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Alabama to Charge Fat Workers

If you're overweight and work for the State of Alabama, it'll soon cause you $25 to work every month. Alabama, ranked third fattest in the nation (behind Mississippi and West Virginia) will be the first to charge state workers for not slimming down:

The state has given its 37,527 employees a year to start getting fit or they'll pay $25 a month for insurance that otherwise is free. [...]

The State Employees' Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don't have free health screenings.

If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program or take steps on their own to improve their health. If they show progress in a follow-up screening, they won't be charged. But if they don't, they must pay starting in January 2011.

Link

A sensible approach or is it just Big Brother?


Sounds sensible to me, especially since they're given the opportunity and the means to get healthier. If they don't want to do that, then of course they should start paying for the inevitable costs of their bad lifestyle.
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Any fool can make a law, but there will be problems in enforcing it fairly across the board ... state employment is a hierarchic bureaucracy with favoritism, corruption, and looking the other way if you have crony connections (or are at the top) rampant in these types of organizations.
Will it also apply to those who make the rules? There will be lots of loopholes and exceptions, you wait and see!
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Sensible until the charges..then it's Big Obnoxious Brother. Some people just can't lose weight through simple programs. Hopefully the screenings and health programs are going to be hands-on and unique enough to actually help each individual so the charges aren't necessary. But I know if I were charged with obesity (doesn't that just sound awful?) I'd go ahead and sue my employer because I know my body has been 'obese' since the 3rd grade despite my athletic lifestyle and small eating.
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pomokey : they're not firing anyone. These people still have the right to be fat and lazy as you say. The insurance for these people is probably costing the state more money, so the state is just passing along the extra cost. It's just like if you're fat you generally have to pay more for food and gas for your heavier car.
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Hmm, they're already charging extra for smokers, and now they're expanding it to address obesity as well ... part of me thinks it seems reasonable to ask that people take on some of the additional cost if they genuinely -are- in a situation where they -could- change their habits and subsequently lower the amount that must be paid for their care over the years (yes, I realize that not everybody CAN lose weight but I'm thinking primarily of those who can here) - according to the article, "research shows someone with a body mass index of 35 to 39 generates $1,748 more in annual medical expenses than someone with a BMI less than 25, considered normal" ...

I suppose in a way it's not that Big Brother is -forcing- anybody to lose weight, simply requiring that they shoulder some of the financial consequences if they don't ... But on the other hand this DOES seem like an awfully slippery slope, how DO you decide what lifestyle choices/situations should come with an additional price tag and which ones don't? There just doesn't seem like there -is- one right, 100% fair answer here ...
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1) Using BMI as a health guide is ridiculous. It was written in 1850 to chart the average Belgian's weight to height during that period. EVEN AT THE TIME, IT WAS A STATISTICAL CHART AND WAS NEVER INTENDED TO SUGGEST WHAT PEOPLE "SHOULD" WEIGH. Agreed, some standard should be reached, but the BMI chart says everyone should be "heroin chic" anorexics. So why does it remain the standard? Because it allows insurance companies to have higher premiums, why else.

2) Talk to any overweight person (especially if they're over 30) and they'll most likely tell you how they once lost weight, eventually gained it back plus some, and were never able to lose it again no matter how hard they tried. Honestly, if it was a simple question of "self control" or whatever else people who have been slim all their lives imagine it to be, don't you think everyone would be slim? Would there be a billion dollar diet industry that fails again and again to actually help people?

This is extreme "big brother," "forced nanny-state" - pick your term - idiocy, merely designed to rake in a few more bucks with the lie that if you have to pay, it's your own fault.
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It seems discriminatory on the face of it, but WOW, health insurance for only $25 a month? These folks are tres lucky! And if they are healthy, its free! The rest of the world doesn't work like that.

Well, Europe does...
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Slippery slope indeed. Want to smoke? Want to not use your free time for an exercise program? Want to have a large family? Want to not brush your teeth? Want to wear high heels? Want to have unprotected sex? Go ahead, pay the toll first.
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Pretty much everyone is at risk for something expensive. Women could ring up higher bills because we live longer. Childbearing is expensive. Some people have genes that predispose them to cancer - should they be charged more after a positive PSA or brca1 test? Where does it end? Should ugly people get a discount since they're at lower risk for STDs? I totally agree with wellness programs that encourage healthy behaviors, but the whole point of health insurance is risk pooling.
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In my human resources class we talked about this. It's completely legal and not considered discrimination. They're not excluding the oveweight people from being able to work and they're not denying them insurance. About the smoking thing- Some companies already have a non-smoking policy where the employees aren't even allowed to smoke outside of work. Crazy. But true.
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Ugly people don't have less sex, jenjen. It just takes a bit more alcohol than usual - which kinda helps with any liquor taxes.
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My thyroid is utterly screwed. My TSH level is the worst the doctor has ever seen in someone who still had a thyroid, so I'm put on medication. Medication that's caused horrific side effects (rapid heartbeat, can't breathe. You really feel like you're going to die.) I am overweight, but regardless of what I do, I don't lose it. My metabolism is boned, and unless a med is found that doesn't cause chronic side effects, I'm screwed.

This is a bullshit solution to an irrelevant problem. Seriously, do some research if you believe this crap.
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So people who've had insulin-dependent diabetes from childhood, people with familial high blood pressure or hypercholesterolaemia who are already doing as much as they can to control it, weightlifters and bodybuilders, all these people "deserve" increased health insurance premiums?

With the "progress" definitions, it sounds like the way to go, pragmatically, would be to push your cholesterol and blood sugar and weight as high as possible for the initial assessment. Then just demonstrate that you've "made progress" in reverting towards the mean. Voila.

Or, y'know, just bring in universal health insurance, and consign this sort of red-tape disaster area to the bureaucratic dustbin where it belongs. You can guess who is winning in this game, and it isn't employers or employees or healthcare workers.
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sort of sucks for them-- they're shunned from society, some of them have tried dieting and it doesn't work, others have diabetes which makes dieting twice as hard, other diseases/medications make you gain weight... Thats pretty horrible. This is the capitalistic way to deal with the issue-- I think encouraging insurance companies to offer healthy lifestyle choices would be a better choice than throwing extra change in their pocket-- it takes years to take the weight off obese people (assuming they don't just get surgery/an eating disorder).
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Since the option to get whatever treatments are necessary to get healthy is totally free, I see no problem with it. It would be unfair to expect employees to pay for weight-loss programs or whatever else was necessary to avoid the surcharge. But since it doesn't cost them to get healthier, if they opt to not do it, they should have to pay. They are making a conscious choice to be unhealthy and cost the system more, so the cost of their decision should be passed on to them.

The program should be really written,though. With well defined standards and with well defined exceptions. Like that you should have to fail more than one standard to have to pay the surcharge. Like if you fail the cholesterol test AND the BMI test or the blood pressure test and the weight test. That way people that are obviously fit healthy people with one strange characteristic aren't charged unfairly. Like I saw something once where they were showing pro athletes, obviously at the peak of health, and that their BMIs would be considered obese. Also there should be noted exceptions for people with other medical conditions that would make it impossible for them to get fit enough to meet the standards. I'd hate for someone with a serious heart condition to be expected to excercise enough to be fit or someone with an untreatable thyroid condition fined for being heavy.

But seriously, even with the surcharge, it's 25 dollars a month. I'd be THRILLED to only pay 25 dollars a month and have health insurance! Absolutely delighted!

Maybe health insurance should be more like car insurance, with statistical risk factors factored into what rate you'll pay. A 24 year old single man with a red sportscar and a bad driving record is going to have to pay more for car insurance than a 50 year old married father with a mini-van and perfectly clean record. It makes sense. It works that way with home owner's insurance,too. It costs you more to insure a house on a Florida beach than it does a house where there's no chance of hurricane damage. Why not health insurance? If you have known risk factors that are going to cost more when the insurance has to pay out, why should your rates be the same as people with bodies that are known to be cheaper to maintain? And it's still a bargain if you have to pay the higher rate, since your risk of needing the insurance is higher. Like if you're the young guy with the sports car, yeah, you are likely to wreck, so it's worth paying more to have insurance to cover it when it happens. If you're the morbidly obese chain smoker, you're likely to have a heart attack, so it's worth paying more for insurance to cover it when it happens. If you're a safe driver with a safe car, you aren't as likely to ever use the insurance, so it's better for you to have lower monthly premiums. If you're a healthy person, you aren't as likely to be hospitalized, so lower monthly premimums are a plus.
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No need to panic, people. All they have to do is make progress. Nobody's expecting them to become size zero supermodels. Even with underlying conditions like hypothyroidism or diabetes, positive changes in diet and/or lifestyle should make some sort of difference.

It baffles me that people wouldn't want to be take advantage of something like this and improve their health. Sure, you have a right to destroy your body... but if you're going to do so, you shouldn't expect other people to foot the bill. If you want to remain big and "beautiful", don't expect your employer or other taxpayers to pay for it. It comes down to personal responsibility, and that's something that a lot of people still don't want to accept.
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Fat is the new smoker. The more Government can take over you life, the more they will. Just wait, they will start taxing per pound for every pound over your "Body Mass Index".

If they were smart, they would leave Alabama. If people started moving out, they would change the law.
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I think it's really inappropriate to take this kind of action. Positive incentives will be better received. Instead of taxing and punishing fat people (who might be overweight because they are on antidepressants or have thyroid problems), why not add social programs encouraging healthy lifestyles, including education about nutrition and physical exercise? This program seems geared to encourage weight loss at whatever cost, as quickly as possible, which is bullshit, the least healthy and least effective way to go about it.

This is such Puritanical witchhunt tripe. Why not start off schools with gardening/cooking classes and good PE, and try to find a longterm solution?
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Seems grossly unfair. I wonder if they charge extra for employees with spouses or dependents covered by insurance, which has to be a much bigger cost. Or older employees. Not to mention not exercising is worse for your health than obesity. I bet it's just that "everybody" loves to rag on smokers and fat people now, so they're easy victims for wage cuts. I do not approve.
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