Health Care: Carrot or Stick?

October 15, 2009

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We are happy to announce the debut of a new feature, The Political Observers. Writers from each side of the political spectrum will share their views in the column, which will appear on Thursdays. Zarberg kicks it off today.

Health care seems to be the dominant story on the news these days, and for very good reason:  the changes being proposed will have some sort of impact on the vast majority of all American citizens.  Since I have spouse with a chronic disease, and I’m government employee for a state that now has the worst rated state health plan in the US, I’m paying pretty close attention to what’s going on. 

One thing in particular that caught my attention about my current health plan is a penalty that will go into effect in 2010 that says if you smoke or are obese you will get dropped from the 80/20 plan to the 70/30 plan.  This means that your health plan will pay 10% less of your claims if you smoke or are obese.  Since I don’t smoke and as an average height American male am only 165 lbs, I don’t fall into either category so my first thought was, “great, I won’t be penalized.”  Ever the optimist.  I didn’t think much of it after that until one of my co-workers pointed out that they’re applying the stick rather than offering the carrot.

The bleeding heart in me says rather than give them a punishment, offer them incentives they can’t refuse to lose weight.  The capitalist in me says hit ’em where it hurts if they’re costing the system, and hit ’em hard.  I’m still mulling over which part of myself I agree with more.  On the one hand, people who are already in shape will not have anything change, other than the standard increases in cost.  On the other hand, what if those obese state employees are genuinely trying to lose weight and simply don’t have the body type or biological makeup?  Interestingly enough, I have a co-worker who if this plan went into effect today, would be considered obese and not eligible for the lower cost plan.  He was vocally upset about it when first informed, but now has used this as an incentive to join a gym and work out 2 days a week.  He’s already lost 10 lbs, and is a shining example of exactly what the state health care plan wanted to achieve with this.

But what about those smokers?  I’ve never smoked more than a cigar on New Year’s with some friends, so I don’t know how addictive nicotine is but based on the large sums of money being made by stop smoking programs and patches and gum and so forth, I’m sure it’s pretty darn addictive.  Will 10% be enough to get them to kick the habit?  I’d rather see something where if they start a doctor-approved plan to stop smoking and it succeeds, the insurance company picks up the tab.  If they fail, the smoker pays. 

In the end, the part of me that is bitter about how broken the current system is will win out over the capitalist and bleeding heart parts of me.  I have a wife that continues to struggle with her health and we’re paying thousands a year above and beyond our health care plan while CEO of our not-for-profit health insurance company just gave himself a $3 million bonus.  We’ve been giving the health insurance companies the carrot for so long, they could stand to have a little stick applied to where it hurts them.

One Comment (+add yours?)

  1. Evan Kline
    Oct 15, 2009 @ 11:33:50

    That’s a pretty interesting way of doing things in your state. You are right that something needs to be done here. With restrictions on what plans are accepted by certain doctors, there really isn’t the necessary competition in the industry that a capitalist market needs. The Blue Shield plan here has obscene amounts of reserves, with the costs to business and people going through the roof. Something needs to be done, and a public OPTION might be the answer. I stress the word “option,” because of all the people who just hear the talking points of certain TV pundits (who really should be called entertainers, not pundits), and mindlessly cry out “I don’t want the government controlling my health care.”
    .-= Evan Kline´s last blog ..5 Fantastic WordPress Plugins You May Not Know About =-.


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