wave of the future?

[creaker]

http://abclocal.go.com/wls/story?section=news/local&id=9035118

March 20, 2013 (CHICAGO) -- The CVS Drug Store chain is fueling an explosive debate over a health insurance policy which has employers checking employees' weight and body fat percentage.

The corporation said the information will remain private and that the policy is meant as an incentive so that their employees will be as healthy as they can be, but many are concerned that the company will have access to the information and could use it against their employees.

Submit to weight, BMI and glucose testing by May 1 or pay more in out of pocket health insurance costs. That's the policy CVS Pharmacy's nearly 200,000 employees now face.


$50/month extra if you don't provide the information. It doesn't sound like the information is actually "officially" used for anything - but I expect it won't stay that way.

[Spartana]

I find this kind of thing very invasive and that info should be in the hands of the person's private doctor and no one else. I would consider it an invasion of privacy by my work to use it to force me to pay more for insurance or submit to tests which may not even give an accurate reading on a persons over all health. Especially if they do use this against employees in some way. Plus BMI is a very bad way to determine fat levels, fitness levels and especially health levels. We had several disscussions on this forum about the use of BMI testing to determine body fat/health and it is wildly inaccurate as it doesn't take into account people who are very heavy weight-wise due to muscles rather than fat. And it certainly doesn't take fitness levels and health issues into account. A thin person with a low BMI could be extremely unhealthly and unfit, where as a person with a high BMI may be very fit and healthy but have a lot of muscle or heavy bone structure. Alan needs to post his photo again where he was "the poster boy for a high BMI" and thus "overweight" (NOT - just muscly) by BMI standards.

[ApatheticNoMore]

It's BS. Haha, not to get too direct or anything ;), but really, on so many levels ....

Where is the evidence that these incentives even work, or are they running it up the flagpole? I mean they may have science on obesity and health (may because even that isn't black and white) but do they have any science that their incentives actually *change behavior*, or is the point not actual behavioral change but just punishment?

Why are people obese? 1) Toxic food culture. CVS you're going to stop selling junk food right? I mean really our food is all toxic, everything is trying to poison you one way or other. 2) Deep unhappiness (so many lives of quiet desperation) and thus emotional eating (unfortunately unlike drug use for unhappiness which can actually be far more distructive in the long run, using food to deal with pain is far more visible). 3) Some people are just genetically going to be somewhat larger than others. 4) Bad habits - maybe just eating too often (fasting is much preferred over dieting by me!).

[JaneV2.0]

This is what happens when you allow a third party to be a gatekeeper. It will only get worse. People are even now being bullied into taking dangerous and questionable drugs like statins, with disastrous consequences.

So far, I've been fortunate to operate under the radar of the medical-industrial complex and I devoutly hope to die as unmolested by it as possible.

[gimmethesimplelife]

I read something like this and I am so glad I live close to Mexico for medical care....I know I sound like a broken record on this one but this is truly scary to me.....OTOH, with the ObamaCare dictates of no exclusions for pre-existing conditions, what could be done with this information down the road, just curious? Rob

[lhamo]

I think this is all about the way you spin it/present it. CVS has taken the wrong approach, making it look like those who don't comply are being PUNISHED (in the way of higher fees) rather than those who comply being REWARDED (in the form of discounted insurance. There was a CNN special on here over the weekend about the health insurance system that had one segment on Safeway's successes with the latter approach. If you incentivize people to take care of their health, it can lead to behavior change. Safeway did this in a number of ways, including discounts on insurance for people with certain markers of good health, such as low BMI (yes, I understand it can be misleading but on an epidemiological scale it is probably still better than any other easy to take test). They also put gym facilities into a lot of their corporate buildings. They interviewed several people, at least one of whom said he wouldn't have started on his fitness routine if he hadn't had this push -- he had lost 100 pounds already and wanted to lose 30 more.

The analogy they made was to the car insurance industry, where your rates are based on your record. I think as long as people with pre-existing conditions are not charged extra high rates under a system like this, as long as it is a positive incentive rather than a punishment it is potentially a good thing. Helps to keep costs down for everyone.

(putting on my fireproof suit now waiting for all the flames this opinion is probably going to attract....)

lhamo

[sweetana3]

I am healthy at my weight, my mom was too and my grandmother also. Our family has zero genetic health issues that we have found. Dad is still going strong at 89. Mom died of an unknown platelet issue that the doctors could not diagnose or correct. Don't smoke or drink and never have.

Why do I need to fit some weight standard that would not make me any more or less long lived? However, give me enough money or reduce my health insurance premiums enough and I might consider it. Note: it would take a lot and I mean a lot.

ps: I will no longer support any CVS business.

[Spartana]

I think this is all about the way you spin it/present it. CVS has taken the wrong approach, making it look like those who don't comply are being PUNISHED (in the way of higher fees) rather than those who comply being REWARDED (in the form of discounted insurance. There was a CNN special on here over the weekend about the health insurance system that had one segment on Safeway's successes with the latter approach. If you incentivize people to take care of their health, it can lead to behavior change. Safeway did this in a number of ways, including discounts on insurance for people with certain markers of good health, such as low BMI (yes, I understand it can be misleading but on an epidemiological scale it is probably still better than any other easy to take test). They also put gym facilities into a lot of their corporate buildings. They interviewed several people, at least one of whom said he wouldn't have started on his fitness routine if he hadn't had this push -- he had lost 100 pounds already and wanted to lose 30 more.

The analogy they made was to the car insurance industry, where your rates are based on your record. I think as long as people with pre-existing conditions are not charged extra high rates under a system like this, as long as it is a positive incentive rather than a punishment it is potentially a good thing. Helps to keep costs down for everyone.

(putting on my fireproof suit now waiting for all the flames this opinion is probably going to attract....)

lhamoNow where did I put my flame thrower :-)! Just joking. I do understand what you are saying, and I agree with creating incentives to people to improve their health. However it's the way CVS is doing it and the requirements of personal information and tests (one's that don't actually give info on health) I have a problem with. Now if CVS said that they will offer free gym memberships to their employees or free counseling to manage health issues that employees can "voluntarily" take advantage of with no change in their cost share of medical insurance, then I see that as an incentive. Otherwise - yeah I think it's flat out wrong to do it the way they did. I know that people think the BMI is a great tool but in my experience it isn't. For example, my sister is about 6 inches shorter than me yet we weight about the same. On the surface, probably based on her BMI compared to mine, you can assume that she is fatter than me and thus unhealthly compared to me. But in reality that isn't the case. She is both bigger boned and has more muscle than me. She also is very lean and has a much lower percent of body fat than me, is stronger, faster, fitter, and healthier then me based on other tests like cholestrol, blood pressure, heart rate, etc... Yet, using the BMI as a gage of health, she would be considered unhealthy and have to pay a higher premium than me - and possibliy be discriminated against in employment. On the other hand someone with cancer, AIDS, anenorixic, who smokes 2 packs a day, or any number of other diseases that cause weight loss due to poor health would be viewed as "healthy" and allowed to have reduced premiums.

And if my sister is reading this I can still whoop your :moon: so don't get all cocky now! :devil::devil:

[ApatheticNoMore]

Well what they are being punished for in this case is the refusal to reveal personal data to those whom it is none of their business, and what is rewarded is being lax about personal data. Because the actual rewards and punishments right now aren't even about weight, they are purely about *disclosure*.


They interviewed several people, at least one of whom said he wouldn't have started on his fitness routine if he hadn't had this push -- he had lost 100 pounds already and wanted to lose 30 more.

So telling that it's a "he". Because I doubt there are very many women who aren't already plenty obsessed with their weight (sometimes regardless of what their weight actually is). It's only drummed in constantly since oh such an early age (you think with all that pressure everyone would be thin already but somehow it's not the case. I know! Maybe what's needed is more pressure ... ).

I'm sure external incentives work for certain personalities, but if it's emotional eating and so on, on some level it's kind of like getting someone to quit drugs based on rewards and punishments, yea it might work for some people, but there's usually a lot more involved than that.

I'd pass the BMI, I'm not very muscular.

[Lainey]

I work for a corporation and I've seen this creeping encroachment also.
First it started with smokers: if you smoke, you paid extra for employee health insurance. Next year it was, if you have high blood pressure or high cholesterol, you must submit to a wellness coach and plan in place to reduce those numbers, or else you don't get money from the company towards your Health Savings account.
Granted, all of this was disclosed voluntarily through a 3rd party, and the company supposedly only gets the aggregated information. The goal is to reduce premiums by reducing costs, and these were the targeted issues. Next year ..?

[Tammy]

Cigna gives $20 off my insurance cost every 2 weeks, cause I cooperated with the voluntary screening. Results didn't matter. Get the screening, save the money. I didn't hesitate. I'm practical that way.

[Rosemary]

Our health insurance offers a discount when members accrue a certain number of points during a year by particular activities. Screening is one of them. It's possible to get enough points without the screening, but difficult.

[Spartana]

Cigna gives $20 off my insurance cost every 2 weeks, cause I cooperated with the voluntary screening. Results didn't matter. Get the screening, save the money. I didn't hesitate. I'm practical that way.

But that's kind of the point - if results don't matter and they (CVS or it's medical insurance provider) isn't going to do anything about it then why even bother to discriminate against those people who don't want their personal medical information in the hands of their employers? So if a person is grossly obese, takes the weight, BMI and glucose tests, fails them all then what? They get a $50 discount and nothing changes. They aren't given any incentives to actually change to a healthier lifestyle and can go on as before - saving $50. More money in my pocket to buy Twinkies with ;-)!

[Tammy]

They are hoping that by making people aware of their numbers, they might be motivated to make lifestyle changes.

[Spartana]

They are hoping that by making people aware of their numbers, they might be motivated to make lifestyle changes.That makes sense and I can understand why they would want people to be pro-active in terms of their health since it may effect the companies bottom line (time off work due to illness). But again I think that should be between the medical doctor and the employee, not the company and the employee as I feel that the employer may discriminate against an employee if they had access to that info. - like determining who should get fired or not promoted due to precieved health risks. And of course even the fittest, healthiest person on the planet can become injured. I have never been needed hospitalization or anything for an illness but I have racked up hundreds of thousand of dollars worth of medical bills (and large periods of time off work) because of sport injuries. Same with my sister. We both have had so many sports injuries and surguries that one corner of our garage looks like an orthopedic ward with all the crutches, wheelchairs, walkers, and every kind of brace you can imagine. heck, even a raised toilet seat :-). I know that insurance companies or employers don't generally prohibit people from doing potentially harmful activities on their time off, but if their goal is to reduce medical issues and time off work because of medical problems, then they would have to look at that along with wellness factors.

[Simpler at Fifty]

My company has been doing the biometrics for 3 years. For a while there was talk that premiums would go up for fat people. We have learned that will not happen. What puzzles me about the whole thing is fat people are not the only ones going to the Dr. They are not the only ones having heart attacks, getting diabetes, having high cholesterol or not exercising. But they are targeted because they are easy targets. The powers that be say 'that fat person eats too much, we should do something about that. They are taxing the healthcare system.' Well one could argue that people that have babies every year tax the system as do people that have infertility treatments or people that get treatment for drug and alcohol addictions or sports injuries. Most insurance plans do not cover obesity thes same as any other illness. There are very specific limitations. So they say you can have surgery but there is a $10k limit. But no limit for drug or alcohol addiction. It is easy for people that are not fat to sit back and say fat people are lazy yada yada yada. Because if you are not fat you cannot imagine why someone would 'choose' to be. Or if you have lost weight 'anyone can do it. I guess a non smoker or non drinker/drug abuser could say the same thing about those people but most do not because those conditions are recognized as sickness. No would think to say to an alcoholic 'just stop drinking' or to a smoker 'just quit'. But for the fat people they should just not eat so much and all their problems would be solved. It isn't that easy or everyone would be thin.

[awakenedsoul]

I just got a letter from EHealth Insurance saying that premiums will be going up. They said that the reason is that they can no longer charge higher premiums to those who are obese or who smoke. They said that it's discrimination. It frustrates me. I have never filed a claim, and have always kept myself in excellent shape. I think people who don't file claims should be rewarded with lower premiums. (like car insurance.)

[Alan]

My company has been doing the biometrics for 3 years. For a while there was talk that premiums would go up for fat people. We have learned that will not happen. What puzzles me about the whole thing is fat people are not the only ones going to the Dr. They are not the only ones having heart attacks, getting diabetes, having high cholesterol or not exercising. But they are targeted because they are easy targets.
We do the biometrics thing too, and offer cash incentives for a dozen or so healthy habits and activities. Our HR director tells me that 39% of our workforce are technically obese and that nearly 70% of our major claims are directly related to obesity. While we don't get any direct premium breaks for these programs stressing healthy lifestyles, our rate of increase is slowed, more than enough to make the cash incentives worthwhile.

In our case, it's not that obese people are easy targets, they're a dis-proportionate source of our claims expense.