You think it's silly and illegal to do this? Not for cigarette smoking. Your essay is disingenuous.

Let's be clear on the difference between status and behavior.

Cigarette smoking, riding a motorcycle w/o a helmet, not exercising and eating nothing but fast food ... these are behaviors. *Current* choices which you *might* be able to make a case for "penalizing".

Being overweight or obese is a status. It tells you little-to-nothing about a person's *current* health choices. Maybe they had undiagnosed hypothyroid. Maybe they spent months in a hospital bed. Maybe they self-medicated with food for years in response to undiagnosed/treated depression. Maybe they did spend *years* lying on the couch and chomping chips for no particular reason. Maybe maybe maybe.

The point is, you don't know. Many of them may NOW work out five times a week and eat a healthy diet and have great cholesterol, BP, etc. Maybe they are losing weight deliberately, but slowly. It seems counterproductive to lump all overweight/obese people inot a single group and penalize them for behaviors they may have abandoned. If they're gonna get dinged even as they are working hard to adopt and maintain healthy behaviors, why bother?

Then they won't have to worry about the higher premiums for long... and in a sane world there wouldn't be just a high premium/low premium between fat and fit, so they'll gradually see their premiums reduce as they reduce their waistline.

They get the premiums they earn... and as they lose the weight they earn lower premiums, because their actions that help them lose weight also reduce the cost of insuring them... this makes perfect sense.

What about bulimics who are thin because they vomit? They don't have to pay the higher premiums. It's stupid stupid stupid to penalize people for their weight.

Mara5525:

What about bulimics who are thin because they vomit? They don't have to pay the higher premiums.

Yes, weight is not always a good indicator of health. Some people are thin because they vomit or starve themselves. Some are naturally thin but eat a lot of junk food and are not at all fit.

So I'll have to re-word an earlier post in this thread.

How about this: Let's put our money where our mouth is... I'll take a person with a waist-to-hips ratio of 0.95 or less, and you take one of 1.1 or higher. We'll bet on which person is healthier.

Then, we'll continue to take more people - I get those who have a WTH ratio of 0.95 or less, you get those with 1.1 or higher...

Sure, I'll get a couple of anorexics and bulimics, and you'll get a couple of people who work out a lot but still have big stomachs... But I can absorb those few comparitive "losses" and still win a vast, vast majority of the bets between us. In the end, your fat people will be less healthy - on average - than my fit people. This is an absolute fact. If you choose to disbelieve that, then I will honestly want to start betting with you, as long as the people are randomly selected (don't go to the gym and select your "fat" guy while going to the cancer ward to select my "fit" one).

The insurance company is essentially placing a bet with each person that enrolls. They are betting that you will be healthy and not need their services, while you are betting that you will need their services. They can afford to "lose" on occasion and pay out for whatever services you need because they set the premiums high enough that they gain enough money "winning" against other people (not needing their services)... But fat people are a bad bet. It's MUCH more likely a fat person is going to need both constant care and expensive emergency services at a much younger age than fit people. Sure, there will be some fit - looking people that are anorexic or bulimic, but that's less than 1% of the population, so the "wins" will outnumber the losses... But all fat people are fat (again I'm not stupid enough to use BMI, so when I'm talking about fat people they are ACTUALLY fat), which means that all of these people WILL "win" (need health care services) more often... If the HMO doesn't change the odds (by taking higher premiums and paying out the same in services), then the fat people will cause them to lose money. They will avoid this by either raising rates on fat people, or raising rates on all people.

I don't think it's right for fit people to subsidize my poor lifestyle choices. When I start making better lifestyle choices, I don't want to subsidize people making poor lifestyle choices. We should incentivize better choices, not do our best to limit the consequences of poor choices.

For one who throws around the word "stupid" quite so often, you don't seem to have thought this subject through.