Extra pounds mean insurance fees for Ala. workers

Direct and Indirect Costs of Diabetes in the United States

The total annual economic cost of diabetes in 2007 was estimated to be $174 billion. Medical expenditures totaled $116 billion and were comprised of $27 billion for diabetes care, $58 billion for chronic diabetes-related complications, and $31 billion for excess general medical costs. Indirect costs resulting from increased absenteeism, reduced productivity, disease-related unemployment disability, and loss of productive capacity due to early mortality totaled $58 billion. This is an increase of $42 billion since 2002. This 32% increase means the dollar amount has risen over $8 billion more each year. The 2007 per capita annual costs of health care for people with diabetes is $11,744 a year, of which $6,649 (57%) is attributed to diabetes. One out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in ten health care dollars is attributed to diabetes.

Medical Expenditures Attributed to Diabetes:
Estimated at $116 billion, including $27 billion for care to directly treat diabetes, $58 billion to treat diabetes-related chronic complications, and $31 billion in excess general medical costs. People with diagnosed diabetes, on average, have medical expenditures that are approximately 2.3 times higher than those without diabetes. Diagnosed diabetes patients account for 5.8 percent of the total U.S. population. $58.3 billion was spent on inpatient hospital care and $9.9 billion on physician's office visits directly attributed to diabetes. Diabetes-related hospitalizations totaled 24.3 million days in 2007, an increase of 7.4 million from the 16.9 million days in 2002. The average cost for a hospital inpatient day due to diabetes is $1,853 and $2,281 due to diabetes-related chronic complications, including neurological, peripheral vascular, cardiovascular, renal, metabolic, and ophthalmic complications.

Indirect Costs of Diabetes:
Estimated to be $58 billion in 2007. In 2007, diabetes accounted for 15 million work days absent, 120 million work days with reduced performance, 6 million reduced productivity days for those not in the workforce, and an additional 107 million work days lost due to unemployment disability attributed to diabetes. Diabetes caused 445,000 cases of unemployment disability in 2007. The value of lost productivity due to premature death related to diabetes is $26.9 billion.

Conclusions:
The increase in the cost of diabetes reflects three causes: the growth in diabetes prevalence; medical costs rising faster than general inflation; and improvements made in the methods and data sources influencing cost estimates.

The actual national burden of diabetes likely exceeds the $174 billion estimate because it omits the social cost of intangibles such as pain and suffering, care provided by non-paid caregivers, excess medical costs associated with undiagnosed diabetes, and diabetes-attributed costs for health care expenditures categories not studied.

According to CDC, in 2007 23.6 million Americans had diabetes, with nearly a third undiagnosed. Another 57 million have pre-diabetes, and are likely to have the disease if they do not alter their living habits. The 23.6 million represents a 13.5% increase from the 20.8 million in 2005. Many factors contribute to this rise, including higher prevalence of overweight and obesity, changes in diagnostic criteria, improved or enhanced detection, decreasing mortality, a growing elderly population, and growth in minority populations in whom the prevalence and incidence of diabetes are increasing.

By this time we are accustomed to politicians and their one size, fits all, laws.
My suggestion, when they have to pay the additional $25 dollars a month, put another $25 dollars a month aside and contribute to the opponent, in the next election, of every politician, that voted for it.
I don't live or work, in Alabama, but will glady, contribute.

An aside for Bev 33071, if you think insurance companies are going to reduce rates, for any reason, you have smoking too many of those little skinny cigarettes

If a substantial chunk of the $116 billion spent directly on diabetics' medical costs went a way it would have to have an effect on premiums. At the very least they wouldn't go up as much.

Health insurance is a competitive business and if it were possible to lower premiums to get market share, without losing money - they would lower them.

could i have your bacon ?

could i have your bacon ?

may i have your bacon ?

could I have your bacon ?

could I have your bacon ?

could I have your bacon ?

Frankly, this story makes me quite angry, not because of the subject, but because of the way the subject is presented. My brother works for the state of Alabama and is affected by this. He sent me the information from the State Employees' Insurance Board so that I could read it myself. It is titled the "Wellness Premium Discount Program."

Unhealthy people are not being penalized. In fact, all employees will be charged $25 for their insurance. (It may be irritating to begin paying for something that has been free, but how many Americans aren't required to contribute to their health coverage by their employers? $25 a month is pretty reasonable when you compare it to what the average American pays.) Those who meet certain health standards will receive a DISCOUNT equivalent to that charge. Those who don't will receive FREE health screenings and counseling to help them. Employees have a year to show IMPROVEMENT, not to lose half their body weight, which would certainly be unreasonable. If an employee has a medical condition which prevents them from losing weight, they are exempt from the charge. And there are several other ways to receive the discount and waive the premium.

My brother (who is an intelligent man, a Mensa member, even!) thinks this is reasonable and fair, and after reading all the information I am inclined to agree. He is already participating in the wellness programs to try to qualify for the discount.

Honestly in all the media coverage I've been exposed to on this topic, the actual state document is the first time I've heard the charge put this way- that healthy people get a discount as opposed to unhealthy people being penalized. I suppose both ways are relatively accurate depending on your point of view. I just find the "spin" that's been put on the entire situation very interesting. The local media chooses to report this story in a negative light because controversy gains viewers/readers and that translates into money. The national media is not only interested in controversy, but gets the opportunity to show the state and the south as bigoted and backward, thus perpetuating a stereotype that is not entirely true. I spent 15+ years working in both television and print news media. Don't ever believe that any news outlet is truly unbiased. Any story can be and is presented in a way to get the viewer/reader to lean in a particular direction. The media isn't referred to as "The Gatekeeper" for no reason.

To those of you making this a debate about heavy vs. thin you need to look closer at the big picture and what this could snowball into. There are many unfair and prejudicial aspects surrounding this policy. This state is assuming that heavy=unhealthy and by and far that is not always the case. There are plenty of thin people with chronic high blood pressure and high cholesterol with terrible eating habits that have the benefit of a great metabolism; I have a family full of them. If heavy people have to pay extra for insurance, what about habitual alcoholics that are destroying their liver? What about people who reside in high-risk crime areas that are more likely to be the victim of a violent crime? What about those that habitually have unprotected sex and risk a disease far more costly than obesity (HIV/AIDS meds can cost up to $30,000K per year that's not including treatment and hospitalization). What about women who are are building a family where the cost of having a child is an average of $16,000-$20,000 per birth? Should they be penalized because they might decide to have a baby...that seems absurd doesn't it? The point being; Where do the possibilities for surcharges end? Who hasn't heard the saying 'give an inch they'll take a mile'. By allowing this policy to be implemented and accepted everyone in this country becomes vulnerable to a domino effect. Where will it end? Regarding the stupidity of this policy as it relates to weight: The bottom line is that there are plenty of thin people who die in hospitals every day from health related complications. This has been overlooked by the State of Alabama and burdens a select group of individuals to foot the bill for all the others that may not be heavy but spend plenty of time overeating, smoking, drinking, engaging in risky sexual behavior, etc. Additionally, what about the billions of dollars we foot the bill for every year treating able-bodied adults who live off welfare and refuse to work...what penalty's do they pay? That's right, they don't it's just another thing we work hard to pay for. Let's talk about the percentage of people in Alabama that use welfare as a means to live and not to get them by until times get better. WAKE UP ALABAMA! This is prejudice at its finest! Once this policy is implemented where will you draw a line in the sand? I think men should pay a premium over women because they die sooner and are more at risk for heart disease!!! Do you see where this is going people! Quit making this about weight. It's something much bigger than that!!!!

Smoking is my only thrill.... they took the joy of that away from me....

I say punish them, tax them, take their money away! All of them! It´s not fair that up til now only us smokers suffered. Now it´s your turn.... pay up obese, drunks, pot heads, diseases, etc etc etc... all of you, all in!

I think that people are looking at this topic the wrong way. Most people who have insurance pay a monthly premium for this insurance. We'll say $100 a month for this argument, so they are arguing that it would be unfair to be charged $25 extra for having a BMI above 35. I can see why that would upset people, but remember that the Alabama state employees are not paying anything for their insurance. If we say that your company pays 75% of your insurance cost per month then that means that the monthly cost of insurance is $400. So insurance is $4,800 a year. The state then pays $180,129,600 per year for their employee's health costs (37,527 employees x $4,800 a year health care cost). So as a resident of Alabama, you are paying $1,200 per year for your health insurance (assuming you have health insurance) plus roughly $40 toward those employees health insurance ($180,129,600 yearly cost of state employees divided by the 4,599,030 Alabama population). This is obviously a very low number since not all of those 4.6 million residents are paying taxes.

So now you are paying $1,240 toward insurance per year (yours plus the state employees). If we assume that the state trend is followed in the state employees, then 30.3% of the employees are obese or 11,370 employees. The article states that research found that a body mass index of 35-39 generates $1,748 more in annual expenses. So now we have an additional $19,874,760 in yearly insurance costs for state employees assuming that employees are not above a BMI of 39. Now every Alabama resident is paying $43.50 per year for state employee's insurance. If you were a resident of Alabama, wouldn't you want those employees contributing to that additional $19.8 million?

For those people who used the big brother mentality and said they could start charging you for risky sexual behavior. Think about this, according to the CDC the average LIFE TIME cost for…

Hepatitis B: $779 Syphilis: $444 HPV: $1,228 for women and $27 for men
Genital Herpes: $417 for women and $511 for men
Chlamydia: $244 for women and $20 for men
Gonorrhea: $266 for women and $53 for men

None of these are anywhere near the yearly average for obesity and these costs assume you got the disease around the age of 24.

The only STD that could be used in this argument is AIDS/HIV which the CDC says is roughly $20,900 per year. The average life expectancy for someone with HIV is 22-26 years. That is a lot of money, but the CDC also states that Alabama has 8,252 reported cases of AIDS/HIV which is only 0.18% of the population. If the state statistics were the same as for state employees that means that 67 state employees have HIV or AIDS which comes to a yearly cost of $1,404,922 which is not nearly as much as obesity.

The main alternative to this fee is to charge everyone for their insurance and then given rewards to those people who live a healthy lifestyle (nonsmoker, not obese) which I saw some opponents suggest. If I were a state employee, I would rather pay $25 per month for being obese then pay $100 per month to "be fair." Especially since people who aren't obese would still be paying less than me.

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This is the document posted by the Alabama State Employee's Board describing the terms of this program

STATE OF ALABAMA Wellness Premium Discount Program

I. Premium Discount in Initial Year of Implementation
Effective January 1, 2010, all active employees will be eligible for a $25 per month wellness premium
discount off the single coverage provided the employee has submitted baseline readings for the following health risk factors: • Blood pressure, • Cholesterol, • Glucose, • Body mass index.
These health risk factors may be provided to the SEIB through participation in the SEIB's worksite
wellness program or submission of a physician certification form no later than November 30, 2009.

II. Premium Discount in Subsequent Years
Effective January 1, 2011, employees can receive the wellness premium discount under one of the
following conditions:

1. employee has been deemed not at risk by the SEIB based on the reported health risk factors; or

2. employee has been deemed at risk by the SEIB based on the reported health risk factors and has: a. submitted a statement from a physician* stating that: i. employee has been counseled regarding the health risk factor(s), or ii. employee has a medical condition that prevents him or her from improving the health risk factor(s), or b. participated and completed one of the SEIB approved wellness programs, or c. reported improvement in the health risk factor(s) through self-management. • At risk employees are eligible for a physician referral waiving the copay.

The government needs to show some real commitment to helping people get fit but individuals need to take some responisbility and stop blaming everyone else.