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Chapter 6: Employer's Healthcare Costs
Terms in this set (55)
More than ____ of premature deaths in the U.S. result from
unhealthy behaviors, such as smoking, diet, or failure to take
medications as prescribed.
Employers are taking two routes to improve the issue
1.Invest in improving the quality of employee health care
2.The other trend is shifting the costs of this improvement to employees
The second option might give ___________ savings but might also lead to long-term health problems and added costs.
Although _____ of employers' health care costs are devoted to medical treatments, medical treatments affect only_____ of individuals' health status.
tailors medications and other treatments to individual needs so patients can develop healthy lifestyles and block preventable diseases from ever arising, or minimize their deleterious effects once developed.
getting people involved in their own health care while preventable diseases can still be prevented; includes smoking cessation, weight reduction, and medicine and treatment regimen adherence programs.
US ranks _____ in life expectancy and preventable chronic diseases affect half of all Americans, the highest rate of any other advanced country.
Key culprits of the rising health care cost Smoking
Employers spend ______ on health care costs
______ are costs from preventable behaviors
($)______ to ($)______ for overweight
$6 billion to $37 billion
($)______ for treatment non-adherence
Despite widespread awareness and acceptance of the risks of smoking, ___ in ___Americans still smokes.
1 in 6
($)______ to ($)______ for obesity
$129 to $147 billion
_____ to ______ ($) for smoking related diseases and chronic health conditions
$289 billion to $1.2 trillion
Employers spend an estimated ________ on health care costs each year
In addition to this direct cost smokers..... (3 things)
smokers miss work more often due to illness, take longer to recover from common illnesses, and take more breaks throughout the average workday than their nonsmoking coworkers.
Smokers cost the US Economy ($) _______ a year
adverse health effects from smoking account for __________ deaths annually or nearly __ in every ____ deaths.
440,000, 1 in every 5
Employers pay as much as _____% more in health care costs than that paid for nonsmokers.
_______ smokers suffer from serious illness attributed to smoking, including ___% of the lung cancer, coronary heart disease, and chronic obstructive lung disease.
8.6 million, 90%
___ out of ____ adults in the US aged ____ years or older are overweight or obese.
7 out of 10, 20 years
The effects of being overweight are comparable to having ___________ or ___________; it is a true diagnosable disease that affects life expectancy.
having diabetes or high blood pressure
Obesity is now considered a trigger for health problems and increased health care spending fast becoming comparable to __________.
Is BMI is calculated the same way for both adults and children?
Formula for BMI
(lbs/inches)^2 x 703
BMI Below 18.5
BMI 30 or above
The annual cost burden of obesity on public and private health insurance will be as high as ($)____________ per year—new 2018 data.
A type of arthritis that occurs when flexible tissue at the ends of bones wears down.
Diabetes is a _________ disorder characterized by......
chronic metabolic, high blood sugar, either b/c the body does not produce enough insulin or b/c cells do not respond to the insulin that is produced.
Type 2 diabetes occurs when your body....
either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain normal glucose levels.
Type 1 diabetes, is a chronic condition in which the pancreas _________. Also called _________ diabetes.
produces little or no insulin, insulin-dependent
The link b/n obesity and diabetes is so strong that the term "_______________________" is becoming common.
obesity and with it diabetes
Employees who are forced to pay higher insurance premiums based on lifestyle behaviors would have no recourse under what federal laws? (3)
1. Americans with Disabilities Act of 2006
2. Civil Rights Act or similar state enactments
3. Invasion of Privacy
True or False: 6 out of 10 adults in the US aged 20 years or older are overweight or obese.
The middle approach has two benefits.
Offset at least some of the employer costs inherent in hiring these employees.
B/c it operates as a surcharge, it provides an incentive to employees to adopt healthier lifestyles.
Relieve employees from bearing health insurance costs not attributable to their own behavior.
It makes employees accountable for their behavior.
Some employers use the ____________ approach by opting to pass on health care costs attributable to unhealthy lifestyles to those employees who smoke, or are overweight or obese.
A smoking-cessation study at General Electric found that smokers who were offered __________ incentives to quit smoking were almost ___ times as likely to remain smoke-free, compared with smokers who tried to quit without financial incentives.
Dieters who received ____________________ are more likely to lost weight more quickly than those who did not.
Even if employers are prohibited, either by law or their own policies, from discriminating against those with higher than average health care costs, it is very difficult to _____ that this is what the employer has done in any given case.
The only protection from employment discrimination that smokers can rely on exists in the form of state laws prohibiting employment discrimination based on tobacco use, which exist in ______ the states, almost all of which are under challenge.
One of the most popular incentives has become health insurance discounts to ________ (up to _____) and those willing to submit to _______________, including level of treatment adherence and monitoring of blood pressure, cholesterol levels, nicotine use, and weight.
nonsmokers, 50%, health risk assessments
Approach 1: Many employers have enacted policies precluding the employment of smokers (WHO, airlines, health care orgs).
Approach 2: Others employers have passed on the additional costs attributable to smoking to the employees who smoke by charging them more for health insurance.
Which approach is more effective?
Smoking opened the door for employers to also think about obesity, another leading preventable cost to the U.S. health care system.
Employers' considerations of smoking, obesity, & treatment adherence do not usually violate privacy interests.
Dynamic pricing (DP)
rating of premiums for health insurance based on lifestyle choices such as smoking, weight status, or medication and treatment adherence behaviors.
Civil Rights Act of 1964
Prohibits discrimination in employment based on race, color, national origin, sex, or religion.
You cannot be protected under this law if you have high BP
Americans with Disabilities Act of 2006
Americans with Disabilities Act of 2006
Prohibits employers from discriminating against disabled people on the basis of their disability with regard to employment (application, hiring, advancement, or discharge), compensation, or job training.
B/c of high health care cost, employers are introducing lifestyle discrimination policies against
Smoking (widely used but expanding to these other areas)
________ to ______of Americans fail to take medications as prescribed, which then increases the severity of their ______________.
One-third, one-half, chronic diseases
Although individuals are largely responsible for managing their weight and controlling their susceptibility to diabetes, at the same time, successful long-term weight management is in part influenced by ______________ factors (and ____________ factors).
While debate often revolves around whether diabetes is a _________ or _________ responsibility, in reality it must be both.
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