Health incentive schemes far from proven

Insurance companies are still trying to come to grips with lifestyle incentive packages in order to attract a larger customer base

According to a representative for corporate giant Walmart, smokers use 25 percent more healthcare services than non-smokers. In an attempt to curb these rising costs, many employers and insurance companies have begun offering incentive programmes for employees. Insurance houses are also jumping on this trend, offering both positive and negative incentives for policyholders, based on their lifestyle and health choices. But do these incentivised programmes really work and how have they affected the financial success of the insurers offering them?

Many insurance houses have decided to embrace the trend of rewarding policyholders for wise health decisions. Humana, Inc. offers free items, such as camping equipment and hotel stays in the Caribbean for policyholders who voluntarily see a doctor and receive standard health screening tests. Blue Shield of California allows its policyholders in Sacramento to save up to $500 on insurance or medical costs if they complete health questionnaires and agree to have medical screenings.

The US government-run Medicare programme, which provides healthcare to the elderly, offers free weight loss counselling and a six-month programme extension for obese members who lose 6.6 pounds. Kaiser Permanente, another insurance giant, is willing to pay its policyholders outright. Members can earn a cash bonus of as much as $150, every three months, if they lose weight and keep it off.

AxaPPP has created the “Health at Hand” scheme, which includes a helpline with free health advice, as well as free screenings for BMI, cholesterol and blood pressure. PruHealth goes a step further, offering lower premium rates and even complimentary gym membership to clients who prove themselves “deserving” by making health and lifestyle changes.

But have incentives really led to company success?

While these programmes are intended to lower costs, not everyone agrees that incentives will be effective in the end. Corporations say that such rewards help them reduce their overall cost of medical care. One Humana executive said of the company’s incentive programme, “This is the next evolution in trying to squeeze costs out by not incurring them in the first place… it’s a giant leap forward in bending the healthcare cost trend.”

Industry analysts are uncertain about the long-term benefits of incentive programmes, since they have not been in use for very long. Other experts have said that the cost benefits from incentives will not appear on insurers’ bottom lines for at least two or three years. In the meantime, the cost of healthcare continues to rise as expected, but the amount of the increase may become smaller when incentive programmes are factored in.

Many analysts agree that offering a positive incentive for healthy behaviour may have a lower impact than “penalising” customers for unhealthy behaviour. Meredith Rosenthal, associate professor for the Harvard School of Public Health, said, “People are much more averse to losing something than they are excited about the possibility of a gain.” On the other hand, some experts have expressed their disagreement with these findings, saying that patients may experience a feeling of failure when they are “penalised” for unwise health decisions. In 2007, a World Health Organisation report stated, “the limited evidence suggests that penalising poor performance may reinforce individuals’ sense of personal failure.”

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The May – June 2013 Issue

Highest corporate tax
rates in Europe

European countries are scrambling to raise every last penny of funds through taxes. But some countries may have gone too far...

Belgium

Though all business taxes in Belgium can be paid online with little effort and preparation, the rates are still sky-high at 57.7 percent, including a staggering 50.8 percent total rate on profits only in social security contributions.

Belarus

In Belarus, a company spends up to 338 hours annually preparing for and paying ten different taxes and duties. The total tax rate has incredibly been lowered to 60.7 percent, from 117.5 percent in 2008.

France

A company in France pays seven different taxes and duties, the sum of which can amount to 65.7 percent of profits; though President François Hollande has announced a wave of business tax rate cuts coming up.

Estonia

A business in Estonia pays 67.3 percent of profits in tax, 37.2 percent exclusively in social security contributions. The country has gone against the grain in Europe by raising businesses taxes from 48.6 percent in 2008 to the current rates.

Italy

While corporate income tax (IRES) in Italy is limited to 38 percent of taxable profit, a company operating in Italy can expect to pay 14 other taxes and duties, including social security contributions, bringing their total payable tax to 68.7 percent of profits, according to the World Bank.

Norway

Norway taxes motor fuels twice, with a road use tax and a CO2 emissions tax. Combined with strikes in the energy sector that have curbed output, the price of gas at a local pump has soared to $10.12 per gallon.

Turkey

Though Turkey sits on the Suez Canal and neighbours many oil rich countries, the price of a gallon of average gas clocks in at $9.41 in Turkish pumps, because of a 60 percent share of taxes. 

Israel

Like Turkey, Israel is surrounded by oil-rich neighbours, but drills very little itself. Gas prices are controlled by the government, so about half of the $9.28 per gallon goes to taxes.

Hong Kong

There are few gas stations in Hong Kong, but the ones available charge up to 76 percent more per gallon than mainland China, where the government caps the cost of fuel. A gallon at the pumps will cost around $8.61 on the island.

Netherlands

Expensive labour costs make the Dutch petrol prices the dearest in Europe, at $8.26 per gallon; though the 57 percent tax add-ons don’t help.

The credit crisis

8 February 2007
HSBC warns of subprime mortgage losses

2 April 2007
New Century goes bus

14 September 2007
Wholesale markets have dried up

17 March 2008
Rescue of Bear Stearns

7 September 2008
Rescue of Fannie Mae

15 September 2008
Lehman Brothers file for bankruptcy

3 October 2008
US congress approves $700bn bailout

14 February 2009
$787bn stimulus approved by congress

 

The effects of the current financial crisis are global and irrefutable. With the collapse of Lehman Brothers, the domino effect of irresponsible public monetary policies, huge levels of unsustainable debt, and a deregulated financial sector, has escalated to the point where no corner of the globe has been left untouched.

1973 oil crisis

October 1973
Syria and Egypt launch an attack on Israel on Yom Kippur and set off a twenty day war;

1977
US President Carter creates Department of Energy, which develops the US strategic petroleum reserve

 

The Organisation of Petroleum Exporting Countries (OPEC) used their oil reserves as a weapon with the Arab Oil Embargo against those who supported Israel. By January 1974, world oil prices were four times higher than they were at the start of the crisis, especially in the US, and the shock led to a huge drop in the stock market with NYSE losing $97bn in just six weeks.  The embargo lasted five months, and the effects are still seen today.

German hyperinflation

1922-1923

Hyperinflation
1923 – 1924
Stabilisation

 

The trouble began when Germany missed a repatriation payment, worth about one third of the German deficit in this period. Inflation was already high but by 1923 it was raging. Prices doubled within hours, and by late 1923, it cost 200bn marks to buy a single loaf of bread. People burned money as it was cheaper than buying firewood. Germany eventually regained control of its economy when it introduced the Rentenmark into circulation in 1923, and then the Reichmark in 1924.

The Great Depression

1929-1933
The Great Crash
1934-1939
Recovery and Recession

 

After the decadence of the Roaring Twenties, the 1930s saw the biggest economic slump of all time. The stock market crashed on 29 October 1929, and optimism and decadent living tumbled along with the figures. The GDP fell from $103.6bn in 1929, to $66bn in 1934 and the subsequent years of recovery were the most dramatic in US history.

1907 bankers’ panic

1907
Otto Heinze and his brother Augustus Heinze bought shares of United Copper.

 

The stock market was already cautious over the tight money supply, but the US was thrown into a depression after the stock market fell nearly 50 percent from its peak in 1906. The Heinze brothers thought they could influence market shares but ended up bankrupting lenders that provided the financing to buy the stock. A chain reaction left nine institutions bankrupt. By February 1908, the panic was over and the government created the Federal Reserve system, to prevent banks from exercising too much control over the economy.