Great work! I hope this becomes big news.

Excellent!

Maybe it's Radley who can "Let America be America again"...;)

On the other hand, I hope that the med insurers don't come up with unrealistic standards for people to meet to qualify as healthy (like the BMI)...just so they can charge higher premiums to everyone.

... and you can expect consumption of alcohol to be considered unhealthy. Thanks a lot.

Maybe the news that it's legal is getting around faster than you think. About a month ago, my wife (who works for the city government in Athens, GA) got notice of a new program that awards points for "healthy" activities (working out at their gym was one, can't remember if keeping below the "obese" level was another), which in turn lowers the health insurance premium you have to pay.

charging individuals different premiums, even within group plans, based on risk, would be a very very good step in the "personal responsibility for health and wellness" campaign. love the idea. an added benefit would be that it would possibly decrease health insurance premiums on small businesses as well. as an employee of a small business (15 person company), i have seen our group health insurance premium increase 11% from this time last year. ridiculous!

for the ins company, how would the individual's health be assessed though? for example, i go to the ob/gyn once per year. in addition to the pelvic etc exam, the MD will check my height, weight, blood pressure, (not cholesterol though). i think most women have yearly doctors visits to a GP or ob/gyn. it would be so easy for the MD to report the results of height, weight and blood pressure directly to an insurance company, and assess risk for the individual from the MDs yearly examination. just thinking thru some ideas. don't know if any of this would be feasible, i don't know a lot about how the insurance industry works and most certainly not a lot about federal and state health and ins laws. i do happen to think the health care industry is lining their pockets at the expense of small businesses though. that makes me mad. michelle

EXCELLENT!

I'm guessing that the reason the lawyers argued that it was illegal is the time-tested practice of "erring on the side of caution". Where if unsure they would come down on the stricter side.

Even if they knew it was not illegal, they have every incentive not to tell the company that info bcse if they did, and then the company found themselves being sued by "fatties of America" or some such they might get the sack. (Of course what they should have been thinking about was the "billable hours" - unless these were in-house lawyers who have every incentive to play golf instead.)

I've had a good-health discount available for years. And yes, Matt, it does require a commitment to refrain from consuming alcohol, but it is through a church conference that frowns on the consumption of alcohol, so no surprise there.

I have an even better idea to promote personal responsibility, and to solve the "healthcare crisis."

Get rid of health insurance altogether.

When you are paying your own medical bills, you have a vested interest in staying healthy.

You can no longer claim you are being "held hostage" in your job because of the health benefits.

The cost of healthcare would go down too. If people could only afford $25. for a doctor's appointment, and $10. for a prescription, that's what they would cost.

I doubt Viagra would be $12. a pill if insurance didn't cover it and people had to pay for it out of their own pocket.

Slotman

So, slotman, how would you propose we "get rid" of health insurance?

The idea of insurance is tied directly to the idea of commerce. It is, in effect, the same concept as investments, getting interest on your CD's, etc. You're investing in your future. There is nothing inherently wrong with insurance, and it would not solve much to get rid of it anyway.

You know why Viagra is $12/pill? It's not because people have health insurance. It's because the approval requirements at the FDA are so stringent, it encourages monopolies. It takes massive amounts of capital, plus a great deal of zero-profit time during the testing phase. Thus, only the huge Pharma corporations can afford to produce these drugs...which creates a monopoly.

Conversely, regulation schemes are exactly why medical care itself costs so much. You have to have a license (a rather expensive license) in order to sell your services as a doctor. Now, granted, I wouldn't want some crazy old man working on my gall bladder in his basement with a pair of pliers, but the incredibly stringent regulatory schemes are precisely why it costs a couple hundred bucks to go see a doctor for 10 minutes.

Insurance companies are not to blame for the high price of healthcare. Abolishing health insurance would solve nothing.

and you can expect consumption of alcohol to be considered unhealthy. Thanks a lot.

Hey, I have a drink most every night. But I consider myself very healthy. Look, if I got slobbered every night, and killed my liver, I wouldn't expect everyone else on my plan to share the burden. Nor would I expect to have to pay for your alcoholism.

I was half joking but my real point is that your going to trust "them" to set a reasonable level of consumption? If they let a group like AA set the bar you would be considered an alcoholic (no offense, I would too). I agree it's a great idea to base premiums on actual health but to an extent that's very difficult to substantiate, and as long as the guidlines are subjective, I'll expect to continue to get screwed.

"It's because the approval requirements at the FDA are so stringent, it encourages monopolies."

Complete nonsense. Even if small companies were able to compete (which I grant they're not) that company would still have a monopoly on whatever drug they create because of patents. Further, why would a small company sell drugs cheaper? A small company would surely have higher overhead.

Even if eliminating FDA requirements would push prices downward, don't you think having a minimum safety standards is kind of a good idea?

As long as health insurers aren't burdened by over-regulation (yeah, right) as to how they can and cannot go about administering "good health" discounts, the market should be able to provide for people's various preferred trade-offs among lifestyle, privacy, and cheaper insurrance. Some people might be perfecly OK with submitting to monthly urine tests to verify that they aren't smoking, periodic liver enzyme tests to show that they aren't drinking too much, or annual weigh-ins if it means cheaper premiums. Others would probably be OK paying more not to have to put up with that.

The most important thing is that consumers have a choice, which would never happen under any sort of centralized system.

The fact that it doesn't seem to be happening on broad basis now is probably due to (among other things, I'm sure) the fact that health insurance is often tied to employment, so people don't tend to shop around. I would also suspect a (legitimate) fear of discrimination lawsuits has kept more providers from pursuing this approach. If bars can get sued over ladies' night, it isn't farfetched that an insurer could get nailed for "discriminating" against fat people.

The problem, as usual, is government interferrence or the threat thereof, Mr. Thompson's assertions to the contrary notwithstanding.

isn't insurance regulated at the state level anyway? insurers often just pick the most stringent state law/reg (CA usually) and apply that across the rest of the states for the sake of uniformity...i'm just thinking that even if this type of underwriting is not forbidden on a federal level, it may be on the state side...but i don't really know what i'm talking about...

this is wonderful news if it is true.

WHat if you are totally healthy, but like rock climbing? A non-smoker that races a car at the local dirt track? A non-drinker that likes skydiving?

I don't think I should have to pay higher rates because some X games thrill seekers broke their necks snowboarding. Are we only going to look at cigarettes and alcohol as high risk? What about people that are healthy, but colon cancer runs in their family?

If all the healthy non-smokers out there think that something like this will make their premiums go down, they don't know much about insurance companies. They won't lower a rate becuase you are healthy, they will just raise the rates on the higher risk people. This will result in many of them going without health insurance. More of the high risk people without coverage equals higher taxes. Why? because the hospitals don't want to eat the costs of those who cannot pay, so the government will. What you save in premiums, you will pay elsewhere.

The reason everything related to the healthcare industry is so expensive is simply because they say it is. Because it is your health, and if you don't pay it you can die, or be in pain or be impaired, they do not care which. They are holding your health hostage.

Why does it cost so much to have a baby? Because you will pay it, to keep your baby safe, and your only other option is to have it at home and let it die if their are any complications. Almost like a gun to your head.

That's why health care is so expensive. Not malpractice insurance, or drug costs, or all the schooling they have to go through, or government licensing costs. It is because you can't live without it, so they can charge what they want. That's all.

And I don't advocate socialized medicine. But I will trust a lawyer, a politician or a used car salesman before I will give anyone associated with the medical profession the time of day. They are the biggest extortionists in our history. Like the health mafia!

Many women have been having babies at home for centuries. It's possible and perfectly feasible to do, but women don't want to take the time to learn AND because it is SO much easier to run to the hospital and let someone else clean up the mess. And health insurance is expensive because of all the reasons mentioned in this thread. To summarize all those reasons, it comes down to one word - regulations. Regulations are strangling the every day American man and business, IMO.

Anyone who thinks they personally are going to save any money at all because of this hasn't been paying attention.

Radley, didn't you post just a few days ago about how ridiculous the BMI's interpretation of your weight status is? Do you think insurance companies will use anything more reasonable? Any valid measure of ones weight on their health will surely require more data than what doctors routinely collect now, requiring higher costs.

What about DNA testing for H.C. discounts? Brave New World...Gattica...

Some of us are genetically unfit for Health Care. Some of us are more fit than others (with apologies to George Orwell).

The "Gattaca" reference is right on. If the health insurance companies can, they will begin to adjust your rates based on your genes.

And what specific studies show which factors cause problems for people? While obesity is being touted as the "be-all, end-all" factor, there is far too much medical debate on that topic ("The Obesity Myth" book details). Seditary lifestyle? How do you prove someone is a "slug" when it comes to exercising and diet? Some folks do gain weight even with good habits.

Basically, since doctors at ERs in this country have to treat all comers, even those who cannot pay (and do NOT think they can turn them away), how will the hospitals break even? By charging those who can pay (or have insurance) more. As a result, we already have de facto socialized medicine and we are already paying for those who can't (or won't).

Humble, my ass.

Just to play devil's advocate here...the Gattaca scenerio is a pretty one-sided view of the potential applications of a genetic approach to health care.

Though we certainly aren't there yet, the potential exists for genetic risk factors for things such as heart disease, cancers, diabetes, Alzheimer's, etc., etc. (perhaps even obesity...i.e., the "thrifty gene(s)" believed to be responsible for rampant obesity among many North American native groups) to be identified early in life. And identifying such risk factors could be instrumental in taking steps to delay, amelieorate, or even posssibly prevent such diseases.

To shut health care providers out of such information because of concerns about health care costs seems rather short-sighted. Pay now, or pay (and suffer) later.

Of course this means that some people would pay more for care than others...but is the point of health insurrance to facilitate your health care, or to "beat" the insurrance companies by costing them more than you actually pay? Clearly if everyone was "successful" at the latter, there would be no insurrance for anyone.

Have to respond here.

First LIFE insurance already looks at the risk factors. Non-smokers get a lower rate and those who fit a height/weight ratio (not sure if it's a BMI, but would guess it is) also recieve a lower rate. I know this is true for State Farm.

I would worry about moving this into the realm of gene testing. The idea of insurance is that a pool of people can provide at a reduced cost, protection against a major illnes, accident etc. Funds held earn additional money to help defray costs. This isn't bad.

Slotman--Your logic doesn't match reality. A MD will have in excess of $150,000 of student loans before he/she (see I'm PC) begins practice. If that is covered, we won't have doctors. Similarly if drug companies can't cover their research and developement costs, we won't have any new drugs. There are literally billions of potential chemicals, drugs whatever you want to call them that could be made. The trick is which one of those is the next Prozac, Norvasc, Viagra. This requires many man-years of research with NO assurance of success.

I can assure you that in Pfizer knew that the cost of Viagra would be only 50 cents a pill, there would NOT be Viagra.

Chris--I personally have had 2 instances were my doctor suggested very expensive drugs/tests for family members. Being a scientist I questioned the rational and was honestly told it was because the liabilty insurance required every possible procedure to be performed to prevent litigation--in both cases the suggested treatment would have been in excess of $200. This isn't adding to the cost?

Peter Lindholm,

Exactly right regarding ER costs etc. To a large extent the insured and those who can pay out-of-pocket subsidize those who can't. Interestingly, though, insurance companies are often billed less for equivalent services, because they are able to negotiate volume discounts with providers. The result is that overall prices have to be jacked up even higher to break even.

Additionally, ER and urgent care doctors are obliged to cover themselves by ruling out all possible causes for a problem before making a diagnosis (meaning, more expensive tests). George spoke about this in the last post, and I got the impression it was a primary doc in his situation, but the problem is even more pronounced when doctors don't have a history with the patient. Identical care from a primary doctor is often much less expensive than its ER counterpart, but those who are uninsured often go to the ER because they can't be turned away.

Chris, the healthcare profession does not jack up prices for the simple reason of having you by the balls and wanting your money. There are much less stressful fields where someone can take your money just as easily. The truth is that it's expensive for the reasons above, and because healthcare providers are paid a lot to cover both high demand and their willingness to put up with an unappreciative public's bad attitude. Most healthcare people get into the field - try to believe this - to help people.

Next topic... for those concerned about insurance companies investigating every genetic detail, predisposition to disease X, the time you smoked a joint in college, whatever... don't you think that at some point the cost of all these tests will be greater than the benefit of increased premiums based on them? It sounds to me like there might be a natural limit on how much information they collect. G