Photo via Bradley Stoke
It just might. As part of the health care overhaul, Congress is looking at a system that would provide incentives--via bonuses and lower premiums--for people that pursue healthy lifestyles. Called the Safeway Amendment, as it's based on the California grocery store chain's health insurance system, it could inspire people to eat healthier, quit smoking, and exercise. Or, it could be a colossal failure, discriminating against people with certain body types and penalizing the poor for having fewer food options and less health education.According to the San Francisco Chronicle:
The provision, designed to "incentivize Americans to lead healthy lifestyles in order to lower their overall health care costs," would allow companies with self-insurance programs to reward employees with bonuses and/or premium reductions of up to 50 percent if they follow health guidelines, like undergoing regular screenings, quitting smoking, losing weight, taking cholesterol-reducing medications and so on.Which on the surface, looks good--each of these things can lead to healthier lifestyles and less burden on health care expenditures. But the problem is, as pointed out in a recent Slate article, the means by which these rewards are delivered. It's a reward based system, where you're only eligible for the bonus if you meet certain benchmarks, like lowering your body weight, or successfully quit smoking.
As is, the system relies upon the dubious measurements of the Body Mass Index to determine whether an individual is 'healthy' or not. According to Slate:
The body mass index was never meant to be used for diagnosing individuals: It's a notoriously sloppy measure that can't distinguish between lean and fatty tissue. Those with athletic builds are often misclassified as being overweight or obese, and some researchers have found that exercise actually leads people to put on weight. Perversely, the Safeway plan could incentivize some of its members to stop exercising.Other problems include the fact that there's a distinct corollary between poverty and obesity in the US--meaning the poor would be more likely to be penalized under such a system.
However, it seems difficult to argue that the core of the system is well-intentioned and a potentially useful idea. If the delivery system were changed so that people could receive bonuses for demonstrating efforts to stay healthier--exercising, eating better, enrolling in gyms, etc--without having to prove dubious body mass reductions, it could prove beneficial.