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October 19th, 2009
06:00 PM ET

Should healthy employees have lower insurance premiums?

ALT TEXT
Should healthy employees have lower insurance premiums? (PHOTO CREDIT: GETTY IMAGES)

FROM CNN's Jack Cafferty:

When it comes to health care reform, it could pay for workers to lose weight, stop smoking or lower their cholesterol.

The Washington Post reports the bills in the Senate include so-called "wellness incentives”, which may more than double the maximum penalties employers can charge workers who flunk medical evaluations.

This follows a trend among some companies that offer lower premiums to employees who don't smoke, complete health assessments, or meet goals for blood pressure, body mass or cholesterol.

Supporters say incentives like these can make people choose healthier lifestyles, but critics say this discriminates against pre-existing conditions. They say it could make health coverage too expensive for those more at risk for things like diabetes, heart disease or stroke.

Skyrocketing health care costs have left some wondering whether health insurance should be more like auto insurance – where good drivers get discounts and reckless ones pay more.

Meanwhile, it's open enrollment time at offices everywhere, and CNNmoney.com reports that employees will face "shockingly higher" health costs. Companies are increasing everything from deductibles to co-payments and employee out-of-pocket maximums.

Many employers are also moving from a co-pay, meaning a flat fee of anywhere from $10 to $35 per doctor visit, to a co-insurance model, where employees will pay a percentage of the total medical expense.

Companies are also offering fewer health plans, which may mean some people will be forced to switch doctors.

Here’s my question to you: Should healthy employees have lower insurance premiums?

Interested to know which ones made it on air?

Dee from Georgia says:
Exactly how would the "healthy" employees be determined? Wouldn't those guys who ran the Detroit marathon and dropped dead perhaps have been classed in the healthy group? What about "healthy" employees who do hazardous things, like drinking and driving or using drugs? How could that be determined? How about those who might not drink and drive, but who sit at home every evening and down a 12-pack of beer?

Terry says:
No. It's a slippery slope that could then lead insurance companies to charge people more who have genetic predispositions to certain diseases. The point of insurance is to pool the risk. It's not right for an insurance company to penalize you for the very reason you bought their product to begin with, car insurance or health insurance!

Christopher says:
If I may be blunt, Mr. Cafferty, it seems like there are people telling others what to do. The day someone tells an impoverished woman with four children to stop having babies, and being a burden on the welfare system, I will start taking care of my weight. Stay out of people's business, and tend to your own life.

David from Arlington, Virginia says:
Absolutely not. Everyone, including young people, should be required to pay a basic premium for health care in order to make sure that there is enough care for everybody. It should be the same amount for everyone. If we start charging more for this and less for that we are going to be in a bigger mess than we already are at the moment.

Patty says:
This sounds like an easy way to discriminate when hiring someone. Is the applicant overweight, limp, or maybe just wear eye glasses? Sounds to me like another reason we need not only a public option, but single payer, non-discriminating health care.

Jim says:
Jack, I design health plans for companies like CNN and believe me it’s very simple to figure out the best health plan choices at Open Enrollment. If you have questions, just let me know.


Filed under: Health care
soundoff (230 Responses)
  1. Ed from the Four Corners

    Yes, healthy employees who exercise, eat healthy, do not smoke, and who avoid other unhealthy activities should get a lower insurance rate from the ones who live unhealthy lifestyles.

    October 19, 2009 at 12:55 pm |
  2. Sue in Los Angeles, CA

    Yes, good drivers have lower auto insurance rates. Healthy people cost the system less and should get a break in premiums. But, there should be a limit on how much the unhealthy pay.

    October 19, 2009 at 1:04 pm |
  3. Antonio from Washington D.C.

    employees of all health classes should have fair health care!!!!

    October 19, 2009 at 1:06 pm |
  4. Sandra

    Yes, as it is now insurance premiums are based on age. The older you get the more you pay. Healthy people cost the system less and should be rewarded for their effort. Too many people are making bad lifestyle choices and the rest of us end up paying for them.

    Sandra
    Temecula, CA

    October 19, 2009 at 1:13 pm |
  5. Susan Frost

    Why not? Then when they actually get sick and their policy gets canceled, at least they won't have wasted so much money paying for something they're not going to get.

    Susan
    Tuscaloosa AL

    October 19, 2009 at 1:17 pm |
  6. MIKE FROM CHICAGO

    Why no- that is the most ridiculous thing I have ever heard of. In a true socialistic world- we share all things in common and show no favoratism for effort, wise conduct, personal well being, giftedness or talents. We share all things equally – right?

    October 19, 2009 at 1:19 pm |
  7. william fitzwater

    yes they should in theory but our medical insurance has medical underwriting which sets rate and risk factors. IT is a form of gambling that sets the insurance company in a posion of power.

    October 19, 2009 at 1:19 pm |
  8. Slotl, Marietta, Ga

    Tell me what constitutes the word "healthy" first. Then I will comment on price breaks for the "healthy".

    With car insurance, you know how many accidents a person has been involved in, the traffic tickets he/she receives.

    How do you measure the term "healthy". Does taking birth control pills mean you are on "regular medication'? What about the folks who believe in holistic medications are they healthier? Is age a factor? Family history? Child-bearing years for women (because of the cost of maternity coverage? Families with children vs families with no children?

    Unfortunately, there is no "standard" or accurate way to determine if someone is healthy.

    October 19, 2009 at 1:19 pm |
  9. Liz from Winterset, Iowa

    Employees, healthy or not, should have no premiums. We should have universal health care like every other civilized nation. It's disgusting that fat cats are getting rich off our illness and letting people die to pad their profits.

    October 19, 2009 at 1:19 pm |
  10. Al Bledsoe in Dallas

    Think about it the young pay for the old in Social Security. Healthcare should be part of social security. So, the young or healthy should pay for the old and unhealthy. I didn't ask to be born with my parent's genes, did you? So, it's just as fair as being born.

    October 19, 2009 at 1:21 pm |
  11. Maria

    If the employees have no pre-existing conditions,or are beginning a new job , continue working at same job. move to another job and take insurance with them and adhere to more peventive care deserve full coverage at lower prices.People with life-altering diseases like cancer, children's diseases like cancer or diabetes I or bone marrow transplants should always be covered, and those with pre-existing conditions: parkinsons,MS,MD, mental health diseases, or brain tumors must be covered.

    I have not heard anything from insurance company willing to adhere to any of these ideas.

    Maria
    Brunswick,MD

    October 19, 2009 at 1:21 pm |
  12. bob frompa

    this health care bill is like scramble eggs the ones that get hurt the most is senior citizens people should wise up every one becomes a senior someday

    October 19, 2009 at 1:26 pm |
  13. Duane

    Duh....YES!!!

    October 19, 2009 at 1:27 pm |
  14. David

    I think not. You know these politician are all too eager to let alcoholism, cigarette smoking and obesity go because it makes money for the people who create these products. Then, these people bribe... errr ...contribute to their political campaigns to keep in favor. Thus, they are looking out for these company`s bottom line. If they do this for insurance too, then they are looking out for insurance company`s bottom like cause of the same bribes... err contributions. Just because these people are healthy now, does not mean they will continue to be as they get older.

    October 19, 2009 at 1:32 pm |
  15. David of Alexandria VA

    Yes - that is, health-minded employees who take personal accountability for their own well-being and reduce costs for all of us in the "pool" should certainly pay less. With all the hoopla about what causes high health care costs, you'd think someone would know that it's disease. Some of that risk can be significantly reduced and we should reward/incentivise that behavior

    Hey you - drop a few pounds, stub out that butt, take a walk - do something which will make you a lower risk for health costs

    October 19, 2009 at 1:34 pm |
  16. JENNA

    Should healthy employees have lower insurance premiums?

    Jack, in 2009 I paid $20 to go to the doctor for my PPO with United Health Care, and over the weekend my employer said the same coverage would be for me to pay a $3000 deductable before UHC would kick in 80% for coverage in 2010. And this IS for me being Healthy. Can you just imagine what it would be for some poor soul that isn't healthy??

    I think what ever comes out as the final bill in the house in senate should be what all our lawmakers get for health care starting in 2010.
    With an exclusion of being able to buy health care for your family because you are an elected official.

    Now what do you think the final bill will look like??

    The Insurance Companies are playing games with our LIVES.

    NO MORE!!!!!!!!

    Jenna
    Roseville CA

    October 19, 2009 at 1:34 pm |
  17. Al, Lawrence KS

    Isn't this the same as penalizing people with pre-existing conditions? Everyone...let me repeat that...everyone should have the same access to healthcare...period.

    October 19, 2009 at 1:38 pm |
  18. Carlos Round Rock, Texas

    Either lower rates or maybe a rebate at the end of each year you stay healthy or are able to keep your medical visits to yearly check ups and preventing illness such as injections.

    October 19, 2009 at 1:42 pm |
  19. JD In NH

    No. The purpose of insurance is to pool resources and share the risk. The healthy employee is not immune from being hit by a bus. Everyone should be treated equally. People who need medical care the most should not be penalized. Wouldn't it be nice if employers didn't have to worry about insurance? Maybe our jobs wouldn't be outsourced if we had a single-payer system like all the other civilized countries in the world.

    October 19, 2009 at 1:43 pm |
  20. eric- hampton va

    Yea it should be just like any other serivice. The less often your in their the less it should cost. Why pay for something that your not going to use?

    October 19, 2009 at 1:43 pm |
  21. WHOEVER

    NO!! OFCOURSE NO: when they or theirs (like their children) get sick, they don't (want to) pay MORE for being sick! Also Medical Insurances, like Life Insurances, should be a risk for the insurance companies as well as other insurances are. If the Premium is too low, an Insurance Company makes some losses and it compensates it with the Higher Premiums next year, to cover its risks better with its Risk Capital. ALL its clients pay equally during their whole life from the moment the new law (the Health Care Reform Bill) has become effective. That way you also prevent that people only seek insurance coverage when they are or become sick. And that is really the only way this (can) work: EQUAL PAY=EQUAL COVERAGE=EQUAL RIGHTS! And there is no other way!

    October 19, 2009 at 1:43 pm |
  22. Jackie in Dallas

    As decided by what criteria, Jack? By number of claims - that's what the insurance companies will want. And doesn't that penalize the group of people who NEED health insurance the most? That's why the public option is desperately needed - we need an insurance option that isn't driven by the profit motive!

    October 19, 2009 at 1:44 pm |
  23. Aidan

    Jack, you already know the answer to this. Go ahead, think about it. If you're healthy, you want cheaper premiums. If you aren't as healthy, or have pre-existing condition(s), you want to be treated equally. Why don't we come up with something incentive based? How about leading a documented healthier lifestyle, and you'll be rewarded with cheaper premiums?

    Aidan from Mesa, AZ

    October 19, 2009 at 1:47 pm |
  24. Terry in Hanover County

    I know overweight individuals who are far healthier than their skinny counterparts. For example, how much money do runners who have to have their hips, knees, and ankles replaced cost the rest of us? Are they healthy but unlucky? By the time so-called "unhealthy" undividuals lose weight, give up smoking and drinking, stop doing drugs, and eat well-balanced diets, they'll either be dead or in a category created by the insurance industry called, "Too Late, We Raised Your Rates Anyway Just Because We Can."

    October 19, 2009 at 1:55 pm |
  25. Tom, Avon, Me, The Heart of Democracy

    We should have medicare for all and pay for it through our taxes rather than have our taxes wasted on $375 hammers for the Pentagon. The other industrialized nations take care of their citizens and it costs them half of what we are now paying not to take care of our citizens.

    October 19, 2009 at 1:57 pm |
  26. Tom from Philly

    We emulated the wrong ancient greek society, instead of the athenians democracy, we really are more like the spartains, and like them we need to just throw our sick and disabled off the side of a cliff to save precious resources, it was more humane that our society today. WE allow human suffering they ended it, effectively in a cost effective manor by terminating the lives of sick children for the greater good of society.

    Why arent we going after insurance company ceo pay instead of shaking down an already burdeoned society with even higher rates of discrimination. Every move they make pushes me further to the left wanting a single payer system with universal coverage. Good god people wake up! They are the lumbering beasts of inefficiency and corruption the right wing claims the goverment to be.

    October 19, 2009 at 1:59 pm |
  27. kk/ohio

    You can be healthy one day and suffer a major problem the next day.

    October 19, 2009 at 2:02 pm |
  28. Lori - PA

    Yes.

    October 19, 2009 at 2:08 pm |
  29. Joe CE

    The idea of insurtance is to spread the cost over a large population. Reducing preminum for health works against this principle. When the healtgh ecome sick and need help, they would get less.

    October 19, 2009 at 2:09 pm |
  30. Tom in Desoto, Tx

    If you don't have accidents your auto insurance is lower than one who hits things. Healthy people's rates should be lower and than those who require more attention. I get almost all my medications from the VA, my insurance company doesn't know everything I take and I have relatively low civilian premiums.

    October 19, 2009 at 2:09 pm |
  31. Melissa

    No, everyone should have the same premiums. No more favoritism.

    October 19, 2009 at 2:11 pm |
  32. Dave from Kansas

    I am a retired Federal worker insured under the Federal Employees Health Program . Old ,young and retired all pay the same depending on the plan they choose and there are no pre-existing conditions . By having everyone pay the same helps to keep the premiums down . As a side note I'm a Service connected Disabled Veteran that uses the VA health care system for all healthcare so what Blue Cross/Blue Shield doesn't cover the VA will .

    October 19, 2009 at 2:11 pm |
  33. Doug - Dallas, TX

    Sure is a novel idea Jack, don't charge the healthy ones as much. Maybe that would catch on if there is a public option!

    October 19, 2009 at 2:12 pm |
  34. Michael in Albuquerque,NM

    Healthy employees are men like me that never go to the doctor.
    They will walk it off when they crash their motorcycle.
    Healthy employees come to work when they are sick.
    The result of their negligence is costly enough for them.

    October 19, 2009 at 2:13 pm |
  35. Leslie

    YES!! I mean if we are going to pay for something that the insurance companies are not going to cover for in the first place we might as well have some money stowed away so we can pay for our health care when the time comes.

    October 19, 2009 at 2:15 pm |
  36. Frank from Peterborough

    You have the question all backwards Jack.

    The real question within your question is should people with illness pay more for health insurance than healthier citizens?

    Taking advantage of the already disadvantaged would only be appealing to the most selfish of society and those who believe serious illness or death will only happen to the other guy and not themselves.

    October 19, 2009 at 2:15 pm |
  37. Dennis in Cleveland,Ohio

    YES! It will help promote better Health in America!

    October 19, 2009 at 2:17 pm |
  38. Remo from beautiful downtown Pflugerville, Tx.

    Why? If they get sick, does that mean their premium automatcially increases?

    October 19, 2009 at 2:18 pm |
  39. Kevin in CA

    Sure ... but don't call it insurance because it's no longer a distributed risk.

    October 19, 2009 at 2:19 pm |
  40. Ms Lou from Fayetteville, NC

    My insurance on my car is lower because I am a safe driver and have been for years. My health insurance should be lower because of my health habits. Basically I am happy with my health care. I just hope they leave us older people alone.

    October 19, 2009 at 2:20 pm |
  41. John from Alabama

    Jack: Yes I think after a period of 18 months employees who are healthy should be rewarded for good habits. Lower premiums are nice, but paid days off for a health life style is better. Ten years of good habits and great health should be worth a big bonus or a month off with pay. President Obama talks about preventive health measures will make us healthy, but real incentives will makes us exercise and eat good food to reach our goals.

    October 19, 2009 at 2:20 pm |
  42. Brad in Memphis, TN

    Divide and conquer. That's what this question is about. If the opponents of universal health care can make you believe there are people in this country who don't fully deserve health care, then we will be stupid enough not to demand it from our leaders. This is one of the tendencies in this country that prevents real progress. Quit looking for someone to blame, demand what's right.

    October 19, 2009 at 2:21 pm |
  43. Jack Carlson

    Probably if it can be proven. How about car accidents? Falling off ladders, or falling down steps. etc.
    Jack C
    WA

    October 19, 2009 at 2:22 pm |
  44. Christian the Great

    No Jack. Some unhealthy people don't have a choice, like poor fat people they can't exercise because they work so much and they can't buy healthy foods because its so high. Some smokers are the same way, some people smoke to relieve stress that they don't have the money to get rid of, like debt. I am overweight and I don't have a choice, my parents are middle class American, who make just enough to keep the lights on and the only food they can afford is unhealthy food. Fried foods and junk foods make up about 90% of our diet.

    October 19, 2009 at 2:24 pm |
  45. Fred R Deleon

    What is morally wrong, can't be politically right. A Lincoln.
    If your question comes down to promote Obama's plan for Americans to eat healthy and exercise more you can very well Obama if he can change the color of his......skin?

    October 19, 2009 at 2:30 pm |
  46. Simonsays/Orlando

    Absolutely. Anybody that watches their diet, weight, exercises and makes an attempt to stay healthy should pay lower premiums than someone who chooses to smoke,get fat, and sit on their butts. Why should someone who cares about their health pay the same premium as someone who doesn't care and expects the rest of us to pay for their lack of effort?

    October 19, 2009 at 2:36 pm |
  47. Jeff in Houston

    Yes. And I will go one further! Why do people who choose not to have children have to help pay for the expenses of those who did choose to have children? I have resented this for years. You produced the child, you take care of it, not me. the same goes for every time little Johny has a cold or a baseball game and the rest of us get to work overtime...but oh boy don't say a word becuase then you are a child hater. No. I'm just a responsible citizen that realizes this planet does nto need more people.

    October 19, 2009 at 2:43 pm |
  48. Ed

    No, health crazy people go to the doctor for every ache and pain whereas unhealthy people are generally apathetic towards visiting a doctor. They may only go one time or even almost one time. We don't need managed care cradle to grave.

    October 19, 2009 at 2:44 pm |
  49. William Joseph Miller, Los Angeles

    Should health insurance companies have the right to exclude people because of pre-existing conditions? Should women pay more for health insurance than men because of pregnancies. Should companies have the right to remove women who have had Caesarian sections from their insurance rolls – unless they get sterilized?
    I am a retired school teacher. I spent a life time teaching in an inner city school in South Los Angeles. Asthma was endemic in my school among both students and teachers. One day, one of my asthmatic colleagues discovered that her inhaler was dry. Nearly half the class offered to lend her their inhaler.
    Now these members of the asthma generation have graduated. Many have earned college degress and are entering the job market. Should their employers discriminate against them because they have asthma? And who is responsible for their asthma to begin with? Is it their fault that their parents could not afford to live in neighborhoods with healthier air? Rather than punish my former students, shouldn't we impose heavy taxes on gas-guzzling truck and automobiles? Shouldn't people in the LA Basin who insist on driving instead of using public transit be held responsible?
    Answer those questions. You are looking for simplistic answers to put on the air. There are no simplistic answers to the costs of health care.

    P.S. If you really want to encourage health, why not slap excises taxes on sugar-based soda pop, sugar, red meat and processed meats? All of these are excellent sources of diabetes, heart disease and cancer.

    October 19, 2009 at 2:47 pm |
  50. Ted, Aloha, OR

    You compared it to auto insurance..You can be the world's best driver but still pay more because of a questinable credit rating.. Rest assured the insurance companies would find a way to use that as a criteria for premiums mainly because they have the ability to be the sole cause of bad credit. And everyone knows that is grounds for denial. Where the hell is that reform? We need to go back to a trade and barter system. Do you think the 3/4 million dollar bonuses would go away? What would the AIG employees do with 9000 cu ft of steer fertilizer in their swimming pools?

    October 19, 2009 at 2:49 pm |
  51. Ryan - Galesburg, IL

    No Jack, we should all be covered equally under a system that creates no bias under the law. The technology needed to determine who is healthy and unhealthy beyond a doubt would be so invasive that neither the government nor corporate America should have such access. Whether it's single-payer or a public option, we have to level the playing field, or we all suffer.

    October 19, 2009 at 2:50 pm |
  52. James in Philly

    The way insurance works is by having a pool of some people who cost the pool money and a lot of people who don't. The costs average out. If young, healthy people don't subsidize older, less healthy people, the numbers don't work anymore. Besides, if you want to start discriminating with premiums, there's no end to it. What about charging urban youth more, because they're more likely to be victims of gang violence? Treating gunshot wounds is very expensive. You can argue it's an incentive for them to move to lower crime neighborhoods.

    October 19, 2009 at 2:52 pm |
  53. Lucy

    Yes. Why? As I was reading that, I was trying to apply it to my own life. I used to smoke, I am flirting with going back to it. If (well, if I had a job first) and if I paid less for not smoking, it would be so much easier for me to just say no to it. If it encourages healthier lifestyles, I say do it.
    Lucy
    SF, CA

    October 19, 2009 at 2:52 pm |
  54. Dick B

    Nah. That is too complicated. How much, under what conditions and all that stuff. I say we just add a tax to all the bad things we consume equal to the amount of the health care costs the products generate. For example, if we sell ten packs of cigarettes a year and we have $100 of health care related expense we simply add a $10 tax to price of each pack when they are purchased. Then anyone who has a health care related expense from smoking gets free care paid out of the tax fund. This has the advantage of changing behavior and making people responsible for their actions. I always believed a good sturdy stick on the butt was better than a hug and kiss on the cheek.

    October 19, 2009 at 2:53 pm |
  55. Larry from Georgetown, Tx

    According to the insurance compaines they already do. Smokers pay a higher premium, where would you people be without us smokers. We pay higer taxes and higher insurance premiums so the rest of you can enjoy all of the benefits.

    October 19, 2009 at 3:00 pm |
  56. Cheryl in Bluffton, SC

    They certainly should, Jack. Americans have more chronic diseases as a result of poor choices in diet and lifestyle. Give them the incentive to avoid those poor choices, and healthcare costs WILL drop. We can't count on Congress to do that, so let's do it ourselves!

    October 19, 2009 at 3:02 pm |
  57. Stacey

    Why isnt this considered obvious?! I am 23 years old, healthy and fit and I pay a fortune for health insurance and I see my doctor MAYBE every year for a physical. Why am I shouldering the financials for the 43 year old obese, diabetic female with myriads of other related health issues?

    October 19, 2009 at 3:05 pm |
  58. Denny from Tacoma, WA

    Of course they should. One should profit by assuming responsibility for one's good health.

    October 19, 2009 at 3:09 pm |
  59. SLM

    Yes, Healthy people cost less in health care costs and should be rewarded. It's more acceptable to reward the healthy people, than to punish the unhealthy ones. Lifestyle is a matter of choice and we can all make the choice to not smoke, be overweight and to exercise.

    October 19, 2009 at 3:11 pm |
  60. Karen, Idaho Falls, Idaho

    Whose decision should it be to determine who is healthy? Anyone can have a sudden illness that was totally unexpected–healthy or not. Everyone should pay the same premium to be determined by income level.

    October 19, 2009 at 3:13 pm |
  61. Jim

    Jack,

    Good arguments on both sides. Where employees can and do make conscientious choices leading to better health, they should be rewarded. But this could be a slippery slope toward higher premiums for anybody who doesn't magically transform into a poster child of radiating, bright-smiling, sparkled-eyed health. Given the health insurers' penchant for bringing their profit-sniffing skis to such slopes, I'd be inclined to proceed with extreme caution.

    Jim
    Reno, Nevada

    October 19, 2009 at 3:13 pm |
  62. Diane Dagenais Turbide

    Jack,

    What you are describing is why the middle class, businesses and government cannot face rising healthcare costs because everyone tries to put on the others the cost of healthcare! I call this passing the buck while the healthcare system is created to please special interests that do not care to make you healthier...why would a healthcare system makes you healthier...you would be the cheapest customer to the healthcare business industry. Look at all the health products with empty promises of health, look at all the money made if we operate instead of prevent illness, look at all the side-agreement for specific heatlhcare providers. Look at how fmaily doctors makes less than specialists. The system is sick and instead of fixing it for people and not for the industry we are now at a point where we keep on making you pay by making a judgment call on your health!

    The problem with the bill is this part : double the maximum penalties employers can charge workers who flunk medical evaluations.

    This clause means your employer and insurance will be judging and be informed of your medical file! In a free country, your decision in regards to your body belongs between you and a qualified doctor! Do not mind incentives to get healthier through tax incentives if going to a gym as an individual or for a family and tax incentives to get businesses offer healthier products and services! If you want judgment call on people make it on business polluting because even if yoo do not smoke...you can still end up with lung cancer!!!!!!

    October 19, 2009 at 3:15 pm |
  63. chuck b // coastal north carolina

    I would think that that would make since.... why punish the healthy

    October 19, 2009 at 3:15 pm |
  64. Bizz, Quarryville, Pennsylvania

    When employers and insurance companies are allowed to start screening people because of being a higher health risk to them. I think that is wrong and a dangerous thing to do. Employers should only hire people who they feel are most qualified for the job they offer, nothing else. There are a lot of people who have health problems because of family history that cannot be helped. Such as different forms of cancer running in their family. Should these people also be made to take a test to see if they have the gene and then be charged higher premiums? Once you open up pandora's box it cannot be closed.

    October 19, 2009 at 3:16 pm |
  65. ken jefferson city mo

    Yes they should why should I have to pay because someone can't control their eating habits or take care of themselves.

    October 19, 2009 at 3:17 pm |
  66. Luke

    Jack,

    I have a family history of diabetes, high blood pressure, and heart disease (not to mention hair loss), so you might think it'd be against insurance premiums being tied to a patient's health. You'd be wrong. If done correctly, this would force people to be responsible for their health and possibly change the culture of medicine to where citizens would be held more accountable for their daily choices.

    If there really is a movement to increase preventative care, I think a way to highlight responsibility for personal health choices should be its cornerstone. Sadly the only way to get this point across to most people will be to link it to their wallets.

    October 19, 2009 at 3:23 pm |
  67. Linda in Charleston, SC

    Healthcare reform should be about getting people the healthcare they need. Nothing should matter except getting healthcare. Pre-existing conditions should not figure into the scenario. In fact Jack, insurance companies shouldn't figure into it either as we will never have healthcare reform of any kind until insurance companies are out of the picture. Insurance companies prey on people. Insurance companies increase medical costs. Insurance companies control the industry on both sides, patient and doctor, contributing to high costs of medical care. I don't expect we will get what is needed. But healthcare shouldn't be based on money or healthiness.

    October 19, 2009 at 3:24 pm |
  68. Tom Mytoocents Fort Lauderdale Florida

    Jack
    The mortality rate indicates far more healthy people die than the sick.. Healthy people die from Drugs, STDs, Firearms, Motor vehicles Infections, Toxins,Infections and Alchhol abuse.
    Wellness incentives is meerly a ploy to penalize the innocent.
    Everybody knows sick people are far more attractive corpses than healthy dead

    October 19, 2009 at 3:27 pm |
  69. Lance, Ridgecrest, Ca

    Jack, so how exactly do we determine which employees are "healthier"? Let's see, maybe DNA tests and charge more if the tests show a preposition towards cancer, diabetes, or heart problems? OR, do we wait until the employee gets sick and increase their premiums, like car insurance? OR check family history and assume heredity will cause the same health issues as the family, charge accordingly. Come on Jack, this is what insurance companies do best, estimate the risks, determine the probability of costs, add a profit margin, and end up with a premium. Let's not throw crap in the game, the only winner would be the insurance companies

    October 19, 2009 at 3:28 pm |
  70. Marion/ Alabama

    Yes,People who are overweight and smoke by choice,should pay more for their choices,not the people who try to stay in good shape.

    October 19, 2009 at 3:29 pm |
  71. bud rupert

    No and hell no! Everybody should have exactly the same health care plan period.
    Once you start providing tiered service the system gets so convolutued and complicated, costs sky rocket and you need a dozen attorneys to figure out what's what.
    Keep it simple my man. Cut out "fee for service", Increase the amount of primary care docs. (with better compensation for them) (not the specialists) go single payer and you'll have better care and reduce costs 30-50%.
    2 things a country as rich as this one should provide to everybody. Defense and health care regardless of what it costs. It's the right thing to do.

    October 19, 2009 at 3:33 pm |
  72. Terry, Chandler AZ

    Absolutly!! I exercise vigoursly at least 90 minutes daily and often as much as three hours. I watch my diet and see my doctor on a regular baisi. My emploier pays the same premium for me as he does for the over weight smoker down the hall. In my opinion the smoking idiots should have premiums double what I pay.

    October 19, 2009 at 3:35 pm |
  73. Jan from NJ

    I never thought of it but that would seem fair but if it means that the really sick people pay even more than they do already then I say no. If they would impliment that and then pay for it by taxing those making over $250,000 a year then I say "GO FOR IT"

    October 19, 2009 at 3:37 pm |
  74. chris

    no it should be the same for all legal taxpaying americans we should be allowed to live our lives as we see fit not the govt. or your boss

    October 19, 2009 at 3:40 pm |
  75. Rae from Indiana

    I already had to switch doctors because of my insurance company, my premiums have increased and my benefits have decreased for as long as I can remember. So please tell me what is new?

    The insurance companies will NOT lower premiums for healthier people, they will just raise them for people they don't want to cover. Are they going to monitor what people eat? Their stress level? How many hours of sleep they get per night? Alcohol consumption? Maybe they will want to do genetic testing next.

    I don't trust the insurance companies and they do nothing to add value to anything except the bottom line of the stockholders in their companies. I wouldn't shed a tear if they were out of the picture entirely.

    October 19, 2009 at 3:40 pm |
  76. Michael "C" Lorton, Virginia

    Jack: Instead of worrying about whether or not healthier employees should have lower rates--and the definition of "healthier employees" has yet to be universally defined---we need to worry about employees having affordable health insurance at all. In today's day and age and the way that our food chain is processed--what is healthier today when we consme food? My grandfather drank, smoked, ate fatty foods, and was a farmer--–and he lived to be 82. We are [all] genetically predisposition--but no one says anything about that-–do they Jack?

    October 19, 2009 at 3:44 pm |
  77. Richard McKinney, Texas

    One thing for sure Jack is that healthy employees will have fewer health problems which will reduce the cost to employers. When you look at it that way then sure they should get a discount.
    You have to look at one more aspect of this though Jack. What happens with people like diabetics? Would an employer be less likely to hire them knowing they will require more medical expenditures?
    Should they only hire healthy people? Or just not hire women because they may have babies That would be a cost effective thing to do. It is a slippery slope and one we might not want to venture down.

    October 19, 2009 at 3:44 pm |
  78. Rob of Brooklyn

    maybe it would be an incentive for people to get in shape. The only thing is the weight charts are from the 50's.Or are fixed for those already in great shape , not for the average person. Have you ever seem them. It makes any normal person a pig-LOL

    October 19, 2009 at 3:46 pm |
  79. Jim from Chicago

    While this sounds good on the surface, who decides what is unhealthy behavior? The insurance industry operates on averages. How can you get full participation if you penalize those who need insurance even though it may not be their fault.

    October 19, 2009 at 3:47 pm |
  80. frankie

    This is a tricky question, because inner-city people who do not have access to grocery stores with fresh meat and produce, and who live where it might be unwise to stay outdoors for some sunshine and exercise, should not be penalized. We need better schools in America and insurance companies that are forced to play fair, these will improve everyone's health in the long run.

    October 19, 2009 at 3:49 pm |
  81. Chipster

    Should people whose homes haven't burned down yet have lower insurance costs? Do you understand the concept of insurance? The idea is that everyone pays into a program that covers health programs when they arise. Suppose you pay less for 10 years than I do because I have a minor health problem, then suddenly, the doctor discovers that you have some terribly form of cancer that will cost a fortune to cure? How is it fair for you to received expensive treatment for years when you've paid less than I have for coverage? The idea is to pool the funds and use them when and where they are needed most. That's why insurance companies invest the funds – to increase the size of the pool (and to pay those big bonuses! 🙂

    October 19, 2009 at 3:51 pm |
  82. sharon

    After the "public choice" is in place.........and all those that will flock to sign up, then yes.

    October 19, 2009 at 3:53 pm |
  83. Jerry Jacksonville, Fl.

    Yes, when people abuse their body by smoking, drinking and eating everything but the kitchen sink then they should have to pay a higher cost for medical care to help take care of themselves because of the disregard for their body and the way they abuse it.

    October 19, 2009 at 3:54 pm |
  84. Cynthia

    No. Because many healthy employees go to the doctor more than unhealthy ones do. How about the healthy pregnant woman with a complicated pregnancy or multiple births? How about people who are always at the doctor because of imagined illnesses. I've known many people over the years who ride the sick book, give them 8 hours of sick leave and they take it, then when they really get sick they go in the hole or get fellow employees to donate their sick leave. Give me a break!

    October 19, 2009 at 3:56 pm |
  85. Conor in Chicago

    So because I smoke and like to drink on the weekends I will now have to pay more in health care costs if I get a sickness for it while people who are healthy but aquire the same medical problems will pay less. That's the America I know and love...

    October 19, 2009 at 3:58 pm |
  86. Joe

    This is a delicate issue where we have to pick and choose what forms of discrimination are allowed. I for one think that a fit, non-smoking individual who eats right and exercises regularly should pay less than a smoking, fast food guzzling, couch potato. But where do we draw the line? I believe one needs to be drawn, but I don't know where.

    October 19, 2009 at 4:01 pm |
  87. Rick

    Jack, as an American living in Canada, I don't worry about health care. My wife's mastecomy–including all tests, surgical fees, hospitalization, and daily home visits by a nurse–all cost nothing. By contrast, my surgery in the US a few years ago cost me several thousand dollars and took insurance 9 months to pay–and I worked for a Fortune 100 company!

    October 19, 2009 at 4:03 pm |
  88. Alex in Seattle

    Yes, like car insurance, the cost should be based on risk just as long as those who have paid into the system are not denied coverage when they make a claim. It would be very unfair to pay more for your higher anticipated health risk and still get denied when you need the care.

    October 19, 2009 at 4:04 pm |
  89. Steve

    Jack,

    This is a tough one for me. I'm a generally healthy person that visits my doctor once a year for my annual physical, but yet I pay $1800 a year for my HMO plan through my employer...so right now I would say that yes, my insurance premium should be lower.

    But what happens as I get older and hereditary items start to come into play such as hypertension an high cholesterol? I eat healthy and workout, but cannot control what is in my genes, so am I going to be forced to pay more for something that I cannot control, even though I make my best effort to do so?

    Steve in Virginia

    October 19, 2009 at 4:04 pm |
  90. Chryssa

    Of course! It's no different than good drivers getting lower rates on car insurance. If I were to lose my job-based coverage, I'd pay out the wazoo simply because I'm of child-bearing age. It would only be fair to reduce it based on the fact that I'm a healthy, active, non-smoking vegetarian with no pre-existing conditions.

    Boise, ID

    October 19, 2009 at 4:06 pm |
  91. lauren wilder

    No, you shouldn't get a break for being 'healthier', you don't get to choose your genes. Health parameters such as blood pressure and cholesterol are misleading, blood pressure control can be achieved with medications that will eventually cause diabetes (and yet more expense) and over half of heart attacks are in people with 'normal' cholesterol. Many with 'high cholesterol' will never have a coronary event, yet taking statins will harm their heart (actually the depletion of Co-Q10 harms everone's health.) Are there healthier parameters to live by? Yes, however what is needed is more therapists and life coaches to get you to better lifestyle choices, not 'preventative medicine' that just gets you on the prescription drug/future chronically ill patient treadmill. Fire the vast majority of primary care doctors and replace with psychological support.

    October 19, 2009 at 4:09 pm |
  92. Dee now in GA

    Exactly how would the "healthy" employees be determined?

    Wouldn't those guys who ran the Detroit marathon and DROPPED DEAD perhaps have been classed in the healthy group?

    What about "healthy" employees who do hazardous things, like drinking and driving or using drugs? How could that be determineed? How about those who might not drink and drive, but who sit at home every evening and down a 12-pack of beer? Will the employers send spies to homes to see just what is going on?

    John Donne said it best. No man is an island, and that goes for the health care system too. What some do affects ALL, and so all should share the cost. At least until Big Bother installs the cameras and the BP monitors and the daily medical tests to determine who is at risk and who is not.

    October 19, 2009 at 4:14 pm |
  93. Pugas-AZ

    Just talking about healthcare reform is kicking up prices to consumers. Hold on for the ride, this is not going to be fun. It is an all out battle and preemptive strikes have already started. The subjectivness of who is healthy or isn't healthy based on their life styled, and basing their premiums on those assumptions will lead to lawsuits and political fallout on a grand scale.

    October 19, 2009 at 4:15 pm |
  94. jeff jackson, alabama

    No! I know many people who pay the equivolent
    of a house payment for company health insurance.
    I know many state and federal employees who pay
    from next to nothing to nothing to the same company.
    If you penalize an unhealthy person who pays out the
    nose already, what are you going to do with the special
    rates of state and federal employees who are unhealthy ?

    October 19, 2009 at 4:18 pm |
  95. Andres Saenz(Albuquerque, NM)

    This one is a no-brainer...healthier employees should definitely have lower health insurance premiums because they need less medical attention(fewer medications, fewer doctor visits, fewer surgeries, etc.) than their heavier counterparts. Not to mention that it could certainly save companies so much money in the long run, potentially reducing the amount of American people who currently don't have any health insurance.

    On the other hand, those people with ever-expanding waistlines who live on drive-thru fast food should have higher premiums because they are the ones who accumulate more medical debt than everyone else.

    October 19, 2009 at 4:19 pm |
  96. Gigi Oregon

    Maybe, as long as they are not forced/ required to get unnecessary tests, but...would that mean the poor or sick would be discriminated against. Probably, then No. It might make Jack have to pay higher premiums then the average older person. Discrimination is not a good thing for the United States image.

    October 19, 2009 at 4:20 pm |
  97. Willard

    The prospect sounds good on the surface, but doesn't hold up to scientific scrutiny. Recent studies have shown that the obese use less health care dollars over their lifetime then healthy people. Smokers even less. Why? They die at an earlier age. Over a lifetime healthy people will use the greatest amount of services. Counter intuitive, but who pays attention to facts these days?

    Will
    Canon City CO

    October 19, 2009 at 4:22 pm |
  98. Mark, Worcester MA

    Your question begs for biased answers. Should healthy employees have lower premiums – no, of course not, a lot of health matters are beyond our control. Should employees who lead healthier lifestyles have lower premiums – absolutely, and this is not a new concept, we already tax cigarettes as an incentive toward better national health.

    October 19, 2009 at 4:23 pm |
  99. Bob Mandell

    Most people are "healthy" until a disease or injury or illness strikes. To punish those unfortunate enough to be ill and reward those who "live healthy" is unfair and I believe unenforceable.

    October 19, 2009 at 4:24 pm |
  100. GWTripp in Pennsylvania

    There is a bigger picture here. In health care reform there needs to be a greater emphasis on getting young, healthy adults to enroll in the health plan. Obama's plan lacks that trigger. In addition, no mention has been made about the high cost of health care. Hospitals charge too much. Doctors charge too much. Medical suppliers charge too much. Cost of researsch in medicine and medical technology is at the very heart of the problem. If we focus our efforts in reducing this cost we will hit the nail on the head.

    October 19, 2009 at 4:26 pm |
  101. chris hamilton

    People who smoke and drink should pay more for health care. companies that sell unhealthy food should pay more taxes for healthcare or change their food menu. why punish the people for being unhealthy its not entirely our fault. american citizens work over 40 hours a week then go home to work im sure many would follow good diets in their lives if we had more time on our hands and quality food. philadelphia p.a.

    October 19, 2009 at 4:27 pm |
  102. Lynda, Greenville NC

    If we move to a system where everyone is required to have health insurance it should certainly be treated like auto insurance – people who are reckless should have higher premiums. Why should I, a healthy, active, nonsmoking, nondrinking, thin female have to pay the same premiums as a person who does the opposite? That would only mean that I am subsidizing their unhealthy habits, which I certainly can't afford to do!

    October 19, 2009 at 4:27 pm |
  103. DON IN WESTPORT, MASS.

    No. On the surface this looks like a good idea but how could you possibly be equitable and fair to everyone. There are just to many variables.
    On the other hand having no fault insurance is also unfair to those who take care of themselves.
    Its a no brainer if you smoke. What about people who have dangerous jobs. What if your an imbeded news man in Iraq or Afghanistan. What if you live in Chicago. What if . What if. Where do you draw the line.
    I think we all can agree that GREED is whats creating this monster. My first attack would be on the pharmecuetical industry who have us by the throat. Why, because they can.

    October 19, 2009 at 4:28 pm |
  104. George Hucker

    No. Single employees have one rate and employees will family have another rate. One payment at the first visit per year. But I do think that every employee should get a statement of their costs to the plan each year. Maybe that will change the smokers to become non smokers. If they are worry about taxes simply quit smoking and no sin taxes paid to the government.

    October 19, 2009 at 4:29 pm |
  105. Annie D.

    Yes, "healthier Insureds" should have lower health care premiums because they take their health seriously and keep health care costs down from fewer visits to physicians, hospitals and pharmacies. For those who aren't as healthy - offer an incentives to work towards that goal so we call can enjoy a few more dollars per paycheck.

    October 19, 2009 at 4:32 pm |
  106. Pablo in Arlington Texas

    Hang about a bit, Jack.
    Who gets to define "healthy"?
    The employer? The insurance company?
    When you follow the string of this proposal to it's logical conclusion, it becomes yet another argument for moving to a single payer system rather than the unhealthy unholy mess we have now.
    Pablo
    Arlington Texas

    October 19, 2009 at 4:33 pm |
  107. Beth Calaveras County CA

    If I get lower rates for being a safe driver and taking care of my car, why not lower rates if I am healthy and take my health seriously? Something like 40% of medical costs go issues that are highly preventable.

    October 19, 2009 at 4:34 pm |
  108. Nichole, Tulsa, OK

    Yes, I believe they should. And I say that as a smoker. I don't think it's fair that someone else should pay higher costs if I come down with COPD – I chose to do that to myself. Just as I don't think it's fair that I pay more when someone who's eaten fast food & drinks soda every single day comes down with diabetes and I have to help foot the bill. It's important that we re-establish personal responsibility in America for the choices that we make.

    October 19, 2009 at 4:34 pm |
  109. Adam Simi Valley, CA

    It's going to be hard for fat people to find work. Of course, they are not a protected class of citizens so there is not any legal problem there. It just means overweight people and sickly people are going to have to work harder to stay employed or find jobs. It means that your mother's medical condition might be the difference in you getting a job or not. Don't pretend employers are not going to take into account the bottom line impact of all their employees.

    October 19, 2009 at 4:36 pm |
  110. Colleen Brooks, Charlotte, NC

    ...how is that much different from pre-existing condition?

    October 19, 2009 at 4:39 pm |
  111. Dennis North Carolina

    no but we need regulation of the insurance industry across the country and state lines.

    October 19, 2009 at 4:41 pm |
  112. Scott - San Diego, CA

    It makes perfect sense, kind of like a good driver discount. Therefore it will never fly, all the overweight smokers will be crying foul.

    October 19, 2009 at 4:41 pm |
  113. Sandra Turner

    If your choices put you into a higher risk catergory, then yes you should pay an increased premium. But, this then puts the emphasis on preventive health care that should be covered for all.

    October 19, 2009 at 4:41 pm |
  114. Anne/California

    Jack-After 15 years working in the healthcare business, to me it is obvious how much "lifestyle" is the cause of most health concerns. Lack of exercise, poor eating habits, smoking and methamphetamine use are the primary catalysts to poor health. Pre-disposed health ailments such as a family history of heart disease or diabetes, can be avoided or greatly minimized by exercising, eating properly, not smoking or using illecit drugs. Healthy Americans have been paying the bill for unhealthy Americans for too long. Yes, reward the healthy!

    October 19, 2009 at 4:41 pm |
  115. Karen in Colorado

    Health insurance should offer premium discounts to those who file few or no claims because they successfully manage their own health. My auto insurance has a discount because I am a safe driver, so why can't the same principle apply to health insurance? Keep employers out of this debate because of privacy and other issues.

    October 19, 2009 at 4:44 pm |
  116. jack

    First remove the antitrust exemption. Then transfer all health policies out of the for profit sector and place them into NON PROFITS. Everyone will be covered and no one will be refused for a pre-existing condition. Upon enrollment a physical will be given and a rate will be determined based on health. Those who eat a whole bucket of fried chicken and wash it down with a pint of B&J's "Chunky Monkey" will be paying higher costs. Those who choose to stay in shape and not lay around on the couch will be rewarded with lower rates. Those who improve can have their policies monthly premiums reduced.

    Get healthy, save a buck.

    October 19, 2009 at 4:45 pm |
  117. Victor in Saanich, B.C. Canada

    Well Jack, being a cancer patient I would say NO !!! There is a misconception out there that healthy means 'for ever'. Up here we had a health minister, who upon receiving the news he had cancer, stated that he thought to himself ' I can't get cancer, I jog' !!! A health calamity should not send a citizen to bankruptcy and poverty afterwards!! A public option is a necessity to bring your country into the new millennium!!

    October 19, 2009 at 4:45 pm |
  118. Lynn, Mo..

    I have hypothyroidism and glaucoma. Not smoking or diets and exercise would not have prevented them. All insurance is evil. Government universal insurance is the answer. Medicare does not discriminate.

    October 19, 2009 at 4:49 pm |
  119. Michael and Diane Phoenix AZ

    So make it like car insurance then....safe drivers, living in the "right neighborhood (redlining)", good grades in school, all add up to lower car insurance premiums, so why not offer lower premiums to those who may not require a lot of medical care....? Would it work, no, because you never what will happen medically.

    October 19, 2009 at 4:53 pm |
  120. Michael, Alexandria, VA

    No, they should not, since one day they will be sick and will then have to payer higher premiums when they can least afford to. If everyone paid a similar premium for their age, you don't have that problem.

    October 19, 2009 at 4:53 pm |
  121. Melanie, CA

    No. Many health issues are affected by genetics. It is not fair to penalize someone for something they have no control over. I have purchased health care all my life, even when young and self-employed. It is the responsible thing to do, just like auto or home insurance. It should be required and set up on a sliding scale by ability to pay not state of health.

    October 19, 2009 at 4:56 pm |
  122. Paul from Canada

    No, not unilaterally across the board, this would be grossly unfair to those people who's medical conditions are of no fault of their own. If one could claim all health issues are a result of poor lifestyle choices, then sure, but that isn't the case and I wouldn't want to be part of any nation who penalizes a person for bad genes or luck.

    October 19, 2009 at 4:57 pm |
  123. kevin kelly from sc

    We should all have lower premiums.Right now my health insurance costs me nothing because I cant find a job and I dont have insurance.

    October 19, 2009 at 5:00 pm |
  124. David Bebeau,Springfield Missouri

    Yes,I work hard staying healthy and its fun being healthy..............
    We should have lower rates than people that don't care.
    David

    October 19, 2009 at 5:01 pm |
  125. Jim in Alabama

    Not necessarily. But those employees who voluntarily participate in any healthy programs offered by their employers should be given a discount because obviously they're trying to remain healthy and avoid health problems and the others are not.

    October 19, 2009 at 5:05 pm |
  126. Donald in CA

    No, those healthy employees have to remember they will have health problems as they get older. Two things you can count on as you get older, you want get healthier or better looking.

    October 19, 2009 at 5:05 pm |
  127. Delia

    NO! If our health were entirely within our coindividual control, than I would say yes. However, we all know it's not! There are genetic factors. Additionally, the food producers should be held accountable for the manipulations they do to make our foods less healthy. Let's not hit the "little guy" with yet another hoop they have to jump through. Wellness should be about knowledge, not withholding benefits or discrimination.

    DELIA
    KATY, TX

    October 19, 2009 at 5:08 pm |
  128. aaron

    of course not. With all the talk of "no pre exisiting conditions", this does exactly the oppisite. This is just another way for the goverment to try and run people's lives. "Either do what we say and what we think is good for you, or pay the price" attitude sure sounds like the Bush ideals the dems are trying to get away from.
    Aaron, valley springs, ca

    October 19, 2009 at 5:10 pm |
  129. Kim Smith, Dodge City, Kansas

    Lower premiums for healthier people would appear to make sense on the surface, but look at the supposedly healthy people that get into car accidents, suffer injuries at work or are hospitalized for reasons other than poor lifestyle choices? Or, using that same logic, why should my property taxes go to schools when I don't have any children utilizing those tax dollars? The answer to lowering health care costs, rests in the hands of profiteers and corporate medical entities that have absolutely zero price controls or regulation. And neither Congress or the Media are very willing to rock that boat for obvious reasons. Just take a look at how many pharmaceutical ads are on TV now, and how many Congressmen own large blocks of stock in those same companies.

    October 19, 2009 at 5:11 pm |
  130. Nell, Clemson, South Carolina

    No. The cost of insuring those with medical problems should be spread across the population. Otherwise, it will not be possible for people with medical problems to buy insurance.

    October 19, 2009 at 5:11 pm |
  131. andyz Lynn, Ma

    The logical answer would be yes but with so many people being turned down for pre-exixting conditions, how would the unfit be effected? What incredible prices would be paid for insurance? Sounds like a great arguement for National Health Insurance. That would be National Health Insurance with a Public Option. Jack, why do we have a Republican Party, the party of NO?

    October 19, 2009 at 5:12 pm |
  132. Dave, Brooklyn, NY

    While that is an intriguing question, there are dangers lurking. Some people are genetically predisposed to certain chronic conditions such as obesity or diabetes and can do little or nothing about their condition. Nevertheless, those who are just lazy and careless about taking care of themselves, such as smokers, should be penalized. The others should be offered supervised treatment so that it can be determined if their disorder can be corrected or not. If not, then it is not their fault and they should not be penalized.

    October 19, 2009 at 5:13 pm |
  133. Bob D Iowa

    Jack, with the privacy issues insurance companies cannot disclose that information to the employer, so no. Can there be discounts for non-smokers or individuals in a wellness program yes but that does not mean they are healthier. Next you may want to subdivide it by age, sex and race.

    October 19, 2009 at 5:16 pm |
  134. Jamar

    Without a doubt yes. I am a hardworking American that is in great physical shape as well as being a member of the U.S. Armed Forces and this is absolutely rediculous and a slap in the face!

    October 19, 2009 at 5:18 pm |
  135. Rick Medina,OH

    Jack,

    The answer is 'Absolutely YES,' with a word of caution. People who are unhealthy through no fault of their own, and with few therapy options should not be penalized. But, people who are healthy enough to work to improve their health even more, should be rewarded for their accomplishments.

    My wife suffers from renal failure, but we've forestalled dialysis for over 3 years since her diagnosis ... with a diet I would not ordinarily choose. But, it has worked so far! If more people made those types of choices, perhaps health care reform would be possible at a more realistic price.

    Rick, Medina, OH

    October 19, 2009 at 5:20 pm |
  136. Ronald Denver Colorado

    Yes they should, it follows logical premise that a healthy individual be given a discount on their insurance, Its only fair.

    October 19, 2009 at 5:21 pm |
  137. Mari Fernandez, Utah

    Somehow that seems a bit on the edge of prejudice, Jack. If we do this then what's next? People are already denied coverage because of a preexisting condition!

    October 19, 2009 at 5:24 pm |
  138. Alan in Louisiana

    Sure, you know how to stay in shape and you go to the doctor less.
    This will make people eat healthier, and decrease obesity. But why should you pay more just because you are less healthy. The reason is if you are overweight that means you are over healthy, therefore you would most likely be able to afford more things. Meaeaning that you get enough food. This proves that the Obama administration does not have a socialist agenda.

    October 19, 2009 at 5:28 pm |
  139. Thom Richer

    Why not, Jack. A little more discrimination against the weak and poor may be just what the doctor ordered for this failing democracy. Tax the fatties and maybe they will not afford to eat and then will be among the healthy. Tax the sick so they won't be able to afford doctor's and hospital care and will die sooner and there will be less to waste treatments on so the healthy good people won't have to pay as much. Tax fat foods, tax more for tobacco products but raise tobacco company subsidies so their profits won't be affected, then blame users for their "unhealthy addiction. You get the idea. Take from the poor and give to the rich. Create the perfect society and rid ourselves of those who are "different, feeble, sick, unclean, don't fit in our perfect world, have no job, do not have blond hair and blue eyes.. Wait a minute! Someone already tried that years ago. Somewhere in Europe, I think. What was his name? I think it started with an "H."

    Thom Richer
    Negaunee, MI

    October 19, 2009 at 5:30 pm |
  140. Johnny C (Los Angeles)

    Hi Jack –

    I have had a 'cadillac' plan from my company for 25 years and have never needed to use it except for the every other year check up that started when I was forty. Although it seems like I have been donating my costs to cover the less fortunate ... if you lowered my costs, how high would the costs be for the sickly?

    The costs are rediculous now, if you lower my costs because I have good health, how will the unhealthy folks be able to pay theirs? I would forego a reduction to help the sick ... too bad the health industry giants, including the insurance companies are content with big bonuses ... there is where the eyes should be focused!

    October 19, 2009 at 5:30 pm |
  141. Antonio from Washington D.C.

    Don't limit those who are unhealthy, Jack! Everyone should have lower insurance premiums!

    October 19, 2009 at 5:34 pm |
  142. john ......... marlton, nj

    Yes, and if not should males drivers under 21 pay more for car insurance....?

    October 19, 2009 at 5:36 pm |
  143. Burt

    That is a loaded question Jack. What about people who were born with certain conditions or people with cancer and heart conditions that could be inherted tendencies through no fault of their own and live healthy lifestyles. Do we charge them extra? I feel we should have no fault across the board fees.

    October 19, 2009 at 5:44 pm |
  144. RL from MI

    NO!! There is so much about health that a person has no control over...accidents, birth defects, heredity,,genes, environment, etc. Not something one should pay higher prices for. If we make it a national issue that we should not allow insurance companies to refuse to insure those with pre-existing conditions, why would we then aALLOW them to charge a higher fee for to those same conditions. All you will do is make obtaining insurance coverage unaffordable –for those who need it MOST! Thereby still unattainable..for yet another reason..big money!

    October 19, 2009 at 5:47 pm |
  145. frank

    There should be an age limit for increasing premiums. If you're in your 20s or 30s and obese there is no excuse. You start getting 50 or older changing lifestyles is not easy. You have a chronic condition. Its not going away. You have heart problems? Diabetes? Its done.

    A blanket increase in charges and cut in benefits is stupid. And if you have people NOT using a doctor because they can't afford it, then you make the situation worse.

    Want to bet you don't have healthy snacks at CNN? Thought so. Most places have chips and doughnuts out. NOT fruit and veggies. Only place I saw that had that was a PRO. And the head was a MPH. Thats Masters in Public Health.

    October 19, 2009 at 5:51 pm |
  146. Shirley

    No! Those very healthy people may be doing very dangerous things that could put them in the hospital, leave them vegetables or crippled for life.

    October 19, 2009 at 5:56 pm |
  147. Susan from Twin Falls Idaho

    They would if they paid them themselves, without being on a plan.

    October 19, 2009 at 6:01 pm |
  148. Bob - Rawson Argentina

    Let me phrase this another way . . .

    Should someone be charged MORE because they are prone to illness NOT due to their life style and choices??

    And THAT is the case for some poor souls! How and WHO decides the difference?? A "Poor Health Panel??"

    October 19, 2009 at 6:04 pm |
  149. Aaron Kreke (Cray-KEE)

    Absolutely! I don't want to have to pay for someone else's apathy regarding their health. There are some pre-existing conditions, but I'd bet they are few and far between. The fact of the matter is Americans are getting entirely to heavy. We need to turn this preverbial bus around.

    October 19, 2009 at 6:05 pm |
  150. Bob - Rawson Argentina

    And THIS really gets me!!

    "employers can charge workers who flunk medical evaluations."

    Who designs this test and who "evaluates" the results??

    If you have a sicjness that is treated but you don't 100% recover such that you fluke following tests does THAT mean you pay more in the future for "pre-exsisting conditions????"

    October 19, 2009 at 6:08 pm |
  151. Keith

    All this discussion of health care reform is making me sick. Should I pay more?

    October 19, 2009 at 6:09 pm |
  152. Annie, Atlanta

    That’s like asking if Americans who don’t have kids in school should pay less in taxes. No! I have type 1 diabetes. I didn’t cause it. I didn’t ask for it, certainly. Should I be punished for it? No, but I am. By the way, it's been ugly in the world of medical expenses for years.

    October 19, 2009 at 6:10 pm |
  153. Greg in Arkansas

    Jack,
    Who is gonna define "Healthy"? Insurance companies? LOL!!

    October 19, 2009 at 6:11 pm |
  154. Carmen

    No, they shouldn't. The premium should be based on income regardless of health status.

    October 19, 2009 at 6:12 pm |
  155. Shelly in Colorado

    Yes – absolutely yes! I am very healthy, very, very rarely go to the Dr. but I am still paying hundreds a month "just in case" I actually get sick. I would be better off putting that money into a savings account. The insurance industry is a joke.

    October 19, 2009 at 6:12 pm |
  156. jeff in hawaii

    Gee Jack,

    Sounds like another sellout to the insurance companies and one more step towards "death panels".

    October 19, 2009 at 6:12 pm |
  157. Roman Deutsch, Butler, PA

    Yes. I have no problem with that. But on the other hand insurance companies are passing the buck so that the elite can have great coverage. But, this I tell you, H1N1 is not prejudice as to whom it attacks. So these execs better keep that in mind. They don't want to change, I know someone who can change all that.

    October 19, 2009 at 6:13 pm |
  158. Kevin, Nor-Cal

    Jack, yes. Healthy people should have lower insurance premiums. If you are active, stay fit, eat correctly you should be given a break. And I'm tired of the obese using pre-existing conditions as an excise. Last time I checked, those crates of Twinkies and buckets of ice cream didn't magically jump their way into your stomach.

    October 19, 2009 at 6:13 pm |
  159. Jon

    Unhealthy employees definitely need to pay more. As it is now, the rest of us end up paying the cost in higher premiums. It is unfair and we need incentive to be healthy in this country.

    October 19, 2009 at 6:13 pm |
  160. Richard

    Sounds like "pay-go." Let's balance the budget.

    October 19, 2009 at 6:13 pm |
  161. Nancy, Tennessee

    No, that makes things too complicated and gives the insurance companies too many ways to charge more in the long run. If an insurance company gives a person lower rates for being healthy and they get sick while covered, are they going to raise their rates for being unhealthy. If they don't raise rates, then that person would be forever locked into that health insurance company and have to stay with the same employer to keep from paying a higher rate. So if you have health insurance coverage now and are healthy don't sit there so smug – you could be the next one paying higher premiums if something goes wrong with your ticker, plumbing, or electrical system.

    October 19, 2009 at 6:13 pm |
  162. David, Arlington, VA

    Absolutely NOT. Everyone including young people should be required to pay a basic premium for healthcare in order to make sure that there is enough care for everybody. It should be the SAME amount for everyone. If we start charging more for this and less for that we are going to be in a bigger mess than we already are at the moment. People get sick for a VARIETY of reasons and not all of them have to do with neglecting oneself, thus no one should be penalized.

    October 19, 2009 at 6:13 pm |
  163. Terry

    No. It's a slippery slope that could then lead insurance companies to charge people more who have genetic predispositions to certain diseases. The point of insurance is to pool the risk. It's not right for an insurance company to penalize you for the very reason you bought their product to begin with, car insurance or health insurance!

    October 19, 2009 at 6:13 pm |
  164. daveed

    Jack, maybe so. we might make healthier decisions so that we can have a lower premium to save money and have good health. two for the price of one. Daveed , Chicago .

    October 19, 2009 at 6:13 pm |
  165. Flyingwolf, Manchester NH

    What constitutes healthy in a world where acne is a pre-existing condition? This question is another reason that we need the public option.

    October 19, 2009 at 6:14 pm |
  166. Chidube

    Healthier employees should pay lower health premiums. If we do this this will be an incentive for people to make healthier lifestyle choices. Nothing gets people moving like a finacial pinch.

    October 19, 2009 at 6:14 pm |
  167. DJ in Denver

    Two things here are clear to me. One is that we as a collective well all pay a smaller premium because we are a large group. If they charge sick people more then what changed? Two we all need to work on wellness. If you want to charge someone more how about fast food or candy makers.

    October 19, 2009 at 6:14 pm |
  168. Kristine

    One should not forget the part heredity plays in health. With this in mind I think this sort of premiums would be discriminatory.

    October 19, 2009 at 6:14 pm |
  169. Anna in Chicago

    We should not compare car insurance to health insurance. If I do not want to buy car insurance then all I have to do is not to buy a car. If I cause accident then I hurt other people too. I can buy just Libility insurance for my car and be responsible for my car myself. What choice do I have for health insurance. What choices do I have if I have already high blod presure high calestrol and so on. I will be forced to pay higher insurance. We have this now. Health insurance is so high that is unaffordable. Big business want to regulate people and deregulate business. This is the Chineese type of economy.

    October 19, 2009 at 6:14 pm |
  170. John

    I'm in pharmacy school and we are always being shown the statistics of cost and well-being in class, the 80/20 rule! 80% of the cost employers pay is
    from 20% of their
    employees that fail
    to engage in their companys wellness plans! It's a great idea!

    October 19, 2009 at 6:14 pm |
  171. Fritz Hohenheim, L.A.

    By extension, this leads to kicking out those people who are ill. Insurance was not invented to make profits, It's purpose is for everybody to contribute to everybody's coverage. Here in California, its hard to get earthquake insurance, in Florida, hurricane insurance is hard to get, it's nuts.
    I came to this country from Germany 10 years ago, and right now, my plans are to go back when I get older. I don't want to have to rely on the health care of a country that kills it's less fortunate citizens off, when i reach retirement

    October 19, 2009 at 6:14 pm |
  172. John, Fort Collins, CO

    People who do the right things in life should be rewarded with lower costs, be it health insurance, auto insurance, or state and federal taxes. The cost to society for people who do all the wrong things (and are still 100% covered in the end) is grossly unfair. Every company in this country has healthy employees paying thousands to cover their co-workers' bad habits - but neither they, nor their employers, are provided the added cost by their insurance carriers.

    October 19, 2009 at 6:14 pm |
  173. Jeremy, Bozeman, MT

    That's a simple question with a simple answer....yes.

    October 19, 2009 at 6:14 pm |
  174. Michael

    I look at it this way Jack, If you drive safer and don't make as many claims most auto insurabce companies will give you a discount, Why not apply the same logic to health care. ie discounts for people who take care of themselves.
    Michael
    Eastern PA

    October 19, 2009 at 6:15 pm |
  175. Onnicha

    What kind of question is that?

    Of course, healthier people should pay lower health insurance.

    The purpose of having an insurance is to manage the unforeseen risks. Those who are riskier should pay more. Those who are less risky should pay less.

    It's as simple as that.

    If anything, it would also be a good pecuniary incentive for Americans to get healthy.

    October 19, 2009 at 6:15 pm |
  176. Gabriel

    Being healthy should definitely make for lower premiums. I work hard at the gym 6 days a week to keep my svelte figure (I'm 6'4" 220 lbs). I should benefit from all that hard work, as opposed to my colleagues who sport a beer belly, smoke, and can down half a lasagna during lunch.

    October 19, 2009 at 6:15 pm |
  177. Angela

    We should not be incresing premiums an making health care even less accessible for those who need it most. I am totally against wellness incentives...

    October 19, 2009 at 6:15 pm |
  178. isabel

    Even though this seems logical, it would change the world of insurance underwriting forever. Those that are healthiest in any insured population have always paid more for less in any straight comparison. If companies are self-insured, it makes sense to have incentives for employees to be healthier. Otherwise, it would subvert the way insurance companies currently work, and result in higher premiums across the board. The only sane answer is to have a national risk pool (read: public option) which would dilute the expense on a large enough level to bring premiums to an affordable level for all. As far as paying less for the healthy: return to a good outcomes-based HMO style capitation model is the way to go! Healthier people are more productive. Everyone wins if the workforce is healthier.

    October 19, 2009 at 6:16 pm |
  179. ilya

    I'm a healthy 18 year old male. i don't smoke or drink and i exercise every day. I have a clean medical history. Why is it still so damn hard for me to find some health insurance? I can't even imagine how hard it must be for those with pre-existing conditions.....

    October 19, 2009 at 6:16 pm |
  180. john chapman

    Absolutely not! Many people have health problems that are hereditary, or otherwise beyond their control. What about accident victims wit permanent disabilities. Health insurance premiums should be as equal as possible. The idea is to spread ths risk like homeowners insurance.
    We are so hung up on trying to punish people that we cant find the compassion to just be helpful and solve problems without creating " bad guys" to justify our lack of human understanding.

    October 19, 2009 at 6:16 pm |
  181. Janet M.

    Yes-perhaps families would eat better-no more pizza or fast food nights.

    October 19, 2009 at 6:16 pm |
  182. Rich from Cupertino

    Doesn't matter whether you are healthy or unhealthy, the Insurance Companies will get their pound of flesh. They have so many expenses, bogus ads against healthcare insurance reform, higher compensation for their executives, and they need to fund their private death panels to determine who will recieve care and who will not.

    Insurance is simply the wrong model for healthcare. Insurance builds in a nonhealthcare service fee for profit that does nothing to alleviate pain and suffering or spreading risk. Because sooner or later, regardless of our lifestyle, everybody will need some healthcare.

    October 19, 2009 at 6:17 pm |
  183. gale

    it is time to let people who try to live healthy lives pay lower premiums, and use the potentially higher premiums to help those people quit smoking, and lose weight. there should be some lead time to begin such carrot/stick initiatives. it is also time for people like you and wolf, who are wealthy enough to send their 'people' to get information for them–and to laugh about it–to begin paying more than the rest of us.

    October 19, 2009 at 6:17 pm |
  184. Juzby in Detroit

    No, it's an invasion of privacy and the customer doesn't actually get a discount. When insurance companies offer discounts to their "best" customers they first raise their rates for everyone, then offer the discounted rate which doesn't really help anyone's botton line but the insurer.

    October 19, 2009 at 6:17 pm |
  185. Patty

    This sounds like an easy way to discriminate when hiring someone. Is the applicant overweight, have a limp, or maybe just wears eye glasses? Sounds to me like another reason we need not only a public option, but single payer, non discriminating health care.

    October 19, 2009 at 6:17 pm |
  186. Barroq - San Marcos, TX

    Absolutely! Does it make sense that a person who has chosen to live a healthier lifestyle (with some indulgences) and takes care of themselves has to pay the same as a person who has no regard for their health or others? Someone who smokes, or doesn't do the basics of maintaining a healthy lifestyle by making a minimum 15 minutes a day for walking, or whoeats alot of fast food, should be charged more. One of the key ways of providing preventative healthcare to this country is by asserting a level of responsibility on the individual, and the one way to help assert this is charge the people who don't care more.

    October 19, 2009 at 6:17 pm |
  187. Ken in NC

    I have to have flood insurance but my home never floods while others do and their premiums are the same as mine. I should have to have health insurance and others are not as healthy as I am should also so what is the difference. Why should they have higher premuims than I do. Insuring the risk is insuring the risk. On some the company pays while on others they don't.

    October 19, 2009 at 6:17 pm |
  188. Lola

    Absolutely not. When does it stop? Charge African-Americans more because of the risk of sickle cell, women because they can get pregnant, skiers because they might break a limb, certain ethnicities because of diet traditions? It's dangerous and ridiculous.

    October 19, 2009 at 6:18 pm |
  189. michael grande

    Wrong question Jack. The right question would be" should our country concentrate on universal heath care regardless of party affiliaton, income, race, weight,height etc?.
    The impending change in coverage is just one more result of our country (everyone) refusing to deal with the issue.

    October 19, 2009 at 6:18 pm |
  190. Tom in Iowa

    Whatever happened to Health Care for everyone? Health care providers are jacking up their rates at an alarming rate and when this legislation passes we are going to be forced to pay higher rates for mandatory health care AND if you refuse to go along with it you will be charged a penalty. Who dreamed that up? Blue Cross?

    I lost my job two years ago and cannot afford to even go to the doctor, how in hell am I supposed to PAY for mandatory health care coverage when I cannot even afford a doctors visit?

    Once again, the rich providers will get richer at the expense of the poor.

    Way to go congress

    Tom in Iowa

    October 19, 2009 at 6:18 pm |
  191. Kathy

    Yes! Health insurance premiums should be lower for people who maintain a healthy weight, exercise, and do not smoke. Healthy people can still get sick, but if a person maintains a healthy life style the chances of developing diabetes, heart disease, and cancer can be greatly reduced.

    October 19, 2009 at 6:18 pm |
  192. Dia D

    Healthy choices should be rewarded on an individual basis. Wellness has a broad spectrum and goals should be realistic. Everyone has room for improvement and can decrease health risks. Every employee ought to have equal access to resources for improving health. Healthy employees cost less when looking at sick days and medical leave and that deserves recognition.

    October 19, 2009 at 6:19 pm |
  193. Valerie Spencer

    Yes it is fair to have higher premiums for those who are overweight I am a smoker and I would have to pay higher premiums for life insurance. It's a good idea it encourages people to take better care of themselves instead of getting so fat they have to get on disability because they can no longer work.

    October 19, 2009 at 6:19 pm |
  194. Danny from Grundy, VA

    Giving employees incintives to be healthier by lowering their health care costs is all well and good. But it is an infringement to punish "unhealthy" Americans by raising their premiums becuase of the their life-style choices. It would be equivalent to raising premiums on GBLT Americans or Christians. That would be obvisouly illegal.

    October 19, 2009 at 6:19 pm |
  195. Sebastian

    My company health insurance has dropped the co-pay plan and has forced everyone to the plan where the premium of $3000 has to be meet before the cover anything. Thank The good lord i am a disabled vet and have health care with the VA. By adding this program it would destroy a lot of families that can't even afford coverage now as it is. Driving a car is a privilage, one's health should not be treated the same way.

    October 19, 2009 at 6:19 pm |
  196. mark Silverstein

    As practicing physician, I firmly believe that any incentive to stimulate people to control their own health status is great. I work in an industry that thrives on unhealthy lifestyles and longs to treat healthy people in a proactive fashion. Our entire insurance paradigm must change and making people responsible for their actions (or inactions) is a great way to start.

    October 19, 2009 at 6:19 pm |
  197. Kay

    Should healthy employees have lower insurance premiums?

    Yes they should. I eat healthy, exercise (6days a week), yearly check-ups and follow what my doctor said- but yet I am still paying the same rate as the guy that eats at McDonald everyday and really don't care to exercise. A 20 yr old is paying the same rate as a 40 yr old with obesity, it's not right. Something needs to be done.

    October 19, 2009 at 6:19 pm |
  198. Joe

    Yes, healthy employees should pay less. Also, men should pay less buying smaller sized pants and shirts as they use less material. The same should be true for women...imagine the cost for shopping at a woman's clothing store like Lane Bryant. If healthy employees pay less, then those that fly and over weight should pay for two tickets...especially if they fly coach – middle seat!!!! What about those who do not bath?

    By the way, would we classify lying as an 'unhealthy' employee? If so, the DC politicans could pay our national debt!

    October 19, 2009 at 6:19 pm |
  199. luci - Peoria, Il.

    Are you kidding? I have seen several people who look disgustingly healthy, get cancer, heart problems, diabetis, etc.
    They either die unexpectedly or are sick for several years.
    I've seen heavy people, smokers, and people who sit around, be healthy all of their life. Who is to judge of what is going to happen to any of us?

    October 19, 2009 at 6:19 pm |
  200. James A.

    Should I pay the same life insurance premium as the 300 lbs 5'2 guy who smokes, and drinks 12 beers...before noon?

    Until we start to provide incentives for the people to become healthy or penalize those who choose another lifestyle, the price of healthcare will never go down.

    October 19, 2009 at 6:21 pm |
  201. Karl from SF, CA

    I don’t think any company has a majority of fat people or skinny people. They are pretty much evened out. These insurance companies need to average the cost of taking care of all these people and giving incentives to those that need work to get healthier. It don’t cost that much and a lot of it is more encouragement then expensive processes. The term “pre-existing conditions” needs to be eliminated from our vocabulary. Thank God I go on Medicare in February and let the idiots fight it out. Even with car insurance, a good driver can pay more for living in the wrong ZIP code.

    October 19, 2009 at 6:21 pm |
  202. Pat in Georgia

    If the rates worked like car insurance, maybe. Start today and see how the claims go, with discounts as you build a history.

    But I've had hepatitis from a blood transfusion at birth, gallstones at age 23, lyme disease and salmonella. None of these were the result of unhealthy choices and none of these cause me ongoing medical treatments - but my health insurance would most likely be through the roof if only "healthy" people got lower rates.

    Oh – and just to make you feel better – my health insurance already charges co-pays (that don't count toward deductible or annual out-of-pocket limits) AND co-insurance! Enjoy your new and increased cost "choices" for 2010!

    October 19, 2009 at 6:21 pm |
  203. Dee Irons

    My daughter came through many surgeries to save her from a devastating heart defect. She has always been poised on the edge of technology. Almost miraculously she has been able to overcome, finally finish college and is starting to work in health research and is planning to go on for advance degrees.
    When she tried to get on her new husband's health insurance, before she started working, she was denied.
    It seems ironic that we save children and then do everything to make it difficult or impossible when they reach adulthood.

    October 19, 2009 at 6:21 pm |
  204. Kay

    Jack

    Lower premiums for healthy employees completely mitigates the concept of insurance pooling.

    It disadvantages millions of Americans who have pre-existing conditions - or have conditions which are not easily treated or fixed. From MS to migraines - these conditions can not be controlled by 10 more minutes on a treadmill.

    If my family has a genetic pre-disposition for thyroid disease, does this mean that if I need treatment, I am no longer a "healthy employee?"

    Equally as important, however, is the infringement on our individual right to privacy... to keep our bodies and their infirmities private. My physician and me are the only two people who should have access to my "health record."

    This information can only be used in discriminatory ways - eventually may influence hiring, firing and promotion practices of organizations.

    There is not one single person who wishes to be ill or in poor health. And the last thing they need is to have their poor health exploited against them.

    All patently ridiculous - but yet happening before our eyes.

    What has our country come to?

    October 19, 2009 at 6:21 pm |
  205. Rich from Cupertino

    Doesn't matter whether you are healthy or unhealthy, the Insurance Companies will get their pound of flesh. They have so many expenses, bogus ads against healthcare insurance reform, higher compensation for their executives, and they need to fund their private death panels to determine who will receive care and who will not.

    Insurance is simply the wrong model for healthcare. Insurance builds in a nonhealthcare service fee for profit that does nothing to alleviate pain and suffering or spreading risk. Because sooner or later, regardless of our lifestyle, everybody will need some healthcare.

    October 19, 2009 at 6:21 pm |
  206. Terry Kunysz

    I'm a pharmacist. With the majority of the people obese and/or having various self-induced health abnormalities caused by over eating, smoking, drugs, and drinking, and not getting routine exams and cancer screenings. ... We need to think about more rewarding people with good health habits instead. If you have good BP, BMI, not smoking , and participating in risky behaviors... Why not reward those who do more fore themselves in keeping themselves healthy?
    In care insurance or life insurance you pay more if you speed or sky dive.. Everyone has the right to be fat, do drugs, and not to see a doctor. Do expect me to OK you getting same rates as me for health care if I take responsibility to care for myself.

    October 19, 2009 at 6:21 pm |
  207. Scott Jay

    I'd like somone to explain to me how insurance companies wormed their way into controlling our health care & choices. When I was a kid we paid out of pocket for run of the mill health problems, and it wasn't that expensive. We only had insurance for catastrophic illness or accidents. Now if you have an ingrown toenail, you'll wind up going to several doctors, specialists, and blow hundreds of dollars for various fees. America is the greatest country but we all pay way more for everything than other modern industrialized countries do. Heck, even if you want to kill yourself with cigarettes–a pack of Marlboro cost around $7 here, the same pack costs 1.25 in Asia. Our drugs cost more, etc–we're simply being ripped off by greedy monopolist capitalists in the health insurance industry.

    October 19, 2009 at 6:22 pm |
  208. Stu

    Great idea, Jack. Then, when a child is born with some serious condition like a heart defect, his "driving record" equivalent of risk assessment would benefit the rest of us by placing the impossible financial burden entirely on his parents. We'd shortly be making the same assessments of lifestyle choices and all the rest and then the insurance executives could keep all of the money instead of just most of it. .

    October 19, 2009 at 6:22 pm |
  209. Alex Dabit

    I think it's a great idea to adjust insurance premiums based on the lifestyles that a company's employees choose to live. One of the biggest arguments against universal health care is that healthy people shouldnt bear responsibility for the bad choices of others. These "wellness incentives" could not only fix the problem of the healthy paying for the unhealthy, but also creates incentive for people to live healthier lives.

    October 19, 2009 at 6:22 pm |
  210. RanDe from SoCal

    Basic health insurance should be sold and priced based on income. Those who want extra or premium health insurance should recieve discounts for healthy living

    October 19, 2009 at 6:23 pm |
  211. kenneth miles

    what employees? i didn't know we had enough jobs out there to be considering companies having employees. If you look at it it's a win/ win situation for the company wether if you're healthy or not, they'll just come up with some kind of rule if you're to healthy you'll get penalized to.

    October 19, 2009 at 6:23 pm |
  212. Steve

    Jack,

    I'm a vet and was in great health until hit head-on by an uninsured drunk 7 years ago along w/ my family also injured. My orthopedic injuries have complications and need more surgery. I also put on weight as a result b/c of ambulation issues. This crash was not my fault! I wish it on nobody, nor do I want to be punished more via higher premiums for having expensive medical needs. For those in society who push for this and punishes those like me, I say "There but for the grace of God" go you who are fortunate with good health – and when misfortune darkens your doorstep, I would say "Et tu Brute" to those who would suddenly when it was rhem expect compassion. We are a disposable society, turning now to throwing away people.

    October 19, 2009 at 6:24 pm |
  213. David, Arlington, VA

    I am absolutely disgusted by the responses I am reading here. First of all to all of you who believe that there should be different rates, if you ever have a catastrophic accident or unexpected illness that forces up your rates due to no fault of your own, you would freak out and scream about it not being fair. Where is the concern for the least of us? I am really sick of all the indifference in this country and the little or no concern for one's fellow Americans. It is disgusting. This every man for himself mentality is going to bring this country to its knees even worse than it is currently. Giving people incentives for something they should already be doing anyway is a SHAM. It is totally bogus. Whatever happened to "all for one and one for all?" To those commenters who are Christian and said yes to different rates, What would Jesus say? Not what you propose, I can tell you that. SHAME on most people commenting here.

    October 19, 2009 at 6:26 pm |
  214. Hubert Bertrand Oberlin La.

    No matter how you try to be healthy,You have people that get sick even if they try real hard. Good drivers get in wrecks.also.That is a hard one JACK

    October 19, 2009 at 6:26 pm |
  215. Michael E.Fjelstad

    Emphatically YES! I had all the lifestyle problems, but with hard work have reversed them. Type 2 Diabetic, but glucose totally controlled now with hiking and diet, A1C=5.4 (that of normal adult), don't smoke, BP=114/72 Pulse 54, Cholesterol 122, Lost 32 pounds, no more heart arrithmias, etc. Look, most health problems in the U.S. are LIFESTYLE DISEASES, which like my case, can be reversed with a little work. All you fat, lazy, self-destructive people out there, YOU'RE NOT A MINORITY, you're just fools, so why should people who work at being healthy pay for your laziness. Build a bridge, and get over it by getting off the couch, exercising, eating healthy, and enjoy lower insurance rates and a healthier, happier life for yourself and your family! Sedona Mike

    October 19, 2009 at 6:26 pm |
  216. McFarlane, MD

    yes, but... You first need to clearly define "healthy". I know of individuals who bicycle across Iowa during Ragbrai (a yearly event usually greater than 450 miles) who have a body mass index greater than 30 (BMI > 30 = obesity). By all accounts these are "healthy" individuals. So, establish the definition, then determine the criteria... Incentives would help

    October 19, 2009 at 6:27 pm |
  217. Michael from Ft. Hood Texas

    I agree with the premise, but who would set the standards?? Corrupt insurance companies? The problem is as you get older thinks start breaking no matter how well you exercise or eat. So the concept is fatally flawed at best.

    October 19, 2009 at 6:27 pm |
  218. Jim Mease

    That's all we need is to allow the health insurance companies or the government to start dictating who can get coverage and who should pay how much. Are we looking for health care for all, or just the healthy? Who will make those determinations? I don't trust either big government or the fat cat health insurance companies. I don't understand why nobody seems to want to work on lowering profits and gouging health care costs instead of finding more ways to bleed the average Amercian taxpayer. As usual, those in power are going about this crisis from the wrong end of the horse. No wonder it smells like manure!

    Jimmy in Iowa

    October 19, 2009 at 6:28 pm |
  219. C. Farrell, Houston, Tx

    Medical records are and should be kept confidential and should be left up to the employee if he/she wants them exposed. Some employers already take a visual diagnosis of whose healthy and whose not without any professional opinions.

    October 19, 2009 at 6:28 pm |
  220. Mary Ann Lamanna

    No, because you can't and nassess cause and effect in individual cases, only in the aggregate. I weigh 124 (at 5'4"), a healthy weight. Yet I'm a diabetic. So do I get a break for the healthy weight or a penalty for having become diabetic on the assumption that it's my fault?

    (I think family heridity plays a great role in my case–parent, grand[arent, and many other relatives. But the basic point is that the origin of diabetes in any can't be definitely proven . Not fair to penalize people on inference.

    October 19, 2009 at 6:30 pm |
  221. Braden "A Confused Liberal"

    I don't get it!

    Healthy people who use health Benefits less get premium incentives while unhealthy people who use Health Benefits more end up paying higher premiums. IT DOESN'T MAKE SENSE to me!! Isn't that what Whole Foods does? I Don't get it?????

    -Braden
    "A Confused Liberal""

    October 19, 2009 at 6:30 pm |
  222. Katie

    Yes healthy employees should pay less for health insurance. Having said that, we need to move from a disease management system that denies coverage for pre-existing conditions to a prevention based system. The problem is the insurance companies have so much money to throw around that they will work hard to prevent the US from moving to a prevention based system. After all, they make money from denying care to all of us. Can you spell health care r-e-f-o-r-m anyone?
    Katie

    October 19, 2009 at 6:30 pm |
  223. Denise

    What happens when a healthy, follow all the rules, young woman gets breast cancer – she was thin, exercised daily, never smoked, seldom drank, no red meat in 15 years, low cholesterol, good blood pressure – and she was struck at age 42, 3 years ago. She has just now been diagnosed with LGL-Leukemia-Chronic, maybe a result of the intense chemotheraply treatment she had. This is my daughter-in-law and guess she would have been given the "healthy" insurance premium until cancer struck – and then she would be dropped? I know that the 2 healthiest people in our family got cancer – my husband was 60, 4th stage throat cancer (asbestos damage proven), and he was healthy his whole life – and am guessing his life long good health is what enable him to live through that.

    October 19, 2009 at 6:31 pm |
  224. Linda Richards

    No. It's a slippery slope. It's one thing if people choose to engage in unhealthy behavior like smoking or drinking. It's quite another when they are a greater health risk through no fault of their own due to a genetic characteristic. Computer models will be used to determine the propensity for illness due to genetic factors, DNA, ethnicity, environment and who knows what else before babies are born. And what about lifestyle? Will a healthy skier, city-dweller or resident of a sunny state have to pay extra to factor in accidents, smog and skin cancer? And what about people who eat junk food, gulp power drinks, caffeine, or soda? You can bet there will be a surcharge every added risk or poor food choice and of course they'll need to resolve disputes as to whether or not you really do drink soda should you develop a health issue. Although unfair, sharing the risk may be the lesser of evils. Linda in Woodbury, NJ

    October 19, 2009 at 6:31 pm |
  225. Terry Northup

    Should the unhealthy pay more? I inherited high blood pressure, high cholesterol, and diabetes. I didn't choose my parents! I am unhealthy by bad luck of parentage. Why should I have to pay more for something that isn't my fault?

    The purpose of insurance is to put everyone in the same pool, paying the same prices, to benefit those who get sick. The healthy get sick. too. It is there when they need it, why should they pay less? It sounds like another Republican plan to screw the people who need help.

    October 19, 2009 at 6:34 pm |
  226. Jimmy in Texas

    I served in Viet Nam for 21 months and now am a disabled vet due to the government's use of agent orange. As a result, i now face medical conditions that are beyond my control and are not of my making. Is it fair for me to pay higher premiums as a result of these medical conditions? Is this another way to "support our troops" and to say thank you to all of the Viet Nam vets that were never given the recognition and honor that they deserved and were even spit on as they returned to the country they were serving. Raising their premiums seems to be just a continuation of this treatment.

    October 19, 2009 at 6:35 pm |
  227. Rick Weston

    C'mon Jack: employers' have learned reduced premiums (carrot's) for employees who practice healthy behaviors do not reduce health costs. Informed employers' have learned what does work; increased premiums (stick's) for unhealthy behaviors (i.e.smoking).
    A health plan tobacco premium introduced after a smoking control/cessation program is initiated results in a win-win-win outcome for all concerned.
    Smokers who quit "win",they avoid the premium. Smokers who learn to 'control' also "win"; they smoke less and spend less on cigarettes. Typically, the savings amount to more than the premium. If the "premium" is introduced as an alternative to a blanket co-pay increase-non-smokers also "win".
    This approach is not rocket science and it works.

    Rick,
    Toronto, Canada
    In this scenario, non-smokers' subsidy of smokers' extra costs is reduced. A more equitable sharing of costs is established and; the employer can use the new revenue to offset the extra cists attributable to smoking or, invest it back into wellness programs for all employees.

    October 19, 2009 at 6:38 pm |
  228. C. Butler

    If you are on a group plan, the plan is supposed to cover all people as a group. The healthy and unhealthy will balance out to a type of middle ground without affecting anyone's rates negatively.

    If you are applying for a new individual policy, of course they will take your medical history into account.

    C. Butler
    Phoenix, AZ

    October 19, 2009 at 6:38 pm |
  229. Emmet Wilson

    Yes, I do think that health care costs should be similiar to auto insurance. Though it might not be an incentive for people to stop smoking or over eating, it should be fair to make them pay more for the way they choose to live. Also those who are prone to, or have had a stroke, heart attack, diabeties etc, and do not take doctor required medication to counter these conditions should also pay more for health insurance.

    October 19, 2009 at 6:49 pm |
  230. Erika Richard

    Absolutely, people who don't smoke, controll their weight and do not abuse drugs and alcohohl should pay lower health insurance premiums. People need to take responsibillity for their health.

    Erika, S.C.

    October 19, 2009 at 6:58 pm |