My grandma once gave me a sign that read, “Don’t drive faster than your guardian angel can fly.”

That said it all. In my late teens, I was not the most careful driver on the planet. My driving record reflected my lack of self-control, and I became rather familiar with frowning, mustached officers, and their speeches regarding all things safe and slow (During such monologues, I quivered my brow, and frowned appropriately… and then went back to speeding).

In fairly quick succession, everything changed. I began to spend hundreds of dollars on skyrocketing insurance rates. And, I got another speeding ticket... One more ticket would result in a lost license.

All of sudden, I went from a carefree speedster, to a vigilant-hands-at-10-and-2-follow-the-speed-limit guy. Within a couple years, my driving record was clean. My astronomical insurance rates began to fall and I was able to switch to a cheaper insurance company (cavemen and all).

So here’s my question. During the years when I was a risky driver, would you have been willing to pay my high insurance rates?

Um… That’s hardly fair, you say.

Well, do you think it was unfair of the insurance companies to charge me exorbitant fees?

Of course not, you say. You were a risk – both to your poor car and society.

True. I absolutely deserved those insurance rates and point deductions. Without those encumbrances, my automotive maturation would have been seriously delayed. But thanks to the carrot (lower insurance rates) and the stick (possibly losing my license) I reformed my attitude.

This brings me to health care.

Same questions: Do you believe that you should have to pay for another person’s risky health choices? Do you think that insurance companies should be able to charge people based on health factors?

Before you answer that, I’d like you to consider some recent findings by America’s Health Rankings:

* 27% of Americans are now obese. Just 20 years ago, only 12% of the population was obese (“obese” is defined as being 20% or above a person’s recommended weight).

*Since 1988, the average U.S. male has gained 17.1 pounds; the average female, 15 pounds.

*By 2018, 43% Americans will be obese. (1)

In summary -- Americans are getter fatter and fatter. And, like it or not, this increase in obesity affects us all.

Americans currently pay $361 per person for costs directly associated with obesity. That amounts to $86 billion, annually (ouch).

By 2018 we’ll be paying $344 billion per year. That’s $1,425 per person (quadruple ouch). (2)

So, in the next ten years, you and I are looking at a 400% increase in personal obesity spending.

In light of these facts, do you think that you should pay $1425 per year because of another person’s poor health decisions? And, do you believe that an insurance company should be able to decrease or increase fees based on health choices?

If you answered “yes” to the second question, I have some bad news. Under current law, incentives based on health factors can be no larger than 20 percent of the premium paid by employer and employee combined. (3)

That’s not much.

On a good note, some in Congress are taking notice. The Senate Finance Committee recently passed amendments that would allow employers to offer a premium discount of up to 30% those who meet certain health standards (standards include not smoking, normal blood pressure and cholesterol, and recommended BMI).

The amendments would allow the federal government to increase the discounts to 50%. Acceptations would be made for those who have medical reasons for not meeting the health goals.

Those are sweet incentives. There’s a carrot (better insurance rates, longer life) and a stick (higher rates, shorter life).

There’s evidence to back the Committee’s plan. In 2006, Safeway Inc. introduced Safeway Health Measures, a program that gives financial rewards for healthy living. In just three years, Health Measures has saved Safeway $150 million in health care costs. (4) Not bad.

Unfortunately, the House bill (ya, the one that passed) deleted the wellness provisions. (5) (Was it asking for too much personal responsibility?)

And, sadly, the Senate’s wellness amendments are buried in health care drafts that expand an already bloated system… But, at least a few Senators are finally talking about personal health care…

Legislation alone will never fundamentally alter America’s proclivity for paunchiness. But we need to start somewhere. And we need to start by allowing rewards for those who make wise decisions; and to stop promoting expensive Band-Aids that reward poor choices.

Our nation's health – and our budget -- depend on it.

(1) http://www.americashealthrankings.org/2009/spotlight.aspx
(2) http://www.americashealthrankings.org/2009/obesity/ECO.aspx#2008
(3) http://www.washingtonpost.com/wp-dyn/content/article/2009/10/15/AR2009101503036_2.html
(4) http://www.businessinsurance.com/article/20091122/ISSUE01/311229978
(5) http://www.passwellnessact.org/Legislation.aspx