Personal responsibility in health care?
The LA Times Health Blog is reporting on exactly what this country needs. I say it should be instituted for Medicare and Medicaid as well. Over at the NYT, it looks like our federal government may just codify healthy behaviors with tax credits to employers. What a fantastic idea. What is this magic button? Skin in the game. Why? Because people respond to money. In this example, United Health Care can save you a lot of money.
Wow. A family of four deductible being reduced from $5,000 to $1,000 doing nothing more than practicing healthy lifestyles? That's exactly what this country needs.
Would you consider this discrimination to charge families who meet healthy lifestyle goals less than families that don't? I say it's no different than employers (who pay for the premiums) paying smokers less than their non smoking employees, and yet I get trashed for suggesting such a ghastly thing. If you cost your employer less because you practice healthy lifestyles, you should expect to see some benefit. And a lower deductible is an excellent benefit and market solution to having skin in the game. If you don't want to exercise feel free to pay $5,000 a year in deductibles. The ball is in your court. It's nobodies decision but your own whether you want to reduce your contribution to $1,000 a year. And make it affordable for you and your family.
What do the critics say?
You'd have to be a moron to believe that. If the employer is paying for their health care, they have every right to pry. If you don't like it, don't accept the insurance.
Codifying benefits for healthy habits takes FREE=MORE and turns it into FREE=LESS
Problem that I see here is this:
ReplyDeleteTo the best of my knowledge, there is no known correlation between BMI and longevity. And I've seen well documented studies with same result between cholesterol and longevity. If we are going to reward (or punish) on the basis of lab tests, we better be very sure that we are using valid correlations.
I see a few potential problems with the implementation, though I agree in principle. I do think insurance should be based on risk assessment, like car insurance (more tickets= higher premiums). Looking at my own family, I can say that this tactic would be a losing proposition for the insurer. We are all within our BMI, my spouse and I have never smoked, have good bp (normal to low), exercise, etc. Yet my son is on a specialty pharma drug that costs more than our premiums by about 10K/yr, and I have MDD which has probably cost the insurance company more than our premiums. Bear in mind, I have maintained insurance over a period of almost 20 yrs already, so I'm sure there were some years where we didn't cost as much as the premium. But, how would this play out with insurers/employers? I really think my MDD has cost more than my father's obesity and comorbid diabetes and htn, but the discrimination would be significantly greater for the MDD if this were part of the work place knowledge, even though I have always managed to perform at a decent level even when seriously depressed. Discrimination is much greater for mental illness than for physical illness. Should employers be aware of those illness as well?
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