Incentives/Penalties with Medical Insurance for Obesity

So recent data was presented at ACC demonstrating monetary incentives work well to get people to lose weight.  In addition, the data demonstrated monetary penalties worked even better.  So what does this mean for the future of health insurance in the U.S.?  Life and disability insurance have underwriters that take into account BMI, smoking, and other diseases when writing a policy and determining a premium if they decide to issue the policy.  However, medical insurance, at least commercial (not self-insured employer plans) have community rates that do not take into account BMI, smoking, excessive alcohol or illicit drug use.  And the Americans with Disabilities Act recognizes obesity and alcohol addiction as disabilities and employers are not to discriminate.  I am interested in where our National Healthcare Plan will take us over the next few years and wonder whether more litigation will be ahead of us if penalties are put in place. 

Cleveland Clinic has a policy not to hire smokers - even if they do not smoke at work.  Smoking is highly correlated with mental illness, so one could say that it is discrimination, but the policy stands.   Actually overeating/obesity is also correlated with mental illness.  If someone consumes too much alcohol off-hours it will impact their job performance - or even if they just stay up all night having sex or playing Words with Friends :). Smoking, drinking, overeating, and not exercising are all modifiable risk factors that impact a person's health.  It is apples to apples if looking at absenteeism, negative impact on health, and loss of productivity. 

However our country voted for this, so if we accept government issued healthcare, we will be required to play by the rules set forth in the legislation.  If the government is accepting the risk and requiring health insurers to accept the risk without pre-existing conditions, it is reasonable to think that they should have the right to make sure the insured (general public) are doing everything they can to prevent illness so we can reduce costs and provide coverage for everyone.

And on a final note, what's good for one should be good for all.  If small businesses and individuals are required to follow the rules set forth in ObamaCare, then government workers, unions, and large employers should be as well - the "get out of jail free cards" being issued to appease groups that voted for our president and for the congress and senate that signed the bill are atrocious.  Healthcare reform is needed.  But our corrupt government practices that exempt corporations, unions, and those who passed the healthcare reform legislation are indefensible.