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Life Health > Health Insurance

Save Room for Dessert

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I’ve already noted how our recent cover story, “Fat of the Land,” gained the notice of the Corn Refiners Association with a letter sure to appear in an upcoming Feedback page in our print edition. But one of the responses I have yet to receive is from various companies promoting wellness initiatives. I know they are out there, and for the most part, they come off as fairly the same. Some kind of incentive program that either pays employees for losing/maintaining weight, or mechanisms that pay for things like fitness clubs. Obviously, this stuff isn’t doing the job because obesity rates are still going up in the United States. (And most everywhere else in the G20, for that matter). My main point with “Fat of the Land” and the blog posts that have followed is that the health insurance industry is living with an $80 billion cost driver every year. Why isn’t the industry attacking this cost driver with a vengeance?

I imagine the wellness companies out there would argue that the industry already is. But here’s the thing. I have had health insurance my whole life. Never have I received any meaningful outreach on obtaining or maintaining good health. Not when I was obese. Not when I was in great shape. Never.

Now, I’m one of those people that exemplify what some feel is the real solution to obesity: personal responsibility. And to that end, I took responsibility for my personal health and decided (along with my family, who all made the same decision) that I would never be fat again. We were not incented by anything more than a desire to be healthy, and to do whatever it took to get that way. Sadly, not everybody has that sense of need, or determination. Some are spurred to action by the desire to avoid something negative sometimes, as I’m sure some folks are quitting sugar (if only for a while) after reading the New York Times magazine’s recent cover story on the toxicity of sugar itself. But even the occasional scare has not proven able to spur our nation out of its steadily heavier collective weight.

The government is not the answer. To quote Ronald Reagan, the scariest words out there are “I’m from the government and I’m here to help.” Heck, the National School Lunch Program is part of the problem, having longs since outlived its original purpose: to make sure American kids aren’t so underweight that when the next time we need to draft them for a war, they are in fighting shape. (Up to 40% of recruits rejected to fight in WWII were because they were underweight and/or malnourished, having grown up on Depression-era diets.)

The food industry is not the answer. Right after “Fat of the Land” went to press, Denny’s announced it was rolling out a bacon sundae, which just goes to prove that nobody who makes senior-level decisions at Denny’s really eats any of that food. It’s like some low-grade artificial intelligence took two things from separate columns of things people like to eat and mashed them together. I imagine that “bacon sundae” was the third of fourth choice after unmarketable hybrids such as “turkey cereal,” “chocolate chip onions” and “haggis soda.” These are the same people who have been steadily increasing portion size over the last 40 years, and whose dedication to producing quality food is on par with most convention catering companies.

But the insurance industry, that could be an answer, if not the answer. But how?

Let me start by saying that is is not this industry’s responsibility to fix obesity. But as I have noted before, it has an clearly identified and rather substantial cost driver in its midst, so from a purely business sense, the industry does have an obligation to do something about this cost. It has already tried the soft approach of giving people options to do the right thing, weightwise. But in the moments after I recently gave a presentation on obesity at the Mississippi State University I-Day conference, I was met in the hall by numerous attendees who griped to me about how they could not get their own health plan to cover the cost of whatever proactive health improvement thing they were doing. Exercise clubs, eating a special diet, whatever. The point was these people had, on their own, discovered something that was delivering positive health benefits from them…and their health insurers did not care. This is voluntary, proactive loss prevention and every bit of anecdotal evidence I received pointed toward a great, big collective yawn from the industry that needs this sort of thing the most.

At the same time, insurers spent millions trying to get PPACA overturned, which comes off as a gross misuse of resources, considering that the repeal effort never had a credible chance of going any further than the house. So the millions spent by life and health insurers to repeal PPACA was what, exactly? Sending a message? Fine if all you want to do is spend a lot of money registering discontent. And as I’ve said before PPACA offers much for which to be discontented. But really, the trade groups representing the industry knew full well that PPACA would never be repealed. It will likely not be overturned in the Supreme Court, either, as the Court rarely overturns that which Congress has put into law. PPACA is something the industry is going to have to live with, which is why we’re suddenly seeing a renewed interest in tackling cost drivers. Well a great first start would be spending millions on health awareness initiatives rather than on dead-end lobbying efforts.

Frankly, if the industry must lobby for something, why not lobby during PPACA’s implementation period to allow for more aggressive underwriting for people of a certain size, citing their higher risk for health problems? After all, it will be a heck of a lot easier to get an exception to PPACA than to kill PPACA itself. And already airlines are able to charge heavy passegers for two seats, just as life insurers can charge from 33% to 75% more to policyholders who are smokers. In both cases, overweight customers are either causing a direct increase in costs (in airlines, the heavier you are, the more fuel you require the plane to burn to stay aloft. Fact.) or a direct increase in risk (as smokers clearly have a greater mortality risk because of their smoking). The same can easily be said for obesity, but nobody seems to be saying it. Why is that?

Surely political correctness plays a part, amplified by the fact that we are in a country now where the overweight and obese outnumber the fit, so it is becoming not just politically incorrect to hold the overweight financially accountable for their condition, but it is becoming taboo to even talk about it. And yet, if the industry fails to act, if the industry does not do something to drive down this huge cost of obesity-related illness, then how can it rightfully get the public’s support when it goes for other cost drivers, such as the frequency with which people use emergency medical services?

It can’t.


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