The Scarlet "D," a take off on Nathaniel Hawthorne's Scarlet Letter, has been used to describe being unjustly labeled for society's perceived wrongdoing and can be applied to everything ranging from divorce to depression to diabetes.

With healthcare reform commanding our attention and the headlines, many suggestions have been put on the table as to how to curb the upward spiraling cost of health insurance, whose yearly increases can be in the double digits - and even upwards to a reported 29%.

One of the ideas on the table is that those that are healthier should pay less for health insurance. The idea is that the better you take care of yourself, then the lower your health insurance costs ought to be. Smokers, for example, would pay more for insurance premiums than non smokers. Those who exercise regularly and maintain a healthy weight would pay less than those who do not.

This approach makes sense since the basic premise of insurance is to base rates and insurability on risk. Health insurance is like all other businesses: one of its primary goals is to stay in the black. It is understandable that it needs to adhere to the basic principle of its business model: those that have higher risk factors should pay more. For example: If you own a house in a flood or earthquake zone, you probably will pay substantially more for home owners insurance (if you could get it at all) than someone who does not.

Yet often you can control where you own your home, but you cannot always control all of the elements that will affect your health. Take for example, a diagnosis of a chronic condition like diabetes. There is nothing that a person can do to prevent a diagnosis of Type 1; it's the result of a bad spin of the health roulette wheel. Although Type 2 has been christened as a life style disease -- a term used regularly to describe the condition -- sometimes not much can be done to stop the onset of it, with its contributing factors including: a genetic pre-disposition (which I have), a prior history of gestational diabetes, and environmental conditions.

It is little wonder that those managing chronic conditions like Diabetes feel branded with a "Scarlet D." Insensitive outsiders make you feel that it is your fault that you have this condition and  will ask why you didn't eat better or exercise more to slow or stop the onset of the disease. Furthermore, when it comes to the issue of group insurance rates at a company that provides health insurance, those with chronic conditions often feel almost wholly to blame for the skyrocketing cost of healthcare and health insurance rates. Those with holier than thou attitudes, which can include co-workers, human resource managers, and insurance representatives, can brand those noticeable chronic conditions, like Type 1, as the reason for the substantial yearly hike in premiums.

In support of this feeling was a comment to one of my recent posts, "Diabetic or Person with Diabetes": "I don't know about the rest of you but I'm going to just start wearing a scarlet D embroidered on my shirts. That way there won't be any confusion as to who [is a part of] that wasteful 20% of the insured [who] is driving up costs for everyone according to our HR representative at work. It will also make it easier to identify me when they down size to save on insurance costs and start rounding us up for relocation. I clearly contracted type one because of the terrible life choices I was making and will continue to be a burden on the system until I do the right thing and crawl out onto an ice flow."