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June 14, 2007


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One thing that bothers me is that often companies who provide health plans end up footing the bill. Yet companies are not allowed to make an employment decision based on whether the applicant smokes or not, exercises regularly or not, or whether they are severely obese.

This is a point where I think being politically correct and our laws against profiling go too far. A company should be able to know whether or not an applicant smokes as this would cut down on productivity and increase benefits costs... just my 2 cents

3 mostly unrelated points on the issue

1) Interestingly enough, the article doesn't catalog healthcare costs for underweight people.

2) Judging by the terminology they used for the categories, I'm going to guess that the people and costs are broken down by BMI, which is a wholly useless metric for determining health. Anyone who works out regularly and had a moderate amount of muscle mass will be categorically "overweight."

My theory that they're looking at BMI is enforced by the fact that "overweight" has a similar health care cost average than "normal" since "overweight" would include people who are more fit than "normal" and less fit than "normal."

(Aside: By BMI, I am classified as Overweight, even though I have a 28 inch waistline and 12.2% body fat)

3) We can't ask people if they smoke on a job application. But why would we? People could just lie about smoking. It wouldn't be rocket science to figure out what the correct answer is if you see "Do you smoke?" on a job application.

If the smokers are less productive members of the staff, you absolutely can fire them (Unless you're in a union, then you're stuck with them until they die. And then you're stuck with their spouses and kids until they die. And then you're stuck with their cats). But you'll be firing them for being less productive, not for being smokers.

On the flip side, some employers do offer "health benefits." A yearly (or periodic) cash incentive for people that elect to live a healthier lifestyle--be it by not smoking, joining a gym, joining their corporate running team, etc.

"Yet companies are not allowed to make an employment decision based on whether the applicant smokes or not, exercises regularly or not, or whether they are severely obese." I think they can, so long as they are not selecting against a protected class. They would appear heartless and probably suffer a public relations nightmare, but they *could* if they wanted to.

I'm not a lawyer, though.

Didn't a company in Michigan choose to become completely non-smoking and eventually fired people who didn't quit?

BMI has its flaws, but by not grouping "overweight" with the "obese" categories you get rid of most of the flaws. In extreme cases a physically fit person (say, a professional athlete) will get categorized as obese but typically they get categorized as overweight.

Either way, from a BMI perspective, typically doesn't carry any increased health risks when looked at seperately from the obese categories. That may be due to miscategorization, but since BMI is based on an average persons % of body fat, it is more likely that being slightly "overweight" isn't really bad thing. If they just gave the BMI categories numbers (ie underweight=1, normal=1, etc.) then the negative conotation of being in "overweight" (or category 3) would largely go away and so would alot of the complaints about BMI, IMO.

Obese also "spend" more on food. LoL

Heavier people cause more wear and tear on office chairs too.

You talk about how much it costs companies to provide health care to severely overweight people. That's really a lot. Imagine if we have to bear the costs as individuals! Really, all the signs are there for us to keep fit and loss some weight. Along the way, we not only save cost for our employers, more importantly, we save money for ourselves! Less money spent on food, healthcare, getting new furniture, adding new clothes. Yes, it's time I start on my long awaited weight loss plan. Thanks!

Excellent comments.

I am overweight, so I will now start to lose weight so that I can make more money, save my company money in health care costs, and will save money on food/clothes.

Here are my reverse demands, since we're focusing on health:
- BMI's are thrown out. We will now use a physical fitness test. If the fatties and the skinnies can't make the 10 push-ups needed, they pay their own health care.
- Everyone will be required to pass an alcohol test, even on weekends. If an employee consumes more than one alcoholic beverage a day (no averaging out for the week!), he/she will have to pay their own health car.
- Anyone who has smoked at all in his/her life is automatically disqualified for health care.
- All employees are required to become vegetarians. Anyone who consumes any meat is disqualified.
- Those who participate in extreme sports will now be required to pay for their own health care costs. Statistically, they suffer more injuries than the genpop, so they should pay more.
- Those who used drugs at anytime in their life will never be covered.
- The gym is now required 45-60 minutes per day, every day. I don't care about your arthritis or pregnancy, get out there and work out!
- Women are limited to two pregnancies that go to full-term while working for the company. Any pregnancies over that are not covered. Abortions are not covered. Keep your legs closed.
- If you have cancer or a disease that you got from questional behavior, forget about coverage. AIDS will not be covered. You should have kept it in your pants. This is especially important if you are gay since you practice anal sex.

Obviously, your comments are meant to be sarcastic, but the fact remains that people with certain behaviors and health stats do incur higher health costs.
It is true that BMI is not a perfect measure of health, but it does differentiate major health classes (normal/overweight from obese)
There are no documented studies that I know of that talk about the health costs associated with alcohol use, unless you are an alcoholic, in which case, you will most likely be fired for other reasons. There are absolutely no health benefits to a vegetarian diet, and more likely health problems due to the lack of protein and variety.
Someone who quits smoking or using drugs has nearly equal risk of health problems as someone who has never done those things, so it makes absolutely no sense to base it on that. If a health screening can detect the effects, then sure.
Your point is well taken that numbers don’t tell the whole story. Many companies require a physical when you start. Your health premiums could be based on the results of a health screening or blood cholesterol test, which must be repeated every 5 years.

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