General Question

Pandora's avatar

How will they implement new cost for obese people?

Asked by Pandora (29733points) November 17th, 2011

I was just reading an article about insurances raising the cost for smokers, obese people and people with high blood pressure.
Now heres what I am wondering. Most people carry a little extra weight by a certain age and may be consider obese even if they are healthy. My son for example is solid rock muscle but on a scale he is overweight for his height.
He is extremely healthy and works out. (In his case its not a problem because he is in the military.) But for the average person who has to pay for his insurance and who may seem overweight but really isn’t, what are they to do.
Also not ever person with high blood pressure eats poorly or has it because they are purposely unhealthy. I’ve known thin people with high blood pressure and it just runs in their family.
My point, is this just a scam for raising rates? Will asthmatics be penalized, or people who have a family history of some inherited disease?
I read an article that said that rates will raise up to 2 thousand extra per year for these individuals.
Well going back to the original question. Which was how will they implement this. Not every doctor does an accurate obesity test. Many just look at your weight and your height and that is it. I’ve known skinny people who are unhealthy and overweight who are very healthy. So will it simply come down to what a scale says?

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26 Answers

blueiiznh's avatar

GQ. Many just ask height and weight, while most are requiring medical examination. Although the actual guidelines vary from insurance company to insurance company, most use a patient’s BMI to determine whether or not they are to be considered obese.

Pandora's avatar

Yeah, like for my son, his BMI is 18. He knows this because of the full physical they do to determine what is really his BMI, but if an insurance is only going to require your height and weight, than you are screwed even if you are a healthy and work out every day.

Mat74UK's avatar

By ring fencing fast food outlets and electrically collaring fat folk when they get too close.
But no seriously BMI will definitely come into it and I know people who have had to have full medicals before being accepted for life insurance. The wife had to have one due to her fathers medical history.

Coloma's avatar

It’s the industry, plain and simple. Overweight is an obvious thing, being an alcoholic, drug addict or practicing unsafe sex and being at high risk for STDS is not.

It is what it is and it is too bad that heavy people are penalized. Why not raise the rates for surfers that might be mutilated by shark attacks or someone like me that lives in rattlesnake and cougar country.

It’s all part of the racket, classic exploitation.

marinelife's avatar

I think it’s very problematical and it borders on penalizing those who are sick. I expect it to be challenged in the courts.

john65pennington's avatar

I understand your thinking on people that may be obese, because of muscle mass and not fat.

The only way the insurances companies can make this determination is to give a physical to each of their customers.

A blanket monetary raise in insurance premiums, would raise serious questions and possible lawsuits without just cause.

In the police training academy, a persons weight is measure by an instrument to tell the difference between fat and muscle. There is a difference.

Like I have said many times before, it’s all about the money and not the health of the people they insure.

gondwanalon's avatar

There are so many problems with this that I doubt that it will ever be implemented. I know two people (a swimmer and a cyclist) who exercise daily and are over fat but strong as dynamos. They are very physically fit and healthy. Also I know of a very thin secretary who doesn’t exercise and yet she has 50% body fat (measured in a water tank). Now that is sick!

Aethelflaed's avatar

@Coloma Being overweight is not a simple thing. BMI calculations are a shortcut, and have no real bearing on how healthy you are. Being overweight does not automatically make someone unhealthy, or even unfit.

Mariah's avatar

It’s all about statistics….people outside of a certain range of BMIs are statistically more likely to cost insurance companies lots of money because disease is statistically more common among them. They don’t care about individual situations.

This is easy, but it isn’t right.

I have a lot of issues with the way insurance is done. Discrimination against people because of “preexisting conditions” (often the people who need insurance the most) disgusts me.

john65pennington's avatar

Mariah, your answer fits my daughter to a T. She has lupus and no one will insure her.

LuckyGuy's avatar

@Pandora A BMI of 18 is great! That is not a problem. Sure there is some variation but when you get to the morbidly obese categories, there is no question. Our weight is actually something we can and should control. If someone weighs 400 pounds should we pay for his worn out hips and knees? Where would you draw the line? Wherever it is there will be arguments but it is clear something has to change. We can’t afford it any more.
I’d make annual physicals mandatory and if you are morbidly obese your weight has to be X pounds lower than the previous year or your insurance rates will go up. That way the patient has control.
Unpopular, I know but, please, someone offer another suggestion.

Coloma's avatar

I didn’t intend to send the message that being overweight is always related to health issues, but, there is an undeniable connection to heart disease, diabetes and other illnesses of the extremly overweight.

10 to 30–40 lbs. is “normal”, modest to moderately overweight but 50+ is risky, can’t deny that.

I don’t agree with discriminating against anyone and I do agree that one can be moderately overweight and healthy.

LuckyGuy's avatar

@Coloma You said “10 to 30–40 lbs. is “normal”, modest to moderately overweight but 50+ is risky, can’t deny that.” And 100+ pounds is suicidal.
We can’t afford to pay for it any more.

Pandora's avatar

@worriedguy I know 18 is a fantastic BMI but the military determines fat differently than your normal family doctor. They don’t just go by weight and height. By just weight and height he is 20 lbs over the normal but the test performed determine how much of that weight is muscle and how much is fat.
I am short. If I just go from 125lbs (with an average bmi of 24 for a woman) to 145, then my bmi is 30% which puts me in the obese catagory. The moment I go over 126 lbs I am considered overweight. I work out a lot so I usually weigh between 130 to 128 which puts me in the overweight catagory. As I am aging I am finding it harder to keep my weight on the lower end. I haven’t changed my diet much except to make it healthier.
Anyhow my point is that 20 lbs can easily put someone into an obese catagory.
I do agree that if you are 50 plus pounds in general that you really do put yourself in danger.
I do also like your idea of rewarding people for lowering their weight with lower premiums as it continues. We car insurance. The same should happen with health insurance. Then at least you feel you have some control over what you pay. But not all obesity comes from overeating. Sometimes there are other health issues that can be overlooked and if you can’t afford the insurance than chances are you will never find out the real cause. I remember a story of a woman who went to a bunch of different doctors because she kept putting on weight. They all said it was in her head and she just needed to diet and exercise. She tried for several years and still continued to gain weight. I don’t remember the cause of her weight but one doctor decided to thoroughly check her out and found the source. She was treated properly and started to lose weight without trying. I want to say it as something to do with her pituritary gland. I think she had a tumor on it or something.
My point is that doctors often dont’ help and dismiss overweight patients and now so is health insurance.

JLeslie's avatar

Obese is different than overweight. I have a feeling even very muscular men are not obese on a scale. I’m not sure of course, just guessing. Most of the body builders I know have all sorts of whacky numbers in their bloodwork, hight cholesterol and horrible cholesterol ratios being one of them. But, that is a generalization and statistical thing also, so of course it is not true for all very muscular people.

My girlfriend is a weight watchers instructor, and one day she looked up my normal range according to their charts, and their high side of normal I would feel very fat. But, I don’t have a ton of muscle either.

My husband’s company gives a discount to non-smokers. They also have a program where they earn money for exercising.

Personally I am against the direction this is all going. My cholesterol is high, and that might be the next thing they pick on. Probably all of us have something.

LuckyGuy's avatar

A friend of mine works at a large company that pays for most of their employee health care premiums. They just instituted a voluntary program that includes regular weigh-ins at the office. (The place is 90+% male, by the way.)
Employees will get a $30 per month reduction in their monthly health care contribution if they lose 10 pounds in 6 months and keep it off for the remaining 6 months. Interesting.

I don’t know if “thin” people are complaining. ;-)

Pandora's avatar

All I know is insurances are covering less as it is and people are paying higher premium and its getting to the point where people don’t even go to the doctor because they don’t have the time to go.

LuckyGuy's avatar

@Pandora His company is doing the weigh-ins 30 minutes before normal start time. Also, people are encouraged to walk during lunch. Eat , and take a lap around the building. They are is located in a state well below the Mason Dixon Line where it is a bit warmer than here. (We have snow today.)

JLeslie's avatar

My husband’s company use pedometers, and the employees upload the information onto a website that tracks it.

plethora's avatar

@Mariah FYI, the pre-existing condition issue is an actuarial issue, not a discrimination issue. If the company has to provide coverage for pre-existing conditions, they can easily do so without it costing them a dime. But it will cost you and me. If there are ten of us in the group and nine of us are healthy, but one has cancer, the nine healthy people will pay the cost of insuring the one with cancer. Or the company can exclude the person with the pre-existing cancer and the rest of us will have lower premiums.

JLeslie's avatar

@plethora That is the whole point of being part of a group and of insurance. When the one person gets the bad luck, the funds in the kitty from the group is what pays for it. Insurance is for the fluke bad thing happening, and people who participate in the insurance decide it is worth paying even if the individual never use it, just in case they do need it in the future. You are thinking of health insurance on the see a doctor once a year level. The most important part of insurance is catastrophic coverage. Coverage for hospital stays, and severe illness.

Health insurance for seeing a doctor when your “sick” or for some standard blood tests is usually a wash, or many times we have overpaid greatly. It would be much cheaper for me to pay out of pocket for all my doctor appointments, and I go to a few specialists, and have regular blood tests. The thing is if I get cancer or a severe illness, then I would be screwed fnancially.

plethora's avatar

@JLeslie I’m not following you.

I was trying to make the point that no matter what kind of health insurance you have, excluding coverage for conditions that are already in existence at the time the coverage goes into place lowers the cost of insurance for the rest of the group (the “group” being the entire population of policy holders). It has nothing to do with discrimination per @Mariah ‘s comment. Pre-existing conditions can be included, but it has a huge effect on the cost to everyone.

The thing is if I get cancer or a severe illness, then I would be screwed fnancially. If you buy the insurance before you show signs of cancer or a severe illness, that is not a pre-existing condition, and the policy pays.

Am I on the same page with you?

JLeslie's avatar

@plethora We are on the same page, but here is my problem with that system. I could pay for 20 years into a policy with BCBS. During the time I get cancer. During my cancer my company closes, no COBRA available. Every penny I paid for the last 20 years means nothing when I need to start a new policy, and God forbid I have a pre existing condition. If it is socialized, if we are all in the same big group, then every penny we have ever paid in counts. Even if I have BCBS while working at Macy’s, if I want to get off my feet and and work in an office instead at an accounting form, and they also have BCBS, it doesn’t matter BCBS sees me as starting all over. So, even if we do not use the very extreme example of socialized health care, and just go to people having insurance onntheir own, rather than tied to a work group I would be happier. Changing jobs should not mean we lose our insurance, it makes us slaves to the job. If we had private insurance not tied to a job it would be better and more competitive. No matter what we can be considered part of a “group” because no matter what BCBS will have a certain number of people in a paricular plan.

I am not picking on Blue Cross Blue Sheild in particular, just using as an example.

Mariah's avatar

@plethora I’m not certain I’m following you exactly. Here is my understanding of how insurance applies to somebody with a chronic health problem: yes, they can get it covered, but only if they already have insurance when the problem arises, and if their insurance ever lapses for any reason (which is entirely likely because severe illness doesn’t conform to your schedule and being able to work isn’t always a given), they will no longer be able to get their disease covered because it is now a “preexisting condition.” So now they are stuck with possibly hundreds of thousands of dollar per year out of pocket health expenses, all due to the fact that they were unlucky and got a disease they didn’t ask for. I don’t know if it’s exactly “discrimination” per se (although it looks that way to me), but I sure as hell know it isn’t right.

I believe that one person’s life is worth more than a percentage of nine people’s wealth.

JLeslie's avatar

To add, it is not just 9 people paying for the one, it is about there but for the grace of God go I. When it is you in the situation as the sick person, what do you want the rule to be?

plethora's avatar

@JLeslie @Mariah I agree with you both. It’s not discrimination, but I agree that a workable system does not put people in the position of losing coverage due to job change or other reason. That issue can be resolved in a private system if that’s what we want. I’m for it.

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