A single person with no children, costs an employer less in health costs. The logical extension of this is that employers can cut their costs by hiring only single people--unless he/she must give the single person a monetary equivalent bonus for remaining single and non-reproductive. Why should the employer be in the business of discriminating positively or negatively at all?

[Freddie Stubbs]

224. Family status is a right protected by law. Being fat is not

[gulliver]

198. I would.

I just see it as more than likely to be ineffective and counterproductive. It's very hard to administer programs that individualize people in a subject area as diverse as health. Individualized programs require a degree of competency, standardization, computing power, and individual cooperation that is extremely hard to achieve -- at least in my experience. The legal, ethical, financial, and administrative complexity quickly scale out of the reach of most systems. And that doesn't even take into account the cooperation and competency of provider and consumer participants.

The better approach is to create a common "well of health" and make it available to people in the form of nationalized health service. Human health is very much a common problem, not one that needs to be solved multiple times in multiple ways by small entities like insurers (who have interest conflicts in any case). That's just inefficient and invites failure, bad will, corruption...

Small entities can innovate and provide their services for whatever kind of compensation the market will bear. But I am also against setting up competition of this form where a small business can't afford to administer a (fig leaf, likely to fail) wellness program and a big business can.

[CreekDog]

165. it sounds like a lot of the costs are based on adminstration

And the costs of those last 1-2 years of life.

What you weigh at 35 years old, or if your blood pressure is fine at 55, or if your cholesterol at 21 is way too high are variables that probably don't explain individually, the costs in those last years of life. Together, you may get closer, but the regression is going to be complicated and still highly inaccurate (models aren't always right).

[gulliver]

186. Divide and conquer. Obious and stupid.

Let's just reduce everyone's health costs by about 20% across the board using national health insurance. That's simple; that's cost effective. We can take 3% of the savings and invest in subsidizing gym access, diet advice, smoking cessation, free on-line health advice by (gasp) real doctors.

This $5/$10 stuff is chicken feed. The real costs are both social (dividing health care consumers from one another and setting up a health underclass) and administrative (picture half-hour, on-the-clock arguments about whether I have to pay $5 extra this month because Walgreen's measured my blood pressure and it's down).

National health care. Solve it in the big picture. Let's get the middle managers back to managing instead of wasting their genius on meddling with health care.

[tom_paine]

222. Liar. The ultimate goal IS to collect money.

[cgrindley]

225. Seems like a good idea

why shouldn't the overweight or smokers pay a different premium?

[pookieblue]

226. as many other posters said

as well as me.

There are people out there that are overweight due to medical conditions and due to medicines that they are on.

So it would be punishing someone who is overweight and/also just so happens to be sick.

Like me for instance who has gained weight while taking AD's and three rounds on IV Steriods. Not to mention found out that I aslo have Hypothyroidism on top of the MS. So someone like me found be fined close to $500.00 a year. On top of the copays for the meds (one med has a copay of $200 a month)I HAVE to take for my medical conditions. As well as the copays for the doctor office visits. The conditions that were NOT caused by my weight but in fact some of the conditions that CAUSED my weight gain.

Do you really think that THAT sounds like a good idea?

Of course, then they could opt out of fining a person like me due to my medical condition. but then that would be opening a new can of worms, by my company digging in to a persons medical files.

Which is something that should be only between the person and their doctors. No one else.

edited to add... this article as about docking a person's paycheck each week $5.00 for smoking. $10.00 if you are overweight. so a person is being "fined". this isn't about their health insurance. but adding more money to the employers wallet.

[cgrindley]

227. I doubt it would be a simple matter of cross-referencing a BMI

there would probably be a process through which such instances would be identified... although I don't know the specifics in this particular example. I would imagine that there would be exceptions... eg I'm sure you could have an acceptable level of nicotine in your system if you had ulcerative colitis or macular degeneration.

And another thing... so what if the employer benefits by 10 bucks a week times a million billion zillion employees... they'd all be better off losing weight or quitting smoking and by a lot more than a piffling 5-10 bucks a week. Jesus... around here, a pack of smokes is 6.75

Of course, I'd be more in favor of giving a 5 dollar a week bounty to those employees who don't smoke or a 10 dollar a week bounty to those employees who are not obese.

[pookieblue]

228. you missed my point

as I said there are those out there, who have medical conditions or are on medications for medical conditons that can cause weight gain.

But they would still be fined so to speak. I really don't think that it's okay for a company to dock a person's paycheck for something that is not work related. Unless the person has to have a doctor's note or something.

I really do not think that it's okay for a company to be privy to a person's medical records. As I said, that is something that should be between only a person's doctor and that person.

there are just too many lines this is crossing.

oh and who cares about putting more money in the employers' pocket. I do, if it's at the expense of the employee.

Perhaps if they want us to lose weight, they would offer better choices in the snack machine, since many workers eat at the desk. or perhaps an on site gym...not docking a person's paycheck. that is NOT the way to go. Sorry, some people can ill afford to lose more money, when they are already working 10-12 hours a day. Somedays, not taking a lunch break.

[cgrindley]

229. but I addressed your point

I replied that I thought that the process would not be as simple as checking a BMI but that there would be a procedure designed to exclude those whose weight and even perhaps smoking is the result of another condition.

And, yes, the strategy should be voluntary and should be part of a larger drive based on prevention. Healthy food only at the workplace (none of this healthy choice crap... as people will almost always choose crap over nutrition)... and giving a bonus for being a non-smoker, a bonus for maintaining a healthy weight etc.

And I'm not the sort that minds governmental intervention in people's lives. Indeed, I welcome and advocate a highly intrusive nanny state that looks out for the best interests of citizens.