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wshaffer
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22nd-Sep-2011 02:06 pm
not-helpful
I was pretty boggled by this post on Shakesville about a health insurance plan that makes enrollees with BMIs over 30 either accept substandard coverage or enroll in a "weight management plan", which boils down to: go to Weight Watchers or wear a pedometer and take a certain minimum number of steps per 3 month period.

I went and did a search for the health plan site, and, of course, they spin it all as providing incentives for healthy behavior and allowing people to qualify for "enhanced coverage." Which did give me a moment's pause, because, hey, I love the idea of incentives for healthy behaviors.

Except, whoops, a BMI is not a behavior. Why not give everyone rewards for wearing a pedometer or eating their veggies?

Also, while incentives are cool, materially impacting people's ability to afford basic healthcare is not so cool. Even if you smoke and live on Ding Dongs and whiskey, I want you to be able to afford to go to the doctor.
Comments 
22nd-Sep-2011 09:20 pm (UTC)
Urgl. Yeah, I'm all for wellness incentives that offer money (like my old institution did) for going to the gym and doctor regularly, but that's "hey, let's incentivize generally being healthy," not "let's punish you for your BMI."
23rd-Sep-2011 02:13 am (UTC)
Someone You May Know (but I don't like to make these things searchable) was turned down for health insurance because his BMI was too high at the time.

SYMK has like ten million other health problems. But what got classified as a preexisting condition that got him turned down for insurance? Fat. Period. No other considerations listed.

Happily we are in a state where everybody can get health insurance if they can pay for it, so he got the "you got turned down!" state option. But still. Still.
23rd-Sep-2011 03:38 am (UTC)
I suspect that this is neither the first nor the last time that I'll have cause to be enraged at the health care system on Someone I May Know's behalf. Though I am profoundly relieved that he was able to get health insurance of some kind.
23rd-Sep-2011 02:36 am (UTC)
Why not give everyone rewards for wearing a pedometer or eating their veggies?

Because that would make sense. After years of depressing dealings with Health Insurance, I have come to realize that the entire system, no matter what the company, is founded on the idea that nothing should make any sense. :(

ETA: Also, how many steps do they require, exactly? How does it measure up against the average person on an average day?

Edited at 2011-09-23 02:37 am (UTC)
23rd-Sep-2011 03:52 am (UTC)
Yes, it's really about cutting costs, and about doing so in the most clumsy and crude way possible, because doing it thoughtfully would be work.

The program requires an average of 5,000 steps per day, which according to this site (http://www.medicinenet.com/script/main/art.asp?articlekey=120555) is just about average for American adults. I experimented for a while with wearing a pedometer to get an idea of my overall activity levels. I typically averaged 8,000 to 12,000 steps a day, but I live in a very walkable neighborhood, and was generally doing about 5,000 to 7,000 steps of deliberate exercise most days.
23rd-Sep-2011 02:53 pm (UTC)
They just want people to do the average? How does that help to lose weight? (I mean, if someone's average had been 3,000 previously, and he/she upped it to 5,000, that would be good, but I suspect that most people are already doing the 5K, unbeknownst to them.) Oh, wait: the nonsense thing. @_@;;
23rd-Sep-2011 03:37 pm (UTC)
I suspect that the reasoning (if any) is something like, "Well, these people are fat, so clearly they must be doing less than the average amount of physical activity." Demonstrating the flaws in this argument is left as an exercise for the reader.
23rd-Sep-2011 03:21 pm (UTC)
I am sad to hear that.

BMI is bunk, and if I gain a little more muscle, I'll hit 30. Grrrr.

I still remember being at a health fair and being told I needed to lose 20 lbs of fat by their calculation. That would put me at a % bodyfat I haven't been at since high school.

Grrrr...
23rd-Sep-2011 03:51 pm (UTC)
Yeah, my BMI currently fluctuates just around the 30 threshold. Were I on this health insurance plan, I'd be going nuts, because whether I'd need to jump through hoops to keep my benefits could hinge on my level of hydration on the day I was weighed.
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