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Comment by admash | Hacker News Reader

If a policy holder:

  * completes a smoking cessation class
  * has a mammogram/pap smear/PSA test/colonoscopy
  * has cholesterol levels checked
  * attends a monthly diet/nutrition group class
  * attends a participating gym twice a week

then discount the insurance premium appropriately for each positive lifestyle behavior.

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> attends a participating gym twice a week

I exercise at least an hour every day of the week, I cycle, walk, or lift weights in my home gym. How would I prove to my insurance that I'm in fact working out? I rarely miss a workout, but your proposed mechanism would make me pay a higher premium despite being way more active than the average policy holder.

Could be a free fitness tracker they provide you? Or you share your fitness data from Apple health with their app?

It's not such a crazy idea. There are already car insurance companies that give you discounts by putting a GPS tracker in your car and bill you based on driving behavior.

Even if we were to accept the privacy invasion that would entail, it would most likely only work for the cycling and walking (average speed, distance) but it wouldn't really work for lifting weights. There's not really a way to see how hard I'm straining on my deadlifts, squats, pullups, etc.

I'm sure there will be similar issues for other modalities of exercise and training as well.

All they'd need is a heartrate monitor to cover every type of exercise. Some healthcare companies already offer monitoring for a discount as well. The most common I've seen is a pedometer that reports if you've reached a target amount of steps during a day, but I've also seen companies that can track heartrate through an apple watch.

Heart rate is not really a useful metric when lifting weights to be honest. My heart rate might spike a little when I do a set of heavy deadlifts, but putting away the plates afterwards sometimes feels like more of an exercise than the lift itself.

And then there are the cases where wearing a monitor around your wrist or chest might not be such a good idea or impractical (I can imagine ring gymnastics being one). I fear this is one of those cases where technology simply falls short. Some problems are more social than technical.

Is it a privacy invasion when you volunteer to a friend where you work out?

Engaging consensually in a business transaction where you volunteer information willingly is not a privacy violation unless the market is broken (like, for example, ISPs or GSM carriers).

> Engaging consensually in a business transaction

Healthcare is not a business.

If it's provided by other people who are not themselves enslaved, it absolutely is. Maybe a state-subsidized one, but money is changing hands for services whether it comes out of your pocket or not.

Further, we're not talking about healthcare. We're talking about de-risking potential future financial liability by purchasing insurance.

Insurance is absolutely a business.

> If it's provided by other people who are not themselves enslaved, it absolutely is.

What a leap.

> but money is changing hands for services whether it comes out of your pocket or not.

It doesn't mean it's a business in the sense of "commercial activities"

> Further, we're not talking about healthcare.

Let me see:

- we're in the comments section to "World Health Organization: List of Essential Medicines"

- dicsussing denying people healthcare based on invasive monitoring of their activities

Yes. We're definitely talking about healthcare.

> Insurance is absolutely a business.

It definitely is. Especially in the states. And in case of healthcare it definitely shouldn't be. And it definitely shouldn't be advocated for.

That's basically what Vitality does https://www.vitalitygroup.com/

This is just a coupon scheme for rich people. If you have the time and energy to jump through the technical hoops, you get the discount.

Plenty of people go through the gym gate, meeting the Vitality discount condition, and then sit and read a newspaper.

AFAIU their model is successful because incentivising people to make healthy life choices really does reduce their actuarial predicted health costs - so on aggregate the cheaters can't be that significant.

My health fund actually has some kind of fitness app which you earn 'points' in for doing various healthy things. I haven't used it but from the sound of it, it's not far off what you're suggesting here.

I think this idea is good in theory, but has practical problems:

- Privacy concerns

- Administrative overhead

- Potential for fraud/people losing coverage if they miss attending their gym

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