The economics of changing insurance rates based on demonstration of a healthy lifestyle are simply to understand. Still, do we really wish to make it the responsibility of employers to enforce those lifestyles?

[State Health Insurance Commissioner Christopher F.] Koller explained that HEALTHpact was created, at the direction of Governor Carcieri and the General Assembly, as an alternative to high-premium, high-deductible, reduced-coverage health insurance that small-business owners have shunned.
It requires managers and workers to be more engaged in the process of buying health insurance.
To qualify for the least-costly policy under HEALTHpact, a worker must complete a “health risk assessment” that includes a pledge to lower body weight, stop smoking and participate in disease/case management. After that, there are regular assessments, and if the employee does not comply with the requirements, the deductible goes up — significantly.

It seems far more rational, to me, to make health insurance an individual thing and then to offer discounts — adjust premiums — to those who live healthily. Lowering my blood pressure and cholesterol shouldn’t be a concern of my employer, at least inasmuch as it doesn’t affect my performance.