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To the Editor: In his Commentary on law as a tool to facilitate healthier lifestyles, Dr Gostin¹ overlooks an important category of legal interventions that may help to control obesity—legalizing incentive-based health plans. In many states, health insurance carriers are limited to pricing policies in the small group market based only on the age, occupation, and address of the insured. Designed to protect individuals with pre-existing medical conditions, these restrictions prevent carriers from giving discounts based on behavior.

Federal regulations make a distinction between behaviors and conditions, and allow behavior-based incentives.² Unfortunately, many states do not. Actions such as tobacco avoidance, exercising, undergoing a health screening, receiving vaccinations, participating in diabetes education, filling prescriptions, and showing up for appointments are all behaviors that may lower health care costs. Insurance carriers should be allowed to share these savings with their clients. Imagine automobile insurance if premiums were unrelated to driving behavior. . . . [Full Text of this Article]

Tom George, MD
sentgeorge@michigan.senate.gov
State Senator, 20th District, Michigan Senate
Lansing

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