My local National Public Radio station had an excellent set of guests on this morning. The discussion centered around obesity as a health problem and - more importantly, to business - as a productivity and health care insurance cost. The radio show corresponded with the release of a comprehensive report on obesity by the Centers for Disease Control.
Obesity statistics are staggering. Over 35% of adult men in the U.S. would be considered obese in 2007. Obesity-related health care costs totaled an estimated $117 billion in 2000 and have climbed steadily. Medical expenditures for obese workers, depending on severity of obesity and sex, are between 29%–117% greater than expenditures for workers with normal weight. To be clear, all of the physicians on the show recognized obesity as a disease with metabolic causes and results.
As staggering as the costs and the statistics, in many health insurance plans obesity programs, preventative care, counseling and other services are not covered under the policy. This is not true for all insurance plans. The local director for CIGNA health plans called the radio show this morning and discussed a number of programs and a commitment to preventative care for obesity by CIGNA. I am sure there are other plans out there that offer such coverage.
But, can an insurer offer wellness discounts? Can an employer offering a group plan offer wellness discounts? That can be a complicated question. This is because the Health Insurance Portability and Accountability Act (HIPPA) generally prevents "discrimination" among group policy holders based on wellness and other factors. In 2008 both the Department of Labor and IRS issued advisory statements providing specific regulations that must be addressed in order for certain discounted coverage to be exempt from the non-discriminatory provisions of HIPPA. Complicated? Yes.
The point is, with these regulations and guidance, employers can - working with insurers - provide tangible discounts to employees that participate in wellness programs or perhaps meet wellness goals such as reducing obesity. The CDC goal is to reduce adult obesity to less than 15% of the population and the childhood obesity rate to less than 5%. The health care cost savings of reaching such a goal is variously estimated at $150 to $200 billion.