Benefits & Compensation
Exchange ideas about health plans, retirement, work/life benefits, and employee assistance.
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Posted: 2007-07-09 06:56
Smokers at some companies pay higher health insurance premiums for their unhealthy habit. Should obese employees face the same penalty? Should employers have to pay the cost of health care for any worker whose lifestyle leads to high medical claims? We want to know what you think about this issue and the related story "Will the Obese Be Penalized by Insurers Like Smokers?"
http://www.workforce.com/section/00/article/24/99/41.html
mroberts7
Joined: Apr 11, 2002 Posts: 952
Posted: 2007-07-09 07:52
Absolutely they should pay more. Believe it or not, clinical research shows that obese employees incur more medical claims than heavy smokers or drinkers. The problem empoyers have to work around is HIPAA. Due to this wonderful law, employers can only penalize employees 20% if they are obese. Furthermore, there are grumblings that obesity could soon be diagnosed as a disability. It's not rocket science as to one major way to fix our healthcare woes, but we can't keep turning a blind eye to one of the largest problems.
ellymae
Joined: May 06, 2006 Posts: 181
Posted: 2007-07-09 09:38
Should they? Absolutely. Will they? I don't believe it for a minute. Smoking is a definite "lifestyle decision", and although probably a majority of obese people are that way because of lifestyle choices themselves, some are not. Thyroid problems, heredity, all type of factors not definitely related to a person's eating and exercise habits can cause obesity. How to you determine if someone's weight is due to unhealthy choices, or some other medical reason. Then you're looking at discrimination - charging someone more over something that is not in their control. My company charges an additional 20% on the premiums of smokers, but I can't see them ever jumping on the bandwagon of obesity premiums. But I agree with MRoberts....I totally believe that it is more of a cause of claims than some of the other lifestyle choice. Unfortunately I don't see a thing anyone can do about it.
Elly
mbuss
Joined: Jul 10, 2007 Posts: 1
Posted: 2007-07-10 06:58
I agree that there are other reasons someone may be obese. How about offering incentives to members who join and go to a health club on a regular basis. You may be obese and still be healthy.
mroberts7
Joined: Apr 11, 2002 Posts: 952
Posted: 2007-07-10 07:17
There are very few people who are obese based on some medical condition. The percentage of the population that was considered obese in the early 1960's was 13% compared to close to 40% today. Additionally, the standards of classification are more generous today than back then. My guess would be less than 1/2 of a percent of the population are obese due to a medical condition, if that.
Paying for someone's gym membership is not necessarily a bad idea, but who's going to monitor whether the employee is going or not? What if the employee is treating it as social hour? What if the employee is exercising incorrectly and thus not getting the true benefits of the membership? Unfortunately, I would tend to imagine that a small percentage of employees who get reimbursed for a gym membership are actually routinely going and exercising properly.
mroberts7
Joined: Apr 11, 2002 Posts: 952
Posted: 2007-07-10 07:25
Additionally, there's no such thing as being obese AND healthy. It's virtually impossible that high blood pressure and high cholesterol does not accompany obesity. And just because someone isn't incurring a lot of claims now, what about down the road? 15% of people make up 85% of claims on group health plans. Coronoary heart disease, type 2 diabetes, hear failure, strokes, some forms of cancer and psychological disorders (to name a few) are all ailments that obese individuals are at an increased risk for. And these are the types of claims that tend to make up that 85%.
Hrpro
Joined: Mar 16, 2007 Posts: 809
Posted: 2007-07-10 08:31
IMHO anyone who voluntarily engages in a unhealthy lifestyle or behavior should bear the responsibility for that. "I'm big boned" or "family genetics" is a convenient excuse for many but in the grander scheme of things few actually qualify to legitimately use those reasons. More often than not a healthy diet coupled with even moderate exercise will control the problem.
The challenge becomes how do we determine who has a legitimate medical issue and who is voluntarily living the life of the unhealthy practitioner et al. Further, is it ethical to screen out those who have legitimate health conditions, regardless of their source, from our healthplans?
So we make a decision that the obese (If I recall correctly by definition anyone more than 100 pounds about a pre-defined weight based upon age and gender)must pay more for healthcare coverage because they are heavy users based upon health issues connected to obesity. Then we target those with certain diseases and afflictions, the noticeably disabled, and so forth. Ultimately we end up with only the healthy can get medical coverage. What happens when the healthy use the insurance? Are they then to be excluded at some point. (and this is not the same as smoking because one does not smoke because their genetics made them)
I have no issue with designing plans that cause any user to bear a fair share. In my company (self insured) we have done that through plan designs that ensure the heavy users pay more than those who don't use it as much regardless of why. We cap our contribution to drugs for example and employees who have high dollar prescriptions naturally pay more, significantly more in some instances, than the $15 or $20 co-pay. We preclude certain procedures, medical devices etc from our plan that are normally attributed to treatment of the results of medical conditions related to unhealthy lifestyles. Employees are still free to contribute to the FSA, or in one plan the HSA, to help them with the cost of these uncovered treatments. We as an employer do not see it as our responsibility to provide uncontrolled medical coverage for all health issues.
We have a great entitlement mentality in our society. To narrow that point to this discussion we are now fatter as a society than at any time in our history. Interestingly enough at a time when we know more, have healthier food options and better medical care than at any time prior. Much of that can be attributed to a lack of physical activity. Something as a simple as a walk around the block. Instead we eat fast food, munch all day at our desks, go home and play what ever video game system we have while eating frozen prepackaged food cooked in the microwave (or for the upscale the advantium oven)that is loaded with fat, carbs, sodium, etc. We ride the elevator up and down 2 floors or less, we e-mail instead of walk across the room or down the hall. we tie the dog out instead of walk it and then our dogs are fat too.
I am challenged by my weight too. A combination of age and long work hours contributes. But I make the time to exercise daily and I try hard to eat healthy. My family is genetically pre-disposed to cancer and diabetes, at least our medical history would support that. But every day, frequently 7 days a week I find the time for some exercise. Makes for a long day sometimes but humans adapt. Regardless my weight is ion normal ranges as is my cholesterol. My blood pressure is excellent. All blood work is in normal ranges. It can be done and many of us do it every day. We make the effort and why should we be held financially liable for those who do not?
A sad commentary that those who care not for their own health feel the rest of us should pay for it. Somehow I find that not only misguided thinking but also just plain wrong.
JenH
Joined: Jul 10, 2007 Posts: 1
Posted: 2007-07-10 10:23
When I read articles such as this, I once again thank God that I live in Canada where universal health care is my right. Although not perfect, our system does not discriminate - period. Your amazing country needs to fund proper health care and in doing so will help those with issues such as smoking, weight, and other mental and physical concerns. I find it incredible that the insurer/employer would, once again, find any way to make sure that they don't have to pay to provide a true benefit. Surely, people deserve better than that.
howard7
Joined: Sep 13, 2001 Posts: 2615
Posted: 2007-07-10 10:48
Jenh-Your reply indicates that you really either do not understand or wish to understand the basis of the argument put forth by HRpro.
Here are some of the points:
Individual responsiblity to provide a healthly lifestyle-Not society's obligation to pay for what you are doing to your body.
The provision of medical care is not an inalienable right. Your are not born with the right to have health care provided to you just because you exist.
If one couple (without money) decides to have twenty children should we all pay for this? Why?
There would be less people to care for if we did not have to care for people who are here illegally.
What gives you the right to decide how I should spend my assets? After law & order and national defense there are very things that I need to have my government provide me.
So back to the original question. If you "choose" not to get your weight down, regardless of the reason, you will be less healthy. If you are less healthy you should pay more for the service. No one is saying that we should deny them the service just make it usage based. This is no different than any other service-electricity, gasoline, clothing etc. Use more pay more.
cpie
Joined: Jul 11, 2007 Posts: 1
Posted: 2007-07-11 05:47
I watched a program on Cable the other day and it said that rising health care costs are not from the smokers but from people who use illegial drugs. I don't remember the % but is was significantly high.
I think if there is a continued push on smokers they will start to fight back and say they are addicted and become protected under ADA like alcoholics. Charging more for overweight people is just plain flat discrimination. Why not say if you drink alcohol we are going to charge more too. People that drink are not only living an unhealthy life style but they kill people in car accidents, cause property damage, and have higher absenteeism at work etc. They have to go to treatment and their is only a 5% success ratio.
Controlling health care costs is educating your employees to the costs they incur. How many of your employees run to the emergency room when they are sick or slightly hurt rather than use urgent care?
How many of your employee's get unnecessary tests and treatments because they do not take an active interest in their own well being and just go along with what the doctor says without question?
How many of your employee's have ever asked the doctor is this procedure really necessary and how much does it cost?
If employers want to help keep their health care costs down educate your employees rather than discriminate against them.
Hrpro
Joined: Mar 16, 2007 Posts: 809
Posted: 2007-07-11 06:24
" think if there is a continued push on smokers they will start to fight back and say they are addicted and become protected under ADA like alcoholics."
Alcoholics, like drug abusers are not protected under the ADA if they are active users. they are only protected while in recovery. Once they start using again the protection goes away. So a "recovering smoker or tobacco addict" would still have to be tobacco free. In that I quit smoking 18+ years ago i guess I qualify to make that statement...me being a recovering tobacco addict and all of that.
In those locations where it is legal to do so (most states by the way) we do not hire smokers and you don't need to ask to discover it, ask any non-smoker.
mroberts7
Joined: Apr 11, 2002 Posts: 952
Posted: 2007-07-11 09:10
Why is charging more for overweight people flat discrimination? The statistics clearly show that obese people will need more services because of their unhealthy lifestyle. Therefore, their out-of-pocket costs for medical services are going to be higher than someone who is not obese, on average.
The goal is not to penalize people for being obese. It's to provide them with a financial incentive (lower premiums or out-of-pocket costs) to lead a healthier lifestyle.
If you looked in my previous post, a recent study actually shows that it's better to be a heavy smoker or drinker than being obese. Additionally, there isn't an inexpensive test, to my knowledge, that can adequately interpret whether a person is a heavy drinker or a light drinker. Plus, there are studies that show one or two drinks several days a week can actually improve people's health.
And I agree that people who use illegal drugs can definitely be major contributors to our health care woes. Fortunately for employers, you can just terminate an employee for using illegal drugs (so long as they are not in recovery as HRPro points out). You CANNOT terminate someone for being obese unless you want to take your chances that you aren't violating the ADA.
Posted: 2007-07-24 07:36
$5 per paycheck will not be enough of an incentive to force people to change their habits. I suppose it's better than nothing since it will slightly help offset the company's health renewal increases, however, this is not going to be their magic bullet.
Panasonic
Joined: Sep 28, 2006 Posts: 1
Posted: 2007-07-24 09:06
Being "thin" doesn't mean your healthy.
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Posted: 2007-07-09 06:56 
