Faced with a choice of paying much higher health insurance premiums or upping their level of exercise, thousands of obese people opted for exercise, researchers report.
The Blue Care Network required obese subscribers to pay premiums as much as 20 percent higher or enroll in one of several options to lose weight, according to Medical News Today. For some families, failing to meet the criteria meant paying nearly $2,000 more each year.
The insurer made a move considered controversial when it launched a huge financial incentive program requiring subscribers deemed obese and enrolled in the Healthy Blue Living program to sign up for a fitness program in order to pay less in out-of-pocket costs. They had several options, among them Weight Watchers and WalkingSpree. The program considered those with certain medical conditions exempt, provided the individual had a physician's waiver.
Nearly 36 percent of U.S. adults are obese, the Centers for Disease Control and Prevention reports. Estimates suggest that medical costs linked to obesity reached $147 billion in 2008.
Doctors diagnose being overweight or obese by determining an individual's body mass index (BMI), according to the National Heart, Lung, and Blood Institute. Those who are overweight have a BMI of 25.0 to 29.9, while obese individuals score between 30.0 and 39.9. Extreme obesity is associated with 40.0 and higher.
The research team represented the University of Michigan Health System and Stanford University. They followed 6,548 subjects -- more than half of the 12,102 individuals who enrolled in a wellness program -- who chose the pedometer-based WalkingSpree option.
The initiative required each subject in the Internet-tracking walking program to take on average 5,000 steps each day over a three-month period to get the financial incentives offered. This translated into 450,000 steps each quarter. At the end of a year, almost 97 percent had met or surpassed the objective.
Around two-thirds of the participants liked the program. The others weren't happy with the financial incentives offered, which they considered coercive.
The researchers published their findings in the journal Translational Behavioral Medicine. They suggest that under the Affordable Care Act, the kinds of wellness programs offered will increase to pass along health-cost savings to employers and insurance companies.
For most of my life, I have been overweight, occasionally obese, based on BMI. One reason is long-term medical conditions that often keep me off my feet. Another is medication like steroids that can cause patients to pack on weight. I also have a family history of obesity.
I could probably get a waiver to opt out of a wellness program. However, the apparent lack of standardization over who's eligible for one is troubling. Most obese individuals are physically able to opt for exercise over higher insurance costs. However, if an incentive program applied to the elderly, fewer subscribers would be able to participate, based on physical condition.
Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.