"However, when you get sick that rate doesn’t go up, so there’s no incentive from your employers standpoint to fire you when sick."
Sorry but that's just wrong. Most large employers and even many smaller shops "self-insure" meaning they are footing the bill. Your health insurance company is just a front/conduit/paper pusher. In those cases, it is your employer who is ultimately deciding your prescription is not in the formulary, your jaw surgery is cosmetic even though you suffer from chronic headaches, etc. It is also your employer who sees that employee number 438 is costing them >> 1M/yr in covered medical bills (cuz cancer). They have every incentive to suddenly realize you are not working out for entirely unrelated (and fake) reasons.
Sorry but that's just wrong. Most large employers and even many smaller shops "self-insure" meaning they are footing the bill. Your health insurance company is just a front/conduit/paper pusher. In those cases, it is your employer who is ultimately deciding your prescription is not in the formulary, your jaw surgery is cosmetic even though you suffer from chronic headaches, etc. It is also your employer who sees that employee number 438 is costing them >> 1M/yr in covered medical bills (cuz cancer). They have every incentive to suddenly realize you are not working out for entirely unrelated (and fake) reasons.