Armed Polite Society

Main Forums => The Roundtable => Topic started by: MillCreek on May 25, 2017, 11:00:03 AM

Title: Higher BMI is going to result in higher health insurance costs
Post by: MillCreek on May 25, 2017, 11:00:03 AM
http://www.medpagetoday.com/Endocrinology/Obesity/65566

More and more literature showing that the fatter you are, the more you cost the healthcare system.  Can higher insurance premiums be that far behind?
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: makattak on May 25, 2017, 11:03:16 AM
http://www.medpagetoday.com/Endocrinology/Obesity/65566

More and more literature showing that the fatter you are, the more you cost the healthcare system.  Can higher insurance premiums be that far behind?

That's racist.

And before you think I'm just being facetious, I'm fairly certain that lower income is closely correlated to higher BMI and minorities are disproportionately represented among lower incomes.

So, when this happens, it will be called racism.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: K Frame on May 25, 2017, 11:03:50 AM
"That's racist."

No, it's bulkist.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: Ben on May 25, 2017, 11:13:45 AM
http://www.medpagetoday.com/Endocrinology/Obesity/65566

More and more literature showing that the fatter you are, the more you cost the healthcare system.  Can higher insurance premiums be that far behind?

It is interesting to me that they are using BMI, versus actually measuring fat to make the determination. I always thought BMI was a generalization. That is, usually high BMI correlates to excess fat, but what about athletes? Will they be charged more for a higher BMI? Not that I'm any big time athlete, and I can stand to lose a few pounds, but my BMI is higher than some acquaintances that are pretty darn flabby, and I'm not.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: Pb on May 25, 2017, 11:28:43 AM
Obesity is usually something controllable by a person.  It makes perfect sense that fat people should pay higher premiums than thin people.  Just like bad drivers pay more for car insurance.

It is unfair to require fit people to pay higher costs to subsidize artificially low premiums of someone who chooses to overeat.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: makattak on May 25, 2017, 11:48:41 AM
Obesity is usually something controllable by a person.  It makes perfect sense that fat people should pay higher premiums than thin people.  Just like bad drivers pay more for car insurance.

It is unfair to require fit people to pay higher costs to subsidize artificially low premiums of someone who chooses to overeat.

Nope. It's unfair that ANYONE has to pay a higher cost than ANYONE else. In fact, it's unfair anyone has to pay anything at all. At least, that's what I've been told by the "HEALTHCARE IS A HUMAN RIGHT!" crowd.

Except smokers. They deserve everything they get. (Fat people MAY be added to the "acceptable" bigotry as well, but given the "body shaming" stupidity, I'm not certain that will be allowed.)
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: Brad Johnson on May 25, 2017, 12:21:54 PM
BMI is a poor indicator. It's a one-size-fits-all approach which ignores a very important basic criteria (aka mass composition, adipose or muscle). It works within a certain segment of body types but fails miserably outside those rather narrow boundaries. I don't doubt for a minute that a sample of persons with health issues will show a correlation - persons who are unfit, sedentary, and/or generally make poor health choices will most likely fall into a higher BMI range. But, as we all know, correlation does not equal causation. Morbid obesity is certainly a health problem but there are more exacting determiners which have a much broader applicability and that do not carry BMI's inherent limitations.

Brad
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: DittoHead on May 25, 2017, 12:44:42 PM
correlation does not equal causation. Morbid obesity is certainly a health problem but there are more exacting determiners which have a much broader applicability and that do not carry BMI's inherent limitations.

But insurance works just fine off correlation. I suspect down the road they will switch to a more accurate tool but BMI is dead easy calculate and very non intrusive to measure.

The changes that have and will continue to occur with insurance and the use of big data analytics are fascinating to me. I know there was controversy over using DNA analysis to determine risk factors. Not sure if anything came of it? People seem to want to limit how much information insurance companies can use. The fear seems to be that we'll eventually get to the point where it's no longer risk pooling but a more individual analysis and you'll essentially be pre-paying for whatever is eventually going to go wrong with you.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: RevDisk on May 25, 2017, 01:01:59 PM
I am always vaguely shocked when people use BMI for... well, anything. It was developed around 1830 to 1850 for "social physics" (ie social sciences, ie soft sciences) and NOT, NOT, NOT supposed to be used for anything remotely medical. It's on par scientifically with phrenology, bleeding and humoralism.

The concept "being fat is bad for you" is fine. BMI however is not the way to go about that. I have no bloody idea why people don't just use body fat ratio. It's less complex and actually friggin useful. Calipers are $5, and give you a rough but accurate enough percentage.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: KD5NRH on May 25, 2017, 06:13:31 PM
It is interesting to me that they are using BMI, versus actually measuring fat to make the determination. I always thought BMI was a generalization. That is, usually high BMI correlates to excess fat, but what about athletes? Will they be charged more for a higher BMI?

The way it was done at one previous employer, you could contest the initial BMI measurement and go to the doc for a proper body fat measurement on their dime.  If you're in a totally different category than the BMI said, you get the doc check every year automatically.

The concept "being fat is bad for you" is fine. BMI however is not the way to go about that. I have no bloody idea why people don't just use body fat ratio. It's less complex and actually friggin useful. Calipers are $5, and give you a rough but accurate enough percentage.

Most of the insurance tests I've had were height, weight and wrist size.  They're already doing height and weight anyway, and wrist circumference is quicker and more consistent between testers than a three-site skinfold, especially when you've got everybody lined up in the same room and don't want the hassle of getting to the normal measurement sites; wrists are already out there in the open.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: grampster on May 25, 2017, 06:25:05 PM
40 years ago, while chatting with my doc as he explored my prostate, he asked if I wanted to know what I'd look like as I aged especially if I hit 70's.  Through clenched teeth and in a rather higher pitched voice, I said "yes".

He said how old is you dad?  I said he was around 70.  Doc sez, look at your dad.  Your body will probably look just like he does when you get there.  I was probably 5 inches taller than my dad, but otherwise at age my present age of 73 (and dyslexia) , I look just like my dad did.  I'm 6 feet tall and about 230 and look mostly like a stocky rectangle.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: Ben on May 25, 2017, 06:50:31 PM
I know there was controversy over using DNA analysis to determine risk factors. Not sure if anything came of it? People seem to want to limit how much information insurance companies can use. The fear seems to be that we'll eventually get to the point where it's no longer risk pooling but a more individual analysis and you'll essentially be pre-paying for whatever is eventually going to go wrong with you.

I'm as big of a privacy nut as most of the folks here (possibly in the top ten  =D ). However, last month I heard a fascinating interview with the guy who headed the human genome mapping project. Some of the health predictions they could make with near certainty were fascinating. I wouldn't mind having my DNA recorded and sifted through in order to identify potential problems down the road. Especially for the heads up on those I could potentially mitigate.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: BlueStarLizzard on May 25, 2017, 07:28:00 PM
I'm not looking it up but there was a story out of England recently with a female athlete of some sort who got really screwed over by the British Health Services because they use BMI to assess body fat ratio.
The woman is *visibly* toned and in obviously great shape and got told to loose weight because she was obese.  :facepalm:

So, while I understand obesity being an obvious question for health insurers, I find using BMI to make that judgement ludicrous. 
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: RoadKingLarry on May 25, 2017, 10:17:29 PM
When I was in the Navy I saw several cases of BMI being used to screw over people that didn't fit the stick figure mold.
Both were weight lifters/body builders that had to go to extreme lengths to get the classification of obese changed because the command had other issues with them.
The first one was trying to go SEAL but because he didn't fir the mold they labeled him obese. I doubt there was enough body fat on that guy to grease a small skillet. He eventually fought it to the right people and got shipped off to BUDS, never did hear how he did.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: Scout26 on May 25, 2017, 10:34:51 PM
My last Platoon Sergeant was a weight lifter, dude was just massive and not an ounce of fat on him.  Built like a brick shithouse.  And every month I had to tape him because he didn't meet Army height/weight standards.
Title: Re: Higher BMI is going to result in higher health insurance costs
Post by: RevDisk on May 26, 2017, 09:52:06 AM
When I was in the Navy I saw several cases of BMI being used to screw over people that didn't fit the stick figure mold.
Both were weight lifters/body builders that had to go to extreme lengths to get the classification of obese changed because the command had other issues with them.
The first one was trying to go SEAL but because he didn't fir the mold they labeled him obese. I doubt there was enough body fat on that guy to grease a small skillet. He eventually fought it to the right people and got shipped off to BUDS, never did hear how he did.

If you're muscle heavy guy, you learn the drill in short order and have an appointment set up around APFT time to get a proper body fat thing done at the clinic. After the third year in, the clinic had an unofficial list and set up appointments in advance.