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  #1   ^
Old Mon, Oct-31-11, 12:08
Demi's Avatar
Demi Demi is offline
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Plan: LCHF/IF
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Default Firms to charge smokers, obese more for healthcare

Quote:
From Reuters
October 31, 2011

Firms to charge smokers, obese more for healthcare

Like a lot of companies, Veridian Credit Union wants its employees to be healthier. In January, the Waterloo, Iowa-company rolled out a wellness program and voluntary screenings.

It also gave workers a mandate - quit smoking, curb obesity, or you'll be paying higher healthcare costs in 2013. It doesn't yet know by how much, but one thing's for certain - the unhealthy will pay more.

The credit union, which has more than 500 employees, is not alone.

In recent years, a growing number of companies have been encouraging workers to voluntarily improve their health to control escalating insurance costs. And while workers mostly like to see an employer offer smoking cessation classes and weight loss programs, too few are signing up or showing signs of improvement.

So now more employers are trying a different strategy - they're replacing the carrot with a stick and raising costs for workers who can't seem to lower their cholesterol or tackle obesity. They're also coming down hard on smokers. For example, discount store giant Wal-Mart (WMT.N) says that starting in 2012 it will charge tobacco users higher premiums but also offer free smoking cessation programs.

Tobacco users consume about 25 percent more healthcare services than non-tobacco users, says Greg Rossiter, a spokesman for Wal-Mart, which insures more than 1 million people, including family members. "The decisions aren't easy, but we need to balance costs and provide quality coverage."

For decades, workers - especially with large employers - have taken many health benefits for granted and until the past few years hardly noticed the price increases.

<For graphic of costs see: r.reuters.com/vyf74s>

But the new policies could not only badly dent their take home pay and benefits but also reduce their freedom to behave as they want outside of work and make them resentful toward their employers. There are also fears the trend will hurt the lower-paid hardest as health costs can eat up a bigger slice of their disposable income and because they may not have much access to gyms and fresh food in their neighborhoods.

"It's not inherently wrong to hold people responsible," says Lewis Maltby, president of the National Workrights Institute, a research and advocacy organization on employment issues based in Princeton, New Jersey. "But it's a dangerous precedent," he says. "Everything you do in your personal private life affects your health."

Overall, the use of penalties is expected to climb in 2012 to almost 40 percent of large and mid-sized companies, up from 19 percent this year and only 8 percent in 2009, according to an October survey by consulting firm Towers Watson and the National Business Group on Health. The penalties include higher premiums and deductibles for individuals who failed to participate in health management activities as well as those who engaged in risky health behaviors such as smoking.

"Nothing else has worked to control health trends," says LuAnn Heinen, vice president of the National Business Group on Health, which represents large employers on health and benefits issues. "A financial incentive reduces that procrastination."

LACK OF JOBS

The weak economy is contributing to the change. Employers face higher health care costs - in part - because they're hiring fewer younger healthy workers and losing fewer more sickly senior employees.

The poor job market also means employers don't have to be as generous with these benefits to compete. They now expect workers to contribute to the solution just as they would to a 401(k) retirement plan, says Jim Winkler, a managing principal at consulting firm Aon Hewitt's health and benefits practice. "You're going to face consequences based on whether you've achieved or not," he says.

And those that don't are more likely to be punished. An Aon Hewitt survey released in June found that almost half of employers expect by 2016 to have programs that penalize workers "for not achieving specific health outcomes" such as lowering their weight, up from 10 percent in 2011

The programs have until now met little resistance in the courts. The 1996 Health Insurance Portability and Accountability Act (HIPAA) prevents workers from being discriminated against on the basis of health if they're in a group health insurance plan. But HIPAA also allows employers to offer wellness programs and to offer incentives of up to 20 percent of the cost for participation.

President Barack Obama's big health care reform, the 2010 Patient Protection and Affordable Care Act, will enable employers beginning in 2014 to bump that difference in premiums to 30 percent and potentially up to 50 percent.

Employers do, however, also need to provide an alternative for workers who can't meet the goals. That could include producing a doctor's note to say it is medically very difficult, or even impossible, to achieve certain goals, says Timothy Jost, a professor at the Washington and Lee School of Law. For example, a worker with asthma may not be able to participate in a company exercise program.

These wellness programs typically include a health risk assessment completed online, and on-site free medical screenings for things such as blood pressure, body mass index, and cholesterol.

The programs, while voluntary, often typically offer financial benefits - including lower insurance premiums, gift cards and employer contributions to health savings accounts. For example, workers at the railroad company Union Pacific (UNP.N) get $100 in their health savings account for completing the health assessment, $100 if they don't use tobacco and $100 if they get an annual physical (tobacco users also can get the $100 if they participate in a tobacco cessation program).

INCENTIVE TO EXERCISE

Like Wal-Mart, more employers are coming down harder on individuals who have voluntarily identified themselves as tobacco users, often during their health risk assessment. As yet, very few employers identify smokers through on-site medical screenings.

Veridian, which until now has not charged its employees for healthcare premiums, says increases to its health care costs have been unsustainable, climbing 9 percent annually for the past three years. Earlier this year, it rolled out a wellness program and free screenings, which 90 percent of workers have now completed.

As it starts charging, it will provide discounts to those making progress as it "wants to reward those who have healthy lifestyles," says Renee Christoffer, senior vice president of administration for the credit union.

Mark Koppedryer, vice president of branches at Veridian, was one of the workers who participated in the screenings. The 37-year-old father of three initially participated to show his support but was shocked to find out that he had elevated blood pressure and cholesterol scores.

His colleague, Stacy Phillips, says she used the new wellness programs to exercise more. "I knew there needed to be a change in my life," says the 35-year-old, who has lost 40 pounds since January. "This made me more aware that at some time there would be a cost."

These changes come at a time when health insurance premiums are soaring. In 2011, the average-cost of an employer-provided family plan was more than $15,000, according to a survey by the Kaiser Family Foundation and the Health Research and Educational Trust. That's 31 percent higher than five years ago. And the number is expected to climb another 5-8 percent next year, according to various estimates.

In contrast, the giant medical and research center Cleveland Clinic, which employs about 40,000 people, has seen these costs grow by only 2 percent this year because it has implemented a comprehensive wellness program that has dramatically improved the health of many workers.

The effort began several years when it banned smoking at the medical center and then refused to hire smokers. It later recognized that having a gym and weight loss classes wasn't enough to get people to participate. It made these facilities and programs free and provided lower premiums to workers who maintained their health or improved it, typically with their doctor's help.

"You don't do this overnight," says Paul Terpeluk, Medical Director of Occupational Health at the Cleveland Clinic. You have to develop a program and change the culture, he said.

INTRUSIVE

But not all programs are as well constructed and effective, says Mark A. Rothstein, a lawyer and professor at the University of Louisville School of Medicine. The wellness programs may be well-intentioned, he says, but there's not strong empirical evidence that they work and getting a weekly call about your weight or smoking habits, which is offered by some programs, could be humiliating for participants.

"What might be seen as a question to one person may be an intrusion to another," he says. That's one reason that lower-paid janitors at his school participate but, "the professors on campus consider it a privacy tax so we don't get some stranger calling us about how much we weigh."

And there are also those that no matter how much they exercise or how healthy they eat can't lose weight or lower their blood pressure or body mass index. "There are thousands and thousands of people whose paycheck is being cut because of factors beyond their control," says Maltby from the National Workrights Institute.

The programs could be especially burdensome for low-income workers, who are more likely to fail health assessment tests and less likely to have access to gyms and healthier fresh produce, says Harald Schmidt - a research associate at the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania.

"We want to use provisions to help people and not penalize people for factors beyond their control," Schmidt says. "Poorer people are often less healthy and this constitutes a potential double whammy. They are likely to face a higher burden in insurance premiums."

That's the case for Barbara Collins, a 35-year-old Wal-Mart employee - who lives in Placerville , California. She says she'll have to pay $127 every two weeks for health insurance next year, including a penalty of almost $25 because she's a smoker.

"I'll cut back on cigarettes and hopefully eventually quit," says Collins, who earned $19,000 pretax, or about $730 every two weeks, last year. "Christmas will definitely be tight this year and for years to come if this lasts," she says. "Family vacations, there's no way I can afford that.".
http://www.reuters.com/article/2011...E79U3CB20111031
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  #2   ^
Old Mon, Oct-31-11, 12:31
Seejay's Avatar
Seejay Seejay is offline
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Just another way to reduce compensation for the workers. Sigh. A particularly ugly one too. No tax for the skinny fat! you can't see it or smell it

I wonder if it would be an actionable cause for an employment lawyer - under the heading of discriminatory compensation practices.
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  #3   ^
Old Mon, Oct-31-11, 12:51
sprinkles's Avatar
sprinkles sprinkles is offline
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Default

Quote:
Originally Posted by Seejay
I wonder if it would be an actionable cause for an employment lawyer - under the heading of discriminatory compensation practices.


Unfortunately, I don't think the "obese" are a protected group. Ins. laws vary state to state...we just had an uprising at work because our insurance company doesn't cover non-hormonal birth control for women, even if it is clinically not an option for some of them...leaving a good portion of the workforce uncovered. This sh*t is rampant.
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  #4   ^
Old Mon, Oct-31-11, 13:16
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kvcooks kvcooks is offline
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Doesn't sound like a such bad idea to me. I've had to pay for my own health insurance for the past 3 years, but when I was working, the smokers took many more sick days and certainly had more health problems- the 2 seriously obese folks had gout and hypertension.

I'm a healthy, non-smoker, non-drinker with occasional migraines. Don't take any daily meds, do take supplements. I was turned down by one company, accepted by another without coverage for migraines, and got insured with Aetna, which has increased my premium by 20% each year. It's such a disgusting racket, but I'm afraid to be without insurance.
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  #5   ^
Old Mon, Oct-31-11, 13:27
Seejay's Avatar
Seejay Seejay is offline
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Why not just charge more for the people who cost more, then? Like drivers who have had a zillion accidents and tickets. That way we could pick on the skinny unhealthy who take lifestyle medicines at great cost to society instead of changing lifestyle. (I am referring to the drug industry's category of "lifestyle drugs" - treating symptoms)
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  #6   ^
Old Mon, Oct-31-11, 13:56
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Merpig Merpig is offline
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Plan: IF/Fung IDM/Potato Hack?
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Default

Quote:
"I'll cut back on cigarettes and hopefully eventually quit," says Collins, who earned $19,000 pretax, or about $730 every two weeks, last year. "Christmas will definitely be tight this year and for years to come if this lasts," she says. "Family vacations, there's no way I can afford that.".
Hmm, I'm not saying I agree with this policy. But I have to admit, when I read the above the first thing that popped into my head was: "Well if you gave up smoking how much money would you be able to save for Christmas and family vacations?"

But I agree with Seejay, why limit to smokers and obese? How about drinkers? People who engage in risky sports and other activities? There's no end.

Then again, people can lie to their employers about their engaging in many such activties, but being obese is hard to hide.
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  #7   ^
Old Mon, Oct-31-11, 18:14
liddie01's Avatar
liddie01 liddie01 is offline
Butter is Better!
Posts: 5,894
 
Plan: Atkins OWL
Stats: 234/220.4/160 Female 5"8.5"
BF:its back again!
Progress: 18%
Location: Mount Carmel, Pa.
Default

Smokers at my company already pay more for insurance, although if they try the smoking cessation program their rates go back down. So far we don't get higher rates for our weight, but I can see it coming. we do have a small gym on site, but they always push the 5 servings of fruit and veggies and healthy whole grains stuff that does not work for me as far at diet goes.
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  #8   ^
Old Mon, Oct-31-11, 20:28
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LAwoman75 LAwoman75 is offline
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Plan: Whole food, semi low carb
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With my private health insurance policy, smokers already pay a higher premium. It's the same with our life insurance policy.
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  #9   ^
Old Tue, Nov-01-11, 13:50
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aj_cohn aj_cohn is offline
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Plan: Protein Power
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Location: United States
Default

It's likely that health insurers will include the total cholesterol number and BMI as part of their screening criteria for health. Total cholesterol is a completely irrelevant measure, as discussed in many places on this forum. BMI is also useless as a health measure.

So, unless these health plans are going to use screening criteria that actually mean something hip:waist ratios, % of BF (by dunk tank or "bod pod," direct measurement of LDL including subtypes, triglycerides, HbA1C, etc. as well as behavioral criteria (smoking, skydiving, rock climbing, driving record), I'd sue any employer who tried to use those meaningless health criteria at my workplace.
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  #10   ^
Old Tue, Nov-01-11, 14:58
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fire_dancr fire_dancr is offline
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Plan: Atkins
Stats: 266/222/166 Female 65 inches
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They are doing that at are work with smoking. You have to pay an extra 14 bucks a paycheck if you smoke. They won't even hire smokers after January this year. But they won't do the obese tax because everyone in HR is obese.
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  #11   ^
Old Tue, Nov-01-11, 18:15
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rightnow rightnow is offline
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Plan: ~VLC/~dirty primal
Stats: 520/361/350 Female 66 inches
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Progress: 94%
Location: Ozarks USA
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I am willing to pay more for airplane rights for being super obese. On the airplane, it is a very cut-and-dry question of the fact that I take up more room, and more weight, in an environment where both are at a premium.

Concerning medical stuff, aside from being ridiculously fat, it is kind of pathetic that I'm one of the healthiest people I know. In my extended family, me and one of my cousins are literally the ONLY people over the age of about 27 who are not on daily prescription drugs -- often several; who have not already lost at least one body organ; etc. Am I healthy? Probably not, given likely thyroid issues and massive weight.

Am I costing my health insurance more than my thinner coworkers? Definitely not. I just had my first full day off work in 330 days (I kid you not, and that includes weekends) today. At all times I carry a full sick bank, I seldom take personal floating holidays and I chronically lose vacation as it doesn't accrue when you are 'full' up with it. Meanwhile I have coworkers whose reasons for medical attention seem utterly endless (some for perfectly healthy reasons such as childbirth, many for depression, or the typical losing-gallbladders-etc. issues). I even have a child covered, and in the last year we've had almost nothing -- I think one flu and yesterday, a tetanus shot.

So my only gripe is that this is about gradual control and marketing, not about reality. Why not bill people based on what they actually cost the previous year/s?

Now, since obesity is a likely side-effect "when genetically allowed" of every disease--being a part of the immune system--that would have a massive increase to the money they make given now well over half the population is technically overweight.

So what we are really billing people for is genetics and age. If you are 25 and asian, it's probably going to go ok for you, but if you are 45 and German possibly not so well, and if you are any age and native American, you're completely screwed. To me the genetic relationship to whether people store fat or how much before simply developing a full-blown disease, is kind of disturbing.

PJ
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  #12   ^
Old Tue, Nov-01-11, 20:24
gonwtwindo's Avatar
gonwtwindo gonwtwindo is offline
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Plan: General Low Carb
Stats: 164/162.6/151 Female 5'3"
BF:Sure is
Progress: 11%
Location: SoCal
Default

Quote:
"I'll cut back on cigarettes and hopefully eventually quit," says Collins, who earned $19,000 pretax, or about $730 every two weeks, last year. "Christmas will definitely be tight this year and for years to come if this lasts," she says. "Family vacations, there's no way I can afford that."


I don't get this thinking. How much is a pack of cigarettes these days? If she quits, wouldn't that not only stop the increase in insurance payments, but leave extra money each month? That could be saved for a vacation.

I just don't get it. I realize it is challenging, but my mother quit cold turkey and my ex quit with the help of Chantix. It can be done.
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  #13   ^
Old Tue, Nov-01-11, 21:20
heirloom10 heirloom10 is offline
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Plan: Kwasniewski
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that shit is insaneeee.
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  #14   ^
Old Tue, Nov-01-11, 22:49
gonwtwindo's Avatar
gonwtwindo gonwtwindo is offline
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Posts: 6,653
 
Plan: General Low Carb
Stats: 164/162.6/151 Female 5'3"
BF:Sure is
Progress: 11%
Location: SoCal
Default

Oops, Merpig, I didn't see your post before I wrote mine! Well, looks like we are on the same page...
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  #15   ^
Old Tue, Nov-01-11, 23:13
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cakepro cakepro is offline
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Posts: 341
 
Plan: NANY
Stats: 330/281/170 Female 64.5 inches
BF:Mostly Fried Foods
Progress: 31%
Location: Houston
Default

From time to time when I'm spacing out in a long line at the grocery store, I'll notice the prices on cigarettes and it just boggles my mind that people pay 7 freaking bucks for a pack of smokes.

Too bad Ramen noodles are like 25 cents a pack. In general, I am not in favor of the ever-invasive government butting further into our lives but I do like the fat tax that's been implemented in some places. However, on the flip side of that coin, if the idiots who create the food pyramid were lobbying for increased taxation on foods they view as bad, we'd be paying $25 per pound of butter and empty, sugar-laden breakfast cereal would be as cheap as Ramen noodles.
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