"Will you actually get screened before you get coverage some day? I don't know," he said. "Personally I hope it never comes to that."
"This idea of charging differently based on behavior has gotten the attention of employers," said Paul Fronstin, chief health economist at the Employee Benefit Research Institute in Washington. "The question is how to implement it."
This should come as no surprise. Auto insurance rates are tied to behavior - tickets and accidents and DUIs.
Companies, who have done everything they can to negotiate prices down with the hospitals and the providers, are looking for new ways to economize, Cole said. Facing an obesity epidemic that will only make matters worse, companies are now looking toward aggressive wellness programs as a way to keep health care costs down.
But will companies choose to encourage good health care habits by rewarding people for lowered cholesterol readings or will they penalize employees for ignoring their doctors' orders to lose weight?
"When I work with employers, I encourage them to use the carrot instead of the stick," Cole said.
Fronstin sees the day when an employer says if you have diabetes and you don't follow your doctor's suggested regimen, your premiums are going to be 10 percent higher, or if you suffer a complication related to your neglect, your deductible will be $500 instead of $200. But if you follow your doctor's instructions, you will not have to pay a co-pay for your medicine.
"We are talking about getting people to be responsible," he said.
But I am worried about where this is going.
If I don't get a mammogram every year and I am diagnosed with Stage 3 breast cancer, do I have to pick up the tab? If I don't get my teeth cleaned every six months and I get gingivitis, is the gum surgery on me?
And what kind of credit - lower premiums, a rebate to my Health Spending Account - do I get for the fact that I am pretty sure my yoga classes made spinal surgery unnecessary?
And what happens if my employers find out about my little pasta problem?
susan.reimer@baltsun.com
