If someone is big enough to be classified as 'clinically obese,' do you think that it is reasonable for their health insurance premiums to be higher?

Shale has a point. And so, no ~ not unless those with chronic gerd (which can result in esophageal cancer), or a long history of poor immune system (sick all of the time), or Chrone's disease, or chronic respiratory ailments, all pay higher rates, too.

But this does exist!

Had a discussion with a neighbor just yesterday who works in the lumber industry, and their insurance requires the employees AND their spouses to get a physical evaluation once a year, then the insurance premiums are adjusted accordingly. But the changes are a substantial amount.

Eh, it's tough to say. I can understand the reasons to do so, but I also think it's some turbulent waters to tread.

Nah.

There are so many risk factors other than obesity I don't think any one group can be fairly singled out.

Forgiveness Man wrote:

Eh, it's tough to say. I can understand the reasons to do so, but I also think it's some turbulent waters to tread.

Oh you can walk on water too? Nice! So would you be for or against a government mandate prohibiting the extra cost? Because that's the only way private insurance companies won't charge extra.

How would they determine "morbidly obese". Some people do not take into account that the BMI chart is a terrible way to determine obesity. If you use this chart, most larger athletes, including heavy weight boxers who are very muscular and chiseled, then become "morbidly obese" due to height and weight.

According to the BMI the following are obese/morbidly obese:

Tom Cruise
Mel Gibson
Sylvester Stallone
Arnold Schwarzenegger
sammy sosa
barry bonds
mike tyson
donovann mcnabb

there are a ton of more celebrities--- ones that you would not consider to be obese but the bmi does.

So classification of obesity is bogus

Shale wrote:

I think the question implied ppl who look like this guy. There is a difference between squeaking into the obese category on the BMI, and what is generally considered 'morbidly' obese.

Yeah, but it would stir up a hornet's nest. Give the insurance providers an inch and they'll dive in for the whole foot like a bunch of turkey-vultures. Once that started their obesity rates would likely get standardized like the proposterous ones in Wants2laugh's posting. They're always looking for loop-holes.

I do not trust them.

If said "obese" person has had a history of health risks due to their obesity, or if their physicians physicals forecast potential health issues directly related to their weight, then yes they should. I wouldn't penalize someone's premiums just because they happen to be larger than whatever the standard says they should be, but if they are in a high risk group, then absolutely.

When somebody says obese we tend to think people who eat their way up to the 6-800 pound mark or so...but not everybody who is too fat to walk anymore got there either from their poor eating habits or from that alone. There are some people whose genetics are largely to blame and should they be treated the same way as somebody who just stuffs their face and refuses to consider their health?

I wouldn't say automatically, but rather pending a complete physical exam.

I'm sorry, but that woman who was in the news some months ago who was trying to get in the record books as the heaviest woman in the world should be paying sky high for her health coverage. If doctors say "Hey, you need to drop 50 lbs. over the course of the next few months or something bad is going to happen to you soon" and they don't, then their rates should surge.

Depends on their overall health. If they're just fat, but haven't had any real health problems, then no....but if they have an assortment of health issues/risks related to their weight, then yeah.

No why should they?

No. Insurance premiums should only increase if there is an established health issue that is ever present, or recurring. Someone being overweight (and the concerns that "might" occur because of it) isn't reason enough to have them pay additional costs for coverage.

It depends on different factors. They are some people whose obesity is due to health problems or side effects from medications.

For those of you with insomnia:

Quote :

Letter Ruling by HHS to Prof. John Banzhaf Permitting Differences
in Health Insurance Rates Based Upon Both Smoking and Obesity


CENTERS FOR MEDICARE AND MEDICAID SERVICES
Department of Health and Human Services

SEP 28 2004

Centers For Medicare and Medicaid Services
Medicare Plan Policy Group
7500 Security Blvd.
Baltimore, MD 21244

Professor John F. Banzhaf III
Professor of Public Interest Law
George Washington University Law School
2000 H Street, NW
Washington, DC 20006

Dear Professor Banzhaf:

We are writing in response to your letter of June 7, 2004 , regarding Secretary Thompson's statement that the Department of Health and Human Services has not prohibited health insurance companies from charging obese individuals higher insurance premiums. You also asked that we allow a differential health insurance rate factor for obesity as a community rating class under section 1308( (C) of the Public Health Service (PHS) Act [42 USC 300e-1]. Please forgive the delay in our response.

This letter is to confirm the Secretary's response in the article you referenced and that based on our research States are not bound by federal statute in the case of permissible underwriting practices in the health insurance market they regulate.

In light of the Surgeon General reports and other studies and your request, we have undertaken a re-examination of the position CMS took in 1987 on the question of whether obesity could "reasonably be used to predict the use of health services" (the standard for approval as a community rating factor under section 1302((C). While no Federally-qualified HMO has submitted such a factor for approval, triggering the approval process under section 1302((C), we could theoretically permit Federally-qualified HMOs to use such a factor. This would mean that the HMO would be permitted under the Title XIII community rating rules to charge a higher premium to members classified as obese than the premium charged to otherwise similarly situated non-obese individuals.

However, even if we changed our 1987 position on obesity under the Title XIII community rating provisions, this would have a very limited effect in light of a subsequently enacted provisions contained in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Most Federally-qualified HMOs would be subject, for most of their members, to the HIPAA requirements that apply to employment-related "Group Market" health insurance. These provisions are found in Part A of Title XXVII of the PHS Act, as added by HIPAA. Section 2702 of the PHS Act is titled "Prohibiting Discrimination Against Individual Participants and Beneficiaries Based on Health Status." While being a smoker is a behavior, not a health status, arguably the condition of obesity is a health status.

Section 2702(b) (1) provides that a covered health plan:

"...may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health-status related factor in relation to the individual. . ."

If we determined obesity to be a "health status" for purposes of the requirement in section 2702(b), a decision to reverse the 1987 CMS decision on obesity arguably would only permit Federally-qualified HMOs to consider obesity as a factor with respect to establishing its rates for its "individual market" members, to whom the provisions in section 2702(b) would not apply.

We also note that section 2702(b)(2) clarifies that the prohibition on discriminating based on health status does not prevent an insurer from using premium discounts or rebates, or modifying copayments and deductibles, "in return for adherence to programs of health promotion and disease prevention." The original HIPAA title I interim regulations, issued April 8, 1997 (62 FR 16894) asked for comment on how to implement this exception. HHS, along with the Departments of Labor and the Treasury later proposed, in a Notice of Proposed Rulemaking published January 8, 2001 (66 Federal Register 1421-1435), to limit this exception to those incentives provided pursuant to "bona fide wellness programs." In order to qualify as "bona fide," a wellness program would have to meet four criteria set forth in the NPRM.

The first would be that the cost of providing the discount can not exceed a specified percentage (proposed to be between 10-20%) of the cost of providing the coverage. Second, it must be reasonably designed to promote good health (and not simply a subterfuge for raising rates for certain individuals based on health status). Third, the incentive must be available to all similarly situated individuals, and if the way to qualify for the incentive is unreasonable or medically precluded because of a health factor for a particular individual, the individual must be offered an alternate way to qualify for the incentive. Fourth, plan materials must describe the availability of such alternatives.

Please contact Frank Szeflinski of my staff on (303) 844-7119, if you have any questions.

Sincerely,


Thomas Hutchinson Director
Medicare Plan Policy Group

http://ash.org/higher4smokers

LOL, the are supposed to be the #8 and a close parenthesis.

i think health care already costs too much--- evident by the fact that 50 million americans do not have health insurance--- how about we reform health care and make it CHEAPER for everyone????