plus 1, Argument turns into trip to jail - Sonoma Index Tribune

Argument turns into trip to jail - Sonoma Index Tribune

Posted: 30 Oct 2009 01:00 AM PDT

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Many factors affect health care costs - Charleston Daily Mail

Posted: 29 Oct 2009 09:54 PM PDT

In a television commercial for auto insurance, the spokeswoman asks a customer a series of questions to determine how good a risk he is. Every time he provides positive information, she chirps triumphantly: "Discount!"

With medical costs rising fast, insurers also feel pressure to identify people whose behavior poses risks to health - tobacco use, for one; obesity, for another.

But while targeting a couple of behaviors for attention and making their practitioners the scapegoats for rising medical costs in general may satisfyingly allow the public to discharge some of its frustration, it is unlikely to slow rising medical expenses very much.

That's why the recent unfortunate misunderstanding of what the Public Employees Insurance Agency is trying to do kicked up such a storm of protest.

It initially appeared that the PEIA, which charges smokers higher premiums, also intended to charge overweight state employees higher premiums as well - in effect, a "fat tax."

But a host of other factors also drive up medical costs - alcoholism, drug abuse, gang membership, firearms, contact sports, skiing, reckless driving, riding ATVs, premature births, etc.

Most health care dollars are spent on the very young and the very old. The increasing longevity of Americans, and the resulting replacement lenses and knee and hip replacements - is a significant driver of health care costs.

If only certain risk factors resulted in punitively higher health insurance rates, the targeted groups would want to know why other behaviors did not result in higher premiums.

Fortunately, that's been straightened out. As the Daily Mail's Sara Gavin detailed this week, the PEIA has since 2004 offered substantial help - not punishment - to employees who need to lose weight. The public generously covers the services of registered dieticians, physiologists and personal trainers at 50 locations across the state to help its employees meet fitness goals.

That's a better approach.

Unfortunately, only about 15 percent of the estimated 20,000 active employees who qualify for those additional benefits have taken advantage of them so far.

Here's to encouraging others to seek that help.

It could raise medical costs in the short term. But

in the long term, that approach will do more to bend the cost curve.

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