Be Healthy or Else: How Corporations Became Obsessed with Fitness Tracking

Until you show up uninsured at the same ER for the same visit and end up with a $10,000 bill because you don't have insurance.

Whether it hits your deductible or not, insurance negotiates rates that are easily 75% cheaper than what you'd pay without it.

This is one of those "preliterate peoples do not develop epidemic myopia" sort of things, perhaps.

It's always phrased as the former, but employees that don't get the discount often see it as the later.

In my experience? It's a drain, and a good way to encourage me not to go see the doctor. Because it's every time I go to the doctor for literally my entire life. I have never not gotten a 10 minute lecture, including when I was on a varsity swim team.

Beyond that, it's a lecture that comes even when it's not the problem. In the not so recent past, we discussed my weight for 15 minutes...and the active pertussis infection I had for 5. If you have a chronic condition, you're almost certainly going to have your doctor tie it to your weight.

And here's the thing - fat people know we're fat.

What's the difference?

This is just semantics. In either case, it costs money to not participate.

Marketers like to frame things as the latter, as behavioral economics tells us you get better participation by using the latter words.

But we should draw a distinction between marketing and the bottom line. The bottom line is there's a $50 cost.

I would object. What would stop them actually rising the bonus or the costs for the rest in the future? You've justified it in so many ways. It's the grand health initiative! Let's make America healthy again!

Easy to sell and all that sweet data can be used for other good causes.

Meanwhile the discussion over overpriced medicines disappears. You can (must?) even push the prices for medicines, therapies, etc. leading to the fact that the insurances best customers, people who can't do anything about their sickness (anymore) will be burdened even more. Enforcing the "sick and out" narrative in this sick system.

> What this actually means: The trying-to-be-healthy population are no longer subsidizing the not-trying-to-be-healthy population. I don't know if this is a bad outcome

It is. It's like taxes but we lost that viewpoint (US maybe never even had it but we did in Germany) because of privatization.

There are other ways to educate people on how to be healthy and what the benefits are. Starting doing it at school SERIOUSLY would be a step. Marking obviously unhealthy food as such is another. Misleading advertisements is a big one. And so on. It can be done but I don't believe there is a really strong lobby for that out there. Or not strong enough.

This assumes the only reason for not participating is lack of motivation to be healthy. What about those of us who don't want to voluntarily surrender our entire genetic code to an insurance company? And once most people have, how do you know that your future premiums won't be based on genetic markers for certain diseases?

It's not obvious to me, in the US medical system, that "healthy" people use fewer healthcare dollars over their lifetimes.

Of course I'd like that to be the case and it would be satisfying to shift costs to people making relatively poorer health decisions.

The problem is, it appears that healthcare spending skyrockets asymptotically at the very end of life - as you are literally dying - and that explosion of costs and care-use occurs regardless of how healthy you were throughout your life. Healthy people (and their relatives) desperately attempt to eke out extra days and weeks of life just like unhealthy people (and their relatives) do.

I don't know how to solve this problem but until this is no longer the case I don't think it's appropriate for "healthy" people to act so wounded about the money they're paying in for the couch potatoes.

How terrible would it be to have a doctor tell you to stop smoking? Or to stop drinking? Or stop abusing drugs? Or to stop cutting yourself? It's all self destructive behavior just like overeating.

Has our culture really become so sensitive that it's now no longer acceptable for a doctor to tell you when you're being unhealthy and contributing to your own demise????

On the other hand, think about it like this:

What if insurance costs $10,000 a month, with a $9900 discount for "healthy behavior", so your average person pays $100 a month.

It's a great deal.

Now what happens if someone gets sick and can't upkeep his healthy behavior?

He loses his insurance.

This defeats the purpose of health insurance, but most people tend not to think of long-term repercussions.

And there's already a financial incentive as well: Discrimination provides a financial advantage to people who appear more healthy (younger, thinner, taller).

Yeah, let's ignore all that has been done in Europe in terms of health, which did not involve markets but did work in practice.

Us being rich, it's much more pleasant to financially harass the poor, rather than doing stuff like public health care, a preventive medical policy, or a real education system which would cost money to us, but would have a real impact.

But if you're fat, smoke and don't do anything, and then you have a heart attack its kind of easy to link things together.

Person's health depends not only on their choices. Some people are born more healthy and some are less. So does it mean that if somebody has errors in their DNA they should get less salary?

It would be more fair just to make a tax for alcohol and cigarettes.

Firstly, it's pretty hard to measure the choices people have made. Any attempt at measurement is going to add extra costs for little or no benefit.

Secondly, we're judging people on things where we don't know the complete story. If a single parent is eating unhealthily and not exercising because they are short on both money and time, that's hardly something to make them pay for. If someone's been addicted to cigarettes for 20 years, they have probably tried and failed to give them up. To me treating wealthy people's skiing injuries should be at least as controversial as treating poor people's smoking-related problems. Personally I like to run to keep fit, but I view that as good fortune - I'm lucky that I'm healthy enough to run and that I enjoy it, and that I have time to do it.

Finally if someone gets diabetes after drinking 20 cokes a day, they're definitely paying for that decision even without a financial penalty.

In summary I guess that I feel that good health is a very fortunate thing to have, and I certainly don't feel entitled to extra cash for my good luck.

The question here is as to whether this $1000 bonus/penalty changes behaviour or just rewards those who are naturally healthy/enjoy sport/like healthy food.

A little voice inside me keeps repeating that it will not be like that in the long run. They will start saying it's a bonus, but years after years, it will transform into a malus in the calculations, like they always do.

> But it gets even harder, because who defines healthy?

+10. And the more you dig into health, the more you realize health professionals don't always have the best informations as you though they would. It's worth to take time to try many things on your own in parallel of traditional advices otherwise you can miss so many good practices, or engage in so bad ones.

I don't envy anyone who has to try to make people healthy, but looking at where we are heading it seems very necessary unless the government has to step in and impose calorie rations on overweight people.

In Europe healthcare costs are just another tax, which rate is set by goverment and your employer is just responsible for substracting that from your salary and transfering to government's bank account, but has no say about how much you should pay.The plus side is that your employer simply does not give a damn about your lifestyle choices.