Will there be surcharges built into the health insurance reform?

[madville]

Is there anything to stop or require the insurance companies to charge people extra for activities such as smoking, drinking, mountain climbing, skydiving, etc like they do with life insurance? Could they charge obese people extra for health insurance?

It's a fact non-smoking, non-drinking, in-shape people have less health problems than the opposite, do they deserve a discount on health insurance for leading a healthier lifestyle?

[MH1]

1. some of that happens now

I get a $150 rebate for going to the gym 120 times in a year.

[madville]

3. Exactly what I'm talking about

Haven't heard that one before. How do they know that you actually go? Is it insurance through your employer? I had an employer once that would give us a 90 minute lunch instead of 60 minutes if we went to the gym at work.

[MH1]

15. we have to log our visits

the gym I go to has a phone with the program on speed-dial. You go to the gym, after your workout you call the #, give your account # and pin, and the machine tells you how many recorded visits you have. It's very convenient for me because of where that gym is located. There are other ways you can document your workouts if you don't go to a gym that participates in the phone program.

and yes, it's employer-based insurance.

[Stinky The Clown]

2. Why not incetivize good behavior instead of punishing bad behavior?

Why are you all about sticks and not about carrots?

[madville]

6. That was exactly what I suggested in the second paragraph of the OP

Give a discount for healthier behavior.

It's kind of 6 of one, half dozen of the other. I do see how the perception is more positive giving a discount instead of charging a penalty. I charge everybody $100 a month for health insurance but if you are a smoker, drinker, or obese I charge you $150. The flip side is I charge everyone $150 and offer non-smokers, non-drinkers, and fit people a $50 discount. The discount does sound better even though the results are the same.

[rucky]

4. That's a slippery slope you're skiing on.

Do you really want to go there?

[madville]

7. I'm not advocating it one way or the other

I smoke cigarettes myself. I'm more curious if there have been any rumblings about such a thing going into widespread practice.

[rucky]

9. I've heard some discussion on the issue.

But I don't think anything but the vagina was addressed in the bill.

[JoeyT]

5. I have no idea.

Though it will be interesting to see the first lawsuit when a drug causes someone to gain weight and their insurance skyrockets.
Strangely enough, "I don't smoke/drink/overeat why should *I* subsidize your lifestyle!?" is often applauded as an argument, while "I have good genes and I never get sick, why should *I* subsidize people with weak immune systems?" is shouted down. Both arguments are weak: They ignore the basic ideal of health insurance.

At what point does it become unfair? People that have sex regularly are going to turn up with STDs more often than people who don't. You can't prove you practice safe sex, so why not charge extra for sexually active people? This might not seem like such a big deal until you consider the cost of HIV drugs.

[madville]

10. It's scary really

This could potentially be yet another way for private corporations to influence and control peoples' lives and habits. Eventually one day we will have a government run public option, they could very well institute the same sort of behavioral controls/rewards/penalties themselves.

[JoeyT]

13. Yep

I can think of no better way of signing off a whole boatload of rights, especially for women and gay people, than to allow insurance companies to financially mandate behavior. :(

[madville]

16. It won't just be the insurance companies either

The government will abuse power over the people right along with the corporations, slippery slope and all that.

[JoeyT]

17. While the government

would try, they'd never be able to match the corporations for sheer ability to oppress.
The government would have to face lawsuits over constitutionality of laws and all that jive. The corporations would only be answerable to themselves. That's one of the reasons I'm so iffy about a mandate.

[PSPS]

8. I don't know, but that isn't the way health insurance is supposed to work.

The proper model for health insurance is pooled risk with the largest pool possible. You then price according to the risk of the pool, not the individual.

What you're describing is pricing according to the risk of the individual instead of the risk of the pool, and that's what we have now with private for-profit health insurance. When you go in this direction (price by the individual risk,) you inevitably end up with unaffordable premiums and denied coverage.

[fasttense]

11. Good point, clear and concise, well written PSPS.

So many people like to fill their technical responses with gobble gook words that no one else understands. I guess they think it makes them look smart.

But you described the system clearly and appropriately.

Thanks.

[madville]

12. The more frightening reality to this is

When you go in this direction (price by the individual risk,) you inevitably end up with unaffordable premiums and denied coverage.

The even more frightening path is unaffordable premiums and mandated coverage.

Look at auto insurance. Premiums are determined by the individuals age, driving record, credit, etc. You know the ins. corps are licking their chops at the thought of leveling extra premium rates on certain groups once they have a mandate in place.

[Jamastiene]

14. You can just about bet that will be next. n/t

[madville]

18. If the bill doesn't specifically say they can't do it then it will be tried I bet

n/t