Fewer back higher premiums for unhealthy living

A poll also finds declining support for higher deductibles or co-pays for people who fail to meet certain health standards.

By Pamela Lewis Dolan — Posted Nov. 26, 2007

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A Wall Street Journal Online/Harris Interactive Healthcare Poll found that Americans are becoming more financially sympathetic to those with unhealthy lifestyles.

The early October survey of 2,267 U.S. adults found that the number of people who think it's fair to charge people with unhealthy lifestyles more for health insurance premiums fell from 53% last year to 37% this year. The same drop was seen among those who said it was fair for people with unhealthy lifestyles to pay higher deductibles or co-pays.

Paul Fronstin, director of health research and education programs for the Employee Benefit Research Institute, said he couldn't explain the changing attitudes.

While insurers for some time have charged higher rates for smokers on individual plans, employers have been slow to implement such rules, he said.

But more insurers, such as United HealthGroup, are developing group health plans that give healthier employees a cost break. For example, PreferredOne, a Minnesota health plan, started a new policy earlier this year that offers lower premiums for healthy people, based on blood pressure, body mass index, cholesterol levels and other wellness indicators.

And a few employers have banned smoking outright -- even at home. Others assess extra monthly charges for employees who fail to meet certain health levels, or who refuse to participate in stop-smoking or weight-loss programs.

A recent separate survey shows employers growing more aggressive in offering financial incentives to encourage workers to monitor and improve their health.

A survey of 355 large employers by Watson Wyatt Worldwide, a corporate consultant, and the National Business Group on Health, an alliance of big companies, found that 46% of those employers either offer health-related financial incentives, or plan to do so next year. By 2009, that number is expected to top 70%.

The survey noted the financial incentives for companies to implement effective health and productivity programs. Watson Wyatt said companies with such programs achieved 20% more revenue per employee, had 16.1% higher market value and delivered 57% higher shareholder returns from 2004 to 2006 than did those companies without programs.

Also, the survey said firms with programs had cost increases that were significantly lower for general health coverage, as well as sick leave and long- and short-term disability.

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Easing up on unhealthy habits

A Wall Street Journal/Harris Interactive Healthcare Poll found less support for insurance penalties for the "unhealthy," though those who believe in the practice say it would encourage healthier living.

2003 2006 2007
Americans who said it was fair to charge those with unhealthy lifestyles higher insurance premiums than those who live healthy lifestyles 37% 53% 37%
...who said it was unfair 46% 32% 42%
...who weren't sure 17% 14% 20%
Americans who said it was fair to charge those with unhealthy lifestyles higher deductibles or co-pays 36% 53% 35%
...who said it was unfair 47% 30% 46%
...who weren't sure 17% 16% 19%

Note: Respondents could choose more than one answer.

Source: Wall Street Journal/Harris Interactive Healthcare Poll

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From a more personal perspective

Results from the 2007 poll were broken down by how the respondents described their own habits, and by gender. Here is a profile of the respondents who thought it was fair those living unhealthy lifestyles to pay more:

What they said was "fair" Seriously overweight or obese Regularly smoke cigarettes Exercise regularly Male Female
Higher premiums 26% 15% 45% 47% 28%
Higher co-pays or deductibles 19% 13% 41% 44% 26%

Note: Respondents could choose more than one answer.

Source: Wall Street Journal/Harris Interactive Healthcare Poll

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