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Work Out or Pay the Price (Literally)

Health care costs a fortune and instead of waiting for officials to make changes, companies such as Des Moines-based Principal Financial Group (PFG), are taking matters into their own hands. What's their idea? They plan on charging less-than-healthy employees higher fees for their health care.

PFG launched its program on Oct. 11 to make employees shape up or pay up. Here's how it works. All employees start off with "enhanced coverage" where they have lower deductibles and co-pays than the "standard coverage." Then the employees agree to a health screening, and if they reach certain scores in all the criteria (like low blood pressure, good cholesterol levels, and healthy BMI), they get to stay on the low-cost plan. If they don't score well on these tests, then they have to agree to work with a health coach (provided by the company), to improve their scores. If a person refuses to take the tests in the first place, won't work with the coach, or slacks off on an exercise program assigned by the coach, then they'll end up paying high deductibles and co-pays.

This is a fairly new approach, and some companies are leery about initiating such programs for fear that they'll upset their employees, or be sued by them. What do you think? Would lower health care costs encourage you to eat right, exercise, and take better care of yourself? Or do you think these types of health care programs are a form of discrimination?


Join The Conversation
gumdrops334 gumdrops334 9 years
how are they going to check that everyone IS exercising? There are plenty of "overweight" people out there who do exercise on a regular basis, and have a naturally high BMI. Are they going to check off each day you exercise? I mean, this can only go so far. And like someone said before, am I going to have to pay extra because I have bad eyesight, and don't eat enough carrots? And do promiscuous people have to pay more because they may have STDs? This is discrimination in the worst kind. And yes, I do believe staying fit is a lot harder for poor people. Yes, there are ways around it, but it is WAY WAY WAY more convenient for the well-off to exercise everyday. And, I believe that eating healthy as well is a lot more expensive than most cheap junk you can find. At my grocery, the produce is pretty expensive. One cantaloupe is $3 and a watermelon is $4. That's not a meal. I can buy plenty of meals however, for $2 or less, albeit they are very unhealthy.
behemoth_the_cat behemoth_the_cat 9 years
DISCRIMINATION and a way to make the already rich insurance companies even richer. this will affect not only people who don't eat healthy or watch their weight, but people that have naturally occuring high blood pressure or similar problems.
Spectra Spectra 9 years
I like this idea. I never get sick and I'm in great shape. I'm not on any prescription meds and I only have to go to the doctor for my checkups and stuff. I don't think I should have to pay as much for my health insurance as someone who never works out and has numerous health problems as a result of that. Health insurance is a big cluster one knows how much anything costs and it's all overinflated. If health insurance worked more like auto insurance, it'd be a lot cheaper. That is, preventive maintenance things wouldn't be covered (ie, checkups, minor procedures, etc.) but they would be priced fairly. Major procedures would be covered, so it works to your benefit to keep up with your "maintenance" to try and avoid a major procedure.
chibarosa chibarosa 9 years
I work in the area of employee benefits. With the program detailed above, employees who have health problems get a FREE health coach. They're only penalized if they refuse to be tested or don't work with their coach. If we can educate employees on how to lead healthier lifestyles, then we all win, because when people are unhealthy they develop more health problems and then we all pay higher premiums as a result. But if a health coach can help an employee to quit smoking and start doing a little exercise, even if it's marching in place in front of the tv, then that employee will SAVE money and start feeling better, and will be a more productive and happier employee down the road. No gym membership is required. Yes, the current system is to charge employer groups who have large numbers of young pregnant-eligible females and older males higher premiums because they pose a higher financial risk. They also charge higher premiums to groups that have lots of sick people. That's just the way it works.
absolutromantic absolutromantic 9 years
To add to what others are saying, I still don't see how being healthy costs money. You can walk outside. You can do calisthenics in your living room. If you are that tight for space, you can jog in place! As for food, I find that cooking my own food is often MUCH more economical than buying the processed junk that so many do. I live near a project (who doesn't, in Manhattan), and it galls me at the grocery store when I see a family that is clearly pinching pennies and they're buying soda, frozen dinners, etc (and I'm sure they think they're great just for not going to McDonalds). It is NOT expensive to eat healthy - it's only expensive to stop being lazy and get off your butt and cook for yourself and exercise.
juju4 juju4 9 years
What I like about this plan is that even if you score low on their tests, that doesn't mean that you don't have the higher costing plan. It just means that the company PAYS for a health coach for you. Obviously, if you have hereditary condition, you may already be leading a healthy lifestyle even if you your scores on the tests don't reflect that. In that case, I would think the health coach would tell you to keep doing what you are doing. I think the company is not just looking out for the bottom dollar, but also hoping to help out the employees who aren't as healthy. For all of those people that are saying that being healthy costs money....isn't providing a free health coach a good thing?
cravinsugar cravinsugar 9 years
What about people who will get diabetes no matter what because it runs in the family on both sides? that isn't my fault, and fat or skinny I will get it, everyone in my family gets it. like bad eye sight...but I don't see people worrying about making everyone eat carrots or else
juju4 juju4 9 years
I am familiar with PFG, and I am pretty sure they have had a gym in their offices for a long time. They own the tallest building in Des Moines (40 stories) and it is pretty luxe for Iowa standards. Our insurance costs are going out of control. I work in HR, and one of the biggest reasons that rates are going up is that people are developing chronic conditions that need treatment for LIFE. High blood pressure, diabetes, etc. all require long term medication, which is outrageously expensive. We all are paying elevated premiums to help the insurance companies cover these treatments. Each year I see raised premiums and declining benefits. Ultimately though, I think the insurance companies and pharmacuetical companies are making a huge profit off of the declining health of the nation.
psterling psterling 9 years
I think its a great idea! And it would give me more incentive to get my butt of the couch.
hlj504 hlj504 9 years
I think this is an excellent idea. Health care in our country is insanely expensive, and companies can get cheaper rates as well by having employees follow this sort of plan. Additionally, since if a person is shown to be unhealthy for whatever reason, they are able to still get the cheaper deductibles/co-pays, etc. if she show they are making an effort to be healthier - which is a good thing for the employee as well! I think it is a win-win situation.
nikodarling nikodarling 9 years
Its really unfair for those who have congenital health problems that cannot be prevented and maybe there needs to be a special caveat for these issues. Aside from those people I think its a good idea, why should I pay the same for health insurance when some people in my company are chain smoking, fast food eating booze hounds and drive the cost of insurance up. I take very good care of myself and as a result I hardly ever use the health plan because I do not need to. Its the same as car insurance I drive very safely don't take risks and have never had an accident so I pay less than alot of other people.
cravinsugar cravinsugar 9 years
I think it is a pretty crappy idea. Who is my company to tell me how to live? I am an adult, I know what is healthy, and I know how to be healthy. What if I want to remain the same way I am? What if I am happy the way I am? This is basically the company saying "We are not happy with the way you are, so there is no way you can be happy. Do this or pay the price." And please...getting penalized for slacking off of an exercise plan? Who doesn't slack off on exercise once in a while? Way to make a person hate exercise when it should enjoyed. Also, all enjoyment over family get togethers and holidays would be lost if all ou could think about at Thanksgiving dinner is what you can eat and if you decide to have that second piece of pumpkin pie you could go broke. Right now I am enjoying explorin gnew healthy recipes, new veggies I have never tried, and exercising when i can (I would like to see my company tell me after 13 hour workday that if i don't workout i will be penalized) and I am enjoying my self. If someone came to me and said "you have to do this or pay more money" I would go work somewhere else. And tell them to bite me.
bp99 bp99 9 years
Since it's the insurance companies doing this i wouldnt be surprised if the next step was penalizing people with STD's. I mean, it's their own fault that they had unprotected sex, just like people eat too much and don't exercise get obese. So let's have a higher premium for people with multiple sex partners. And have cheap rates if you practice abstinence. You can extrapolate this to just about anything because the incentive here isn't for people to get healthy, it's for the insurance companies to save money. The point would be much better if companies, like my fathers did, offered rewards to be healthy. He got 100$ for filling out a health survey and talking to a health coach over the phone, then gets check ups. There is a free clinic in his company for people to go to, as well as a gym and showers. That's progressive, while this testing and punitive damages just seems kind of greedy.
Berlin Berlin 9 years
I think this is great! It's just like car insurance...if you do well then your rates are cheaper and the ones who drive recklessly and don't take care of their property or think of others pay higher prices, but you have the option to get on the right track for better rates in the future. You should have lower rates if you are fit and healthy and maybe it will be motivation for those others who just trash their body or 'don't have time' to get in shape and add on years! And if they don't want to, then let them be unhealthy and pay the higher fees.
Bookish Bookish 9 years
I agree with HistoryGeek- while I can see the logic behind "unhealthy people cost more", this is also opening the door to tons of privacy issues. Add into that the disconnect between poorer people charged higher rates and it just doesn't work. I think it's a basically sound idea that's not being implemented well. Want healthier employees? Get rid of the vending machines and sitting for eight to ten hours straight in a little box with no movement. People aren't hamsters- you can't put them in a box and then penalize them when they don't run on the treadmill (exercise wheel?) enough.
latent latent 9 years
I don't think it's unfair at all, though perhaps the costs for unhealthy employees could be somewhat mitigated if they're actually making the effort to stick to it, like Steen's dad.
HistoryGeek913 HistoryGeek913 9 years
Another thought. Charging one group of people more for insurance is a slippery slope. Where can it go next? Charging all women more because some women have babies - and that's expensive? Or charging all men more because some men have prostate cancer? Or what about people with a history of cancer in their family? Charge them more because they are a higher risk? What about black women - they are at a higher risk for many diseases than white women. So do you charge black women more than white women? Can you see how fast this "charge more based on risk/cost" could get out of control?
steen steen 9 years
I agree with gumdrops. My dad is 50 years old and fit as a fiddle; he monitors his diet, hits the gym regularly and can probably outrun me. And still, his cholesterol is an ongoing issue. Even on an extreme diet recommended by the doctor, his numbers were higher than expected. I think having a specialist come in, speak to employees, maybe offer them incentives to get healthy --- discount gym memberships, for example --- would motivate people. Then again, my building has a free gym available to employees but it sits empty more often than not.
HistoryGeek913 HistoryGeek913 9 years
ditto gumdrops and nola. I can understand where companies are coming from, but I am not sure this is the solution. Perhaps the solution would be to provide the health coaches and even an exercise room (and TIME to exercise) and see how that would work. Or perhaps offering to pay for gym memberships or health coaches? I think that singling out people who are overweight (and this is what that policy would do - esp with that bit about the high BMI), is counter productive. Overweight people are generally already aware of the fact that they are overweight (speaking from experience), and often it is a matter of time and money keeping people from the gym and making the healthiest choices. It would be fantastic if my office provided time to work out, and had a comp gym membership or on-site gym (even if it meant a 9-10 hour day) as a part of my work duties. It would make working out an easy thing to do, as opposed to trying to pay for a gym membership (not in my budget at the moment) and getting to the gym at the end of a long work day. Money is a huge factor in being able to afford to exercise, both in terms of a gym membership (or even decent shoes), and having the TIME.
aimeeb aimeeb 9 years
aanyanka I agree, eating right and exercising isn't brain surgery.
aanyanka aanyanka 9 years
I agree with ashcwebb. And I think the program sounds like a great way for people who need it to get free advice and training from an exercise coach. And you don't need money to get exercise. One 30 minute walk a day is great for those who are currently not exercising at all. People can also do pushups, situps, crunches, etc... in their own home with absolutely no money needed. I exercise in my living room while watching the 6p.m. news. I don't think health and fitness has to cost a lot of money. A person just needs to be sensible about what they eat and get some exercise.
gumdrops334 gumdrops334 9 years
The idea behind it is motivating, but the reality just isn't there. Some people are genetically prone to high blood pressure and cholesterol, even if they work out everyday and eat right. So it wouldn't be fair to charge them extra. Like nola said, if the company is willing to pay for the employees' gym membership, give them 2 hour lunchbreaks, or even install a gym IN the office, then I could see the rationality. But some people truly can't afford to exercise, whether they have too many work hours, can't afford a gym, or even running shoes. And then they DEFINITELY can't afford extra health insurance fees.
nola45 nola45 9 years
The problem here is that less well educated and poorer folks tend to have poorer health habits (less exercise, obesity), and then if they can't manage to do what the health coach says, they will also be hit with higher premiums, making them poorer still. It doesn't seem fair. If the company will provide them the time for the required exercise (an hour off a day if you go to the company gym, for example), well, that's different. And if the company pays for any recommended medications... Poorer folks often have less time because they don't pay for house cleaners and don't have nannies, and sometimes can't pay for medications that the company doesn't subsidize.
Lovely_1 Lovely_1 9 years
My mom's company does this and think it is reasonable. If you are unhealthy and can change it, but aren't willing to, I think your preminums should be higher then someone who is fit and healthly and take care of their body.
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