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Higher Health Insurance Premiums for Overweight: Discrimination?

This article was written by in Insurance. 72 comments.


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.

Forced to Be Fit: CBS Evening NewsThe 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]

Published or updated November 5, 2007. If you enjoyed this article, subscribe to the RSS feed or receive daily emails. Follow @ConsumerismComm on Twitter and visit our Facebook page for more updates.

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About the author

Luke Landes, also known as Flexo, is the founder of Consumerism Commentary. He has been blogging and writing for the internet since 1995 and has been building online communities since 1991. Find out more about him and follow Luke Landes on Twitter. View all articles by .

{ 72 comments… read them below or add one }

avatar Jason H

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!

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avatar Noname

I am a “Chubbie” as you call it. To look at my you would not guess I am as heavy as I am. I have told people my weight and they are surprised. That said I am considered by society and bogus measurement systems like BMI as overweight. I personally have no issue with paying 50% more for my insurance than the “Skinny Stick” person. I just don’t appreciate being denied coverage. When you say weight discrimination is not discrimination it is. You are wrong about your definition of discrimination. That is the definition put forth by government.

discrimination, favoritism, favouritism is the unfair treatment of a person or group on the basis of prejudice (http://www.wordreference.com/definition/discrimination)

1 a: the act of discriminating b: the process by which two stimuli differing in some aspect are responded to differently
2: the quality or power of finely distinguishing
3 a: the act, practice, or an instance of discriminating categorically rather than individually b: prejudiced or prejudicial outlook, action, or treatment
http://www.merriam-webster.com/dictionary/discrimination

I was denied insurance do to a BMI the insurance company made up. They inflate the BMI. Also a one size fits all calculation for BMI is not accurate and a high BMI does not always mean fat and unhealthy. Athletes have higher BMI’s due to muscle mass. FYI – Losing weight for many is not as easy as you think. I don’t eat crap like twinkies. Learn about weight and metabolism before you comment.

More on BMI:

*“BMI can be calculated quickly and without expensive equipment. However, BMI categories do not take into account many factors such as frame size and muscularity.[9] The categories also fail to account for varying proportions of fat, bone, cartilage, water weight, and more.”

*“The medical establishment has generally acknowledged some shortcomings of BMI.[11] Because the BMI is dependent only upon weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly).”
http://en.wikipedia.org/wiki/Body_mass_index

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avatar Kay

Amen!! My company has just dropped our heath insurance. I’ve never in my 29 yrs in the work force have had to insure myself. I have just found out I probably won’t be able to. According to the BMI I’m considered morbidly (SP) obese. I couldn’t believe it. I thought man I shouldn’t be able to walk, touch my toes or been able to spend 5 hrs doing yard work last Sat. consisting of weed eating, cutting grass, trimming edges and cleaning up the mess. All this in 90 degree weather, not going in the air conditioning once and only taking three 5 min. sit down breaks and 1 glass of water.
And in response to Jason H’s comment.
Just because a persons heavy DOES NOT mean their lazy.

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avatar Donna

Are you fat? No? I agree people need to exercise more. But sometimes there is more to the situation. So, you judge people for being over weight. We don’t know everyones situation and you can’t just say “Get up and exercise” Because everyone is different. You don’t know me and I don’t know you. But I have lost 43 pounds and proud of it! But not every one can lift weights any more. I have carpel tunnel problems and had surgery on one hand. I wasn’t even fat when I developed this problem. I was pregnant and working in a factory. I have had back pain since. So, see not every one can “Work Out.” Before I got pregnant, I could lift most any thing, but, now I can’t. So, Please don’t judge before you know each person personally and know their situation. Thank you, Donna Alloway

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avatar ntguru

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.

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avatar nat31

For all those on here that make rude comments about obese people let me tell you the truth is not all those obese people sit around eating. My sister has had weight problems since she was young and has followed healthy eating and exercise , she loses a little weight but will never be skinny. So with that said you can shove your theories were ever you choose. Good day.

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avatar Betsy

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?

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avatar Compounding

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.

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avatar Derek

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.

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avatar Jeremy

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”…

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avatar nat31

Oh my imagine a whiner complaining about people whining. Now that’s oringinal. I feel if all minded their own business and were’nt so judgemental of others everything would be better. However, if you want to look at issues with obesity people could be less rude and it seems where most have no problems insurance providing money toward rehab for druggies, alcoholics, or other addictions they have issue with food addictions. By the way this does exisist and if you look into it you may find a name for it instead chubby or fatty. How would you like your flaws constantly pointed out you might be ugly or so skinny you look like a bone. How would that feel. Calling names does not make one want to change themselves it only makes them lose self esteem and lean toward whatever addiction gives them comfort. No one is perfect not even thin people or those with this better than thou attitude. Stop and take a good look in the mirror before you judge others. I don’t know how you were raised, but apparently with not respect for others or mannners.

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avatar Toby

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.

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avatar porter

I couldn’t have said it better my self! Thanks

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avatar Debi

I agree. Wholeheartedly. Thin people are not always necessarily healthier. Look at them. A lot of the young people today are thin but have no muscle mass. They are floppy, soft, unfit. And you compare them to someone who may weigh more who is actually fit and has muscle tone. People come in all shapes and sizes and there ARE sometimes genetic reasons they are heavier. It makes some of them no less healthy. It is discrimination. Should we charge people who discriminate against others more also, healthy or not, because their mouth shooting off discriminatory opinions places them in the high risk of getting their ass beat? Emergency room visits galore!

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avatar Kat

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.

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avatar Kevin

That is until you need knee replacement surgery and physical therapy due to all the impact running. I myself was listed under that (OBESE) label and was getting charged more for insurance until I fought it. I am 5’11 230lbs and walk 4 miles per day and bench 270lbs. I am in no way OBESE but the failed BMI chart that shows me as a marshmallow. If you don’t know what you are talking about then keep your mouth shut. Unfortunately stupidity isn’t painful or you would be charged more for your health insurance also.

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avatar nat31

I feel it should be based on a physical and through exam. Just because one person is thin and one is not does’nt mean the thin one is healthier. This may me you look physically better, but I am not big and I do have asthma, and I know many obese people who don’t. I also know many thin people with heart issues and diabetes should they pay more?

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avatar Toby

@ 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?

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avatar Kat

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.

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avatar royp

Actually, if you remove your breasts you have eliminated your risk of breast cancer.

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avatar nat31

So what about other addictions such as alcoholics or drug addicts? It sounds to me you just want to make sure you get off cheap so if some one else has to absorb the cost so be it. What if this was your child or mother dealing with this issue would you still feel it was not discrimination.

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avatar Toby

@ 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?

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avatar Kat

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?

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avatar nat31

yeah so is transmitted diseases practice protection or do not engage in sex. I guess they should pay more too.

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avatar Derek

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?

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avatar nat31

very good points and there has to be lines drawn.

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avatar Laura

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.

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avatar Jeremy

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.

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avatar Michael JE Whalen

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)

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avatar Barb

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?

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avatar Llama Money

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.

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avatar Stephanie

You are completely uneducated and should not speak about this until you are.

I was diagnosed with Hashimotos hypothyroidism with a TSH level of nearly 20. I gained weight on 800 calories a day (documented and medically supervised).
By the time my disease was diagnosed, nearly 80 pounds had been packed onto me and it had NOTHING to do with diet at all. Nothing.

Now I get the burden of trying to lose it. It does not magically disappear once medication regulates the thyroid.

So I diet and exercise and lose 30-40 pounds, and the thyroid function decreases more, and those pounds come back very, very quickly, before the medication can pull it back into normal range. And there I am again….all that lost weight for nothing.

Lather, rinse, repeat. It never ends.

And for all this, I get to be called fat, lazy, “Twinkie eater”, etc.

If this wasn’t so awful, I’d wish it upon some of you so you can have your eyes opened.

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avatar Luke Landes ♦127,365 (Platinum)

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.

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avatar Llama Money

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.

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avatar JBN

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.

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avatar Noname

I don’t buy this crap. Overweight people don’t all eat unhealthy or bing. I don’t care if I have to pay a little more, but I am not a Major Risk factor. I am not that overweight. The private insurance companies have too stringent and unrealistic guidelines. That is the problem. They over inflated BMI and BMI is not an accurate measurement. Your article says anything over a 25 BMI should have a rate increase. Read below.

[edit] Limitations and shortcomings
The medical establishment has generally acknowledged some shortcomings of BMI.[11] Because the BMI is dependent only upon weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly).

One recent study Romero-Corral et al. found that BMI-defined obesity was present in 19.1% of men and 24.7% of women, but that obesity as measured by bodyfat percentage was present in 43.9% of men and 52.3% of women.[12] Moreover, in the intermediate range of BMI (25-29.9), BMI failed to discriminate between bodyfat percentage and lean mass. The study concluded that “the accuracy of BMI in diagnosing obesity is limited, particularly for individuals in the intermediate BMI ranges, in men and in the elderly… These results may help to explain the unexpected better survival in overweight/mild obese patients.”

The exponent of 2 in the denominator of the formula for BMI is arbitrary. It is meant to reduce variability in the BMI associated only with a difference in size, rather than with differences in weight relative to one’s ideal weight. If taller people were simply scaled-up versions of shorter people, the appropriate exponent would be 3, as weight would increase with the cube of height. However, on average, taller people have a slimmer build relative to their height than do shorter people, and the exponent which matches the variation best is between 2 and 3. An analysis based on data gathered in the USA suggested an exponent of 2.6 would yield the best fit for children aged 2 to 19 years old.[13] The exponent 2 is used instead by convention and for simplicity.

Some argue that the error in the BMI is significant and so pervasive that it is not generally useful in evaluation of health.[14] Owing to these limitations, body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing and the limitations of manual measurement have also led to new, alternative methods to measure obesity, such as the body volume index. However, recent studies of American football linemen who undergo intensive weight training to increase their muscle mass show that they frequently suffer many of the same problems as people ordinarily considered obese, notably sleep apnea.[15][16]

A further limitation relates to loss of height through aging. In this situation, BMI will increase without any corresponding increase in weight.

To overcome the shortcomings of BMI, and some of the less acknowledged limitations inherent in body fat percentages, the concepts fat-free mass index (FFMI) and fat mass index (FMI) were introduced in the early 1990s.[18]http://en.wikipedia.org/wiki/Body_mass_index

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avatar kitty

” 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.

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avatar MOM

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!

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avatar Noname

Sorry to hear about your sons issues. I hope he get well. You are right no one under or overweight should be paying huge premiums for their insurance. You hit on the issue, because if he was the “perfect” weight as dreamed up by the private insurance companies you would not be paying a higher rate. It is usually not the condition as much as the weight factor.

Good luck. I hope things work out.

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avatar soy

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.

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avatar Noname

And some of us fat folks do eat in moderation and do watch what we eat. There is a very big misconception that all overweight people eat three hamburgers and a pound of fries for dinner then sit in front of the TV eating their pint of ice cream. It is a myth!

Tonight and quite often I throw vegetables and shrimp, which has hardly any calories it it, in a skillet and that is dinner. Very low in fat and calories. I don’t eat much red meat. I eat more chicken baked or in the skillet with light spray oil, baked fish and veggies. I don’t eat white pastas, breads or rice as it has bad carbs, which turn into fat. Do I like the occasional desert of course who doesn’t. Unfortunately some foods that are high in sugar can turn to fat.

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avatar Ergochk

Carbs and sugar don’t “turn into fat”. The consumed calories you dont burn is what gets converted into fat. Likewise, not eating enough calories puts your body into “starvation mode” where your body stores everything out of self defens.

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avatar Jodi

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.

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avatar Noname

Get a clue. Not all overweight people make bad food choices. It is a myth that all fat folks sit on the couch and eat an entire box of Twinkies. I and my family have alway eaten lean meats and veggies. I didn’t grow up eating fast food. I eat it now rarely. When I do I try to get one grilled chicken sandwich no fries. I never supersize anything. I don’t keep cookies and crap in my home. I also check the fat content in food. I do not buy foods with high saturated fats. Usually no more than 2-3 grams less if possible. If I go to a buffet it is a waste of money because I can rarely go back for seconds. We don’t all eat massive amounts of crap. Some of us may have a slower metabolic rates. You are probably young wait until you hit middle age it won’t be so easy. I have a friend who can eat a whole pizza and not gain a pound. Yet if I do that I gain a couple of pounds. Skinny people like you have no clue about it.

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avatar Sid Vicious

First off there are genetic factors in everyones life!! Some people can’t help their weight and they need care to. Not everyone can go to the gym! but they can learn to at least eat healthy. I have been all over the world and worked as a personal bodyguard to major bands and stars. I have seen first hand the differnt medical coverages in several countries. I love my country! but the medical system here SUCKS period. You will never know until you have to face a life ending injury or illness. I myself broke my ankle i and developed blood clots that went to my heart and lungs and almost killed me and i had medical coverage and guess what they didnt want to pay S%#T. We all live in the USA pay taxes as well we as the people deserve to be treated fairly reguardless of weight and disabilities After all the medical system is set up for the Dr’s and insurance companies to make as much money as they can as they watch You or a loved one die to get their kick backs at the end of the year. Rather than judge people by the way they look we as americans should just be helping better our system and stop letting big brother make all of our choices in these type of matters ” we are a free counttry right”? I dont remember voting on any big issues with our health care system or costs do you? A simple solution would be give the person a physical they would pay out of their pocket and do blood work etc to determine their health if its good give them coverage and not judge by their weight there are some overwight people healthier than someone with an ideal bmi. Wake UP people it is discrimination.

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avatar Noname

Thank you! As an “overweight” person I am going to have to pay as much as $474 for HIPPA coverage because I cannot get individual insurance. If I wasn’t eligible for HIPPA I would have to pay $684-$767 for Major Risk Medical. I have never had an ailment that was Major Risk. I don’t eat crap. I consider myself healthy. Contrary to some of these insensitive posters all overweight people don’t just sit on the couch and eat Twinkies. Some of these idiots also think we eat massive volumes of food. I don’t eat anymore than the average person; it is impossible I get miserable if I eat lots of food. I have a friend who can out eat me and she is skinny. She never gains weight. Metabolism has a lot to do with weight as well as heredity. One person can eat a whole large pizza and gain nothing while the other person eats it and puts on pounds.

I used to be able to pack it away, but the older a person gets (I am in my mid 40s) the less they eat, but also the less they are able to lose weight. I try to make good food choices. I always look at labels before buying any food. I don’t eat high fat content foods. My family is not made up of tiny skinny people. My uncle is 6’6″ and very large framed. My father and mother were also tall and large framed. Even when I did lose weight according to the bogus weight charts that are out there I looked skinny and sick and at that time weighed 155lbs. I never did reach the goal weight of 145lbs or whatever they decided was the “perfect” weight that was set for me; it was impossible. Some people just cannot be “skinny” by society’s standards.

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avatar Abbygirl

I come from a family of heavyset people… for years and years I was as thin as a rail… then in my 40′s I started to gain weight, like my mother, my grandmother my great grandmother etc etc etc…. I have tried so many diets, exercise etc etc etc and can’t seem to take it off, now my knee’s are going bad..and I can’t find health insurance.. I would love lap band or gastric bypass, but the poor or obese always are the ones screwed out of health insurance, dental help or other.. I am with so many of the others above, if we are going to discrimintate against obese, then those whom that smoke, drink, do drugs should not be alowed to get any insurance either, and cancer, in many ways cancers is preventable, most cancers are caused from the foods we eat, the things that are inhaled at certain businesses by employees, how about cancer from old bad insulation.. you know the one that causes mesolithioma, maybe we should charge more for there insurance, or cancel it because they were working for a company who made these products.. Its all Bull… everyone should be able to afford insurance.. young, old, obese, smokers etc etc.. I am obese, but rarely see a doctor.. I have no signs of diabetes.. high blood pressure etc etc…and am now 56. The real truth is, insurance companies, want to pocket as much as they can, and don’t want anyone sick. A time will come when they won’t pay for anything… because they can’t line there pockets. Just like homeowners insurance, gee, we can’t pay because you didn’t have flood insurance… anytime you have a catastrphic thing happen your gonna find they are not going to pay.. So I guess, really no insurances are worth a hill of beans.. Wait and watch, it will come…

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avatar rita

Sometimes there good reasons someone gains weight that are out of their control. thyroid desease, hormones, age, to name two there are lots more but I would be here all nite if I tried to name them all. what about people who have disabilities and are less active? it is never a good idea to judge someday it may be you.

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avatar Tangerine

Sure, charge more insurance for over weight people.

BUT

Also charge more insurance for people on prescription drugs.
AND for people who use illegal drugs (drug test everyone – all the time).
AND people who drink.
AND people who smoke or chew tobacco.
AND people with congenital health issues.
AND people with PAD
AND people with AIDS or cancer or other deadly diseases

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avatar Noname

You hit it. Some of the things you mention would be covered or overlooked by the private insurance companies it the person is not “overweight”. I had one deny me due to my blood work the only thing out of range was the red count by .01. One spinich dinner and it’s fixed! Unbelievable. My doctor certainly was not the least bit concerned. She told me to increase iron foods and it would be back up. The other thing they cited were normal and within range. Example a total cholesterol of 188. If it is below 200 it is normal. They were nitpicking anything to deny me solely because of weight. If I met their bogus weight and BMI range the above issues would not have mattered. I probably could have had a BMI of 20 and be 150 and smoke two packs a day and I would get insured. As long as you aren’t “overweight”.

With the current administration in Washington they just may be out of business if we go to socialized or universal healthcare, so it would behoove them to stop discriminating and provide coverage for all that need and want it.

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avatar Tangerine

Health insurance rates should be increased on boneheads who make their living counting jumping jacks.
They are far more likely to incur bodily harm when they go around spouting unintelligent bigotry.

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avatar Jadie

The vast majority of arguments against “fat people” reveal a lot of uneducated biases and ignorant assumptions. For example, it is assumed that heavy people are just lazy and eat a lot. What about athletes who are seriously injured and become heavy because they can suddenly no longer exercise? And speaking of athletes, this country spends a lot of money paying for the medical costs of activity-related injuries that would be 100% preventable if you just stayed home and sat on your couch eating carrot sticks. This type of discrimination against people based on our presumptions of what their lifestyle should be (inevitably we assume they should be more like us) is counter-productive for everyone. Also, statistically speaking, poor people are more likely to be overweight, for many reasons, and cannot afford to pay for gyms, don’t have time for excessive exercise schedules, and cannot afford the added premiums for higher health insurance. And actually, in many cases, heavy people are declined for coverage altogether, even when perfectly fit and healthy (muscle weighs more than fat, people). Heavy people having no coverage only leads to them becoming a lot more unhealthy and eventually costing our whole system a lot more, when they require ER visits they cannot pay for, etc.

You may want to punish people that you think aren’t as self-controlled and disciplined as you, but your bias will come back to bite you in the end.

In the meantime, I think we should lobby to deny coverage to athletes, who cost us an extraordinary amount of money for medical costs related to avoidable injuries.

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avatar NJW

There are several false assumptions being made by some of those posting here. My 23 yr old college student son is a good example of unfair discrimination caused by over-reliance on BMI numbers. At 6 feet 5 inches and 270 lbs, shoe size 15, and a large frame, my son doesn’t fit the assumed image of a fat, lazy health care hog. Actually, he went to the doctor (fully insured by our family policy) only twice in the last 5 yrs because he’s so healthy. Most of us know people who go to the doctor frequently for an assortment of complaints and those I know who do that have an average body size/BMI number. Nonetheless, they cost their insurance company far, far more than my son does. Ironically, now that Nic is 23 he has to get his own policy and I’m being told that his premium will be an extra 25% because of his height weight ratio. He has been very healthy his entire life so where’s the fairness in that? BMI charts may work well for average sized people but they are not a true indicator of a large muscular man’s health.

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avatar Noname

Well said. I tried to get insurance and cannot due to the BMI garbage that the insurance companies use to weed out those that don’t fit their perception of “perfect”.

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avatar Michelle

Hi Noname

My name is Michelle and I am a Producer for daytime talk show. I would love to find out more about your story, and why you were denied from insurance, as we are doing a segment on BMI.

If you could please e-mail me at msiegel@kingworld.com with your contact information, I would greatly appreciate it.

Thank you and I hope to hear from you soon,

Michelle

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avatar NJW

Noname, you have my sympathy. I think insurance companies should use the applicant’s past medical records to balance the BMI scale in the name of fairness. That said, it doesn’t seem to me that they are interested in taking a true measure of a person’s health. Rather, the insurance companies are making a money grab based on a very narrow focus on a set of numbers that may have no correlation to the amount of health care dollars actually being spent. Good Luck!

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avatar aaron

but yet when companies started fireing people who smoke i heard no complaints… insurance rates for smokers are consistantly higher then non smokers regardless of activity level, eating habits etc. so where the outrage at this discrimination…oh wait smokers are evil that right….
BTW i smoke but am in the process of quitting just so you know where my bias lies

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avatar JohnP

What if someone does not want to be a skeleton? An anorexic tween is probably going to die decades earlier anyway than any moderately active guy with a little pudge … or shocker … muscle.

BMI is, in MANY cases, pointless. Corporations might as well be tacking on premiums for your hobbies, wardrobe, number of kids, religion, location, diet (more directly), sexuality (including what race you have penchent for), hairstyle, or anything else (I’m sure you could find some vague connection between even life expectancy and favorite color). This is, for the most part, just an attempt to get more money out of people.

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avatar Sara

I see alot of what I have been going through lately. I am considered to be overweight, and I am a single mom of 2 kids. I eat good things, I don’t eat a bunch of crap I walk I go to the gym but losing weight at times seems to be near impossible. Then about 7 months ago I was told my kidneys are failing, and that I will need to be on dialysis for a while, now I dont know what you guys know about it but that leaves you completely drained.
So after going to the dr, then to work and then back to home to take care of kids, i squeeze in an hour of excersizing, just so I can be denied life insurance. I am not whining, I just think that people have become more and more greedy and unconcerning. Everybody seems to worry about money and only money, what about the people?

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avatar jimbo1

Being overweight is a health risk factor but is only one of many factors that determine a persons health. It is impossible for a health insurance company to say that an overweight person is more at risk than thin person who eats garbage all day and doesn’t exercise. Many ideal sized people are sick inside while many overweight people are pretty healthy. While I lnow I could lose some weight I run at least 3 miles and lift three times a week. I have perfect cholesterol and blood pressure and some how am uninsurable. While I don’t think they should be forced to offer me insurance I am only sugesting that they use a little more reasonable screen than BMI.

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avatar PT

There are a lot of excuses and phony arguments like “slippery slope” – there’s no slope, slippery or otherwise. It’s very simple – your premiums should be a function of your habits, because it’s not fair to stick everyone else with the bill. It’s NOT “the whole idea of a group plan” to spread the risk regardless of whether that risk is self-imposed. It’s to spread the risk of the unknown. But obesity isn’t unknown. Smoking, alcoholism and drug use are not unknown. Driving record is not unknown.

I certainly agree with the comments re: BMI but let’s stop fooling ourselves, shall we? They’re suggesting that this be done not based on “overweight” but “obese.” Yes if you lift weights you’ll carry an extra 10-15 lbs but not 35, and you could have some kind of “competitive bodybuilder” exception signed off by a doctor – these things are determined based on a physical exam.

If this is limited to habits, rather than known or perceived genetic predispositions or pre-existing conditions (e.g., cancer) then that’s fair. As for pre-existing conditions, there should be SOME difference in premium, but it should be limited.

But something has to be done. The reality is that bad habits account for about half of the “escalation in healthcare costs” over the last 30 years, thus account for about half of the increase in premiums in that time. And some people’s bad habits shouldn’t be subsidized by others.

As for the title of Katie Couric’s series – “Forced to be Fit” – that’s not exactly accurate. Nobody’s forcing you to lose weight – you just don’t get to stick others with the bill.

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avatar Farah

You guys are suckers to the weight change industries brain washing. Weight is genetic and unchangeable. Get over it long faces. Some people think having a narrow face means bad nutrition and unhealthiness. I am guessing most of you critical commenters, with small bones and muscles, would not pass that test.

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avatar ackwright

To respond to those who taking this the wrong way. The issue is not whether the “chubbies” are lazy or not willing to lose the weight or have a gentic defect which won’t allow them to lose weight. the question is whether it is fair to have them pay higher premiums like smokers have to pay higher premiums. Studies have shown that smoking can lead to major health problems, as does obesity. BMI or Body Mass Index ( which is a guideline created for Doctors and Nurse as a tool…not an exact science…which i do believe insurance companies should be going off what the doctor say per indiviual patient). The obese run a much higher risk for Heat attacks, strokes and type 2 diabetes, which is adult diabetes, and is been found that is cause by bad diet ie..too much candy, soda, and twinkies. Yes, you can lose weight and gain weight, but you can not change your skin color, your race, or religion(depending?). You can educate yourself and get on a tred mill. There are a few cases where it is impossible to lose the weight..these are genetic defects…not lazy. The truth is almost 99% of the obese can lose the weight, and a small 1% cannot due to their genes. Is it fair to pay for some else’s bad habits? would you buy a crack head crack…no..so why should we all have to pay for smokers, and obese health care when all the studies have shown they lead to more health problems which mean higher cost for medical coverage.The obese have higher risk for heart attack about 40,000 same with stroke or diabetes all run about 40k in medical expenses.. If the nation as a whole ever got over 50% of the population to be obese…well then no more weekend get aways, because medicare would take half our pay checks. Personal Side Note…It is not natural to weight over 400lbs..peace :)

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avatar ann

You know its always so nice to see so much intelligence going on. I love when society always chalk being overweight up to overeating. Laughing my head off at that one. They never figure that it’s not always food the factor, but a medical situation that the person has no control over. I know it not a good thing, but just once I wish the roles would reverse and see how those responses could comeback and haunt those really “intelligent” people in to say, oh my bad it not what I thought. If we were to stop paying for people from other worlds and take care of our world it would be cheaper. People who want to work and can’t, or you have to be drugged up to kill pain. Then you have to have a drug test that eliminates you. Do more research people before bad mouthing others about paying more for insurance, which you will not get anyway because you don’t have the perfect medical-free body.

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avatar nicbel

Wow…so I guess I should get charged extra because high cholesterol runs in my family and now mine is high..I prefer not to kill my liver with statins…

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avatar Veterkins

I have only seen one person post a comment that none of you have picked up on!

Truly what is insurance – it’s a taking the costs of medical treatment for a group of people and dividing that cost among all. Insurance is to minimize the loss incurred for future medical needs; whatever those needs may be. We average the costs and determine an amount needed to cover those costs.

You that are healthy think you should pay less than anyone else. You don’t take into consideration that life changes over time and so does your health. For those that are currently unhealthy, their lives changed at some point. For whatever reason. BTW, for those of you that are “healthy” why do you even bother paying premiums? I mean, you’re
so convinced you are being penalized for the obese person, and from your statements – you believe you are going to remain that way, right? Oh wait, you pay insurance because you might get sick one day and need insurance! Well, the rest of us are paying for your “future” medical costs as much as we are paying for someone else’s current medical costs.

But what has happened over the years, CEO’s think they have to rake in millions, companies started forgetting that their prime objective was to provide medical coverage and changed their focus to the corporations “bottom line” and a need to produce higher profits to satisfy their “stock holders”.

It doesn’t matter what state of health you are in, healthy or unhealthy; good habits or bad habits. Every single person in this nation deserves health coverage. It should be a right, not a benefit! There shouldn’t be “for profit” terminology when it comes to ANYONE’s health!

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avatar Anonymous

LOLOLOLOL “Weight is genetic and unchangeable” – keep telling yourself that, fatty. Oh and I love this comment too “society always chalk being overweight up to overeating”. No it isn’t just over-eating, it is part genetics, and part laziness (i.e. not exercising or at least staying active).

If you are overweight, stop with the excuses already. Yes there is a VERY SMALL PERCENTAGE of people who cannot control their weight due to genetics or a medical condition. However, for the other very large percentage of people, you’re just too lazy and undisciplined to lose the weight. Admit it, and stop making excuses – you just look foolish.

(And of course fat people should pay more in health insurance, that’s common sense and not even debatable. Anyone arguing otherwise is either fat or stupid – or both.)

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avatar Veterkins

And people like Physically Fit should pay more just because of their sheer stupidity and for no other reason. Someone in the family obviously has medical problems and it affected the gene pool for Physically Fits conception.

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avatar Physically Fit

Just stating facts. If you have facts that show that a large majority of obesity is due to reasons beyond their control, feel free to post them. Seriously, fatties, stop making excuses. Hit the gym (an hour PER DAY for at least FOUR days per week), eat healthy (no fried foods, trans-fats, snacking between meals), and STAY ACTIVE (i.e. don’t exercise for 30 minutes, then go home and sit in front of the TV for 5 hrs).

And really this doesn’t even go for just fat people – because you can be skinny and unhealthy too. With fat people it’s just more obvious you aren’t taking care of yourself. Anyone who has unhealthy vitals (i.e. high blood pressure, high cholesterol, poor recovery heart-rates, etc.) should also have higher insurance rates. A battery of tests to determine these vitals should be mandatory every year if you have insurance. And your rates would be dependent on how you test.

You can try to insult me, but you know what I’m saying is true. Stop pretending, and DO something about it.

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avatar Deb

You need to charge more for people with HIV, car related injuries, and any injury related to exercising. I never hurt my knees like runners do and they are costly for the knee repairs. I didn’t choose to be a Nurse which usually results in back and hip and knee related injuries. I never had unprotected sex like the ‘reckless’ people ‘we need to teach a lesson to’ for having unprotected sex like HIV, anal tearing and other such repairs. I am young. I don’t Want to pay for an old person. I think they should not grow old or they should all be lumped together separate from young people and if they can’t afford it ‘it will teach them a lesson.’ They should have died young. I know someone who is on our insurance plan who is parapalegic because they fell off a building. I never worked as a carpenter so I never put myself in such danger, I ‘think we need to penalize’ them for falling down like that. I’m not sure your basis for ‘deciding’ who ‘to punish.’

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avatar Deb

You should make a list of ‘who we will sit’ as Judge and Jury over for their ‘behavior.’ Since someone didn’t elect to become a drug addict which would have resulted in them remaining skinny, we should punish them for ‘instead’ having an addiction to food. Since they didn’t become an alcoholic (are you planning on not assessing a penalty to people who lose a liver or pancreas or their eyes because they drink?), you ‘choose’ to punish them. If you will be fair, I think you need a Entire List of ‘reckless stuff’ and penalize Anyone who is an alcoholic, drug addict, had car accidents, work accidents, risky sex behaviors etc. Otherwise how is it not prejudice?

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avatar FedUp

I agree. I was always thin until 15 years ago, I started to gain weight – 160 pounds in the last 15 years! Turns out, I have Hashimoto’s disease where the antibodies eventually destroy the thyroid – your main source for metabolism. My fault? I don’t think so. Try going after the white collar CEOs and account managers working for the insurance companies – let’s see if their bonuses match those in the financial industry mess of last year. It’s all about the greed of money. Penalizing those with dibilitating illnesses is not the answer – taking another look at the system in place is…..

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