As long as health insurance is predominantly accessed through a third-party payer – employers – most Americans will have to rely on their them to shop for them. This has been a great deal for those who suffer from preexisting conditions as the insurance provider takes on the employer group in toto.
It’s also been a great deal for those whose conditions are of their own volition, or lack thereof as it were, as they are able to average in their morbidity and get a break.
Politicians talk of a health care crisis and how a country as prosperous as ours should not allow anyone to be without health care. It’s a right, not a privilege; a matter of dignity.
Fact is, our national health care “crisis” is not being caused solely by the insurance companies, nor the current delivery system but rather by the insureds themselves. In a way, our prosperity is our downfall. Everyone can afford Twinkies and smokes.
Experts say that upwards of 40 percent of U.S. medical costs are linked to obesity, smoking and other lifestyle factors — a statistic not lost on the nation’s employers. As a result, more than half of large corporations now use incentives to get employees to shape up, a 2008 survey found.
America is fat, and still surprisingly smoky too. Health insurers have been prodding consumers to get off their duffs, join clubs and live healthier lifestyles to no avail. Have you seen the insipid television commercials?
Now employers want a crack at it.
Sheila Kromer doesn’t want any help.
She enjoys smoking and she doesn’t want to quit.
Nor does she want advice on how to eat right. Or how to exercise. “I’m smart enough to take care of myself,” she says.
As a chemist at 3M, she’s had plenty of chances to join health and fitness programs on the job. But like many Minnesotans, she’s simply chosen not to.
Smart is as smart does. As it stands Sheila, you’re a jackass, and you’re gonna pay for it. Now and later.
As health care in America evolves, I predict consumers will have more choice via HSA’s, innovation, and an opening of the third-party payer choke. Competition and consumer selection will force providers to lower costs and increase service, coverage and quality.
It will be a great day for those of us that take care of ourselves and make good choices…but a very bad day for Sheila.
When you buy life insurance, if your “build” ratios are off, your cholesterol and triglycerides are high and you smoke, you will pay a higher premium, if you are accepted at all. If your car seems to find its way to stationery objects more often than your peers, you will pay a higher premium, if you are accepted at all.
But if you are obese and smoke, and work for a large enough employer, you pay the same premium as the rest of your coworkers. You pay less than you should and the healthy ones pay more than they should. Sound familiar?
As more and more Sheila’s show up looking for work, employers have figured out that while they can’t fire Sheila for being a health care time bomb, they can encourage her to make better choices to lower her coworkers, employer’s, and our economy’s health care burden.
At a growing number of workplaces, employees are paying a price for refusing to take part in wellness programs. Some face hundreds of dollars a year in higher costs for health insurance. Some are missing out on cash and gifts used to reward their colleagues — not for their work, but for the way they eat, exercise and conduct their lives.
Once, on-site gyms and Weight Watchers classes were viewed as perks. But now, many employers see wellness programs as their best weapon in the war on health costs.
At 3M, General Mills and many other Twin Cities worksites, employees can earn up to $100 in cash or shave hundreds of dollars off their health insurance if they (and sometimes their spouses) take a “health risk assessment” — a detailed survey of their personal health habits.
What a concept. Accountability. Liberals would say government is the solution. Universal health care! But employers aren’t waiting around for Obama’s Liberal League to take over yet another industry.
“I really think it’s an encroachment on our freedoms and our choices in life,” said Kromer, 50, of White Bear Lake. “They should not be able to tell me what I can and cannot do off of work time.”
Last month, she turned down the $100 incentive at 3M to fill out a health survey.
Sheila is also free to not work for 3M and she is free to pay for her own health insurance. Her coworkers and employer should be free to not pay for her “freedoms” to burden our health care system with type-2 diabetes and lung cancer.
As a smoker, she worries that the information might be used against her. “If I ever had to fill one out, I’m going to be real honest with you,” she confesses. “I would lie.”
…and pretty soon employers will look for nicotine when they do a drug test. Plus, it’s pretty hard to lie about obesity.
For the time being the incentives are small but expect employers to up the ante if they see results.
“When you have your employer kind of dictating how to live your life, it’s kind of a scary thing,” said Shawn Gertken, 35, a government worker in Wabasha County. “Where does it all end? Pretty soon they’re going to be after you if you choose to ride a motorcycle after work.”
They might if you aren’t smart enough to wear a helmet, Future-Head-Injury-Guy.
It’s no surprise, then, that, many businesses are losing patience footing the bill for preventable diseases, says Susan Relland, a Washington, D.C., attorney who specializes in health law. “Just running the math, they realize that the health of their employees is having a very direct financial impact on the company.”
Imagine if we had Universal Health Care, run by the Federal Government; no competition and mandated participation. Now imagine a liberal administration and Congress asking American’s to get off their big rear ends, start exercising and stop smoking.
Never.
Liberals have gained a great deal of power in the last fifty years by catering to the results of poor decision-making both personal and corporate and they’re not about to relinquish it now.
Didn’t save for retirement? Social security.
Your baby is inconvenient? Government subsidized abortions.
Can’t pay your bills? How about a mortgage?
Can’t find work? The government will hire you, two by two. One to dig a hole, the other to fill it in.
Ran your industry into the ground on the backs of the UAW? Here’s a bailout check from G.W. Bush on his way out the door.
Capitalism isn’t perfect either but there are far more examples where it has worked than where government has.
Giving employers and consumers choice, while holding them accountable to their own decision-making is the only way to solve our nation’s health care crisis.
Hmmm . . . I thought smokers were a net plus to government revenue.
While they are young & middle aged, they pay tobacco taxes + SS & Medicare.
They die sooner after they retire then non-smokers.
Yeah, sorry. Preventative health care does not save money. It’s counter intuitive but that’s just the way it is. For the individual, it’s prudent. Is it morally the right thing to do? Sure yeah, you betcha. Should you use propaganda and incentives to make people take better care of themselves, maybe, maybe not. But the unpopular truth about health care costs is that you can bash people over the head about smoking and eating and at the end of the day the most expensive (and growing) cost of health care is end of life care. And no, not just the smokers and obese people linger. In fact, like terry says, statistically, they die quicker and save us money.
The company my husband and I work for is self-insured through Blue Cross. It’s irksome when we rarely go to the Dr yet pay the same amount out of our checks for coverage that the 300 lb smokers who bring their kids to the Dr for every (frequent) cough and ear infection (what’s the deal with so many ear infections anymore?!). The company is trying to get people to take better care of themselves to save money, but you know darn well the only ones that listen are the ones that do or will do so anyway. They are not the ones living in a trailer with insulation over the windows, sitting in there smoking and watching TV, eating crap for every meal. Sorry, it sounds a bit elitist, but you can picture. If nothing else, you’d think you’d be depressed! Starting in ’09, incentives (monetary) will be availablen to those who don’t smoke or will quit, work out, etc. We’ll see how it goes. They also stipulated that if you are in a car accident with injuries and you were not wearing a seatbelt, it’s an automatic $2500 deductible. That got my attention-ha! Although I always buckle up on the highway but not our county road, I now do everywhere. Incentives work for those who listen and have their wits.
That’s wise, Coleen. If you have safety equipment available, you should make use of it. Never forget that “An ounce of prevention is worth a pound of cure”. It applies well to operating cars, but as for the body? There are no guarantees.
I side with Colleen. I have many co-workers who go to the doctor when they (or their children) have a cold, a cough, or a minor flu. Either way you get better in a couple of days. It’s just that these people cost me money.
Interesting. So it’s only the 300lb smokers that bring their kids into the dr all the time for every cough? In my experience, the single person (me) didn’t go to the dr all the time, while the parents didn’t just take the kids to the dr every time you turned around but also missed a lot more work. Once you jack the smokers and the overweight, then what? I ride a motorcycle. It can be dangerous. I guess I am next on the list. Mitch rides a bicycle on the roads. Dangerous. Some people like to keep in shape by engaging in dangerous activities. Basketball, football. Some people have a swimming pool in the back yard. Wack them next. Now you have the people who will skew the costs of insurance. They have a high incidents of heart disease, diabetes, cancer in their families. Then you have older people who will also have more health issues than the 22 year old new hires. Sooner or later, they’re going to get to your ox.
As a 216 pound single smoker, I’m with Buzz.
I smoke about a pack a day. At approximately $1.25/pack in tobacco taxes (on average), my net worth to the government is $456.25/year. Since I have not had any “smoking related illnesses” for the past 20 years that I’ve been a smoker, I’ve already pre-paid $9,125 for my healthcare. I don’t anticipate needing heathcare for anything “smoking related” for at least another 30 years, so I’ve effectly pre-paid $22,812.50 in my future healthcare needs.
Furthermore, since I am in the military (reserve), I could always get called up, shipped back to the combat zone where I was 5 years ago, and have my life cut short by something other than a “smoking related illness.” Government still gets to keep the money I prepaid for my future healthcare.
Lastly, if this sounds absurd – it is. It’s just as absurd as blaming smokers for enjoying the priviledge of partaking in a legally purchased and taxed product, and have to do it outside on frigid winter nights like tonight where I might have to take advantage of my prepaid healthcare fees to be treated for frostbite before I have a “smoking related illness.”
I used to have a boss who thought I was crazy for driving a motorcycle without a helmet.
He was into bungee-jumping.
http://www.shotinthedark.info/wp/?p=3808
Not written by the founder of Shot in the Dark Mitch Berg but a more liberal “contributor”. The basic premise is the “settled science” that says that since something has been “proved” the costs are “proved”. Junkscience.com calls this “chasing numbers”: IE lower cholesterol numbers or lower weight directly translate to lower medical costs. The link isn’t really there.
At Hennepin County the “single” health insurance costs tended to rise at single digit rates while the family coverage rose at double digit rates. You might argue that a lot of single people are young but Hennepin County has a very low turnover and relatively few “starter job” young hires. We subcontracted out a lot, 3M probably did in the last decade. The workforces at major employers is aging.
Katherine Kerstine of the Strib recently had an article about how legislated mandates add more than 20% to Minnesota Health care/insurance costs. They basically need a “boogieman” to try to blame the costs on.
On a personal level: On Friday I got “Shanghaied” into Health Partners for a physical under threat of not renewing my prescription for generic blood pressure medications. Seems I haven’t been in there in three years. I am significantly overweight but no health problems. The doctor told me to lose weight and keep taking the meds but otherwise OK. I tend to believe that “sugar” is the big culprit nowadays. One pound of sugar can last me years at home. The only time I drink “sugar pop” is at a bar when I don’t want to drive beer. I usually eat cereal that it unsweetened and drink only “skim milk”. It’s amazing the number of people who seem to live on a sugar based diet! I had one of those little disposable salt shakers I brought from work a year ago. It still isn’t empty. I have “religiously” taken at least one aspirin a day for my entire adult life (always those little aches and pains). It’s amazing how few people do this and keep doing it. I tell them to get a big bottle of cheap generic aspirin, it’s all USP anyway. I try to lose weight but it’s mostly for “quality of life” reasons.
Relatively few “office workers” in major corporations now smoke. The Hennepin Government Center has a daytime population of probably 10,000 people but I see only a handful smoking outside. Sedentary work and smoking are a more “toxic” combination but most smokers are in the “trades” where the work is more physical or in smaller employers.
One little “secret” is that in any Health Plan group a very small portion of the people use the vast majority of the services. It can be as high as 10% using 90%. It would probably be “un-PC” to profile these “frequent fliers”. They have the accounting to easily do this. I didn’t get a letter detailing costs when I got a flu shot at a HP flu shot “event” but they send me cost details for other things. If they can do that they can do a detailed analysis of who really costs the insurance in each subcategory. For example, the rise in rates for those with single coverage rises a lot less than those with family coverage. They could easily factor age in there. They can use these cost figures like an accounting spreadsheet where they can look at any factors they want.
HP didn’t charge me the copay because this was an annual physical. I would predict that I will get a statement that this visit and the blood work cost HP $200, all done by HP in-house. The costs to insurers by smokers is probably lower than they say because smokers usually “tough out” colds and flue rather than go to the doctor for every sniffle.
The above is also posted at my http://freedomtoact.blogspot.com/2008/12/health-care-costs-and-insureremployer.html
Johnny Roosh wrote: “Politicians talk of a health care crisis and how a country as prosperous as ours should not allow anyone to be without health care. It’s a right, not a privilege; a matter of dignity.”
Actually the constitution give no “right to health care”. It is actually a legislated mandate. You have no right to dental care of plastic surgery, to give two examples.
Get employers out of the business of socializing health costs on a small scale. Individual risks, individual costs, and individual freedom.
Terry: “I used to have a boss who thought I was crazy for driving a motorcycle without a helmet.”
That’s not crazy. That’s stupid.
No wonder you have a plate in your head!
That was actually the result of a bicycle accident, AC. I rode a motorcycle almost every day for twenty years and never had an accident.
But everyone else I knew that had been riding that long had wrecked at least one motorcycle.
Little kids ride bicycles. How dangerous can they be?
The basic problem here is that thanks to our screwed up system, people now completely misunderstand the idea of “insurance.” If people paid for preventative care and maintenance care, the price would become more competitive and as the price dropped, people would use it at the level that it was necessary but not overuse it. They would find ways to stay healthy or pay the price in real dollars.
Insurance is about pooling risks that we can’t control and it only works in HC if we remove what we can control on to price system that incentivizes the behavior which costs less. Getting angry because fat people are costing you more isn’t looking at the whole problem here. For all you know, that Fat person costs your insurance way less than a person who needs to take a special new drug every day for $$$$ in order to live but who otherwise is living a relatively normal life.
And folks, there is no “if only” silver bullet. Forcing people to take better care of themselves won’t save us enough money. Killing off brokers, insurers and putting their jobs in the hands of the federal government won’t save any money. (Canada and Europe costs of HC Administration are proof of the opposite). If there was an easy answer, we would have found it by now.
To be clear, I do not favor trading in businessmen for bureaucrats.
Margaret++
Little kids wear helmets. You are very lucky, Terry. There’s a reason ER workers call ’em “donorcycles.”
I am writing to express my disappointment in this article. As a fellow writer of a blog devoted to personal liberties, I find the author’s remarks to be incredibly myopic.
The general point of the article is well taken; that individuals need to be accountable for their own actions. I couldn’t agree more. In our society, there are too many that believe that everyone is to blame for their own misfortunes—everyone, that is, except for themselves.
The author of the article, Johnny Roosh, writes the article with an incredibly insolent and judgmental attitude, and should have taken some time to do a little research on the issue at hand. Mr. Roosh also resorts to attacking and name-calling of Sheila Kromer, the co-chair of Ban the Ban Minnesota, as well as attacking me personally.
In my opinion, the article loses all credibility when Mr. Roosh attacks specific individuals, such as Sheila and myself. He also resorts to calling Sheila and me names, such as “jackass”, which seems incredibly childish and counter-productive.
Furthermore, Mr. Roosh does not seem to comprehend the point of group health insurance. It’s called group health insurance because everyone in the “group” typically pays the same rates, regardless if you smoke, drink, skydive, engage in unsafe sex, drive recklessly, or have 20 children. Nearly everyone can point to other individuals and blame them for their lifestyle choice resulting in obscene health insurance premiums. We are humans and we are not perfect.
If Mr. Roosh would have done a bit of research, he would understand that those who have unhealthy diets and those who smoke do not necessarily cause undue drain on the health care system. For example, a Dutch study shows that, “The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.” And to assume that Sheila, as an individual, will cost the health care system more than any healthy non-smoker is completely baseless.
Also, keep in mind that smokers pay for an incredibly regressive federal and state sales tax, a Minnesota “Health Impact” fee, and the State of Minnesota and Blue Cross Blue Shield tobacco settlement. This results in over ½ billion dollars coming back to the state and to BCBS per year.
Mr. Roosh’s idea of liberty is essentially being an apologist for corrupt insurance companies and socially engineering everyone in our society to walk side by side on treadmills sipping tea. I’m sure if I were to examine his lifestyle closely, I could find a potential unhealthy activity or two in which he engages, so perhaps he should realize that singling out only two specific potential health risk groups is unfair and judgmental.
I understand that blogs are intended to be a venue to express specific opinions. At the same time, I felt it necessary to share my opinion on this particular issue.
Shawn R. Gertken
Co-Chair, Ban the Ban Minnesota, Inc.
http://www.banthebanminnesota.com
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