Your BMI is 35: Should You Pay More For Healthcare?

My son had a baseball tournament this weekend.  On both Saturday and Sunday, I made the choice to go to a park and get a run in while all the other folks packed up and went to lunch between games.  I still got something to eat, I just decided to use the time to get some exercise while there was maximum supervision (read: free babysitting) around to watch the kids.

I didn't really want to get the run in.  I still did.  My point?  I tried.  Once it's done, they can't take it Bmi-calculator away from you.  Whether I'm 170 pounds or 270, the fact that I got some exercise and do it consistently (run/walk - who cares?  Just get the heart rate up) matters.

Here's why it's on my mind.  It really doesn't matter who owns healthcare - employers or the government - because the issue is the same.  Most of the healthcare issues we face as a country are self-inflicted.  Check out this line of thought and stats from a recent column by Geoff Colvin at Fortune:

"At the beginning of the 20th century, the top causes of death in the US were communicable diseases - flu, tuberculosis - curses that could strike any of us.  Today, the top causes are mostly the result of the way we live - coronary artery disease, hypertension, diabetes and some cancers.  We spend 50% of our health care costs on diseases caused mostly by the way we behave.

If Americans behaved just a little differently, our health care costs could settle down to the sustainable growth rate that matches the economic growth.  We don't need a nation of triathletes.  We just need to smoke and drink less, walk a little more, eat a few more vegatables and lose some weight.  More than 90% of Type 2 diabetes, 80% of coronary artery disease, 70% of stroke, and 70% of colon cancer are potentially preventable by that combination of moderate behavior changes, reports Harvard epidemiologist Walter Willett."

My friend Dawn Burke had a post up recently on Fistful of Talent called "This HR Fatty wants to give someone a fat lip", where she rightfully blasts a company's announced decision not to hire anyone over a BMI of 35. 

I agree with her - that's stupid.  Lots of very talented people have weight problems, and if you start eliminating those people from working for your company with an imperfect measure like BMI, you've played yourself.

But - based on the data above, which is certainly accurate, why should everyone pay the same for healthcare?  Why is that a right?  More from Colvin:

"Why don't we act healthier?  Part of it is economic - we bear ever less of the costs of our unhealthy behavior.  In 1960 we paid 56% of our personal health care costs out of our own pockets, in 2010 we paid 14%."

You're kidding me, right?  No wonder people don't care.  

I'm not saying that only people who are thin deserve a right to pay less for heathcare, I'm saying that people who try ought to pay less.  You've got a BMI of 35+ but there's an improving trend in all the wellness stats (blood pressure, blood glucose, resting heart rate - help me out here wellness types...)?  You should pay less, regardless of your BMI, or what the world thinks about how you look.  You're controlling what you can, perhaps within a god-given genetic profile.  

But... You're very overweight and don't even TRY to talk care of yourself?  The same wellness stats point to a 5-year trend that indicates you've got a high probability of exploding on Thursday?  Why wouldn't you pay more?

I don't get it.  It's a basic accountability factor, and we won't reverse the trend related to healthcare costs until people who don't try (and then end up high risk) have to pay more.  Lots more.

And that issue is the same whether ObamaCare becomes a reality - or not.

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