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Subsidising other people's unhealthy choices is clearly going to be a controversial topic, but I've come to the conclusion that the only sensible approach is to ignore the choices and threat the condition.

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.

I think lot of people see being overweight is a moral failure and want to punish people for it. That's all there is to it, no matter how cleverly worded it can be about "being healthy" and "subsidizing" and "choices".

Seconded!

Being "healthy" is the realization of two interacting random processes: things that are in your control and things that are not. The tricky part is that the division between these categories is really fuzzy and markedly different for everyone.

The link between cause and effect is also likely less simple than wellness models predict. Started running? You might feel good now but not realize that you're exacerbating the arthritis your genetics predisposes you to in 20 years. Stopped smoking? Awesome! But why did your employer put you in a state of constant chronic stress for 10 years resulting in elevated cortisol that resulted in a stroke?

The path between cause and effect is very difficult if not practically impossible to trace out for populations. So although wellness programs are not as sinister as some believe, they definitely are not as nice or positive as they present themselves, either.

The reason such programs are becoming more common is because they are becoming cheaper. Given that, how can you be certain that the cost is exceeding the benefits (as you claim)? How low would the costs/how high the benefits before you changed your position on this?

To me treating wealthy people's skiing injuries should be at least as controversial as treating poor people's smoking-related problems.

The former is paid for by the wealthy person, the latter by society. The poor person is directly harming me by smoking. It's perfectly reasonable to criticize the poor person in this case. Similarly, one might criticize a polluter (who harms us all), but not criticize people who have gay sex in the privacy of their own home (harming no one).

Think of it as shared responsibility - the rich are responsible for paying, the poor can reasonably be held responsible for other things.

> The former is paid for by the wealthy person, the latter by society.

How so? Both are paid for by an insurance pool. Unless the skier is paying a higher insurance premium for the extra risk that they are incurring by skiing, they are not paying for their skiing injuries.

Most poor people have insurance which is paid for by the rich.

If insurance companies start to charge skiiers their actuarial cost, I have no problem with this. If they don't I suspect it's simply because there aren't very many.

I have a somewhat more practical objection - when you reduce their pay, how are these people supposed to get healthy again? Achieving healthy status seems more costly than maintaining it, but with this system, if you fall behind, your resources are further reduced on top of you being physically worse, making it even harder to get back to being healthy. It's like Mario Kart without blue shells.

> It's like Mario Kart without blue shells.

good analogy

This is how punishments work in general. They don't help people - they just weed people out.

Except it's not a cut for people who don't follow. It's a bonus for those that do. Anyone can get the bonus, just do the dance.

Huh? Surely you understand that there's no difference between calling something a "cut" or a "bonus" when the result is the same?

Perception my friend. Perception is everything.

We give a tax cut to people with kids to encourage families in the US. How would people react if we changed it to a no-kid penalty paid by all people without children? Same thing right? But we would react very different to it.

This is a glass half empty, half full argument. Honestly, I am taking the view that "wellness programs" should be mandatory fun. Why? Just look at social programs like social security, garbage collection, public schools, welfare ... I mean we all pay into a system even when we are healthy, wealthy, and happy .. but there comes a time, when we won't be. The buy in ideology here, is what is good for the goose is good for the gander. Healthcare costs are rising for every company out there. It's _not_ free. When someone joins a wellness program they are doing so for a benefit. But .. as a company it is insuring that people are doing their best to keep the social healthcare system that the company purchased costs down for everyone. You are doing this for your fellow co-workers, not you. It's being caring enough to say hey .. I'm working hard to keep myself in the best shape I can, so I don't have to die and cost our company money when they negotiation on the bulk for ALL of us. This is not a company thing, it's a fellow-man thing. This is about as close to universal healthcare as you are going to see and it's a good thing.

Eating less costs less. Burpees are free.

There is an entire subreddit dedicated to eating cheap and healthy: https://www.reddit.com/r/EatCheapAndHealthy/

You don't need a gym, even to get into seriously good shape https://www.reddit.com/r/bodyweightfitness/

There is no fixed pie here, there only question is if you want it or not.

And time and energy are infinite, right.

It doesn't take more time to eat less, but for exercise it is simply a question of priority. Yes you will have to find some part of your day where you do something you value less, then take the time to exercise instead of doing that.

It's great that you have the privilege of sufficient spare time to allocate towards exercise and the luck to avoid any conflicting medical problems. Investing in your own health with regular exercise and an improved diet will hopefully lead to fewer problems later in life.

However, please remember that some people are not as privileged. Free time is not always available. Good food - and sufficient time to prepare it - isn't always available either. Life is complicated and work, kids, and other important obligations take priority for many people.

> Eating less costs less.

Eating less doesn't always lead to better health. Nutrition is complicated.

> there only question is if you want it or not.

Do you also tell people with a broken leg that they could walk if the wanted to? Staying healthy is not a matter of willpower and/or education. Staying healthy isn't even deterministic, because our knowledge of medicine, nutrition, etc is still imperfect.

> You don't need a gym, even to get into seriously good shape https://www.reddit.com/r/bodyweightfitness/

/r/bodyweightfitness is actually pretty hostile to low/no-equipment approaches. It should tell you something that the top comment on a "Jail for 3 years - training with no equipment" post leads with "you might have access to a gym".

> It sounds a lot less sinister if you rephrase it

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.

> subsidize other people's intentionally unhealthy life choices

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.

As someone who works at a company that is removing all vending machines at the first week of the year, I agree. It's none of their damn business what people eat or drink and taking vending machines out just reduces employee morale.

> none of their damn business what people eat or drink

Well if they're buying the food and drink and providing it to their employees then it's literally part of their business operations.

It's not their duty to regulate the private dietary choices of every individual.

But they aren't. They are giving a bonus to people that make good choices. Seems good to me.

Disclaimer: makes good choices and am health nut.

Why do you think other people don't make the same good choices?

I am at Walmart right now. I looked around.

Other Americans do not make the same good choices I make.

Okay, my question could be interpreted that way. My intended question was "Other Americans don't make the same good choices; why do you think that is?"

I agree with that, but it's also not their duty to supply easy access to shitty unhealthy food either.

I don't think anyone in this thread argued that it was their duty to do anything. Everything we've talked about employers doing in this thread has been optional for the the employer. So you haven't said anything that anyone appears to disagree with.

But I wouldn't say it was regulating. Can you see a difference between being allowed to eat and drink whatever you want, and requiring that your employer provide whatever you want to eat and drink?

If your local shop doesn't happen to sell your favourite drink they aren't regulating you are they? That's just not what that word means.

They are not buying food and drink - a third party installs vending machines on site and actually pays the business to do so.

I'm not sure that a minor business indirection like that really makes a material difference to what we're discussing.

They're still providing a service to their employees as part of their business operations. People are talking about this like having cans of drinks is some kind of human right that they're entitled to. I'm arguing that it's a business decision and totally up to the employer. There aren't any laws, or I'm arguing any moral imperatives, that means they have to offer you any particular drinks.

Individuals should pay for their own bad choices. Im in Aus and a pack of smokes last year (yesterday) cost $28. Today $35. thats for 25 cigarettes. Taxes work. In america it's a little more tricky, and nailing down the cause of long term conditions is also tricky.

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.

My understanding was that obese people and smokers ultimately cost less to insure because they tended to die relatively quickly and with less prolonged fuss. Should individuals pay for their own good choices?

http://www.nytimes.com/2008/02/05/health/05iht-obese.1.97488...

Interesting read. I guess is a balance of extra productivity from not dying vs getting rid of some smoker :P

Retirees tend not to have much productivity whether they are dead or not.

Retired folk are (or can be) still an economic benefit as long as they live. Consider the trivial case of a grandparent watching children so the parents can have time to recover. But obesity and smoking do not kill people the day they leave work for the last time, it kills people in their 40s with years ahead of them to be productive.

Diabetes is punishment enough for your hypothetical gluttony. I see no reason to arrange society in a way to further punish sick people.