7 ms·

>If he chooses not to participate in the program, Abrams must pay an extra $50 per month toward his premium. Is he paying $50 more for not participating, or ge

by pliny 10y ago

>If he chooses not to participate in the program, Abrams must pay an extra $50 per month toward his premium. Is he paying $50 more for not participating, or getting a $50 discount for participating? If it's the latter (Anthem insurance doesn't change their premiums, but now rewards people for using preventative medicine), then how could anyone object? It really is a win-win, and people who don't want to participate are no worse off. But, if Anthem Insurance aren't trying to motivate healthier behavior, but only trying to identify people who are already trying to become healthier (or stay healthy) and lower their premiums in order to remain more competitive, then it's the former. Workers are being penalized because P(Not trying to be healthy | Doesn't participate in the wellness program) is greater than P(Not trying to be healthy). What this actually means: The trying-to-be-healthy population are no longer subsidizing the not-trying-to-be-healthy population. I don't know if this is a bad outcome, I remember hearing an interview with Cathy O'Neil (the author) where she applies the same rhetoric and logic to loan approval and to criminal sentencing, in both cases she ignores the fact that going from the status quo (in this case, one where wellness programs exist) to her preferred reality (in this case, one where wellness programs do not exist) tends to take a lot of innocent people who are winners in the status quo (in this case, people who try to stay healthy, and enjoy lower premiums) and makes them into losers (since now they have to pay the same premiums as people who don't use preventative medicine). > Except, as it happens, this regimen already exists and it’s called humiliation and fat-shaming. Have someone tell you you’re overweight, or pay a major fine. I'm not overweight, so maybe I don't have the right perspective on this, but how terrible could "having a doctor tell you that you're overweight" be? Like, the only context I can understand this quote is that "Have someone tell you you're overweight" is some sort of grievous injury, and not just trivially inconvenient.

breckenedge 10y ago
Disclaimer: I am paid by my employer, a 3rd party provider of wellness programs, to write health incentives software. It's always phrased as the former, but employees that don't get the discount often see it as the later.
- thesmallestcat 10y ago
  Wait, it's phrased as a pay cut, but those who lose out see it as a bonus for those who benefit? That would be surprising. Did you mix up "former" and "latter"?
codedokode 10y ago
To me it looks like people who were born healthy get higher salary.
- brianwawok 10y ago
  Isn't that true anyway due to bias? I believe taller men or women with bigger chests make bigger paychecks all else equal. I think in a geek world all paychecks would be determine by work ethic and brain power, but I don't think that's how the world works.
  - codedokode 10y ago
    That might be true if a woman works as a waitress (and attracts customers to come more often) but I doubt that is important for a software developer.
    - xiaoma 10y ago
      No, it has a significant impact even on programmers, though less of one than it has on people in sales or customer service: http://timothy-judge.com/Height%20paper--JAP%20published.pdf http://timothy-judge.com/Height%20paper--JAP%20published.pdf
    - brianwawok 10y ago
      Look it up. People with nice faces and certain hair also make more. Humans have a hard time not showing bias in all parts of their life.
  - drewrv 10y ago
    Maybe it's true due to human psychology but that doesn't mean we should institutionalize it.
- throwaway5752 10y ago
  Overweight or not (I am overweight) exercise is really important. As long as it doesn't result in hiring or advancement bias, it should be incentivized because it lowers corporate benefit costs in aggregate and improves the performance of the workforce. A large body of scientific studies exist showing that it: Improves cognitive function (https://www.ncbi.nlm.nih.gov/pubmed/24696506 https://www.ncbi.nlm.nih.gov/pubmed/24696506) Reduces sick leave (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2092583/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2092583/) Improves happiness/ more brain cells (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789405/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789405/) Smarter, happier people that miss less work are going to be more successful. Some people are born more gifted in this respect, but exercise can be very effective at narrowing that advantage for the rest of at surprisingly little cost in money and time.
Fomite 10y ago
>I'm not overweight, so maybe I don't have the right perspective on this, but how terrible could "having a doctor tell you that you're overweight" be? Like, the only context I can understand this quote is that "Have someone tell you you're overweight" is some sort of grievous injury, and not just trivially inconvenient." In my experience? It's a drain, and a good way to encourage me not to go see the doctor. Because it's every time I go to the doctor for literally my entire life. I have never not gotten a 10 minute lecture, including when I was on a varsity swim team. Beyond that, it's a lecture that comes even when it's not the problem. In the not so recent past, we discussed my weight for 15 minutes...and the active pertussis infection I had for 5. If you have a chronic condition, you're almost certainly going to have your doctor tie it to your weight. And here's the thing - fat people know we're fat.
- pliny 10y ago
  When you put it like that, it does sound very unpleasant.
  - Fomite 10y ago
    It is. The last post also ignored some larger problems - like fat people essentially having medical problems missed because doctors attribute it to their weight, or the exact opposite - skinny people not getting diabetic tests or cardiac stress tests because they're skinny.
    - nradov 10y ago
      The blood tests that are part of most medical insurance wellness plans now do check for diabetes symptoms. If your blood glucose or A1c is above the reference range then it will get flagged for your doctor as a possible diabetes case regardless of whether you're fat or skinny.
- spectrum1234 10y ago
  The solution doctors should provide starts with mental health (motivation, etc), not physical solution. This is the biggest problem in health care!!! Note that the US government is doing nothing to change this. It's almost illegal for doctors to "prescribe" mental solutions over physical. Everyone wants a quick fix but the solution starts in the brain. If you don't want the $50 savings then save the .125% of your salary and don't do it. Simple. Don't act like you don't have a choice.
kahrkunne 10y ago
>Is he paying $50 more for not participating, or getting a $50 discount for participating? What's the difference?
- pdkl95 10y ago
  Less cognitive dissonance.
mhneu 10y ago
Is he paying $50 more for not participating, or getting a $50 discount for participating? This is just semantics. In either case, it costs money to not participate. Marketers like to frame things as the latter, as behavioral economics tells us you get better participation by using the latter words. But we should draw a distinction between marketing and the bottom line. The bottom line is there's a $50 cost.
- spectrum1234 10y ago
  No its not according to numerous psychology studies
aluhut 10y ago
> If it's the latter (Anthem insurance doesn't change their premiums, but now rewards people for using preventative medicine), then how could anyone object? It really is a win-win, and people who don't want to participate are no worse off. I would object. What would stop them actually rising the bonus or the costs for the rest in the future? You've justified it in so many ways. It's the grand health initiative! Let's make America healthy again! Easy to sell and all that sweet data can be used for other good causes. Meanwhile the discussion over overpriced medicines disappears. You can (must?) even push the prices for medicines, therapies, etc. leading to the fact that the insurances best customers, people who can't do anything about their sickness (anymore) will be burdened even more. Enforcing the "sick and out" narrative in this sick system. > What this actually means: The trying-to-be-healthy population are no longer subsidizing the not-trying-to-be-healthy population. I don't know if this is a bad outcome It is. It's like taxes but we lost that viewpoint (US maybe never even had it but we did in Germany) because of privatization. There are other ways to educate people on how to be healthy and what the benefits are. Starting doing it at school SERIOUSLY would be a step. Marking obviously unhealthy food as such is another. Misleading advertisements is a big one. And so on. It can be done but I don't believe there is a really strong lobby for that out there. Or not strong enough.
- unclenoriega 10y ago
  I think it makes sense in the US because health insurance is a for-profit business here. It seems odd to criticize an insurance business for giving lower pricing to people who are less likely to use the insurance. I think it's a terrible way to run a healthcare system, but that's a different discussion. Edit: (RTFA!) So, it's not the insurers, but the people paying for the insurance. One step removed from what I said, but I think the rest still applies.
  - aluhut 10y ago
    > It seems odd to criticize an insurance business for giving lower pricing to people who are less likely to use the insurance. It looks naive to assume that, together with the infrastructure costs and the running costs for this system this for-profit business wants to make less money. What would the selling discussion have looked like? "Hey I have a system here that will make the most credit worthy clients pay less. Interested?"
sverige 10y ago
> Workers are being penalized because P(Not trying to be healthy | Doesn't participate in the wellness program) is greater than P(Not trying to be healthy). This assumes the only reason for not participating is lack of motivation to be healthy. What about those of us who don't want to voluntarily surrender our entire genetic code to an insurance company? And once most people have, how do you know that your future premiums won't be based on genetic markers for certain diseases?
- spectrum1234 10y ago
  Then don't. If you make 40k a year its only .125% of your salary.
  - vectorwhat 10y ago
    I don't. But you avoided his entire second question.
    - spectrum1234 10y ago
      It should be. A sustainable solution to increasing costs certainly isn't perfect. If a perfect solution exists its certainly not sustainable. This is econ 101. We need to be thinking not just of poor people now but the millions more poor people of the future - which systems makes them the least poor? Please read up on adverse selection and moral hazard. The world isn't puppies and rainbows. Sustainability is the most important thing for any market when it comes to helping the poor in the very long term.
      - vectorwhat 10y ago
        Who believes in puppies and rainbows? lol A sustainable insurance market is also obtainable without genetic information. In fact, without any patient information at all. Information allows segmenting the population to allow for diverse premiums. Without any patient information the premium will just reflect the whole population risk. We can argue if this system is fair or not (I don't like these discussion because they hinge on the definition of fair, which is silly); but your point is about economic feasibility, and it's quite feasible to have a health care system without digging up dirt on everyone. And, as a libertarian, I have to admit that this country has one of the most inefficient health care systems in the world. The amount of money we spend for results that are worse than any other industrial country is obscene!
rsync 10y ago
"tends to take a lot of innocent people who are winners in the status quo (in this case, people who try to stay healthy, and enjoy lower premiums) and makes them into losers (since now they have to pay the same premiums as people who don't use preventative medicine)." It's not obvious to me, in the US medical system, that "healthy" people use fewer healthcare dollars over their lifetimes. Of course I'd like that to be the case and it would be satisfying to shift costs to people making relatively poorer health decisions. The problem is, it appears that healthcare spending skyrockets asymptotically at the very end of life - as you are literally dying - and that explosion of costs and care-use occurs regardless of how healthy you were throughout your life. Healthy people (and their relatives) desperately attempt to eke out extra days and weeks of life just like unhealthy people (and their relatives) do. I don't know how to solve this problem but until this is no longer the case I don't think it's appropriate for "healthy" people to act so wounded about the money they're paying in for the couch potatoes.
- existencebox 10y ago
  There are many parts of what you're saying I disagree with. Here's some work from Harvard establishing that obesity does incurr a higher healthcare cost burden (https://www.hsph.harvard.edu/obesity-prevention-source/obesity-consequences/economic/ https://www.hsph.harvard.edu/obesity-prevention-source/obesi...) I can cite similar articles for excessive smoking/drinking as well, and as anecdata the physicians in my family firsthand support the statements in the above. You're absolutely right re: asymptotic end of life costs, and I would be in full support of a rethink to the ROI on those costs (especially if they're being footed via e.g. medicare/other tax based resources) But if anything I think this is _more_ reason for healthy people to be angry, as I'd argue that the upper bound on marginal benefit to keep a 90 year old alive another year as opposed to proactively treating smoking/obesity is probably far lower. (just by the empiricism that even in a best case the 90 year old probably doesn't have as much time left) At the end of the day, the amount of money that my employer reports as paying for insurance is _astounding_ and I've yet to see any data to support that it's being used effectively, especially given trends of increasing rates without commensurate gains in QOL/life expectancy (there has absolutely been gains but most of the recent cost hikes have been political and divorced from a more needs based cost growth, assessing "need" as per net long term outcomes) As I said in another post, I've had to surmount a few stress based/sedentary based injuries, and to be bluntly selfish, I'd rather that money to buy myself more stability/a faster retirement so that I may better take care of my own body and not incur a heavy cost on others later in life. (or worse, cut years off my own)
DoodleBuggy 10y ago
>>> but how terrible could "having a doctor tell you that you're overweight" be? How terrible would it be to have a doctor tell you to stop smoking? Or to stop drinking? Or stop abusing drugs? Or to stop cutting yourself? It's all self destructive behavior just like overeating. Has our culture really become so sensitive that it's now no longer acceptable for a doctor to tell you when you're being unhealthy and contributing to your own demise????
- DanBC 10y ago
  > How terrible would it be to have a doctor tell you to stop smoking? Or to stop drinking? Or stop abusing drugs? Or to stop cutting yourself? It's all self destructive behavior just like overeating. It's not terrible, it's just pointless. Fat people know they're fat; people who self harm know they self harm and they know it's not ideal. Merely saying "stop doing that" does nothing ot help them stop.
  - deleted 10y ago
    [deleted]
  - jimmywanger 10y ago
    > Fat people know they're fat. Many don't. Or they don't blame overeating. It's always "genetics" or "metabolism". Not just plain old overeating.
    - DanBC 10y ago
      Sure, but even for those people merely telling them they're fat, and that they're fat because they eat the wrong food will do nothing to stop them from being fat.
      - jimmywanger 10y ago
        > will do nothing to stop them from being fat. I disagree with one point. It puts things into their control, rather than out of their control. If the doctor says you're fat because your metabolism is low, or you're big boned, you can shrug it off and say "Well, there's nothing I can do about it, might as well not try." If the doctor says you're fat because you eat too much food, you can do the same thing, but then at least the ball is in your court. You are fat because of your actions, and it's theoretically possible to change your actions, but it's definitely not possible to change your genetics or metabolism.
dispose13432 10y ago
>Is he paying $50 more for not participating, or getting a $50 discount for participating? On the other hand, think about it like this: What if insurance costs $10,000 a month, with a $9900 discount for "healthy behavior", so your average person pays $100 a month. It's a great deal. Now what happens if someone gets sick and can't upkeep his healthy behavior? He loses his insurance. This defeats the purpose of health insurance, but most people tend not to think of long-term repercussions.

by pliny 10y ago

breckenedge 10y ago

Disclaimer: I am paid by my employer, a 3rd party provider of wellness programs, to write health incentives software. It's always phrased as the former, but employees that don't get the discount often see it as the later.

thesmallestcat 10y ago
Wait, it's phrased as a pay cut, but those who lose out see it as a bonus for those who benefit? That would be surprising. Did you mix up "former" and "latter"?

codedokode 10y ago

To me it looks like people who were born healthy get higher salary.

brianwawok 10y ago
Isn't that true anyway due to bias? I believe taller men or women with bigger chests make bigger paychecks all else equal. I think in a geek world all paychecks would be determine by work ethic and brain power, but I don't think that's how the world works.
- codedokode 10y ago
  That might be true if a woman works as a waitress (and attracts customers to come more often) but I doubt that is important for a software developer.
  - xiaoma 10y ago
    No, it has a significant impact even on programmers, though less of one than it has on people in sales or customer service: http://timothy-judge.com/Height%20paper--JAP%20published.pdf http://timothy-judge.com/Height%20paper--JAP%20published.pdf
  - brianwawok 10y ago
    Look it up. People with nice faces and certain hair also make more. Humans have a hard time not showing bias in all parts of their life.
- drewrv 10y ago
  Maybe it's true due to human psychology but that doesn't mean we should institutionalize it.
throwaway5752 10y ago
Overweight or not (I am overweight) exercise is really important. As long as it doesn't result in hiring or advancement bias, it should be incentivized because it lowers corporate benefit costs in aggregate and improves the performance of the workforce. A large body of scientific studies exist showing that it: Improves cognitive function (https://www.ncbi.nlm.nih.gov/pubmed/24696506 https://www.ncbi.nlm.nih.gov/pubmed/24696506) Reduces sick leave (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2092583/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2092583/) Improves happiness/ more brain cells (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789405/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789405/) Smarter, happier people that miss less work are going to be more successful. Some people are born more gifted in this respect, but exercise can be very effective at narrowing that advantage for the rest of at surprisingly little cost in money and time.

Fomite 10y ago

>I'm not overweight, so maybe I don't have the right perspective on this, but how terrible could "having a doctor tell you that you're overweight" be? Like, the only context I can understand this quote is that "Have someone tell you you're overweight" is some sort of grievous injury, and not just trivially inconvenient." In my experience? It's a drain, and a good way to encourage me not to go see the doctor. Because it's every time I go to the doctor for literally my entire life. I have never not gotten a 10 minute lecture, including when I was on a varsity swim team. Beyond that, it's a lecture that comes even when it's not the problem. In the not so recent past, we discussed my weight for 15 minutes...and the active pertussis infection I had for 5. If you have a chronic condition, you're almost certainly going to have your doctor tie it to your weight. And here's the thing - fat people know we're fat.

pliny 10y ago
When you put it like that, it does sound very unpleasant.
- Fomite 10y ago
  It is. The last post also ignored some larger problems - like fat people essentially having medical problems missed because doctors attribute it to their weight, or the exact opposite - skinny people not getting diabetic tests or cardiac stress tests because they're skinny.
  - nradov 10y ago
    The blood tests that are part of most medical insurance wellness plans now do check for diabetes symptoms. If your blood glucose or A1c is above the reference range then it will get flagged for your doctor as a possible diabetes case regardless of whether you're fat or skinny.
spectrum1234 10y ago
The solution doctors should provide starts with mental health (motivation, etc), not physical solution. This is the biggest problem in health care!!! Note that the US government is doing nothing to change this. It's almost illegal for doctors to "prescribe" mental solutions over physical. Everyone wants a quick fix but the solution starts in the brain. If you don't want the $50 savings then save the .125% of your salary and don't do it. Simple. Don't act like you don't have a choice.

kahrkunne 10y ago

>Is he paying $50 more for not participating, or getting a $50 discount for participating? What's the difference?

pdkl95 10y ago
Less cognitive dissonance.

mhneu 10y ago

Is he paying $50 more for not participating, or getting a $50 discount for participating? This is just semantics. In either case, it costs money to not participate. Marketers like to frame things as the latter, as behavioral economics tells us you get better participation by using the latter words. But we should draw a distinction between marketing and the bottom line. The bottom line is there's a $50 cost.

spectrum1234 10y ago
No its not according to numerous psychology studies

aluhut 10y ago

> If it's the latter (Anthem insurance doesn't change their premiums, but now rewards people for using preventative medicine), then how could anyone object? It really is a win-win, and people who don't want to participate are no worse off. I would object. What would stop them actually rising the bonus or the costs for the rest in the future? You've justified it in so many ways. It's the grand health initiative! Let's make America healthy again! Easy to sell and all that sweet data can be used for other good causes. Meanwhile the discussion over overpriced medicines disappears. You can (must?) even push the prices for medicines, therapies, etc. leading to the fact that the insurances best customers, people who can't do anything about their sickness (anymore) will be burdened even more. Enforcing the "sick and out" narrative in this sick system. > What this actually means: The trying-to-be-healthy population are no longer subsidizing the not-trying-to-be-healthy population. I don't know if this is a bad outcome It is. It's like taxes but we lost that viewpoint (US maybe never even had it but we did in Germany) because of privatization. There are other ways to educate people on how to be healthy and what the benefits are. Starting doing it at school SERIOUSLY would be a step. Marking obviously unhealthy food as such is another. Misleading advertisements is a big one. And so on. It can be done but I don't believe there is a really strong lobby for that out there. Or not strong enough.

unclenoriega 10y ago
I think it makes sense in the US because health insurance is a for-profit business here. It seems odd to criticize an insurance business for giving lower pricing to people who are less likely to use the insurance. I think it's a terrible way to run a healthcare system, but that's a different discussion. Edit: (RTFA!) So, it's not the insurers, but the people paying for the insurance. One step removed from what I said, but I think the rest still applies.
- aluhut 10y ago
  > It seems odd to criticize an insurance business for giving lower pricing to people who are less likely to use the insurance. It looks naive to assume that, together with the infrastructure costs and the running costs for this system this for-profit business wants to make less money. What would the selling discussion have looked like? "Hey I have a system here that will make the most credit worthy clients pay less. Interested?"

sverige 10y ago

> Workers are being penalized because P(Not trying to be healthy | Doesn't participate in the wellness program) is greater than P(Not trying to be healthy). This assumes the only reason for not participating is lack of motivation to be healthy. What about those of us who don't want to voluntarily surrender our entire genetic code to an insurance company? And once most people have, how do you know that your future premiums won't be based on genetic markers for certain diseases?

spectrum1234 10y ago
Then don't. If you make 40k a year its only .125% of your salary.
- vectorwhat 10y ago
  I don't. But you avoided his entire second question.
  - spectrum1234 10y ago
    It should be. A sustainable solution to increasing costs certainly isn't perfect. If a perfect solution exists its certainly not sustainable. This is econ 101. We need to be thinking not just of poor people now but the millions more poor people of the future - which systems makes them the least poor? Please read up on adverse selection and moral hazard. The world isn't puppies and rainbows. Sustainability is the most important thing for any market when it comes to helping the poor in the very long term.
    - vectorwhat 10y ago
      Who believes in puppies and rainbows? lol A sustainable insurance market is also obtainable without genetic information. In fact, without any patient information at all. Information allows segmenting the population to allow for diverse premiums. Without any patient information the premium will just reflect the whole population risk. We can argue if this system is fair or not (I don't like these discussion because they hinge on the definition of fair, which is silly); but your point is about economic feasibility, and it's quite feasible to have a health care system without digging up dirt on everyone. And, as a libertarian, I have to admit that this country has one of the most inefficient health care systems in the world. The amount of money we spend for results that are worse than any other industrial country is obscene!

rsync 10y ago

"tends to take a lot of innocent people who are winners in the status quo (in this case, people who try to stay healthy, and enjoy lower premiums) and makes them into losers (since now they have to pay the same premiums as people who don't use preventative medicine)." It's not obvious to me, in the US medical system, that "healthy" people use fewer healthcare dollars over their lifetimes. Of course I'd like that to be the case and it would be satisfying to shift costs to people making relatively poorer health decisions. The problem is, it appears that healthcare spending skyrockets asymptotically at the very end of life - as you are literally dying - and that explosion of costs and care-use occurs regardless of how healthy you were throughout your life. Healthy people (and their relatives) desperately attempt to eke out extra days and weeks of life just like unhealthy people (and their relatives) do. I don't know how to solve this problem but until this is no longer the case I don't think it's appropriate for "healthy" people to act so wounded about the money they're paying in for the couch potatoes.

existencebox 10y ago
There are many parts of what you're saying I disagree with. Here's some work from Harvard establishing that obesity does incurr a higher healthcare cost burden (https://www.hsph.harvard.edu/obesity-prevention-source/obesity-consequences/economic/ https://www.hsph.harvard.edu/obesity-prevention-source/obesi...) I can cite similar articles for excessive smoking/drinking as well, and as anecdata the physicians in my family firsthand support the statements in the above. You're absolutely right re: asymptotic end of life costs, and I would be in full support of a rethink to the ROI on those costs (especially if they're being footed via e.g. medicare/other tax based resources) But if anything I think this is _more_ reason for healthy people to be angry, as I'd argue that the upper bound on marginal benefit to keep a 90 year old alive another year as opposed to proactively treating smoking/obesity is probably far lower. (just by the empiricism that even in a best case the 90 year old probably doesn't have as much time left) At the end of the day, the amount of money that my employer reports as paying for insurance is _astounding_ and I've yet to see any data to support that it's being used effectively, especially given trends of increasing rates without commensurate gains in QOL/life expectancy (there has absolutely been gains but most of the recent cost hikes have been political and divorced from a more needs based cost growth, assessing "need" as per net long term outcomes) As I said in another post, I've had to surmount a few stress based/sedentary based injuries, and to be bluntly selfish, I'd rather that money to buy myself more stability/a faster retirement so that I may better take care of my own body and not incur a heavy cost on others later in life. (or worse, cut years off my own)

DoodleBuggy 10y ago

>>> but how terrible could "having a doctor tell you that you're overweight" be? How terrible would it be to have a doctor tell you to stop smoking? Or to stop drinking? Or stop abusing drugs? Or to stop cutting yourself? It's all self destructive behavior just like overeating. Has our culture really become so sensitive that it's now no longer acceptable for a doctor to tell you when you're being unhealthy and contributing to your own demise????

DanBC 10y ago
> How terrible would it be to have a doctor tell you to stop smoking? Or to stop drinking? Or stop abusing drugs? Or to stop cutting yourself? It's all self destructive behavior just like overeating. It's not terrible, it's just pointless. Fat people know they're fat; people who self harm know they self harm and they know it's not ideal. Merely saying "stop doing that" does nothing ot help them stop.
- deleted 10y ago
  [deleted]
- jimmywanger 10y ago
  > Fat people know they're fat. Many don't. Or they don't blame overeating. It's always "genetics" or "metabolism". Not just plain old overeating.
  - DanBC 10y ago
    Sure, but even for those people merely telling them they're fat, and that they're fat because they eat the wrong food will do nothing to stop them from being fat.
    - jimmywanger 10y ago
      > will do nothing to stop them from being fat. I disagree with one point. It puts things into their control, rather than out of their control. If the doctor says you're fat because your metabolism is low, or you're big boned, you can shrug it off and say "Well, there's nothing I can do about it, might as well not try." If the doctor says you're fat because you eat too much food, you can do the same thing, but then at least the ball is in your court. You are fat because of your actions, and it's theoretically possible to change your actions, but it's definitely not possible to change your genetics or metabolism.

dispose13432 10y ago

>Is he paying $50 more for not participating, or getting a $50 discount for participating? On the other hand, think about it like this: What if insurance costs $10,000 a month, with a $9900 discount for "healthy behavior", so your average person pays $100 a month. It's a great deal. Now what happens if someone gets sick and can't upkeep his healthy behavior? He loses his insurance. This defeats the purpose of health insurance, but most people tend not to think of long-term repercussions.