Healthy Workers Could Get Bigger Insurance Breaks

A health care reform proposal that would allow employers and insurers to give large discounts to employees who lose weight or lower their cholesterol is facing push back from several groups worried about premium disparities, Kaiser Health News reports.

"The discounts are being pushed by Steve Burd, the chief executive officer of Safeway Inc., who has met with several lawmakers on Capitol Hill and says that rewarding healthy behavior has helped keep his firm's health care costs flat while other companies' have skyrocketed.

"But the proposal, which involves the sensitive issue of how aggressive employers can be in trying to induce workers to change their behavior to reduce their risks of disease, is greeted by skepticism by many patient advocates who think it could be coercive and unfair."

"Under current law, employers and insurers are permitted to give discounts of up to 20 percent on premiums, co-payments or deductibles to workers who take part in wellness programs, which include anti-smoking and weight-loss programs. Some wellness programs simply require participation in order to get the discount but other programs require employees to reduce their weight, blood pressure or cholesterol by specific levels." The health overhaul bill passed by the Senate Health, Education, Labor and Pensions Committee "would allow employers to increase those discounts to 30 percent and up to 50 percent if the secretaries of Labor, Health and Human Services and Treasury agree. A House proposal would allow employers to charge workers who participate in wellness programs 50 percent less than workers who don't" (Carey, 7/28).

In the meantime, healthy workers who are generally satisfied with their coverage have become integral to the reform debate, The Washington Post reports: "Although polls have consistently shown that just over half of Americans think the health-care system is in need of reform, a substantial majority say they are satisfied with their own insurance and care. Any hope of change will require their support, according to experts and advocates across the ideological spectrum."

"But that does not mean that most Americans necessarily oppose change. In fact, polls also show that a majority of Americans think the health-care system needs alteration. '"Satisfied"' means they like their doctor and have insurance to go to that doctor,' said Stan Greenberg, a Democratic pollster. 'Maybe they think their policy is better than what most people have. But it doesn't mean they don't want reform.'"

A recent poll conducted by the Kaiser Family Foundation found, for instance, that "56 percent of Americans think health-care reform is particularly important, given the state of the economy." (KHN is a project of the Foundation.) Most also said the U.S. will be better off if reform happens. But less agreement was evident in regard to what changes might mean for individual families. "The reason for the apparent paradox is that even though most people are satisfied with their insurance, they harbor deep concerns about losing their coverage or their ability to afford it and medical care if costs continue rising" (Stein and Mostrous, 7/28).

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