Controversial Debate Topic of the Day

**jumper69** · June 4th, 2004, 12:05 PM

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. ???

**jdf** · June 4th, 2004, 12:13 PM

It's easy to see that I would be against the one saying that people who are obese would have to pay more. 99.9% of my visits to the doctor have NOTHING to do with my weight. I have low blood pressure, (so far...knock on wood) have no symptoms of diabetes, and have very few if any other weight related medical issues. I do exercise (albeit not enough). If you were to compare me to a lot of thin people out there, I might even be considered to be in better physical shape than they are. I can walk further (often with a 3 year old on my shoulders), ride a bicycle (although slowly...that trailer creates a bit of "drag") long distances, bike, hike, swim, etc with the best of them.

I am afraid that a blanket statement should not be used. I think each case where a person "seems" to fit a profile, needs to be assessed individually.

Plus, it may be easier to hide it if you smoke or drink, where as an overweight person is automatically penalized.

**travelinman** · June 4th, 2004, 12:16 PM

Yes people are responsible for their actions, but I would rather see a base line cost and provide incentives for savings rather then penalties. The problem is the insurance weight charts. According to them I should weigh 175 pounds. Even when I was training for my black belt and had less then 10% body fat I weight about 185 pounds with put me over their limit.

**gae** · June 4th, 2004, 12:18 PM

On an individual basis, that's already the case, jumper.

Group premiums are based on demographics and the "experience" of the group. So, if you have a group of 100 employees, all non smokers and physically fit people with no significant medical history, the premiums will be reasonable.

Throw in a couple of high priced premature births, and those same non-smoking, physically fit people will pay more.

**jumper69** · June 4th, 2004, 12:20 PM

but I would rather see a base line cost and provide incentives for savings rather then penalties.

So does that mean that smokers, for example, should pay higher costs initially then if they quit, have their premiums reduced?

I agree with JDF to a certain extent as well. Obese folks are more obvious and therefore more easily targeted for higer premiums. Although medically speaking (and I've been blasted for this before) only 3-4% of people have a medical reason for being obese.

**gae** · June 4th, 2004, 12:26 PM

So does that mean that smokers, for example, should pay higher costs initially then if they quit, have their premiums reduced?

That's the case with life and disability insurance.

**jumper69** · June 4th, 2004, 12:38 PM

Throw in a couple of high priced premature births, and those same non-smoking, physically fit people will pay more.

I guess that's my question: Why?

I didn't choose to get pregnant.

So I subsidize your choice to get prego. That's not fair. I also pay for other peoples diabetes, emphyzema, etc. Why?

If those two conditions for example occured for not controllable reasons, that's one thing. But if, as science has shown, diabetes can be controlled or prevented via diet and exercise and emphyazema can be prevented by not smoking, then why do I have to pay for it?

[ June 04, 2004 09:40 AM: Message edited by: Jumper69 ]

**jdf** · June 4th, 2004, 12:39 PM

I think trav hit the nail on the head...

incentives for healthier people, rather than punishments and penalties for what may be viewed as high risk.

Emperor Napoleon · June 4th, 2004, 12:40 PM

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...

**travelinman** · June 4th, 2004, 12:46 PM

Originally posted by Jumper69:
<blockquote>quote:<hr />Throw in a couple of high priced premature births, and those same non-smoking, physically fit people will pay more.

I guess that's my question: Why?

I didn't choose to get pregnant.

So I subsidize your choice to get prego. That's not fair. I also pay for other peoples diabetes, emphyzema, etc. Why?

If those two conditions for example occured for not controllable reasons, that's one thing. But if, as science has shown, diabetes can be controlled or prevented via diet and exercise and emphyazema can be prevented by not smoking, then why do I have to pay for it?

[ June 04, 2004 09:40 AM: Message edited by: Jumper69 ]<hr /></blockquote>Because it's group insurance. You could be the healthiest person in the world and you get single health coverage and it will be more then any group policy.

Like lawyers, insurance companies are in business to make money, helping people is secondary.

[ June 04, 2004 09:51 AM: Message edited by: travelinman ]

Thread: Controversial Debate Topic of the Day

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