Health care issues: Incentives for staying healthy

A look at key issues in the health care debate:

THE ISSUE: Should private employers offer incentives that encourage their workers to stay healthy?

THE POLITICS: The health care bill moving through the Senate would encourage employer programs that reward workers with lower premiums if they make healthier lifestyle choices. Some employers, like Safeway, already discount premiums for workers that meet certain standards for body mass index, quit smoking, or control blood pressure. Current regulations allow such incentives to be no larger than 20 percent of the total premium. That could rise as high as 50 percent under the measures lawmakers are considering. The insurance industry favors expanding these wellness incentive programs, but some critics fear they could discriminate against workers who don't fit an employer's idea of good health.

WHAT IT MEANS: Some groups like the American Cancer Society and the American Heart Association worry that lowering premiums for those deemed healthy will simply raise costs for people with health problems. Critics also are concerned the programs are a way for employers to weed out unhealthy workers and force them into different insurance plans. Much of the debate centers on whether it's right to use health insurance as the means to drive healthy behavior. That challenges traditional views of keeping health insurance affordable for those who need it most.

- Sam Hananel