Only if someone is truly obese - not the obese that a 29 BMI indicates. We need dr's to determine if someone is obese - not a BMI.

If health insurance raises rates based on whether you are a smoker or obese is narrow minded. We all know that some people can not control their weight. There should be incentives for those to lose weight or quit smoking, but those individuals that do smoke or are obese deserve and need health insurance just as much as someone who does not. If you raise the cost to these select individuals you are hurting the welfare of those people. Insurance companies should take the good with the bad just like any other business has to. If you charge extra for smoking or being fat; you should charge extra for eating a poor diet, not exercising, having a high stress level and so on.

If you penalize one group of "High Risk Behaviors" then you need to penalize all "High Risk" groups. With this mindset insurance companies should penalize heavy drinkers, recreational drug users (not that they would tell you they are recreational drug users), drivers that speed or don't wear seatbelts, those that use tanning beds or have high exposure to the sun (ex. landscapers/construction workers, lifeguards, etc.), and individuals that work in manufacturing environments that have poor air quality. To me, it is ridiculous to penalize individuals for participating in legal behavior. The information is out there stating that smoking can lead to lung cancer or that excessive sun exposure can cause skin cancer. It is up to the individual to decide whether or not to participate in these "high risk" behaviors - not the government or health insurance companies right to penalize these individuals for their legal rights/choices.

What about life insurance companies? They set your premiums based on your lifestyle, including vocation, smoker versus non-smoker, general health, etc. And auto insurance companies base your premiums on your driving history. Why not health insurance companies?

Obese, smoker, poor nutrition, lack of physical activity, why should that matter? Why not charge everyone the same way and at the end of the year give money back based on how much an individual uses their insurance for things other than preventive? Then people who are actually using the system are the ones who are paying more. If you are someone who is in perfect health but runs to the doctor for every little ache or pain, you don't get the "rebate" and you are paying for your fair share of insurance. If you are an obese smoker who doesn't exercise but also doesn't go to the doctor because you are not sick, you will get the rebate just like everyone else who isn't running up the costs of healthcare. I think that's fair.

You are describing an HSA plan. They reward you for using your benefits wisely.

I agree with this comment. The BMI scales are off and are not a fair indicator of a healthy lifestyle. Some genetic disorders can also contribute to weight issues and you should not be punished for your genes. However, there is also something to be said for poor lifestyle habits that are known to cause additional health problems.

Reading your comment, you state that individuals can choose to participate in certain high-risk behaviors like smoking or not wearing their seat belts. If they are making that choice, then it seems logical that they are also choosing the possibility of receiving higher premiums for health care insurance (smoking) and car insurance (seat belt behavior). Choices can have consequences.

Reading your comment, you state that individuals can choose to participate in certain high-risk behaviors like smoking or not wearing their seat belts. If they are making that choice, then it seems logical that they are also choosing the possibility of receiving higher premiums for health care insurance (smoking) and car insurance (seat belt behavior). Choices can have consequences.

While life style plays are part in obesity (diet and exercise), there are still many other factors that play a role that are not fully understood. There are genetic factors or even specific treatments that cause people to gain weight. It is very unfair and more focused on "the bottom line" to make someone pay more for coverage, if they complied with a necessary treatment and gained weight.

I think maybe people who are obese should have the option of paying more and living their lifestyle or opting into a program that gives them discounts if they stay in and make progress with health programs for weight reduction and other related health issues

Obesity incurs huge costs on our medical system, and the amount grows every year. The CDC says this: "In 2008, the annual healthcare cost of obesity in the US was estimated to be as high as 147 billion dollars a year. The annual medical burden of obesity increased to 9.1% in 2006 compared to 6.5% in 1998. Medical expenses for obese employees are estimated to be 42% higher than for a person with a healthy weight." The dollar amount for that 42% is $1,429 (cnn.com). These amounts cannot be ignored. If the obese are not charged more, those living healthy lifestyles are being punished for something they have no control over: the choices of others.

Freedom comes with responsibility, and the freedom to eat as much as we want and move as little as we want brings with it the responsibilities of obesity.

I certainly see where you are coming from but I have a different prospective. I am obese. I eat right and exercise and I still gained weight due to a back injury. For some of us, this is not a choice. We are trapped with very little choice as to what we can do to change our reality. We deal with the stress of not only having a larger body but the added stress of others looking at us and judging us based on our size. Judging others for the way they look is wrong. You don't know their situation. You just assume....

I am very upset over this! I am consider obese and I have had gastric bypass but even before I had the surgery I was very healthy. My best friend has the perfect BMI and she has so many health issuse and no she dosen't smoke or drink and yes she exercise and eats right, so why should I have to pay a higher deductible because of my BMI. I go to the doctor twice a year and I do not have any health problems so why should I pay more! I didn't ask to be over weight no matter what you think. This is discrimination how can you tell someone that because of your body type that your going to be at a higher risk!Instead why not help with gym fees or nurition class!

What about the cost for those who are "healthy" and are dying of liver disease because they drink to much. I am over weight but I don't go to the doctor nowhere near most "healthy" people so why should I pay more because of statistics!

come-on people you cant have it both ways. being obese is a lifestyle choice.

I understand why insurance companies are considering this, but I think this is bogus! For those that smoke BBS offered all sorts of smoking cessation classes, offered help to stop smoking, but for us large people, we have not been offered anything except to see a nutritionist 4x a year. I'm sorry the nutritionist told me I need to stop drinking sodas (I don't drink sodas, and haven't in over 10 yrs), eat a gluten free, all organic diet, or foods I can't afford. I was told to exercise more, not sure how I can do that seeing as I work full time and teach aerobics most nights of the week and Saturday mornings, and when I am not teaching I am at the gym working out. So the nutritionist did not help at all. Also being overweight is not necessarily because we eat poorly or don't exercise, sometimes there are other factors. Which is why I think BBS has not offered any other program or suggestions to help those of us who try to practice portion control, and eat fruits and veggies another way to get the weight off!

People who chose not to exercise and eat properly and do other things to create their own problems should have to shoulder the burden they create for themselves. If they had to pay the additional premiums to cover the medical conditions they are potentially bringing onto themselves with bad lifestyle choices (diabetes, heart disease, joint issues, etc), perhaps they would be motivated to make better choices and spare themselves the eventual problems or at least bear the costs themselves rather than burden other policy holders.

People born with genetic issues are an entirely different issue. People can't choose their genes and thus should not be similarly penalized.

I believe the biggest reason Health Insurance premiums are so high today is that people have not taken care of themselves as they should. I will do anything to keep rising costs of Health Insurance down for myself. Last year I went to see a Nutritionist knowing I needed to get some weight off. I lost 34lbs and hadn't felt that great physically and mentally about myself in a very long time. In fact I just stopped smoking 1 1/2 weeks ago. I had been talking about quiting for months now and once we were told that if you show nicotine in your Health Assessment that your premium will go up $250.00. I went on Chantix and quit. Its nice to take a deep breath without coughing or feeling like your lungs are full of smoke. Your health is important and when you take care of yourself you feel good and when you feel good you can live your life good!

I do not think we should judge a person as obese simply by the numbers on a scale or their BMI. While I am considered obese, I have zero health issues and currently take zero medications. Why should I pay more when I am not costing my insurance any additional money?

While I agree that those that are "morbidly obese" (which should be defined by the PCP and should take in a number of factors for each individual, not just looking at the BMI chart) should pay more for their insurance, I also believe that there need to be more programs in place to assist them in regaining control of their weight. Aside from extreme procedures, like gastric bypass, simple things like requiring those individuals to meet with a nutrition counselor (probably several times a year) or cover the expense of personal training if you meet the criteria (or are at risk due to current lifestyle) should be included benefits for those that are paying higher premiums. If you provide the proper assistance, at little to no extra cost (or make it mandatory for continued coverage or risk even more rate increases) then there would be both an option and an incentive for taking control of your weight. With higher premiums should come increased benefits for those that need them the most.

This is difficult because being overweight is not always a choice. There are many medical factors that play into someone's weight and inability to lose it. Smoking is always a lifestyle choice. Being overweight is not always a choice or the fault of the person. Yes, there are some that make the choice. It should be based on the medical reasons and many factors, not ignorance that because someone is overweight its 100% them.

I still go back to charging fairly. Obese, smoker, poor nutrition, lack of physical activity, shouldn't matter. Charge everyone the same way and at the end of the year give money back based on how much an individual uses their insurance for things other than preventive. It could be an HSA or it rebate program, it doesn't matter. If you use the system a lot one year, you don't get a rebate. This would also cover the company in case there is an epidemic breakout (flu and such). Use it only for preventive, get a rebate (or keep your HSA money). This way obese, smoker, "healthy", chronic condition, lifestyle choice, emotions, politically correct do not come into play. It's just good, fair, unemotional business.

Great idea, but the problem with this is that insurance companies truly do not believe in preventative care. They claim they do, but they have nothing that allows for it and they truly don't cover most preventative items. There are some preventative items they cover and I applaud them for that, but the fail in 90% of preventative care. One Example: Chiropractic care. People who see their Chiro for regular maintenance see their primary care specialist less for illness. I know this for a fact because I am the prime example. I also come frome the healthcare industry.

I understand where the people who think people who are obese should be charged more are coming from.*However*, how do you charge for that fairly? If I understand correctly, a lifelong smoker who stops smoking would stop being charged a higher premium immediately, but the physical damage from smoking would already be done and/or it would take a long time for health and lung function to go back to 'normal'. Do the people that want the obese to pay more expect higher premiums to be charged until the person gets back to a non-obese (however determined) weight, even though that may be a process that takes years?

I think you misunderstand when I say "preventive". These are things like your annual physical, mammograms, well baby check-ups and the like. Chiropractic services are a treatment option, so you would be going to the doctor more than someone who isn't seeing a chiropractor and your rebate would be less.

Obesity is not always a choice, and the causal links between obesity and many of the health conditions associated with it aren't clear. There are correlations, certainly, but not necessarily causal links. Also, obesity can be caused by genetics, by poverty and poor access to good food and safe exercise areas, and by health conditions like Polycystic Ovarian Syndrome. Then there's the issue of BMI being used to measure obesity, but it is a flawed system; it's just a ratio of weight to height. If you're unusually tall you may be "obese" based on your BMI even if you're a healthy weight. There are too many factors related to obesity, and those factors are too poorly understood, to punish people for being obese. Not to mention the fact that if health care becomes less affordable for obese people, they're less likely to seek out preventive care and will end up costing the system more than they would have if they could afford preventive care. There's no sense in scapegoating obese people.