Not dis­crim­i­na­tion

Modern Healthcare - - Opinions Letters -

Re­gard­ing “Se­nate bill’s well­ness pro­vi­sions spur dis­crim­i­na­tion wor­ries” (Mod­ern­Health­, Jan. 3):

This leg­is­la­tion is ex­actly what em­ploy­ers need to help curb health­care inflation with pre­mi­ums ex­pected to in­crease 17% to 25% in 2010. Read­ing com­men­tary that such pro­grams could spur dis­crim­i­na­tion makes my blood boil and com­pletely mis­rep­re­sents the in­ten­tions and safe­guards that are al­ready in place and that will con­tinue to come with th­ese pro­posed po­lices.

Work­ing with health plans that rep­re­sent nearly 31 mil­lion lives, we know by and large that most em­ploy­ers want to pro­vide mean­ing­ful health ben­e­fits to their em­ploy­ees and their fam­i­lies but sim­ply can­not af­ford it. Un­like all other in­sur­ance pro­grams, such as au­to­mo­bile, prop­erty-ca­su­alty and life in­sur­ance, where pre­mi­ums are priced on the un­der­writ­ing risk of each pol­i­cy­holder, health in­sur­ance pre­mi­ums are “group rated” and es­sen­tially spread over the group mem­bers.

This in fact dis­crim­i­nates against the healthy em­ploy­ees who must pay higher pre­mi­ums be­cause they are grouped with un­healthy and costly mem­bers. No one is sug­gest­ing a change to this struc­ture but an equi­lib­rium that re­wards healthy lifestyles and com­pli­ance with care pro­to­cols for chronic con­di­tions. Why do we tol­er­ate peo­ple who con­tinue to re­quire care be­cause they don’t take their med­i­ca­tions or mon­i­tor their con­di­tions or im­prove their lifestyles by los­ing weight, ex­er­cis­ing or quit­ting smok­ing—to tackle what caused their chronic ill­ness?

Well­ness pro­grams and re­lated in­cen­tives are “ad­di­tional” ex­penses that em­ploy­ers are re­quired to in­vest in that, if used by em­ploy­ees and their fam­i­lies, can sub­stan­tially lower med­i­cal inflation and year-over-year costs.

Any­one who ar­gues that well­ness in­cen­tives dis­crim­i­nate is re­ally say­ing that in­di­vid­u­als should not have any re­spon­si­bil­ity or ac­count­abil­ity for manag­ing their health and lifestyles and that so­ci­ety should con­tinue to fi­nan­cially sup­port th­ese in­di­vid­u­als and th­ese be­hav­iors.

It is th­ese pro­tec­tion­ists who have got us where we are to­day. Such be­hav­ior is not sup­ported any­where else in our so­ci­ety. Let’s get the facts straight and sup­port pro­grams that slow the de­mand side of the health­care cri­sis. Well­ness in­cen­tives as de­scribed are fair, in­tu­itive and aligned with free-mar­ket eco­nomics. They are needed and work. Dar­ren Hodg­don

CEO LifeStart Group


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