BenefitsPro ran an article saying… Changing lifestyle choices could cut $730B in annual health care spending and that more than a quarter of all health care spending is due to conditions such as smoking, diabetes and poor diet.

“Nearly three-quarters of a trillion dollars in health care spending can be linked to modifiable health risks, such as obesity, high blood pressure, and smoking…”

There are three key strategies that would prove to be very effective towards changing lifestyle choices.

(1) Preventative – Individuals have a responsibility to be examined at least periodically (every two years, yearly as we get older – I will let the AMA set the standard) and get their immunizations. Those that do receive a premium credit.

(2) Wellness / Biometrics – Smokers should be charged more (no need to argue why, everyone should be aware of the added health risks and costs). Premium credits for those actively managing and meeting standards for blood pressure, BMI, cholesterol, and blood sugar level. People with obesity appear to have triple the risk of hospitalization with COVID-19, compared to people without obesity, the CDC reports. Being severely obese may increase the risk by 4.5 times. – All these biometrics are key indicators of health. Control these factors and receive a premium credit, those that do not should pay more. They are costing everyone else.

(3) Genetics & DNA – Technology is a great tool. Let us use it to help predetermine the medical conditions which we are predisposed. Not to punish people with higher costs, but to be proactive. A lifestyle change at an early age could help prevent certain illnesses. Information can be kept confidential with case managers and not shared or used with underwriting. – i.e. If you knew you had a family history of cancer, breast or colon, you could be proactive and monitor the signs. Same principle for other genetic diseases.

An important part of any health care discussions is preexisting conditions.  No one should be denied coverage due to preexisting conditions. However, no one should be allowed to burden the system who carries no insurance, goes to the doctor, learns they need medical care and now applies for insurance. They should be required to apply for insurance, bear a heavy portion of the medical expenses for a year or two (contracted rate), and have the carrier assign a case manager.

How do we pay for preexisting conditions? – Every transaction, buying aspirin, medical procedures, hospital stays – anything medical related – should be charged a ‘PreX’ fee of 1 penny (maybe 2 depending on the accounting). The money would go towards funding preexisting conditions, nothing else. If it raises more than is needed the surplus can be used for cancer or other medical research.



Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.