You clearly don't understand the point, nor do you have any grasp of the concept of a "slippery slope". Insurance is a method of pooling risk. Once you allow insurance companies to single out target groups for higher expense, based on legal behavior, you set the stage for all manner of intrusion into private matters and abuse.

And Mr. Thacker, while your innocent faith in the benignity of insurance companies is touching, you clearly don't realize that by overcharging EVERY member of a target group, regardless of whether or not they actually consume excess services, the insurance companies will garner further profit. You really don't think they are in business for the purpose of lowering your premiums, do you?

And btw, Mr. Thacker, do you drink? Are you fat? Any history of insanity in your family? Ever drive around in a small car? What's your cholesterol level? History of diabetes in your family? Do you ever exceed the speed limit while driving? Do you walk in high traffic urban areas? What's the radon level in your basement? Ever engage in anal sex? How about oral sex with an IV drug user?

You clearly don't understand insurance. Insurance companies make about the same profit regardless. The only difference it makes it whether non-smokers have to pay more to subsidize smokers, or whether smokers bear the full extra cost.

Yes, there are problems with genetic predispositions. But there are equally problems when people know their own predispositions, but the companies don't, and they go out and buy extra insurance. Moral hazard, don't you know.

If smokers can be singled out for higher premiums, so can drinkers, and fast food eaters, and people who engage in unprotected promiscuous sex, and people who might be prone to...oh, I don't know...sickle cell anemia.

Steve, you should run to your nearest bookstore and purchase a copy of "The Merchant of Venus" by Frederick Pohl. Then get "The Mystery of Capital" by Hernando de Soto. Together, they will help you understand the proper function of government in promoting and regulating capitalism.

This idiot is seriously proposing that we turn over power to insurance companies that any rational person denies to the government? How do lunatics like this get published? What’s next? Insurance company audits of genetic compatibility as a prerequisite for marriage licenses?

Again, this is the adverse selection problem. You can get a genetic test, find out you have the genes for a disease, then go out and purchase insurance to cover those costs. Since the insurance company can't see your genes you'd have an adavantage. Soon such markets would disappear and people would be left covering the entire cost themselves or the tax payer would.

There. Is. No. Free. Lunch.

Have you got that?

Although I suppose your premiums would be tax deductible.

That would be one way of dealing with the problem of using after tax income to purchase health insurance. Of course, there are a couple of issues here. If there is a tax exemption for health insurance, could there be one of car insurance? After all, people who don't have car insurance could be imposing (external) costs on the rest of us.

Still, I think even with a tax break for health insurance we'd see a decline in health care expenditures, at least the "frivolous" ones (plastic boobs, nose jobs, tummy tucks, viagra, etc.).

Although I suppose your premiums would be tax deductible.

Some may worry that we're on a "slippery slope," here that health insurance companies may soon factor in traits and habits such as obesity, regularity of exercise, or alcohol consumption, too.

But why shouldn't they?

This idiot is seriously proposing that we turn over power to insurance companies that any rational person denies to the government? How do lunatics like this get published? What's next? Insurance company audits of genetic compatibility as a prerequisite for marriage licenses?

In other words, if employers just gave employees the money and people were forced to buy their own health insurance, do you think it would go down significantly?

Probably. For one thing, that money would be taxed. For example, say your company paid $2,000 for health insurance. Instead it put the $2,000 in your pay checks. Now after taxes you might only get say $1,750. You'd clearly have to go with a policy that provided less coverage.

The other effects noted by Fersboo and yourself would also likely play a role. You certainly notice the cost of something more when you have to write the check vs. your employer.

I honestly believe that if I had to pay a couple hundred extra a month because I smoked that I would have quit smoking a long time ago.

Michael, the answers to your questions are yes, yes, and maybe (see point below).

Because the end-user does not bear most of the burden of healthcare costs in employer provided systems, there is little end-user incentive to manage the costs. The solution, brought about by legislation late in 2004, is called Consumer-driven Care and there is a good discussion at http://www.lifetimebenefitsllc.com .

Many insurance companies offer incentives for members to practice healthy lifestyles and preventive medicine. The short-term benefit to the end-user is a rewards program, while decreasing costs constitute long-term benefit.

Just a semi-related question. Do you think that, because employers have picked up such a HUGE amount of the healt insurance tab, we're overpaying?

In other words, if employers just gave employees the money and people were forced to buy their own health insurance, do you think it would go down significantly?

I think it would. I also think a great many people would stop engaging in high risk (and therefore, high premium) behaviours, like I just did when I recently quit smoking.

In fact, I think getting rid of group insurancve could have an amazingly good impact on both the economy and our health in this country.