I have a friend who is a physician’s assistant, and spent some time working for a city wellness program. The plan was set up to help city employees improve their overall health, and in the process, get a discount on the health insurance premiums that were deducted from their paychecks. I think this could be a good idea for health insurance companies aswell. Individual health insurance carriers are allowed to offer clients policies with increased premiums based on an adverse medical history. Some companies also have a ‘preferred’ rate that will lower the standard premium by a few dollars a month for very healthy applicants. All companies have tobacco rates, which are higher than standard rates. Once you get a policy though, your rate will increase every year, whether your health improves, declines, or stays the same. If you are a smoker when you apply and later quit, you can get your premium changed to non-smoker rates, usually after 12 smoke-free months.
In Colorado, Anthem Blue Cross Blue Shield will accept an otherwise healthy 5’4″ female applicant who weighs 208 pounds. Her rate will be the same as another female her age who weighs 125 pounds. Anthem’s weight guidelines tend to be a little more lenient than most carriers, but in general, most insurance companies will accept people who are overweight (to be declined based on weight, an applicant must be morbidly obese or have a combination of other health problems). Once the client has a policy, her health insurance provides no incentive to lose weight, because her premiums will increase at the same rate as everyone else’s. Even if she subsequently gains 50 pounds, Anthem must continue to cover her as long as she pays her premiums. But what if insurance companies set up a program to decrease premiums (or have smaller rate increases) for clients who are actively improving their health? Perhaps if an annual physical shows that an overweight client has lost 20 pounds, he or she could get a small discount on premiums. Or maybe a client who works with her doctor to set up a plan to manage borderline cholesterol through diet and exercise – and gets her cholesterol down to a healthy range – could be offered a renewal rate slightly lower than the standard premium for her age. By doing this, Colorado health insurance companies would be encouraging people to actively manage their own wellness, which is much less expensive than relying on doctors and pharmaceuticals to fix the problem.
Obviously this plan has lots of technicalities that would need to be ironed out before it could be implemented. Insurance companies would need to have specific guidelines laid out in terms of what constitutes enough of an improvement to qualify for a discount, and clients would need to have a doctor sign off on any progress made, likely during their annual physical. But the possibilities are endless. Since so many of the major illnesses we face are caused or exacerbated by behavior (smoking, overeating, sedentary lifestyles, too much stress, etc.) it seems that any encouragement to improve behavior related to health would be a step in the right direction. And even though most people know what they should be doing in order to improve their health, a financial incentive couldn’t hurt.
