Pay-by-the-pound insurance
Beginning in 2011, North Carolina will charge overweight state employees higher rates for their insurance. The West Virginia Public Employees Insurance Agency considered a similar policy but decided against it in December. American City & County asked the readers of its weekly e-mail newsletter if public employees should pay more for health insurance if they smoke or are overweight. Below are some of the responses.
“I think we can get the high costs of medical care under control if we just implement a ‘few’ common sense measures as increase rates or, better yet, deny coverage for folks [with dangerous or unhealthy habits]. I would not be in favor of a premium add-on for fat people unless we also [had] a premium add-on for every risky thing we do.”
— Dale Carlson, coordinator for administration, Division of Special Education, Department of Elementary & Secondary Education, Jefferson City, Mo.
“If overweight people and smokers are a high risk and have to pay more for insurance, I believe the following groups should also have to pay more: drinkers, [people with] high blood pressure, any other group that ‘national’ groups determine are at high risk of developing something that could kill them. I place this last group in the first position, as it seems to get larger every year.”
— Beverly Lanier, administrative assistant, Bandon, Ore.
“No, I do not believe that public employees should be charged more if they are overweight or smokers or anything else for that matter. I am embarrassed and even ashamed that such a question has even occurred in this country, which is supposed to be so wonderful.”
— Allen Lee, senior information technology specialist, Hennepin County, Minn.
“I honestly believe it is ethically wrong to single out any section of society and charge them more for health insurance or any other work benefit. The insurance companies need to average the costs across all participants in the program. Now, if they want to motivate people to improve their health, they could institute a program that would give you discounts on insurance if you participate in a wellness program [while] working with a health counselor, and provide discounts for health clubs in an effort to help participants live a [healthier] life style. Charging more insurance cost to overweight people is wrong.”
— Ann Penman-Morgan, Utah Museum of Fine Arts security supervisor, Salt Lake City, Utah
“Make no mistake, they absolutely should pay more! If they don’t, we all do!”
— John Searing, deputy commissioner of Fire, Rescue & Emergency Services, Suffolk County, N.Y.
“Yes, heavier employees should pay by the pound. It will give them an incentive to be healthier.”
— Scott Svab, finance director, Canal Fulton, Ohio
“I work for Gainesville Regional Utilities, a municipal utility of the city of Gainesville, Fla. As with many larger municipalities, we are self-insured, and health care costs are seemingly an ever-increasing cost in the budget. We are fortunate to have a wellness program that financially rewards participants who exercise regularly, eat right, don’t smoke and work to control cholesterol, diabetes and blood pressure. This year, over 300 participants qualified for an extra $350 in their December paycheck by meeting the requirements of the program. Since about 20 percent of our employees — between general government and our utility — are apparently motivated by a financial reward in addition to just wanting to take care of themselves, my personal opinion is that maybe an additional number might be motivated by having to pay more if they were overweight and/or a smoker. While it seems punitive, it is for their own good, and if they don’t change, then at least they are paying for what they have chosen to do and not burdening others with the costs of supporting their life style choices. We are fortunate to have a progressive City Commission who has supported these wellness initiatives over the past 10 years and can point to overall savings and a smaller incremental increase in health care costs.”
— Ralph Wisco, utilities stores manager, Gainesville (Fla.) Regional Utilities