Friday, August 29, 2008
It's only NUMBERS
OK - I am really pissed! Suzanne just sparked a big arugument in our area by sending us this article. How is it that a state government can charge more money for someone's health insurance by checking ONE NUMBER!? So - of course we all did our BMIs. I am 36.1 MORBIDLY obese. Suzanne is 26 - Overweight. But - Suzanne has high cholesterol, high blood pressure, and she carries her weight in her waist and is 10 years older than me. I have no health issues, but because I have a higher BMI I would get charged $25 a month more for my health insurance. How does that make ANY sense? How can the cost of health insurance be determined by one number? And one number that when it comes down to it discounts a WHOLE lot of other factors!? This really upsets me. It is like Gattica is really coming to pass. The article says that people will be screened for other health issues - but in that case why do the BMI at all. Are they only going screen the fat people? Skinny people can get as sick as they want?
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3 comments:
Did you read the article? They're not checking one number--they're checking multiple numbers. Suzanne would get dinged too--they will screen for blood pressure, cholesterol and glucose as well as obesity. And then anyone who tests badly in one or more of these areas will have a year to make improvements before the $25 charge kicks in. The article doesn't have enough detail to know how much you have to improve BY to avoid the extra charge. It does seem back-asswards, though, since punitive approaches to changing behavior never work as well as rewarding good behavior, as the other states cited in the article do. They'd do better to charge everyone the $25, but waive that for people participating in fitness and wellness programs. But I can see why Alabama wants to do something about this--they have the third highest obesity rate in the country and I'm sure they are looking at their long term projections for health care costs and have decided they need to do SOMETHING to reduce the costs. And like it or not, all insurance costs are driven not by individual risk but group risk. I might be the best driver in the world, but my rates are based on what all the 39 year old females are up to. It's the same thing with health care--Connor is the worst health care risk in the world, but his rates aren't based on him but on the risk of all 7 year old boys. And while you might be able to be super healthy while obese, that's not the norm across the larger group of people who are obese.
Yes I read it - which is why I said why look at the BMI at all - it is just one number and not particularly indicative of overall good or poor health. It is like pinpointing any OTHER one number factor - such as age. Older people are more likely to get sick, why don't we raise THEIR rates?
But ALL of those things are just numbers. Having high blood pressure doesn't mean you're unhealthy--it just raises your risk of heart attack and stroke. It doesn't mean you WILL have a heart attack or stroke. Same thing with glucose and cholesterol, and same thing with obesity. They are all just indicators of risk, and all perfectly legitimate indicators of risk, just like being a smoker doesn't mean that you WILL get cancer, just that you have a higher risk of cancer. I assumed you hadn't read the article because you said they were going to charge more for health insurance based on ONE NUMBER, and that you would have to pay based on your BMI but Suzanne wouldn't even though she has these other problems. But she would have to pay the higher rate too--you are both risky from an insurance standpoint.
They do charge more based on your age, or rather, the group rates are higher when the group contains a higher than average number of older people, and everyone ends up paying for that. But they can't charge the older people more because that's illegal. Instead, they do things like leveraged buyouts and early retirement bonuses to get the older people out of the employee base. Older workers are expensive--they have higher salaries and longer vacation time and higher health insurance costs. But you can't discriminate based on age (and, after all, it's not like someone can DO something about getting older) so they can't single out the older workers and charge them more.
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