This is one of the least scientific "Science" pieces ever, because its logic is flawed. Its problem isn't with the extra fee for obesity, but with the actuarial system itself. The author would like each insuree to be elaborately evaluated for body content and health, which would drive the cost of insurance skyward into the stratosphere. The system doesn't and can't afford to work that way. The actuarial system is really just a fancy word for handicapping insurance the way gambling houses handicap horse races; it figures the odds. Despite the author's seriously undocumented claims, odds are way in favor of smokers and obese people getting sick over non-smoking people of normal weight range. The author's lack of clear thinking led him to argue against using the factors instead of ripping the oddsmaking system itself, which is his real beef. Sure, two pounds might not make a big difference in one's health, but the insurance company has to draw the guidelines somewhere (is a 59 year-old a significantly better life insurance risk than a 60 year-old? Probably not, but oddsmakers say "yes" because they have to draw the line somewhere -- after all, older folks are more of a risk, no question about it). Besides, if a guy that big is too lazy to lose two lousy pounds to qualify for a 50 percent discount on health insurance, I say he deserves to pay double!

I agree that this article was worthless... but there are two things that COULD be done to make the system far more fair, and more efficient.

Waist-to-hips ratio (WTH) is an actually VALID statistic, as opposed to BMI, for measuring a person's "fatness". There are numerous studies showing a far better fit correlation between WTH and likelihood of heart disease, hypertention, etc... and waist-to-hips takes a well trained person about 20 seconds with a tailor's tape to evaluate (measure the waist, measure the hips, devide the waist measurement by the hips measurement.... done).

So WTH works. There's a range that is considered "healthy" depending on the gender... so a woman might be considered "healthy" between 0.7 and 0.9, while a man is "healthy" between 0.8 and 1.0...

If that range is healthy, and we see an increased correlation with illnesses and other issues the further we digress from that range, then it indeed doesn't make sense to charge a man with a 1.01 the same that you'd charge a man with a 1.7... Why not just charge based on the difference... Say 2% increase in the cost for every 0.01 deviation from the "healthy" range in the WTH ratio... So man with a 1.7 would pay 240% of what a man with a 0.9 would pay.

You'd just have to offer a 10 month subsidy for pregnant women... and we're done. It's fair, it's VALID, and it's efficient.

BMI is useless for individual evaluations. Attempting to use it for individual evaluations is reprehensible, and would immediately open the insurance company up to a VERY valid class-action suit.

I agree. Governor Schwarzenneger has been "morbidly obese" for most of his adult life according to BMI . . .

BMI was designed for evaluating results across thousands of individuals, when every person with a below-average lean-body mass is countered by someone with an above-average lean-body mass. It is meaningless for individuals.

I've always found this correlation between availability of healthy options & income level in the USA intriguing. I'm Canadian, and since my wife is still a student, earn below the poverty line & shop at a low-end grocery store in a relatively remote city a thousand miles from fresh fruit & vegetable production. There are fewer healthy options than at the suburban specialty stores in the big cities, but there are options available, and in recent years, they aren't much more expensive. Reducing salt, saturated fat & cholesterol by 70% from the levels in the cheapest products increases our overall grocery bill by maybe 10-15% and adds about ten minutes a week to shopping time.

I understand that food quality as a whole is in generally a little higher in Canada than in the United States, but the whole concept of nutritionally sound food being unavailable in low-income areas is more a feature of industrialized developing countries like China & India than of modern Western nations.