Save Room for Dessert

Let me start by saying that is is not this industry's responsibility to fix obesity. But as I have noted before, it has an clearly identified and rather substantial cost driver in its midst, so from a purely business sense, the industry does have an obligation to do something about this cost. It has already tried the soft approach of giving people options to do the right thing, weightwise. But in the moments after I recently gave a presentation on obesity at the Mississippi State University I-Day conference, I was met in the hall by numerous attendees who griped to me about how they could not get their own health plan to cover the cost of whatever proactive health improvement thing they were doing. Exercise clubs, eating a special diet, whatever. The point was these people had, on their own, discovered something that was delivering positive health benefits from them…and their health insurers did not care. This is voluntary, proactive loss prevention and every bit of anecdotal evidence I received pointed toward a great, big collective yawn from the industry that needs this sort of thing the most.

At the same time, insurers spent millions trying to get PPACA overturned, which comes off as a gross misuse of resources, considering that the repeal effort never had a credible chance of going any further than the house. So the millions spent by life and health insurers to repeal PPACA was what, exactly? Sending a message? Fine if all you want to do is spend a lot of money registering discontent. And as I've said before PPACA offers much for which to be discontented. But really, the trade groups representing the industry knew full well that PPACA would never be repealed. It will likely not be overturned in the Supreme Court, either, as the Court rarely overturns that which Congress has put into law. PPACA is something the industry is going to have to live with, which is why we're suddenly seeing a renewed interest in tackling cost drivers. Well a great first start would be spending millions on health awareness initiatives rather than on dead-end lobbying efforts.

Frankly, if the industry must lobby for something, why not lobby during PPACA's implementation period to allow for more aggressive underwriting for people of a certain size, citing their higher risk for health problems? After all, it will be a heck of a lot easier to get an exception to PPACA than to kill PPACA itself. And already airlines are able to charge heavy passegers for two seats, just as life insurers can charge from 33% to 75% more to policyholders who are smokers. In both cases, overweight customers are either causing a direct increase in costs (in airlines, the heavier you are, the more fuel you require the plane to burn to stay aloft. Fact.) or a direct increase in risk (as smokers clearly have a greater mortality risk because of their smoking). The same can easily be said for obesity, but nobody seems to be saying it. Why is that?

Surely political correctness plays a part, amplified by the fact that we are in a country now where the overweight and obese outnumber the fit, so it is becoming not just politically incorrect to hold the overweight financially accountable for their condition, but it is becoming taboo to even talk about it. And yet, if the industry fails to act, if the industry does not do something to drive down this huge cost of obesity-related illness, then how can it rightfully get the public's support when it goes for other cost drivers, such as the frequency with which people use emergency medical services?

It can't.