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Will George Orwell please pick up the white courtesy phone? We have a question on "wellness incentives"


The bipartisan initiative [Hold onto your wallets! -- lambert], largely eclipsed in the health-care debate, builds on a trend that is in play among some corporations and that more workers will see in the benefits packages they bring home during this fall's open enrollment. Some employers offer lower premiums to workers who complete personal health assessments; others limit coverage for smokers.

The current legislative effort would take the trend a step further. It is backed by major employer groups, including the U.S. Chamber of Commerce and the National Association of Manufacturers. It is opposed by labor unions and organizations devoted to combating serious illnesses, such as the American Heart Association, the American Cancer Society and the American Diabetes Association.

Critics say employers could use the rewards and penalties to drive some workers out of their health plans.

President Obama and members of Congress have said [and of course, we believe them -- lambert] they are trying to create a system in which no one can be denied coverage or charged higher premiums based on their health status. The insurance lobby has said it shares that goal. However, so-called wellness incentives could introduce a colossal loophole. In effect, they would permit insurers and employers to make coverage less affordable for people exhibiting risk factors for problems such as diabetes, heart disease and stroke.

Or... Whatever! Pre-existing conditions are right back in the game, except now they're called "risk factors." Can anybody seriously believe that the bill won't create a whole industry devoted to finding "risk factors" and denying people care who have them? Or can plausibly be said to have had them, perhaps during rescission? Ectomorphs under the bus! Endomorphs under the bus! Black men have a higher "risk factor" for stroke? Under the bus! People who worked in chemical plants have a higher "risk factor" for cancer? Under the bus! People with blue eyes have a higher "risk factor" for uveal melanoma? Under the bus! Women have a higher "risk factor" for pregnancy? Under the bus!

It's the same old game: Collect premiums, deny care.

And thanks, Democrats -- and especially "progressives" -- for letting the insurance companies play their game!

This whole health insurance reform thing is going just great! Thank gawd we've got true progressive leaders at the helm!

NOTE See When a Nudge Becomes a Shove. It's already starting, isn't it? Of course, as soon as you see the corporations as feudal lords, and their "human resources" as fucking peasants, everything falls into place.

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Kick Baucus to the curb's picture
Submitted by Kick Baucus to ... on

The big concession made by insurers has been that no one would be denied coverage. What was always left unspoken was who would pay and how much it would cost to add the here-to-fore uninsurable. Now we know.

Let's say you have a good-paying job with excellent benefits, but you are overweight. You develop diabetes and thus a risk factor for insurance. When your employer doubles, triples or quadruples your premium to reflect your poor health, you cannot opt out. Can't go with a public option, even if it exists. Any subsidy your employer gives you would be infinitely better than going it alone. But you are mandated to buy insurance, so you are stuck. However, your employer and insurer will monitoring your health--for your own good, of course.

FantAstic. Thanks to progressive politics, you will now be a captive payer for a system that elevates your employer to oversee your life outside of work, an insurer with no limits on how much they can charge you for your risk factor, and a government that will clean out your bank account automatically to pay for it. This is a huge improvement over the existing system. Instead of loosing potential business, insurers can more efficiently pass through costs. Carrots? Incentives? Noooo, big insurance stick. BUT, at least government wouldn't be coming between you and your doctor. Naw, just your boss, your union and your insurer.

Submitted by lambert on

The goal of health insurance reform was to hand your entire body over to the corporations for, er, harvest. I wasn't nearly cynical enough.

Mission accomplished!

Valley Girl's picture
Submitted by Valley Girl on

And, crickey- I started thinking about the list of "risk factors"- including truly invasive information collection. Random questions that come to mind:

Do you live near a super-fund site? (there's one in Maine)
Do you live in the inner city? ("easy" to "establish" via zip code)
Are you male and homosexual?
How many sexual partners have you had? (applies to any and all)

Submitted by lambert on

This week's Sunday Times Magazine:

The shorter you are in America, the more likely your chances to develop coronary heart disease, diabetes or stroke. Fat people and short people lead briefer lives, and they put an increased burden on the health care system. Economists estimate that excess weight alone accounts for 9 percent of the country’s medical spending. There’s no such figure for insufficient height, but we do know that obesity and shortness play out in similar ways across the socioeconomic landscape.

Valley Girl's picture
Submitted by Valley Girl on

In an odd moment the other eve I was thinking that "we" should compile a list of "preexisting conditions" that get one cut out of health insurance, but this whole idea of "risk factors" is even richer.

And, as a general comment, to quote a friend of mine "Yup, this is one on of the managed care crowd's pet issues. This stuff -- and the stuff about report cards on docs and "payment reform" to turn providers into insurers -- will get worse."

Valley Girl's picture
Submitted by Valley Girl on

To get treated at the dental practice I'd been to before (but had changed hands) I had to fill out a really intrusive questionnaire as a condition for treatment. That inspired a few of my questions in an earlier comment. And, wtf, I'm employing them, not the other way round.

And, yes, I can absolutely see this happening as a condition of employment, especially given the unemployment statistics- which must surely translate into more applicants for any given job. And, more pressure to waive privacy.

Valley Girl's picture
Submitted by Valley Girl on

Exposure to malnutrition, infectious disease, chronic stress and poverty stunt a child’s development and seem to explain many of the long-term problems associated with short stature.

The economist John Komlos has shown that the United States is losing height relative to other developed nations, and some American demographic groups are even shrinking in absolute terms.

Apart from the obvious effects of malnutrition, infectious disease and poverty, the US population is one of the most stressed out (chronic stress) among the "developed nations" (sorry, no time to get the links).

And, ironically or not, a major stressor is the awfulness of our "health care" system.

Submitted by lambert on

... their children deserve to die because having been a poor child is itself a risk factor. This opens the door to raw evil.

* * *

Of course, this is all hypothetical. The insurance companies would never deny care to anybody who really deserved it.

* * *

VG, can you propagate this over at the Lake?

Submitted by lambert on


"Even factoring in government subsidies, the cost of purchasing a plan is much more than $750," [Is that the figure? -- lambert] Palin writes in her latest Facebook message. "The result: many people, especially the young and healthy, will simply not buy coverage, choosing to pay the fine instead.

Now, if you dug into Palin's reasoning process, you'd quickly come to the batshit premises on which she based the conclusion. That's the batshit that needs to be rejected, not the conclusion as such. Sometimes I get the feeling that if Palin said it was rainy, "progressives" would say it was sunny, without even looking out the window.