What is Fit?

January 22, 2008 at 3:31pm By: Mr. Wilson Posted in 625 Elm Street

The Missus and I are going through some insurance stuff right now. According to the insurance company’s charts, I am the perfect man. I know, most of you are saying, “But we already knew that, Mr. Wilson!”. Well, now there’s even more proof.

Actually, my supposed perfection is just based on my height and weight, combined with my medical history over the past five years. Based on that, I probably do seem pretty healthy. (Had they gone back much farther than five years they might have come to a different conclusion.) But wait, what’s this? The feds say I’m overweight! How can my insurance company call me “super-preferred” if, according to the feds, I’m unhealthy?

The BMI is crap, that’s how.

I trust my insurance company’s assessment of my health infinitely more than I trust the government’s take on it. After all, my insurance company’s existence is on the line. The feds? No matter how wrong they are or what harm they cause, they’ll still be around. In fact, the more wrong they are, the more easily they can claim they need a bigger budget so they can get things right “next time”. Bah.

Problem is, now I feel like I’m under all sorts of pressure. What if I gain 10 pounds? What if I lose 10 pounds? What if I stub my toe? Oh, the stress! Well, no, not really. Actually, I feel quite unstressed. Finding out the insurance company likes me was a nice confidence booster. I know that my body fat percentage is a little high. Before, I just worried about it. Now, I’m actively trying to convert that fat into lean muscle. I have begun a strength-training regimen. I even ran a six-minute mile on Sunday. I haven’t done that in years.

Now that I have to take care of all of my insurance on my own, this is becoming obvious to me: American obesity is, in part, driven by employer health plans. Since the costs of health care are “hidden” to most consumers, the financial incentives to stay healthy are all but lost. Many companies are catching on to that and are starting to change, but the damage has been done. If Americans had to pay more out-of-pocket for their chubbiness, there would be far fewer chubby Americans. Financial incentives wouldn’t make everybody cut back on the donuts, and that’s fine. But millions would step up their weight-loss (or anti-weight-gain) efforts, and the effect on health care costs for everyone would be dramatic.

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The Comments

Dave K January 22, 2008 at 4:15pm

I completely agree that the BMI is crap.  Most professional athletes are obese by BMI standards.  I work out 6 days a week, am in excellent shape, and have a BMI of 28.8 (granted, that’s with a few leftover pounds from December, but I’m a wafer at 25).

I completely disagree that employer health plans have anything to do with obesity.  As we’ve seen with smoking, people will pay whatever they need to to ruin their lives.  So even if they were educated as to how much it costs to be obese (a point I’ll get to in a second), they would still eat Big Macs, Whoppers, and drink pop daily.


I don’t think people are completely in the dark about how much health care costs.  I’m sure a lot of people struggle with the correlation between obesity and health care costs, but that’s beside the point. But people do understand that health care is expensive, that’s why it’s a national political issue.  I think it’s safe to assume (as reality suggests) that peoples’ reaction to how much something costs is to insist the government pays for it.  So for most people, the solution to obesity being expensive is not to eat better, but to get the government to pay for it.

Mr. T January 23, 2008 at 1:00am

I think employer health plans do have an influence on obesity in the sense that it mitigates direct responsibility for one’s own health care costs, but more importantly, I think where they have the most impact is in what they DON’T do for employees. I’ve always thought that the best employer health care plans are those that more aggressively promote healthy behavior. I would love to have a plan that provided matching funds for say, a gym membership, even if that meant a (slightly) higher deductible.

But I agree that the link between health plans and obesity is still a minor factor. Bottom line is that we are fat because we just like to eat a lot (and eat a lot of unhealthy food), and don’t exercise.

Karin Dalziel January 23, 2008 at 7:26pm

If hidden costs meant fatter people, wouldn’t England and Canada have more overweight people, since they have state sponsored health care? It would be interesting to look at statistics.

I think Americans are overweight because the idea of eating well has become so horribly distorted. I have friends that swear by slim fast and don’t eat any vegetables- and think that’s healthy! Then there are diets like Atkins and such.

Mr. T January 23, 2008 at 8:28pm

That’s a good point. I know a lot of people whose idea of “eating well” is some designer frozen meal or Hy-Vee’s chinese food. Our food culture is kind of warped in some areas.

Swid January 23, 2008 at 8:41pm

Despite having the highest per-capita spending on health care in the world, we rank near the bottom among industrialized countries in several measures of public health (infant mortality, obesity rates, average adult height, etc.) So, if/when we move to universal health care, the bar for improvements has been set very low.

(Caveat: knowing how this country works, we’d still probably manage to make the worst out of any health care improvements. We also spend the most per capita on education at every level, but with mixed results: dismal for K-12; pretty good for post-high school.)

Mr. Wilson January 23, 2008 at 8:55pm

One thing to note with regard to our low rankings in some of those areas is that the data are sometimes skewed or misreported, or the ranking doesn’t reflect what it purports to reflect. For example, infant mortality rankings are heavily influenced by how the data are reported; some countries count stillbirths as infant deaths, while others don’t even count deaths within X time after a live birth, for example.

And of course there’s always the matter of making sure you know who’s doing the data compilation and what their agenda is. That applies to all statistics.

That’s not to say we’ve got it all right here in the U.S. We have plenty of room to improve, both in the private and public spheres.

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