<p>Unprotected sex? That’ll cost you extra. Each and every time.</p>
<p>Are you a homosexual man? HIV. Not paying for it.</p>
<p>How do you guys not see where this is headed?</p>
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<p>Do you think this would work? I might be in favor of charging the obese more* if I had reason to believe it would change their behavior, but I’m dubious that the charge would have any effect. Obese people right now face enormous societal pressure to lose weight, and obesity is already costing them money, yet they don’t lose weight. I’m skeptical that more surcharges would have any effect.</p>
<p>I’m even more skeptical about addiction. I don’t see addictive behavior as a forward-looking, planning behavior, do you? When an alcoholic is about to dive into the bottle, I don’t see him being stopped by the thought that he might have higher insurance premiums next year. He needs an incentive that’s much more short-term than six months from now, and even then… Alcoholism is so obviously self-destructive, and yet people are still alcoholics. </p>
<p>Incentives like this work on the margin, if they work at all. But I don’t see this as working at all. Which makes it merely self-righteous.</p>
<ul>
<li>Presuming we could accurately detect obesity. I suppose some people would have to have body fat tests to demonstrate they weren’t obese.</li>
</ul>
<p>“Unprotected sex? That’ll cost you extra.”
:)</p>
<p>We are going to have to install cameras. </p>
<p>Might be a way to get people to lose weight.</p>
<p>Dropping out of high school? Not going to college? Dating losers? Being late to work?</p>
<p>"* Presuming we could accurately detect obesity. I suppose some people would have to have body fat tests to demonstrate they weren’t obese."</p>
<p>That would cost money…</p>
<p>I am not paying… :)</p>
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<p>I think having Green Eyeshade control costs is going to be a very blunt instrument verses the customer who has maximum knowledge of what they value. From the objective measure Cedars is an A rated facility with the best doctors and high patient sat. Green Eyeshade cant cut them out of the network because so many people who are shopping for a policy are going to want them. Further the insurance company cant really tell that you dont care about the possibility of a scar on the back of your knee if it saves $4500. The insurance company cant make a blanket rule that covers a 45yo and a 14 year old girl who might care deeply about a visible scar on her neck. At least not with out ticking of the consumers who then complain about “the lousy insurance company that wont cover anything”. Much easier to approve and then bump the rates next year. </p>
<p>I am a great believer in just telling people whats important to you and asking experts for their advice. My mother had been in the hospital for a few days and experienced all kind of issues with the nursing care. It was obvious to me that there were issues with the staffing level and with the skill levels and the hospital was content to handle things by adding an overlay of managerial ‘expediting’ of problems. Not really satisfactory. I took her to her hematologist later in the week and brought up the issues we experienced. He had permissions in most hospitals in town and knew what we were talking about with issues in the nursing care and was able to tell us two places where we wouldnt have that problem at. </p>
<p>Doctors know about what the options are like from the inside. Just ask them is my tactic.</p>
<p>Oh great, my worthless gym declared my body fat test showed I was borderline obese
(at 5’5" and 128 lbs), supposedly due to fat around my liver. A few too many glasses of red wine, perhaps. Maybe we can have the grocery stores monitor how much alcohol we buy, transmit it to the IRS, and they can charge us accordingly for our health care plan.</p>
<p>[Diabetes</a> in Asians & Asian Americans | ASIAN AMERICAN DIABETES INITIATIVE](<a href=“http://aadi.joslin.org/content/diabetes-asians-asian-americans]Diabetes”>http://aadi.joslin.org/content/diabetes-asians-asian-americans)</p>
<p>Despite having a lower body weight Asian Americans are more likely to have type 2 diabetes than Caucasians.</p>
<p>Pony up.</p>
<p>Bus driver…Since all our purchases are scanned already I am sure that’s not too far away. It is frightening.</p>
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<p>That’s the problem. The customer might have maximum knowledge of what they value (though Google “revealed preference” to discover that we create preferences on the fly rather than accessing them), but the customer has minimum knowledge of the consequences of their treatment decisions, because health care is complicated. I’m in the doctor’s office, eight months pregnant, with septic arthritis. I’ve never even heard of septic arthritis, but I’ve got it. I’m in no position to evaluate which hospital to go to.</p>
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<p>Why do we act like this isnt going to happen?</p>
<p>Step 1: everyone into the risk pool- no exceptions
Step 2: hey your lifestyle is driving up our rates
Step 3: Put down that soda, Fatty. Pick up the Strawberry Acai Berry Blast with active Hemp Cultures and 36 grams of carbs</p>
<p>When do-gooders start fixing society for its own good where do they stop?</p>
<p>Yeah sax, but the Asians may look good naked. </p>
<p>I am willing to sacrifice my time and check out women who may be borderline obese. </p>
<p>I may discriminate based on age. The elderly have to keep their clothes on… Sorry</p>
<p>I am not necessarily saying we should attempt to distinguish every bad behavior, but I am pointing out some of the problems having healthy people pay way more for all the unhealthy people. I can even rationalize paying more but don’t cancel my insurance and create chaos for me all in the name of treating all people exactly the same even when it is evident not all people are the same or have identical circumstances.</p>
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<p>Health-wise, visceral fat (like fat around your liver) is way worse than other fat (like fat thighs and a fat butt). You can be “normal” weight but still have dangerous visceral fat.</p>
<p>(And I’m not willing to up your health insurance premiums for it.)</p>
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<p>Tell them get bent
“But 2013 may be the time for rethinking what “healthy” means in the first place. New research suggests being slightly overweight is actually associated with a lower risk of dying.”</p>
<p>[Healthy</a> Fat? Higher BMI Linked to Lower Risk of Death | Greatist](<a href=“http://greatist.com/health/bmi-mortality-risk-010312]Healthy”>Healthy Fat? Higher BMI Linked to Lower Risk of Death)</p>
<p>I am not the one advocating big brother, but if we are going to go that route, under certain circumstances I will volunteer to help out. You know… Save the govt some money. ;)</p>
<p>Oh thanks for nothing, cf. I liked it better when you were cracking me up. Maybe there’s just something wrong with their cheapo “squeeze the trigger and we can measure your body fat” instrument!</p>
<p>I’m going with argbargy’s thought.</p>
<p>
This is exactly the opposite of how insurance works.</p>
<p>I absolutely support giving people the tools to be healthier, but it is important to understand that not everything is under our control, and the degree of control can vary considerably from person to person.</p>
<p>You want to charge the obese more? How do you accurately determine obesity for everyone? BMI is notoriously inaccurate, and body-fat tests are a bit expensive for regular evaluation. What about the people whose weight is primarily medical or genetic in nature - are they to be taxed as well? How do you address related psychological issues and poverty? It is hard to justify raising rates on someone who already lacks the time and money for a healthy diet!</p>
<p>And where do you draw the lines, anyway? I am not a daily smoker, and probably have smoked less than a pack of cigarettes in my entire life… but every now and then I’ll smoke a cigar, maybe once a month or so. Am I a smoker, or not? How do you create a system that is fair, and not arbitrary?</p>
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<p>You just ask the doctor what he would do and why. You are in front of an expert- use his advice.</p>
<p>The best way to get rid of visceral fat is fasting a day or two a week for a couple of years. </p>
<p>This scenario of the government getting involved in every choice I make is actually the thing I find most frightening about all this. </p>
<p>Don’t tell me I’m paranoid. Everyone said I was paranoid they were listening to all of our phone calls and Internet chat, but I was right. </p>
<p>It’s the people who get to have all this information. Who ARE they ? Creeps me out</p>
<p>arg, I did ask my doctor, of course, and she sent me to Hospital X. But in that situation, neither my doctor nor I is doing cost calculations. My doctor wants me to get better and to have a healthy baby, and I want to get better and to have a healthy baby, but neither of us has the incentive to save money. So if Hospital X and Hospital Y are both fine at treating me but Hospital X costs 50% more and Hospital Y is a teeny bit more inconvenient to get to, neither my doctor nor I have reason to send me to Hospital Y.</p>