Fatties Need Not Apply......CVS imposes penalties on fatties and smokers.

I think this could probably be done with a combination of BMI/waist circumference/body fat %. None of those are absolute, but taken together, it's a reasonable way to draw guidelines. Originally Posted by Liliana Vess

But going by the premise of the original question DJ asked - who is to define what a smoker is? One cigarette a day? one a week? month? year? Ultimately an insurance company is going to have to draw up broad groups instead of creating personalized plans for each individual and I am sure there will be a way to come up with a grouping. On the fringes it will miss a few people and include some who should not be but there will be ways to come up with groups that are generally valid if an insurance company wishes to charge differently for obesity.
Also, I don't want to enter the war of polemics going on here but I hope that people can understand one part of what WU is trying to say. The intrinsic cost of an insurance policy (as opposed to the cost that is charged to the customer) is the sum of all costs that the insurance company incurs for the product. If an insured is obese it will cost the insurance company more to cover them irrespective of the reason for their obesity. So going by the basic principle of price of a product being proportional to its intrinsic cost the policy would cost more.
Then there is the separate moral question of whether we, as a society, are willing to subsidize those who incur costs for unavoidable versus avoidable reasons. It may not always be as simple as it seems. Pregnancies are generally avoidable. But societally we have accepted them as a morally acceptable choice. I am not going to answer the question here but I am just saying that is how the debate is to be framed. At its core insurance is a cost shifting process. If there were no insurance at all everyone would just pay for their own health care. For the majority of people this would be a cost saving and for a few this would be catastrophic. All insurance companies do is to spread risk and cost over a wide population so that all people have a lower risk and all people incur a moderate cost. Put another way there is a cap on the maximum amount an individual would have to pay but the entire population probably pays more than they statistically would be likely to pay without insurance.
And now I have the urge to respond to the other posting about "greedy" insurance companies but I will do that separately.

Partly true, and partly unadulterated horseshit...

If you went out and got your own private insurance and answered "yes" to the questions "do you smoke" or "do you have diabetes", you'd have to pay more for that insurance than me, all other things equal. Up until now, your employer has been gleefully sucking up that cost and paying the extra for you. Now they're saying, "hey, he has to pay for his own insurance if we don't give it to him, so he can damn well pay for his own fucked up health choices, we're not going to subsidize his idiocy anymore".
... Originally Posted by Wakeuр

This is probably what you mean to say but technically an employer is not sucking up the cost and paying extra for more expensive insured. The extra cost was generally being sucked up by other employees who ought to have had lower rates but were carrying the burden of more expensive insured. Employers are generally unlikely to be charitable to higher health risk employees, that would not make business sense. It is true that most employers subsidize health plans but they do not subsidize differently for those with higher health risks versus lower. What they can do is when they ask for a quote from an insurance company they can ask them not to distinguish between two risk classes of people (eg. smokers vs. non-smokers). And in some cases the law will not allow them to distinguish - like married vs. non-married. When a company asks an insurer not to distinguish between two risk classes they are effectively asking the lower risk class to subsidize the higher risk class. The math is pretty straightforward.

And the point I wanted to return to is this is not greed, it is just mathematically understanding the process of cost shifting between risk classes to create uniform risk. Remember that the insurance companies do not create health costs, the health system does that. If you never visited doctors, never took MRI's and never had operations your premiums would be great. If smokers as a group would never go to doctors to get lung cancer treated insurance companies would not charge them a premium. They make economic decisions, not moral ones.
But if anyone is still troubled deep down by the greed of insurance companies, I hope you realize that they are publicly traded and you are free to check out their SEC-10 filings and look at their profit margins. Most of them have had very thin margins historically. The margins will probably start looking better now that Obamacare will force people to buy insurance plus having cut a back room deal to avoid gray market drug importation.

This one is interesting. On one hand, it does make some sense for insurance companies to change their rates based on factors that would affect how often they would have to pay out on a person.

However, this also leads you down the slippery slope of insurance companies starting to dig deeper into your medical history and potentially start doing things like charging rates based on race or gender in the future. Especially as we continue to unlock more of the human genome, could we see a time when you're charged different rates based on your genes? Originally Posted by jbravo_123

There used to be a time when we were charged different rates based on our genes. That was the time before we had health insurance companies and paid our own bills. Most third world countries still have that now. It just so happens that they don't know their genomes, but their health care bills do reflect their genomes - combined with their lifestyle choices.