If you are seeking your own health insurance outside of an employer plan, your weight has a lot to do with the premium you’ll pay as well as your ability to even qualify for insurance. Insurance companies find this to be logical. Overweight individuals account for a higher percentage of health-related costs than they should, all other things being equal.
From the New York Times:
Heavy people do not spend more than normal-size people on food, but their life insurance premiums are two to four times as large. They can expect higher medical expenses, and they tend to make less money and accumulate less wealth in their shortened lifetimes. They can have a harder time being hired, and then a harder time winning plum assignments and promotions…
Complications from obesity, particularly diabetes, which afflicts 21 million Americans, push up the bill: $44,000 for a heart attack, $40,200 for a stroke or $37,000 for end-state kidney disease…
As the cost of group health care increases for corporations, many companies are looking for ways to cut costs. One way to do so is to encourage a healthier lifestyle among employees. In my company, there are a number of programs available to employees who are looking for ways to improve their health. Some companies, in addition to offering employee assistance programs, are beginning to set health insurance premiums, or the percentage of these premiums paid by the employee rather than the employer, by a measure of weight.
The body-mass index (BMI) is one such measure being used to determine how much an employee should pay for their portion of the company’s group insurance plan. The reasoning is simple: overweight individuals cost the company more in health insurance costs. But is this discrimination?
The CBS Evening News with Katie Couric will be running a feature on this issue tomorrow night. This week, the program will focus on obesity in America. The series is called “Forced to Be Fit;” segments to be aired Tuesday through Thursday will take a look at ways people in this country are being encouraged to lose the extra pounds, whether they want to be or not.
Extra Weight, Higher Costs [New York Times]
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No it’s not discrimination to raise rates for “chubbies.” Discrimination is something that you as a person can’t do anything about (race, gender, etc), fat people just need to get up, drop the twinkie, and start working out. They need to stop the fad diets and find a real strong motivating trainer to get them working and they will no longer be fat. It’s not magic, it takes work. I’m 100% behind the anti-gym in this respect (www.theantigym.com).
No Chubbies and No Chubblitos!
I agree with the first comment. I don’t want to see discrimination against genetic or other things that one cannot control. However, for smoking and obesity I am all for charging those folks more for insurance. I’m getting really tired of the “it’s not my fault” whine.
That would be totally discriminating!
insert sarcasm…
Why don’t we just charge the drunkdriver who lost his leg more money because it was his fault he lost his leg?
I myself have a little extra weight that I have put on in the past few years (mainly during college). It is unhealthy, and therefore means that I could be accountable for more healthcare spending. As such, it should be my responsibility to pay more for it. It should there be my responsibility to lose some weight if I am not happy with my premiums.
I intend to lose this weight for several reasons:
1) It will help to keep my premiums low (both for health insurance, as well as life insurance).
2) It is just the healthy thing to do, and I take my health seriously.
3) It has the ability to impact my overall earning potential, which is something I am also greatly concerned with.
When people see me, they are astonished to hear my actual weight (if we ever get into that discussion). I do not look as heavy as I am (a great deal of that has to do with my height, and the fact that I do have decent muscle mass, in addition to the undesirable fat). So, I don’t think it is affecting me, yet, in a manner that could affect my pay… but if I don’t get it under control now, it will only get worse.
While I don’t see an issue with charging higher premiums for people that are obese, I would question the means of using BMI as the sole indicator.
If you use BMI to determine if someone is obese, you would find that nearly every elite athlete in professional sports would be considered overweight or obese. There should be a variety of factors used to determine the level of fitness.
The company that I work for is offering a discount on our annual premiums if we enter a handful of numbers, including our cholesterol, blood pressure, glucose, etc. Once you enter these numbers, you are supposed to be contacted by a health professional to devise a plan to help improve your health and fitness. It is possible these numbers could be used to determine premiums but there has not been any mention of that at this point.
I just realized there’s this whole entire system set up to make sure that the only people who get sent to prison are ones who commit crimes! OMG that is so totally discrimination!!!
I’m going to get right on that, as soon as I’m done fighting the injustice that only poor people can collect welfare.
I’m so very sick of fat people whining about “discrimination”...
Wow, I’m actually surprised by the vicious nature of some of the comments.
Basing health-care premiums of group plans on a person’s weight is a slippery slope. Up until now, the point of group plans at work is that everyone pays the same premiums so the risk is evenly distributed no matter what a given person costs the plan. Once you start adjusting premiums based on individual factors, you run the risk of affecting people with other health issues.
If you charge obese people more, what about people with pre-existing conditions? I mean, we know that pregnant lady is going to cost us 20k in the next year when she delivers and that guy with prostate cancer is going to be a real drain on the medical plan as well, let’s charge them more.
Where do you draw the line? Smokers? Alcoholics? Drug-users? People with children? Because kids are always getting sick and needing vaccinations. Older people are also prone to needing pills and such. What’s that? You broke your leg on a ski trip? Well, that’s gonna cost you.
Weight is also an arbitrary measure. People come in different builds and while once you surpass about 300lbs or so, you are probably severely overweight, there is a whole range of healthy weights below that. As someone else already pointed out that BMI is not a good measure of healthy weight. No matter how much I try, I’ll never weigh 97lbs. Does that mean I am any less healthy that Kate Moss? And speaking of anorexics, they are a drain on health plan too. How do they plan on screening for and charging under-weight people…
For those commenters spouting off about fat people “whining”, I urge you to look before you leap. Be careful that your explicit support for one form of discrimination does not turn into a tacit support for many other forms.
First they already discriminate against those with a pre-existing condition.
Second, if they use weight as a factor, anorexics will be charged more as well.
I see nothing wrong with paying more or less due to weight. I run and keep myself healthy. I should pay less than those who don\’t.
@ Kat: You are incorrect regarding pre-existing conditions and group medical coverage. HIPAA is the federal law that limits the amount of time a group health insurance policy can refuse to cover a pre-existing condition (12 to 18 months). A group health care plan cannot exclude those with pre-existing conditions or charge them higher premiums, so I hardly think you can say they “discriminate” against those individuals.
You say you are healthy and therefore you should pay less. Does that mean that if you were diagnosed with breast cancer you would be willing to pay substantially higher premiums? Is that fair? Where do you draw the line?
Breast cancer at this point is not a preventable disease. Nor are a number of others.
Being obese and unhealthy is preventable,as are the issues that come along with it.
@ Kat: So your saying that anyone who comes down with a disease that is preventable should be required to pay a higher premium.
Contracting HIV/AIDS is preventable. Should people who get AIDS be charged more? Alcoholism is preventable. So it nicotine addiction. Should people who get liver disease of lung cancer be charged more? It was preventable afterall.
Are you ready to draw a line? Or are you still stuck on picking on fat people because they are easier to pick out of a crowd than people who’s are alcoholics or whose behavior puts them at risk for contracting HIV/AIDS?
I am not stuck on fat people because they are easy to pick out of a crowd. I think it is fair because it is an easy thing to prevent and an easy thing to fix. It comes down to laziness.
I think smokers and alcholics should pay more too.
I do draw the line at AIDs. I don’t believe that is 100% preventable.
Most of what this country is paying for in terms of healthcare comes from the issues of being fat, not AIDS.
As someone who actually pays 100% for her healthcare, I already pay for my weight. Why shouldn’t employers get to pay less for their healthy weight range employees as well?
This has been a very interesting conversation and has given quite a few things to consider.
Kat, while I initially thought this wouldn’t be a problem I can see a lot of validity in what Toby is saying. Generally speaking being overweight is a matter of poor exercise and/or eating habits, however I believe there are medical conditions that can cause people to gain weight or have more difficulty in maintaining their weight. Is it right to charge these people more as well?
I’m having a hard time determining where you draw the line in terms of who should be charged more and why. Even if you only look at the issue of weight, I don’t think it is a black and white decision as to whether someone is overweight to justify being charged more than someone else. How would you determine whether someone is within the appropriate weight range to avoid additional costs?
I understand the concept of what the insurance companies are doing, but the method in doing it leaves to many opportunities for mistakes. BMI is not a completely accurate way to measure obesity. How do they differentiate between a genetic problems and one caused by poor choices?
I see it as another opportunity for them to deny people coverage who need it and charge more money for some people who are obese through no fault of their own.I agree with Toby that it’s a slippery slope.
What if you’re overweight due to medication that makes you exhausted or increases your appetite?
What if you acquire AIDS thru a cheating partner? I just get the feeling that insurance companies will make people through toms of hoops to get lower premiums that they would deserve.
Smokers should be charged more, yes, but not people with breast cancer. No one chooses to have breast cancer.
Having said that, as was pointed out, there are medical conditions that cause obesity, so not all obese people are actually in the same situation. So yeah, that is a good point.
It’s tempting to say that you can simply exempt obese people who have such a medical condition, though.
One thing to keep in mind in this debate is the point that Laura brings up. Namely: insurance companies are highly profitable corporations and are leading this push, not because they cannot afford it or are threatened by anything close to bankruptcy, but because they must continually show greater profits.
If they were in the business of promoting health, they would be promoting charging less for healthy practices.
It is important to make that distinction in creating policy. This is a good argument for a single payer system such as already exists in Medicare. Obviously, since it cares for the most likely to be ill among us, the elderly, Medicare handles the worst of the worst. If it can handle it under those conditions why couldn’t this issue be handled with a single payer system for all of us. When the profit motivation is taken out of the equation, the perspective is less skewed. Really now, no insurance company is really concerned with obese people shrinking their bottoms, they are more concerned that their own bottom lines will be put on a diet.
We all deserve to be in the best position for “common health” and “fat people” are the result of the hijacking of the “common wealth” by big corporations which are unaccountable for the results of their products and have set up an inertia of common “illth” (See reference below). Fast food advertising has produced a generation of obese children who will now grow up and cost you and me untold dollars, not to mention misery for 60 years while they battle associated diseases – diabetes, heart disease, etc. McDonalds and such have purposefully created products and promotions that appeal to over-consumption by children, thus creating lifelong habits in those incapable of make lifelong decisions (children). We are now seeing, and beginning to pay for, the results of these policies.
“Fat people” are the canary in the mine for a much larger systemic illness created by granting corporations the right to use our commonwealth without paying for it. Our policies, personal and institutional, should promote the common-Health, common-Wealth & common-Beauty of all to the detriment of none, without exception.
Anyone interested in information on this topic and a definition of “illth” see Peter Barnes e-book: “Capitalism 3.0”(not an ad a recommendatin)
And what about overweight people who are healthy—low blood pressure, normal cholesterol, etc.? They might have health problems down the line, but at the moment, why should they get charged more?
Medical conditions don’t cause obesity. Poor lifestyle habits do. Many medical conditions can cause a person to become obese more easily – but that’s not to say it can’t be prevented. It just requires self-control and discipline, much like managing one’s finances.
Llama: In most cases, you are right, but there are many disorders, though rare, that cause obesity. Additionally, growth hormones in food, availability of fatty foods in relation to healthy foods, and genetic disposition all help to contribute to obesity, making “natural” human weight maintenance (diet and exercise) less effective now than in any other time in human history. The belief that all it takes is a little self-control and discipline is over-simplistic.
The issue is not obesity.
Back on point: It’s not just obese individuals who would be affected by differentiated insurance premium prices. If the indicator is the standard worldwide BMI measurement, then slightly “overweight” (using the World Health Organization’s definition) but healthy individuals could be affected as well.
I’m carrying around an extra 25 pounds more than I should, so I’d likely get hit with higher premiums too if my company worked this way. I still agree with it though,even if I hate the idea of insurance companies making MORE money. If anything, it’s an added incentive to stay fit and in shape. I would hate the first few months of paying extra, but in the end, I’d be in better shape and healthier because of it.
Dear Flexo,
I find your discussion of discrimination in terms of employee health care coverage costs based on one’s BMI to sponsor an insightful viewpoint. The figures linking one’s medical costs to weight are truly dramatic and eye-opening and knowledge of such statistical evidence should be broadcast across the nation, as a means of raising a red flag to the millions of ‘affected’ Americans. Concerning your posed question of discrimination and reasoning, stating that “overweight individuals cost the company more in health insurance costs� than do normal weight individuals, I do not wholly feel that charging obese individuals more for employer based health insurance is hypothetically unfair. However, as to whether or not this is just, I am less willing to consent. According to Damon Darlin, author of Extra Weight, Higher Costs, as referenced in your post, heavier individuals accumulate higher medical bills and pull in lower wages over their shortened lifetimes. Due to their chronic disease, they are at an exceptionally increased risk of suffering from expensive and potentially debilitating ailments such as arthritis, diabetes, diabetes, and heart disease. In terms of fiscal content, these disorders cost around $80 billion annually, for the over 97 million obese and morbidly obese Americans. With 85 percent of this monetary burden being covered by insurers, tax payers, and the government, the inclination toward increasing coverage costs for individuals with a BMI of 25.0 or above is understandable. Individuals battling obesity and the related conditions do not need the added stress of funding these newly acquired ailments due to the implementation of health care related economic discrimination. Although many of their health problems are catalyzed by being over weight, inculcating these individuals with higher premiums will neither dramatically lower governmental healthcare spending nor curtail the obesity epidemic. It will however, likely lead to an increase in the number of uninsured Americans. Rather, the cause of obesity should be the topic at hand, not the resulting symptoms and ailments. The external reward of fiscal gain due to a ‘normal’ BMI will never consistently overcome the temptation toward unhealthy eating habits for bingers, but the intrinsic reward of benefiting one’s own health and well-being may. Thus, while on paper it may seem logical to ‘overcharge’ the overeaters, it will not solve anyone’s problems.
” I run and keep myself healthy. I should pay less than those who don’t.”
Yes, but as a runner, you run a higher risk of injuries as well as osteoarthritis down the line. Maybe knee replacement some years in future. Did you know that there are a lot of hip and knee replacements in baby boomers because they try to jump, run and do high impact exercises thinking they are still young? Should you pay more because of your higher risk of injuries? Should competive gymnasts and figure skaters pay more as well? After all, most of them experience injuries because of their choices.
There are a number of behaviors that can result in increase cost. Where would you draw the line?
By the way, I am slim, eat healthy and exercise. But because I had premature menopause staying slim is an uphill battle. How many people here know that for woman’s metabolism changes greatly after the menopause, to the point that some women can eat 1200 calories a day and still gain weight; slowly but surely. Then there is weight gain that is side effect of some medications, like prednisone (not sure I spelled it right).
Here is by the way an interesting post from a doctor’s blog related to the subject from some time ago:
http://dinosaurmusings.blogspot.com/2006/12/patient-responsibility.html
This post was in response to a West Virginia plan to vary coverage for medicaid patients based on certain behaviors, being obese was one of them. It is pretty enlightening.
I just saw this blog and had to add my comments. My 14 year old son was perfectly healthy last year. He lost 35 lbs in 6 weeks and was then diagnosed as having a thyroid disease and under weight. The doctors had to battle to save his life a few times from toxic storm. He finally had to have radiation treatment in January. After one year of treatment, he is now 45 lbs over weight with a different thyroid disease. He is still in treatment and the doctors are trying so hard to get this under control.
So, according to “helpful” people, my husband and I should be paying higher insurance premiumns because he was under weight and because he is now over weight—all because his his health issues will cost more to cover his treatments. It really doesn’t matter that he was not “lazy”, he just is a bigger risk.
So tell me how exactly how obesity (either caused by heath issues or “laziness”) is really any different than heart disease or diabetes? Exactly who is qualified to make the distinction on laziness and health issues, God or man? Do you want the job? I don’t!
Hey sounds like discrimination to me. How can you judge what is healthy and or not? It’s like this, you generalize the whole population. You may look thin but you may not be healthy, and you may look fat, but then you are healthy. Some people here have little or no compassion for certain things.
And yes. We all need to be healthy. But the way we are going at it with all these labels and stuff, its going to take a long time before we get thin and fit.
It’s called eat in moderation and stop crash dieting.
Drunk drivers pay higher insurance rates, because they are a stated risk. They are a higher risk because they drink too much, and put others in danger. Obesity is most often a direct result of over indulgence, and the result is higher medical costs. Why is it discrimination to pay for poor choices that have impact on others? I don’t want to pay for someone else’s irresponsibility, poor choices or food addiction, I shouldn’t have to. And by the way, I am not without my own extra pounds, so I am not being cruel-I am being realistic.