higher health insurance premiums for overweight people?

$794,820,000. That's quite a number, the best part of a billion dollars. It's also my rough estimate of how much obese and overweight people are costing the state of Maine and employers here.



The California Department of Health Services recently released a study placing the price tag for corpulence at $21.7 billion for that state's 35.5 million residents. That works out to about $611.40 a head.



Direct and indirect medical costs accounted for 47 percent of that while lost job productivity was responsible for more than 51 percent. The study calculated the cost for the year 2000; costs for 2005 are expected to reach $28 billion.



Taking the per capita cost for the year 2000 and multiplying it by the population of the state of Maine renders a conservative estimate of the effect on the economy as a whole. Most likely the costs would be greater as the number is based on 5-year-old figures and Maine has a higher percentage of obese and overweight people. A 2002 study by the Centers for Disease Control and Prevention indicated 55.9 percent of Maine's population was considered to be overweight or obese as opposed to 54.6 percent of California's.



Insurance companies and employers have long recognized the need to control these costs and have instituted any number of "wellness plans." These plans attempt to get people out of their recliners by offering rewards for self-reported exercise time. Some even consider taking a stroll behind a self-propelled mower or planting a few petunias in the garden as eligible activities.



Unfortunately, the people who are most likely to collect the rewards from these programs are the ones who were doing these things anyway. A gym bag with matching water bottle is little incentive for Mr. Big to trade in his lawn tractor with the cup holder for a push mower.



Perhaps a more effective plan would be to put the onus on those who are part of the problem. Structuring health insurance plans like auto insurance plans would go a long way toward placing the costs for unhealthy behavior on those who are most responsible for those costs.



Sounds a bit Draconian? Perhaps it is, but it's also obvious the current plan isn't very effective and something needs to be done.



By increasing insurance premiums for individuals who persist in unhealthy behaviors (e.g.; overweight, smoking, substance abuse, etc.) just as auto insurance is increased for speeding, drunken driving, etc., an incentive is created to modify behavior and a tangible reward (reduced premiums) is provided those who maintain healthy lifestyles.



Health care and insurance reform have become standard planks in every candidate's platform. Nevertheless, like the weather, it's something that is a major topic of conversation but the recipient of little effective action. Complaining about the increasing cost of health insurance and investigating the practices of insurance companies, health care facilities, doctors and drug companies while ignoring the consumers is a lot like complaining about the heat, humidity and the dangers of skin cancer while ignoring the fact that you were the one who chose to move to Florida.



It's difficult to talk about a subject that may directly affect yourself, your spouse, a family member or a close friend. However, ignoring the situation will not make it go away. Attempting to be philosophically correct will just result in talking around the problem without actually coming to grips with it.



Government regulation can only go so far in controlling costs; at some point individual choice and personal responsibility have to take over. As our mothers told us, "You can't have your cake and eat it too." In this case, we can't have affordable health insurance while eating all the cake we can get our hands on.



We can continue talking about solutions or we can take action. Action, like exercise, will at first be difficult, perhaps painful and something we will try to invent reasons to avoid. However, the rewards will be a healthier population, reduced cost to the state and employers, the possibility of increased wages and reduced taxes due to the reduction in medical expenses, a state that is more attractive to employers, and, of course, the money: $795 million. It would be like winning the lottery.



Dream a little . . .



- Special to the Press Herald