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Health problems and difficulties have been main problem across the world. There have been several reports on cases where individuals fall ill but have no money to be cured or unable to pay for the health care bills. In North Carolina, this has been the situation with many people falling ill but lacking accessibility to high quality medications. It is therefore due to this fact that healthcare insurance companies were introduced in North Carolina and all over the world. However, objective of introducing these healthcare insurance companies was that so as they should be in a position to help people particularly those who can't raise money for their bills, to have access to high quality treatment and within short possible time. In order to be insured therefore, an individual is supposed to pay a premium which is initial cost for being insured under certain insurance company. This is therefore the case where contradiction has risen from in North Carolina with many people coming up with many different debates, opinion, and views. In North Carolina, there has been a question of whether premiums for health insurance for state employees should be based on weight/smoking.


At any given time, obese and smokers should not be given a chance nor be allowed to pay same insurance premium with other groups of insured individuals. Even though actuaries employed by the insurance companies are ones that determine insurance premiums. The cost advertising, paying for services rendered by healthcare practitioners, selling, administration of the insurance program in addition to the investment of premium payments and a profit margin are factored into premium amount. Exposure to risk is determined by actuaries in accordance to the provisions of the insurance policy and then lay down a premium rate (Zedlewski, 39). Extra underwriting factors like adverse selection for personal policies and particular industry exposures for employer-sponsored group health insurance plans are also factors of charged premium.

According to Hudman et al. (12) the premium is usually charged on a personal plan is very high when compared to the premium charged for the same coverage provided through a group plan as a result of the adverse selection. An insurance company can determine under group plans that certain percentage of participants will be in good health generally. On the other hand, it is more probably under personal plans that individuals in poor health and having a great requirement for insurance will seek purchasing coverage which is an adverse selection, is an outcome of the basic premise that those individuals in good health don't have as much need for insurance when compared to the individuals who are not in good health.

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North Carolina should start to charge high premiums for obese workers registered in their state health insurance plan. Anne Rogers- director of integrated health management with the North Carolina State Employees Health Plan said that "Tobacco use and meager nutrition, and inactivity are the forefront causes of preventable deaths in their state. They are hence attempting to encourage people to adopt healthy lifestyles (eHealthInsurance, 3)."

No you are attempting to save cash and that is a good thing. Notice has to be taken by the federal government. This is because Medicaid and Medicare are ones that pay half of the entire medical costs for the obese and overweight and these are actual social costs of obesity. And they are in existence due to the fact that weight related premiums are not charged by the public health plan, they don't charge at all. Costs of obesity will be therefore internalized and most support for fat taxes using the external argument will be ended by the weight related premiums although it is not clear how this will be done by an individual when health care is offered by government other than health insurance (Rodgers, 44).

Tobacco and weight seems to have been targeted by private sector employers under their insurance pricing ahead of state health plans. For example, Tim Smith (president of BioSignia, Durham) said that they have started to see many employers developing high interested in this plan that offers private employers with a system of measuring risk factors for a worker for the beginning of a chronic disease. Smith said that "Aggregated data alone is presented by the company to the employers and doesn't reveal information about individual (Hudman et al., 8)." He also says that he is not sure in regard to which degree private insurers practicing weight discrimination though it is happening. It is probable that the non-obese in the risk pool would be financing the higher health costs of the obese in case they were not cared for. Smith also says that he don't know why all insurance companies wouldn't raise premiums on the obese apart from possible administration costs since are profit driven (eHealthInsurance, 4). It is therefore our hope that they will go on with this trend under coming health insurance health price controls. This is due to the act that the bigger the public health plan, the severe the price controls, the larger the obesity externally- and the more of a motive for food taxes.

When regarding statistics, the task is intimidating. Overweight and obesity conditions contribute as much as 93 billion dollars to the annual medical bill of the nation in accordance to the studies reviewed by the Washington, D.C. - based non-profit organization called National Business Group on Health which represent large companies (Zedlewski, 56). The total cost of obesity to United States companies is approximated at over $13 billion of $93 billion, a price tag that comprise $8 billion for health insurance costs that was added, $2.4 billion for paid sick leave, $1.8 billion for life insurance and $1 billion for disability insurance. This translates into 39 million lost work days, 239 million days where work activity is curbed, 90 million sick days or days spend in bed and 63 million visits to physicians, this are in accordance to the recent studies on the economic cost of workplace obesity.  

The following statistics has also been collected about health care coverage in North Carolina (eHealthInsurance, 4)

Total North Carolina Residents

North Carolina Uninsured residents

Total North Carolina HMO enrollment

Average annual employee premium in North Carolina employer-sponsored plan after employer contribution

Average North Carolina hospital cost per inpatient day before insurance

However, it is of great significance that obese and smokers should state employees should pay high insurance premiums when compared to other groups of people and state employees. This is due to the fact that high payment of premiums by smokers and heavyweight individuals is also will play a great role in reducing excessive smoking and excessive feeding. Once an individual heard of high insurance premiums for smokers, he will start to look for ways out to stop smoking. When they stop smoking due to high insurance premiums, they will be less exposed to diseases like lung cancer, among many others that are due to smoking. Similarly, heavyweight people will also be afraid and start looking for alternative; they will reduce their meal's consumption and start doing physical exercises other then waiting to be insured. This will reduce cases of diseases among these people immensely (Rodgers, 22). Therefore, high premiums paid by state employees based on weight or smoking is not only for the benefits of light weight and non-smokers and the poor or people who can't raise insurance fee but also for their own benefits in that they will be now in a position of preventing disease attack other than waiting to be treated diseases by insurance companies.

In general, it is of great significance that premiums for health insurance for state employees in North Carolina be paid in regard to the weight and smoking. Overweight and smokers should pay high premiums when compared to non-obese and non-smokers. This is because it will enable all people across North California to have access to heal care and also help to reduce cases of smoking and overfeeding that are proved to be a major threat on the human life. It will also enable smokers and heavy weight individuals to see the need of doing away with such behaviors that are threat to their life and community life. This will also lead to reduced cases of disease attack thus resulting to reduced need of health insurance companies.

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