Thursday, October 11, 2012

Big Brother Health Care?

So I'm chatting away with one of my patients this morning and she had some questions about how her health insurance would work with us when they make some changes starting in January.  We discussed it and I could go into the detail of medical plans vs. vison plans and why we don't accept vison plans, but that is not really the point of this post.  What she brought up next is what got my ethical side all in a quandry. 

A large employer in our area has for the past three years required a physical, pee test and blood work in order to determine your cost for the health insurance.  Everyone apparently starts at a certain cost level, then based on the results of your physical the cost can go down.  If you are at an acceptable BMI, you get a credit on your cost of the health insurance.  If your pee test shows that you are not a smoker, you get another credit.  (She also mentioned that there was an actual penalty for smokers, and you were assessed a fee outright.)  If your cholesterol was below an acceptable level, you received another credit. 

Now I'm not exactly sure how I feel about all this.  On one hand, the smokers, the overweight and generally unhealthy people DO drive up the cost of health care for all of us.  Maybe they should be penalized for their choice of bad habits that cost everyone else more money.  Maybe we need to hit those people where it counts (their wallet!) to get them to try to quit smoking or go get some exercise.

On the other side of the debate, how is your employer entitled to have access to your private medical information??  Where does the Health Information Privacy Act come in to play?  Cripes, I can't even discuss an eye exam with a husband unless his wife gives me permission to speak to him and here we are letting employers have information such as our BMI?  Our weight?  Cholesterol level??  Some people genetically have higher cholesterol levels, through no fault of their own.  Even with diet and exercise their levels stay high.  Should they be penalized for something that they have no control over?

This is really quite the ethical dilemma.  It would make for a really interesting topic in an ethics class for sure.  I'm not sure what they are doing would hold up legally if someone were to call them on it and file a law suit.  I'm not a lawyer, but it really does seem like it's bordering on an invasion of privacy. 

What do you think?  Invasion of privacy or a good way to force the unhealthy to be healthy?


Running With The Girls said...

This plan would definitely benefit me since I'm not overweight (used to be), don't smoke (used to) and my cholesterol is low (used to be high). Some health issues are beyond our control and people shouldn't be penalized for them. But for smoking - I definitely agree. Given that I used to smoke and my mom died from lung cancer (6 yrs ago today) - I say hit smokers where it hurts.

Christy @ My Dirt Road Anthem: A Runner's Blog said...

such a huge issue! as someone who makes a point to take care of myself and who takes care of very unhealthy people who don't.. it kind of makes me angry that my insurance is so high because people can't take better care of themselves and make better decisions like don't smoke! at the same time HIPPA!