the company I just signed with offers 100 bucks a month off your health insurance if you are in shape. I didnt even ask what the qualifications are because I know I will meet them no matter what, but when I start on the 11th I will let yall know.

agree with OP though. Health insurance should be priced based on your health. Yearly intense physical.

It's amazing to think how much healthier our society could be if health insurance cost was incremental based on your actual health.

This ended up being a wall of text, so I am sorry for that up front. I definitely had some thoughts here, and it ended up being much longer than I realized once typed up.

To preface, I work in group benefits administration. I am more on the technical side of delivering benefits to employees of larger employers, but my role means that I have to be pretty knowledgeable about plan design and more consultative type concepts and not just the technology we offer.

I had a pretty lengthy discussion about this with a client recently, and I think that one of the biggest obstacles is that health insurance companies and employers still haven't gotten a great feel for what defines healthy. There are key markers, but i don't know that it's down to a place where they can really aggressively reduce premiums based on those markers.

There are a number of metrics that work in this regard, but the use of them can be dangerous. For a super simple example, if a company uses BMI as the metric to qualify an employee for a health premium discount, then the guy who is in NFL linebacker shape may not qualify. That guy then takes legal or similar action against the company for the way that they offer health insurance, and it just turns into a mess. This is just one example, and it's a simple one at that, but if you extrapolate it across any number of metrics and any number of people feeling slighted, then you have a problem that most HR departments spend a ton of time trying to avoid. Group benefits are generally an HR function, and there you go.

What we see most of now is activity based incentives that are generally nice to have cost reductions in premium and/or nice to have additions to HSA, but they are not really materially changing the financial situation of the employee or their family. Get your biometric screening done and get $100, walk 10,000 steps a day and get $1 a day in your HSA type things. While these are all fine and good, they aren't changing the health of the person in a way that quantitatively impacts their potential to be a claims to premium ratio concern - and that ratio is what the provider cares about at a micro individual level and a more macro group level.

Quick edit is that the other thing that we see a lot of now is an attempt to enforce some metrics based standards for "healthy", but as others have mentioned, they are a very low bar. So, you end up with employees being able to not actually be really healthy - and therefore not reducing their potential claims to premium ratio - who qualify for the low bar healthy metrics. Low bar qualification means low number incentives, so the truly really healthy people don't get incentives proportional to their health. It's all just middle of the road stuff.

Basically, I think that we are seeing programs that are safe and just kind of cool to have simply because the design and enforcement of the type of program that would really, really reward employees for being truly healthy and ultimately work out financially and legally is just really hard and expensive to design and execute. I think that employers and providers are more and more working toward that type of aggressive plan design, but it just takes time to get there. We have to remember that this whole consumer, activity, wellness, etc. movement in group health is really not all that old still.

I would absolutely love to be able design the type of aggressive program that employees like the ones on this thread would like to see happen and that employers also would like to see happen. You would see my name in front of the word Consulting and me working toward retiring super early if that ever happened.

Side rant, but love when obese coworkers tell me how bad running is for me.....

That being said, the main problem in this country is diet, IMO. Go to the grocery store and look at the carts around you when checking out. Most the time they have 0 fresh veggies, maybe 1 protein, and a crap ton of instant and frozen foods. This is on top of the fast food they probably eat 3x a week.

htxag09 said:

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Side rant, but love when obese coworkers tell me how bad running is for me.....

That being said, the main problem in this country is diet, IMO. Go to the grocery store and look at the carts around you when checking out. Most the time they have 0 fresh veggies, maybe 1 protein, and a crap ton of instant and frozen foods. This is on top of the fast food they probably eat 3x a week.

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I have lost about 90 pounds over the last two years and all our secretaries think I'm sick. When they hear about the half marathons and Camp Gladiator, they all tell me I'm crazy and I'll tear up my knees. All the while they still chug doughnuts and sodas all day long.

You are dead right about diet though. Getting in shape is 80% eating and 20% exercise (imho). But I look on exercise not as punishment for what I eat - exercise is a celebration of what my body can now do.

Interesting idea... Individual premiums are outrageous, but if you could get a group premium for like-minded people, it may really be possible. Say, your gym offers a group premium to those members that average 4 days a week (1 hour/day).

If the healthy get punished, the healthy self-employed get outright abused.

It makes perfect sense for higher insurance for the unhealthy. Bad drivers pay more. Smokers even pay more for life insurance. But this is a really complicated issue, legally, politically, ethically, administratively, etc. And would it really change behavior? Or just make it so the healthy stop subsidizing the unhealthy as much?

I can't find the article now, but it showed that financial incentives to improve health didn't really produce a significant improvement in health. I did find this, which states people offered money were more likely to quit smoking, but not lose weight (https://www.health.harvard.edu/staying-healthy/do-financial-incentives-improve-health).

The problem is just cultural and lifestyle. People don't want to buy fresh produce and cook, they'd rather just eat out. The whole not cooking thing has reached epidemic levels in this country in my opinion. I've noticed that even when people say they "cook," they really mean they put a frozen pizza in the oven, or mixed a prepackaged Hamburger helper or Zatarains rice thing or something. I know parents that don't have time for breakfast, so they swing by Shipley's and buy a dozen donut holes before dropping off their kids at daycare. Then they swing by McDonalds or Whataburger on the way home. Then when the kid is old enough, he's going to have cereal for breakfast, buy lunch at school, and eat takeout for dinner. I honestly think this is going to come back to seriously bite us years down the line.

But another problem is we're not supposed to say anything about any of this. If we make someone pay more for health insurance because they're fat, we're fat shaming. If we tell someone they should cook more for their kids, or give them an apply for a snack instead of candy we're judging them "because we don't know what they're going through/what they can afford/etc."

Sorry for ranting.

So many victims.

Fitness and Education are exactly the same.

In order to be fit or educated, it's all about discipline, commitment, active practice, and work ethic. Everything else is just bells and whistles.

I laugh every time I hear some idiot say "education" is a "right." May as well say it's a "right" to run 5 minute miles or bench 300.

To be fair, the argument is "access to education"

Pahdz said:

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To be fair, the argument is "access to education"

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In this day and age, that's a tablet or smartphone and a WiFi connection. Thats 5,000 times more access to information than Aristotle, Einstein, and DaVinci had combined.

Okay you're one of those anti public school guys I see.

Let's do it your way, leave education up to the individuals and see how we end up

Edit- the individual controls how educated they want to be. Don't argue that. Just don't get what you mean by your comments. So what if there is new tech, those are just tools for education.

newhowdyag2004 said:

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I didn't expect to see this much activity...looks like a lot of people are fed up with the unhealthy culture we live in.

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Yes. Shocking on a fitness board. That's not exactly polling the general public.

at the risk of making this political...

we will never be able to separate the healthy from the unhealthy when it comes to insurance and insurance premiums. every one of those coke drinking, cigarette smoking, donut eating fatasses represents a vote, and there are a lot more of them than there are of us. with "affordable health insurance" being such a major political and cultural talking point, our overlords would never let those of us who require hardly any healthcare take our dollars out of the pool. it's politically untenable.