Hmmm

State work­ers who smoke will pay more for insurance

I’m utter­ly anti-smok­ing, although I fig­ure peo­ple have a right to do what they want when it does­n’t affect oth­ers. This, how­ev­er, alarms me as a trend.

Note—it’s group insur­ance, not indi­vid­ual. The fund in ques­tion is self-insured, so under­writ­ing isn’t nec­es­sar­i­ly going to be the same. How­ev­er, group insur­ance is under­writ­ten based on the whole group, rather than individuals.

I’ve been the man­ag­er of a self-insured health insur­ance fund. I could not begin to imag­ine charg­ing dif­fer­ent pre­mi­ums based on some demo­graph­ic, even smoking.

The next group to pay high­er pre­mi­ums will be fat peo­ple, as they are pre­sumed to have high­er health care costs. Then? Peo­ple who don’t exer­cise, maybe? Any­one with a his­to­ry of health prob­lems? Queer peo­ple, assum­ing that they’re at high­er risk of HIV infec­tion? Will they do tox screens for drug use?

At least the cur­rent deci­sion is based on per­son­al behav­ior, rather than some­thing that is inher­ent to the individual. 

Fat, though, is often pre­sumed to sole­ly be a result of behav­ior, when that isn’t always the case.1I’m not here to edu­cate you about size accep­tance, so don’t go there in the com­ments. There are plen­ty of sites that are far bet­ter suit­ed for that, and I urge you to check them out if you assume that fat is always due to per­son­al choic­es or that all fat peo­ple are unhealthy. There may be a genet­ic pre­dis­po­si­tion to being large. There may be health prob­lems (PCOS, thy­roid imbal­ances, etc.) that cause weight gain. There may be weight gain as a side effect of med­ica­tions.2As an exam­ple, I gained more than 50 lbs. in under a year while tak­ing the most effec­tive anti­de­pres­sant I’ve ever been on. Seri­ous weight gain is a known side effect of that drug. Despite its effi­ca­cy, I refused to take it any­more because I could­n’t stand the weight gain.

If BMI were used (as it almost cer­tain­ly would be), we’d see many peo­ple who aren’t fat clas­si­fied as obese. For instance, a recent analy­sis showed that most of the play­ers in the NFL, based on their BMIs, are “obese”—some even “mor­bid­ly obese.”

Part of my con­cern is based on anoth­er sto­ry try­ing to jus­ti­fy low­er pay for fat peo­ple. There’s dis­cus­sion of that sto­ry at Big Fat Blog.

Cyn is a proud Mommy & Mémé, professional geek, avid reader, fledgling coder, enthusiastic gamer (TTRPGs), occasional singer, and devoted stitcher.
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