Interesting insurance topic

[Neal R.]

I saw this and thought it was interesting. Some of it made me angry and other parts made sense. What are your thoughts?

http://www.latimes.com/business/careers/work/la-fi-obese29jul29,1,4221092,full.story?ctrack=2&cset=true

[rkincaid]

It asks me to enter my user name nad password when I clicked the link. :(

[Neal R.]

hmmm. I don't know why. It is an article from the LA Times I will cut and paste:


Workers are told to shape up or pay up

To hold down medical costs, some firms are penalizing workers who are overweight or don't meet health guidelines.
By Daniel Costello, Times Staff Writer
July 29, 2007




Looking for new ways to trim the fat and boost workers' health, some employers are starting to make overweight employees pay if they don't slim down.

Others, citing growing medical costs tied to obesity, are offering fit workers lucrative incentives that shave thousands of dollars a year off healthcare premiums.

In one of the boldest moves yet, an Indiana-based hospital chain last month said it decided on the stick rather than the carrot. Starting in 2009, Clarian Health Partners will charge employees as much as $30 every two weeks unless they meet weight, cholesterol and blood-pressure guidelines that the company deems healthy.

"At first, I was mad when I thought I would be charged $30 for being overweight," said Courtney Jackson, 28, a customer service representative at Clarian. "But when I found out it was going to be broken into segments — like just $10 for being overweight — it sounded better."

Jackson said she was going to try to slim down before the plan took effect. "If I still have weight to lose when it starts," she said, "I'll deserve to pay the $10."

Employers are getting serious about penalizing workers "because they've run out of other options" said Joe Marlowe, senior vice president at Aon Consulting, a national benefits consulting firm.

Locally, the Los Angeles Unified School District, which has 90,000 employees, is researching financial incentives and disincentives to help bring down healthcare costs.

UnitedHealthcare, a nationwide insurer, introduced a plan this month that, for a typical family, includes a $5,000 yearly deductible that can be reduced to $1,000 if an employee isn't obese and doesn't smoke.

Last summer, a similar plan was offered to county workers in Benton County, Ark. The $2,500-a-year deductible can be reduced to $500 if a worker meets low height-to-weight ratios during yearly on-site physicals. (According to federal guidelines, a man who is 6 feet tall is considered obese if he weighs 221 pounds or more. A 5-foot-6 woman is obese if she weighs more than 185 pounds.)

Thomas Dunlap, the county's benefits administrator, said the plan had witnessed a nearly 30% drop in claims — and provoked changes in the workplace.

Workers can take free weight-reduction classes and there are now regular competitions betweens departments to see who can lose the most weight.

"When we have birthday parties now," Dunlap said, "people don't want sugar-laced cake and candy; they want fruit and deli trays."

Acknowledging that it could be partially the result of the new deductible, he noted that the county didn't have to raise its insurance premiums this year and probably won't next year.

Critics of the lose-it-or-pay trend say that companies that charge overweight employees more for their medical coverage are turning the healthcare system into a police state and, just as worrisome, are working off of a false assumption that it's easy for people who are obese and have other health issues to change their situations.

According to a 2005 Stanford University study, obese people with health coverage may already be punished on the job. Those surveyed were paid an average of $1.20 less per hour than non-obese workers, perhaps because employers intentionally adjust their wages to account for healthcare costs.

"It's reprehensible to punish and emasculate someone for having a disease like obesity," said Walter Lindstrom, director of the Obesity Law and Advocacy Center in Chula Vista, Calif. "Anyone who penalizes workers for being overweight should brace themselves for a backlash."

Lewis Maltby, president of the National Workrights Institute, a Princeton, N.J.-based employee rights group, called the trend "a very dangerous road that could lead to employers controlling everything we do in our private lives."

"To penalize for things that are beyond some people's control is just wrong," Maltby said. "Some people are fat because that's how God made them."

As the number of obese Americans continues to soar — it's now 1 in 3 — employer healthcare premiums are growing twice as fast as inflation to nearly double their cost at the beginning of the decade. Employers have been struggling with how to hold down costs without offending or pushing away workers.

Sixty-two percent of 135 executives responding to a PricewaterhouseCoopers survey this spring said unhealthy workers such as those who smoke or are obese should pay higher benefit costs, compared with 48% in 2005.

Employers might be motivated by new federal rules.

In January, the Department of Labor implemented final clarifications on the Health Insurance Portability and Accountability Act of 1996 that said employers could use financial incentives in wellness programs to motivate workers to get healthy.

Still, some lawyers say weight-based compensation plans may run afoul of other employment laws.

"A key protection in the Americans with Disabilities Act is that employers can't discriminate against employees based on their health status," said J.D. Piro, a principal at Hewitt Associates' healthcare law group. "This is a fight that's likely going to be dealt with in the courts."

In recent years, companies have offered cash, merchandise and gift cards to those who lose weight or lower their blood pressure. A few have begun refusing to hire — and in some cases have fired — workers who smoke.

The new plans are different because employers are demanding that workers participate in health exams and have their weight checked and blood taken to screen for high cholesterol or blood sugar.

At Clarian, employees' pay will be docked if they fail to meet certain weight-to-height ratios, and cholesterol and blood pressure levels or if they smoke. The cutoffs: a body-mass index over 29.9; blood pressure over 140/90; or LDL cholesterol over 130.

Brittney Manning, 29, a patient advocate at Clarian Health's Methodist Hospital in Indianapolis, said many employees were taken aback when the plan was announced last month. But she approves.

"I think it's fair for people to pay according to what their healthcare costs are," she said. She doesn't expect to have to pay the higher fee because she says her weight is normal.

In Arkansas, Deeann Gutekunst, 42, a Benton County deputy treasurer, said she understood the rationale for the county's policy.

"If you have employees who don't care about their health," she said, "what else are you supposed to do?"

[diana j.]

So the assumption is then, that obese people are that way because they did it themselves....pardon me but that's a load of crap...not everyone is fat because they ate too much......smoking I can understand.......we choose to do that....but eating is more complicated..we need food to live and not everyone understands how to control how much they eat. And some physical problems are more hereditary than weight related. How can a person be penalized for a genetic predisposition? It's just another way for those who control our healthcare to stick it to us.

[Alicia521]

My insurance gives a $5 discount per pay period if you complete a health assessment and get all of your important reasons. It doesn't penalize you for being overweight but does give you focus areas if they apply.

My hubby's insurance has a 2400 deductible. His company will pay up to $2000 of your deductible if you meet certain criteria. Chris has an $800 deductible. He would have a $400 deductible if he wasn't over weight. The other factors are smoking, cholesterol, and BP. I guess it gives you something to strive for but it ticks me off.

[kebsa]

I would prefer the carrot rahter than the big stick approach, if they offered incentives and bonuse to those at ideal wieght or those who are losing weight i would be happier. THe fact that they are charging more to overweight employees is just wrong! many health issues are lifestyle realted and unless they start penalising anyone who has a lifestyle related issue it is discrimination. UNder your Americans with dsabilties act, i ma not sure how they can do this any way, i thought that would protect people who were obese. The other reason i think this is wrong is the fact that many of theinusrance comapnaes make is so hard to get wls, it is really wonrg to penalise a person $30 perpay periods for being overweight but then refusing that same person wls whne they want to remedy the problem. the stats are clear, once we are severely overweight, the chance of permanently losing weight without WLS IS really reduced- and they also should drop the tnedency to support gastric bypass only. they shoul support what ever efforts a person makes to mprove the weight

[SpookyJulz]

I think because of the Americans with disabilities act there will be many law suits due to this. Which in turn will raise the costs of health insurance even more. They are discriminating against overweight people and people with health issues. It's hard enough to have health issues while working without insurances making it more difficult on the person.

I know many many genetically thin people who are some of the most unhealthy people out there. They may be skinny but they have no muscle mass, they don't exercise (because they are skinny) and they eat some of the worst crap on earth. How could the insurances determine who is healthier in those situations.

Plus thin people have MS, Lupus, Arthritis, etc etc too. So, because they are thin they get better insurance premiums?

I went on disability because of my back...which is a congenital problem. The Dr's have downplayed the severity of the situation so much that I was again denied disability. I was terminated from my job because my job is sedintary...I sit all day long. The back issue I had caused horrible pain if I sat for long periods of time. I had back surgery. I have still been treated as if I were faking it.

It makes me angry because it is just another way for insurances and employers to discriminate against overweight people and people with disabilities.

I wonder when they will ever learn that if you treat employees with respect and give incentives rather than penalizing them that they would have less turn over and have employees with better attitudes that way.

[diana j.]

Karen......Julz.....I'm with you both on this, alot of valid points and concerns. somewhere along the line insurance stopped being about people's health and well-being and became more about the bottom line........MONEY!

[rkincaid]

What? Lewis Maltby? MALTBY? Am I related to this guy somehow? lol


I know many many genetically thin people who are some of the most unhealthy people out there. They may be skinny but they have no muscle mass, they don't exercise (because they are skinny) and they eat some of the worst crap on earth. How could the insurances determine who is healthier in those situations.

I comepletely agree.

[Halo]

I see another twist to this as well. Insurance companies are trying to save money? I would imagine that this news may just give individuals the extra push they need to have WLS. I believe this will end up costing the insurance companies more ...

I do believe it is wrong...how can they choose this one thing? How about AIDS and being gay...alcoholics...anoretics...athletes (injuries)...older adults,(Alzheimers)....ADA won't alow it!

[diana j.]

This is such a HOT button issue with me.....when you hear the stats on who can't afford insurance, it's scary. Why should poor people have to do without..... or kids or the elderly? This is supposed to be the greatest country in the world and we let people die everyday because they can't afford the care they need. I see these folks everyday....trying to make a choice between their meds or food. How does this happen and why is it allowed to go on? And now some well-compensated person who works for an insurance company, to come up with ideas to save money (so some fat-cat at the top can make the payment on his Bentley) decides obese people need to be penalized......... for what?.......being people. Aren't we discriminated against enough, don't we have a myriad of issues we must deal with on a daily basis just trying to get our health back?.......They are more part of the problem then part of the solution. The countries with socialized medicine are to be admired.....they care about their citizens!

[kebsa]

if they do penalse obese people on the grounds that they have made bad lifestyle choces, it will increase law suits untl th e ssue gets sorted but honestly, a lot of cancers are partly genetic and aprtly lifestyle, same with cardiac stuff and the lst goes on- if you go not nay hospital you will find a life style compnenet to most patients illness- how would they treat the person who needs a knee replacement, has not be overweight and played a lot of sport ( eg foot ball) would they penalise that person because staying fit reduced the rsk of heart problems but increased the rsik of orthopedic problems- it is ludicrous unless they simply want to aboid paying at all which is quite possible. we are luckier with socialized medicine but the NHS in the uk has started blocking surgery for some situations if they believe there is lifestly issues eg the person who needs a bypass but who is still smokingm i also read that they are severely restricting the number of people who have badn surgery as pbesity is self inflicted. i would not have had my band done back when i did here in south australia. in 2001 hardly any patients had the band done throught he public system, most were like me, those who had private insurance. both health systems are better at waiting unitl a problems exists than supportng a person to make changes to avoid a problem

[Moviejunkie]

Kebsa,
I loved what you said about penalizing us for being fat then making it harder to get wls surgery other than Gastric Bypass. Exactly. We now know that obesity is a disease with so many components. Do people who don't have a weight problem really think we are fat just because we eat too much or that we like being fat? Sometimes I just wish that people without a weight problem could live in my skin for a few days. Believe me, we don't want to be heavy. That is why we are banding together.

[Kim G]

I would bet that the companies wanting to do this don't even have coverage for WLS. This really makes me sick. There is NO way I could have lost a 100 pounds w/o my band and kept it off. I am still considered obese, darn it just a 2 more points and I want be, but I am still obese so what would the cut off be? For real would they have realistic numbers....

How rude is this!

[cathy]

Please forgive me for a slight hi-jack - -and I hope no one takes offense - but I felt that I just had to speak out.

There was a comment made that insinuated that this was that same as penalizing people for being gay because of AIDS. AIDS is *NOT* a "gay disease". In fact, the gay community has been very active in addressing this and the rate of infection in the gay community is declining as the rate of infection in the heterosexual community is growing.

AIDS can, and unfortunately, does infect young, old, rich, poor, gay, straight. It is growing among our young people still - and while there has been progress, there is no solution.

The band plays on..............

I will step off my soapbox and hope I didn't step on toes. But this topic touch my life in a very personal way

[SpookyJulz]

There was a comment made that insinuated that this was that same as penalizing people for being gay because of AIDS. AIDS is *NOT* a "gay disease".

You are right AIDS is not a gay disease....however, insurance companies are narrow minded, as many who have been declined insurance for WLS well know. It would be just like some insurance companies to penalize someone for being gay because they might get AIDS. It's wrong for insurance companies to judge anyones situation. But, they do it anyway.

I was denied a hysterectomy for almost a year because the insurance did not deam it necessary. I was having a nurse come to my home once a month for a demerol shot because of the pain. They would pay for demerol shots but not surgery.

Many insurances will pay for a man to get a vasectomy but they won't pay for a woman's birth control pills.

[kebsa]

Cathy, i think everyboady really does understand that difference and the example was being used as a way of saying just how unreasonable the insuracne companies are- they are so judgemental and itis made even worse because the judgements are made on inaccurate information and assumptions such as AIDS being a gay issue- you are quite correct, AIDS is everybodies issue

[cathy]

Having gone thru the death of my brother due to complications of AIDS and having done volunteer work for an AIDS service organization, I can sadly say that that is not the case. There are still lots of people that believe this is a "gay disease", that it is "God's punishment", that "those people" deserve it.

Please understand - I am not saying that anyone here believes that, or that was the intent, or anything else. I may be hyper-sensitive to these type of comments. But there is still so much misinformation surrounding AIDS - and that misinformation will allow this horrible virus to continue to kill people.

But back on topic more - I don't know that I would say insurance companies are narrow-minded. I would say that they are a business, and a business exists to make money. We would like insurance companies to be altruistic - after all, they are dealing with our health and well-being, something most everyone holds dear. Sometimes you could even say their decisions are a matter of life and death. But at the end of the day, they are a business and they make decisions based on the bottom line.

Don't get me wrong - I am not saying I think that is right or that I like it. But I do think it is realistic and does help to understand some of the asinine decisions and policy they make. You have to understand your enemy before you can conquer them! ;)

[Neets]

I was just getting ready to post this article myself! What a sorry state of affairs this country's health system is in! I think it's outrageous and invasive, BUT...I also understand what they must be dealing with in regard to rising health care costs. Big changes need to happen. BUT...when I look at what CEO's take home every year, not to mention their bonuses and perks etcetera, then I'm furious!