Controversial Debate Topic of the Day

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Originally posted by Sea Gull:
I see your point Jumper. If a person does not have to use benefits for a given period of time they should be given some kind of rebate. I was at Cincom for 5 yrs and had full medical coverage from the first day. I never once used it but over the course of 5 yrs. paid roughly $2,500 into it. So regardless of what causes a person to use the benefits the person who does not use them at all is paying for everyone else. Kind of like single people paying a higher tax burden to support families...

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<font size="2" face="Verdana, Helvetica, sans-serif">Your wrong, while you may not have gone to the doctor, you were covered every day. That's what insurance is.

Main Entry: 1in?sur?ance
Pronunciation: in-'shur-&n(t)s also 'in-"
Function: noun
1 a : the business of insuring persons or property b : coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril c : the sum for which something is insured

2 : a means of guaranteeing protection or safety

I was re-reading my original post and I should also mention that our medical plan is employer MANAGED as well. I think that is why the debate popped up about higher premiums for higer risk folks.

I guess this is a legal question as well but can an employer funded and managed health care plan set individual premiums based on usage or would the lawyers be all over them like white on rice on a paper plate in a glass of milk in a snowstorm?

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Originally posted by Jumper69:
We kind of had a mini debate about this at work the other day and I thought it might be good fodder for this board.

Background:

Comair has an employer funded medical benefits plan. We, as employees, pay very reasonable premiums compared to other companies. Recently our executives discussed increasing those premiums due to rising costs and the number of people who are going to the doctor or hospital for what are, or should be, controlable reasons.
So, inevitably the topic of those who engage in high rish behavior (i.e smoking, obease) should pay more than those who maintain a healthier lifestyle.

SO.....kids:

Should people who smoke, drink alot, are severely overweight or who otherwise tax the system...pay more for their insurance than those who don't smoke, drink, are at ideal weight and do not visit the docs as often, etc. etc. ???

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<font size="2" face="Verdana, Helvetica, sans-serif">I think smokers should pay more. Interesting that you posted this topic, because I recently had this very same discussion with a coworker who protested this very same point.

So I wrote personnel. It just so happens I work for an insurance company, and all our medical claims are handled in house. What really, really, really, really irks me is that the company built what we kindly call a "butt hutt" - an atrium for smokers to puff away during the business day.

The response from personnel was less than positive. They acted as if they had to appease the smoking constituency.

As it happens, my best friend's mother was diagnosed with emphysema and small cell carcinoma, so I wrote personnel back and let them know - in a tactful way - they were contributing to grueling situations my friend's family was enduring.

I have differing opinions regarding fat people. Some people - like me - have a natural propensity to put on the pounds. And secondly, just because someone is thin or looks thin doesn't mean they have low body fat, or have good cholesterol. Nor does it mean they exercise or eat right, either.

The guy who sits two doors up from me sucks down sugary mountain dew all day, while I keep a stash of the diet stuff. I'm the one on the eliptical 5 days a week, 40 to 50 minutes a session, while he goes home and tends to his children. Guess who is ultra thin and guess who could stand to lose 25 pounds?

When I worked for United Technologies they were also self insured. What they did was to build health clubs at their plants and offer incentives in reduced premiums if you joined their program.

They monitored Body Fat and club attendance, did yearly blood tests for cholesterol, smoking and PSA, they also did stress tests and lung capacity tests.

They had a Personal Trainer, Physical Therapist and a nutritionist on site.

It worked great until the late 80s when the aerospace industry took a dive, then this program was the first to go during the layoffs.

<font color="#000002" size="1">[ June 04, 2004 10:08 AM: Message edited by: travelinman ]</font>

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Originally posted by travelinman:
</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Sea Gull:
I see your point Jumper. If a person does not have to use benefits for a given period of time they should be given some kind of rebate. I was at Cincom for 5 yrs and had full medical coverage from the first day. I never once used it but over the course of 5 yrs. paid roughly $2,500 into it. So regardless of what causes a person to use the benefits the person who does not use them at all is paying for everyone else. Kind of like single people paying a higher tax burden to support families...

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<font size="2" face="Verdana, Helvetica, sans-serif">Your wrong, while you may not have gone to the doctor, you were covered every day. That's what insurance is.

Main Entry: 1in?sur?ance
Pronunciation: in-'shur-&n(t)s also 'in-"
Function: noun
1 a : the business of insuring persons or property b : coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril c : the sum for which something is insured

2 : a means of guaranteeing protection or safety</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">No you're wrong: they never had to spend a penny on me whereas on others in the plan they had to spend thousands of dollars. My estimate of $2,500 was axctually low too. I paid $50/month so over 5 yrs it was more than $2,500. I was healthy and didn't require the plan to spend any money on me, so I paid for the care of others in the plan. Using your logic you should support welfare and other entitlement programs based on the theroy that the benefit of the many outweighs the benefit of the few. Me not being sick and paying for those who were is like a taxpayer paying to support someone on welfare. If you agree that one is OK you have to agree that the other is too.

No, it's not the same. I doubt you were forced to buy insurance. I have family coverage with my company, so Gail doesn't need to buy it from her employer. We could both choose not to buy it and take home more cash, but we want the INSURANCE that if one of us gets sick the medical bills will be paid.

That's what your buying, insurance.

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They monitored Body Fat and club attendance, did yearly blood tests for cholesterol, smoking and PSA, they also did stress tests and lung capacity tests.

They had a Personal Trainer, Physical Therapist and a nutritionist on site.

It worked great until the late 80s when the aerospace industry took a dive, then this program was the first to go during the layoffs.

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<font size="2" face="Verdana, Helvetica, sans-serif">That seems short sighted. Long term costs can be reduced by just this type of program. However, I'd be willing to bet the only folks who used the gym were those that already led a more healthy lifestyle anyway.

We have some real <s>cows</s> heavy and <s>chimneys</s> chain smokeing people at work here. You know the kind who will take the elevator up one flight to go smoke. Chance are they wouldn't use a gym anyway...

<font color="#000002" size="1">[ June 04, 2004 10:29 AM: Message edited by: Jumper69 ]</font>

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No, it's not the same. I doubt you were forced to buy insurance. I have family coverage with my company, so Gail doesn't need to buy it from her employer. We could both choose not to buy it and take home more cash, but we want the INSURANCE that if one of us gets sick the medical bills will be paid.
That's what your buying, insurance.

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<font size="2" face="Verdana, Helvetica, sans-serif">So Trav, would be in favor then of GL getting a much reduced premium for the following year??

You guys don't know how group insurance works.

The premiums are based on the demographics and experience of the group. It doesn't matter that GL didn't ever use the coverage; other people in the company did.

I understand the thinking that maybe he should get reduced premuims the following year, but if that sort of thing was instituted, overall premiums would go up, because there'd be another layer of bureaucracy.

Not unless he was able to show a reduced risk. Not using the benefits is not the same as reducing risk.