Fat Tax....

[sg1987]

I love it...long overdue....:munchin

Alabama Plans to Tax Fat Employees to Recoup Insurance Costs
Tuesday , September 02, 2008
By Jana Winter
Fox News


Alabama is rolling out a creative but controversial program that will subject its 37,527 state employees to possibly humiliating at-work weigh-ins and fat tests. If they tip the scales, they'll be given a choice: slim down or pay up.

The state is trying to solve two of its biggest problems — health insurance costs and obesity — in one fell swoop.

Beginning in 2010, Alabama, which has the second highest obesity rate in the country, will start charging all of its employees an extra $25 per month for health insurance. (Currently, single workers pay nothing; family plans cost $180 a month.)

But there's a way to avoid the fee: Get a check-up at an in-office "wellness center," where nurses will check for diabetes and hypertension and measure blood pressure, cholesterol, glucose levels and Body Mass Index (BMI).

The idea is to encourage employees to act responsibly, lose weight and lower their health care needs. But critics say it will humiliate and stigmatize obese employees and amounts to nothing short of a "fat tax."

A BMI test uses height and weigh measurements to calculate the percentage of body fat in adult males and females. Alabama is using a BMI threshold of 35 — 30 is considered obese, by most medical standards — to determine who doesn't have to pay the automatic $25 deduction.

Health practitioners often factor in skinfold (fat) and waist circumference measurements while calculating a patient's BMI.

Does Alabama think you're fat? Take this humiliation-free BMI test online.

If you're deemed fit, you're exempt. But if you flunk the BMI exam, it's shape up or pay up. Obese workers will be required to see a doctor and will have to show proof of their attempt to lose weight.

The program is optional ... sort of. If you don't take the tests, you'll have to pay the $25 charge.

The $25-per-month fee is not the only way Alabama hopes to discourage bad health decisions by state employees, said the program's creator, William Ashmore, executive director of the Alabama State Employees' Insurance Board. Alabama already charges smokers a monthly $25 insurance fee.

"There are folks walking around with diabetes and hypertension that don't even know it, and it's just a matter of time before something catastrophic happens to them," Ashmore said. "If we can get people to manage their health, we'll have healthier employees and less healthcare costs."

He said employees with a BMI of 35 or higher cost the state 40 percent more than those with a BMI under 35, and the program will help in many ways. "This is not a fat tax," Ashmore said. "It's not punitive."

But that's exactly what critics are calling it: a punitive "fat tax" designed to stigmatize the obese by inappropriately — and possibly illegally — bringing weight into the workplace.

"This is a dreadful, dreadful policy," said Judith S. Stern, an obesity expert and nutrition professor at University of California at Davis. "Overweight and obese people, especially women, feel that their weight is private, and being weighed at work is like having a prostate exam in the hall. It's not appropriate."

Critics also say Alabama's program borders on discrimination by using obesity, which is medically categorized as a disease, as its benchmark.

"I think it discriminates against people with a disease — obesity is a disease," Stern said. "Would you charge more money if they had breast cancer?"

Alabama's program is a dangerous step on a very slippery slope, says Mark V. Pauly, professor of health care systems at the University of Pennsylvania's Wharton School of Business. "The unanswered question is, 'How much you want to do this?'" he said. "If you got lung cancer because you smoked, do we charge you a penalty there? What about couch potatoes? Do we put all the employees on treadmills?"

Medical and social considerations aside, other critics say it's just not going to work. "There's the thought that obese people are weak-willed, and if we charge them more they won't be as fat," Stern said. "This assumes they have control over what's involved, and often they don't."

And there's the cost factor. In its efforts to reduce heath care costs Alabama will spend an extra $1.6 million for health screenings and programs next year.

"From the viewpoint of the employer who provides health care and pension, this kind of cancels out," Pauly said. "What you lost on health care you get back in pension plan, because now these people are living longer."

Whatever the plan, a company's success in lowering health care costs and curbing obesity could depend entirely on how it's framed. Rewards tend to work better than punishment.

"It's possible to set these things up to look like more like carrots than sticks," Pauly said. "And people tend to respond better to carrots."

Alabama isn't alone in its struggle to cut costs and curb obesity. Two-thirds of American adults are overweight or obese, according to a recent report from Trust for America's Health, a nonprofit organization based in Washington, D.C.

Clarian Health Partners, a hospital chain in Indiana, has taken a different approach. In 2009, they will start deducting money from the paychecks of workers who do not meet — and don't show efforts to meet — various health criteria. Smoking without trying to quit will cost $5; high glucose, high blood pressure and high cholesterol levels will cost $5 each; a high Body Mass Index will cost $10.

This is also happening abroad. Japan is monitoring the waist measurements of its policyholders, according to official government websites. Citizens receive jury duty-like summonses to appear for measurements — and if they're too fat, their employer will be slapped with a hefty fine. The maximum waist size allowed for men is 33.5 inches and 35.4 inches for women.

It's unlikely that Japan's program will catch on stateside, but that doesn't mean Americans are off the hook. Alabama's so-called "fat tax" could just be the beginning of a trend.

"A lot of employers are talking about this," Pauly said. "There's the feeling that you have to do something. What you do then is a matter of design and discretion."

As for Alabama, Ashmore is sure that those who have their doubts will soon come around. He encourages workers to swing by his Montgomery office to pick up pamphlets about the program and to learn more about reducing their Body Mass Index.

But to get to his second-floor office they'll first have to make it past the Chick-Fil-A downstairs (average meal: 1,000 calories).

[Team Sergeant]

Where's the aclu?

I'm sure we're about to hear from them and the AAFP (American Association of FAT People).......:rolleyes:

[The Reaper]

Then why is it not legal to charge gay men a higher rate as well, since they are tremendously more likely to acquire HIV/AIDS, and cost the system much more money over the many years that they will require expensive meds and care?

At least the fatties will probably die quickly from coronary disease.

TR

[rubberneck]

Playing devils advocate here for a second but not every fat (clinically obese) person is that way through personal choice. There have been a number of studies that have identified a genetic causes for obesity beyond lifet style choices. Is it far to tax them for being obese but not tax someone who has cancer? In both cases there is a genetic condition beyond the individuals control and both place an undue burden on the health care system. Why is it fair to tax one and not the other, outside of the perception that the cancer patient is a victim and the obese person is a fat lazy slob?

I'd be willing to bet next months mortgage that there are a number of exceptionally fit people, including some Quiet Professionals on this board, who would have to pay extra under this proposed system. The system uses your BMI to judge if you are obese or not. The main failing with the BMI is that it doesn't take into account your muscle mass. Lets take for example a 5'11" 225 pound male with less than 10% body fat, runs daily, lifts weights, has normal blood pressure. This person has a BMI of 31 and would be considered "obese".

Don't get me wrong, there is a real serious issue at play here and it needs to be addressed, but their approach has to be far more nuanced than it is. It seems to me that they didn't give this plan much thought.

[Team Sergeant]

Playing devils advocate here for a second but not every fat (clinically obese) person is that way through personal choice. There have been a number of studies that have identified a genetic causes for obesity beyond lifet style choices.

I read those studies, they were all done by fat doctors.;)

Morbid Obesity is the same as smoking, you choose to do it.

There is NO genetic predisposition forcing one to eat three Big Mac's, two Biggie Fires and a diet Coke.

One out of one million might have a TRUE medical problem relating to overeating, the rest are just pigs.

But don't take my word on it, just do some traveling and visit some countries where people work hard and don't over eat.;)

TS

[rubberneck]

Morbid Obesity is the same as smoking, you choose to do it.

TS

Perhaps you are correct but that brings up another question. Why go after obese employee's while ignoring the ones that smoke? Smoking causes a similar strain on health care resources much in the same way obesity does.

[The Reaper]

Perhaps you are correct but that brings up another question. Why go after obese employee's while ignoring the ones that smoke? Smoking causes a similar strain on health care resources much in the same way obesity does.

Did you even read the article?

TR

[sg1987]

Smoking causes a similar strain on health care resources much in the same way obesity does.

I'm thinking smoking, HIV (lifestyle choices), etc. are no different than the various hazards we tack on to homeowner policies.

Also, if a monetary fee will help cause the improvement in the overall health of citizens I say put it on ‘em!

[rubberneck]

I did, in between taking several phone calls and sending out several e-mails. I missed the one line that said that smokers were charged $25 a month.

[Razor]

"I think it discriminates against people with a disease — obesity is a disease," Stern said. "Would you charge more money if they had breast cancer?"

Actually, yes. Almost all health/life insurance companies conduct some type of health history pre-screening, and many will charge higher premiums to those with a family history of certain diseases, including cancer. This holds even if the insured doesn't currently show any signs of having the disease. How's that for "not fair", or "not their fault"? :rolleyes:

The very interesting future of health/life insurance is enmeshed in the advances in genetic testing. Are you genetically predisposed to contract coronary disease, or cancer, or diabetes? Not only will the insurance companies find out through testing, but they may even deny you coverage based off the tests.

[rubberneck]

Actually, yes. Almost all health/life insurance companies conduct some type of health history pre-screening, and many will charge higher premiums to those with a family history of certain diseases, including cancer. This holds even if the insured doesn't currently show any signs of having the disease. How's that for "not fair", or "not their fault"? :rolleyes:

Not here in the people's socialist republic where no one can be turned down for health care insurance and the companies are forbidden by law from charging unhealthy people more for their premiums. As a result I pay $911.23 a month for my families health care insurance the same exact amount that someone who has cancer, heart disease and diabities pays. Wonderful, ain't it?

[ZonieDiver]

<snip> There have been a number of studies that have identified a genetic causes for obesity beyond lifet style choices. Is it far to tax them for being obese but not tax someone who has cancer? In both cases there is a genetic condition beyond the individuals control and both place an undue burden on the health care system. <snip>

I have heard this argument repeatedly - genetics or "gland problems" - but they fly in the face of reason. IF there is some genetic component or some gland problem that can cause this, then scientists need to be isolating and replicating it and "poof" - world hunger is solved!

[MVS2]

Not here in the people's socialist republic where no one can be turned down for health care insurance and the companies are forbidden by law from charging unhealthy people more for their premiums. As a result I pay $911.23 a month for my families health care insurance the same exact amount that someone who has cancer, heart disease and diabities pays. Wonderful, ain't it?



Good point - how about taking $/month from each paycheck and hiring a runner to buy lunches at Subway or the local grocery store. Put the Mickey Dee's addicts out of commission for one meal a day.

[Jack Moroney (RIP)]

BMI is a bunch of bullshit-especially for those of us that are not short but just wound up tight. Cut loose those internal bunji cords that are compressing my skeleton and I would be 6'2":D I love it when some pencil necked medical professional at the VA gets upset with me because I have reached the potential of exceeding my bursting radius and they cannot find a friggin' blood pressure cuff large enough to go around my arm. I'll agree that other indicators such as blood pressure, cholesterol, etc are good indicators but BMI is some statiticians invention so they can look at the figures on a damn bar graph without otherwise measuring physical performance to determine if someone is fit to perform required tasks. Time for a snack:D

[Pete]

Playing devils advocate here for a second but not every fat (clinically obese) person is that way through personal choice.......

I read to the end but came back. I did see the other comments about this.

I'd like to add - cross off movies - look at the documentary films from the 40s and 50s. I like those time fillers on TMC. The little travelogs where the countryside was seen at 45 to 55 mph and you stopped every couple of hours at a tourist trap. Notice the lack of Fat people? In fact dig up just about any public film up through the early 80s and fat people are almost never seen.

Go to any Mall today and take a look around. Wall to wall lardos. Some may be predisposed to gain but buying a Diet Coke with the two double meat & cheese whoppers, large fries and an apple pie ain't the way to cut back.


Edited to add - And Lord, Lord, Lord, spandex should not be made in XXXX.

[Paslode]

I am 6'0" when I weighed in at the high 130's I looked like a malnurished Etheopian and the Doc said I was healthy, then when I got up near 170 and looked normal the Doc cautioned me about gaining too much weight. BMI makes no sense too me.

As far as fat people go. When I was in school we might have 1 or 2 kids that were obese. Now when I visit my school with my kids I would bet that 20% are obese and another 10 or 15% are borderline. Even many of the 'athetic' kids are blobs with little muscle tone.

Some of it is hereditary, but most of it is caused by parking your ass in front of the TV and the dependency on Fast Foods.

[Razor]

BMI is an antiquated, scientifically unsound testing methodology that replaces accuracy with expediency.

[Remington Raidr]

About time they started putting the hammer down on those fat pigs. If they fail to comply, they should be rounded up and sent to Manzanar to be fed a diet of tofu and rainwater until they get their minds right. Just the threat of relocation would move most of these porkers to stop stuffing it. We have to do something, and soon.:mad:

[greenberetTFS]

BMI is a bunch of bullshit-especially for those of us that are not short but just wound up tight. Cut loose those internal bunji cords that are compressing my skeleton and I would be 6'2":D I love it when some pencil necked medical professional at the VA gets upset with me because I have reached the potential of exceeding my bursting radius and they cannot find a friggin' blood pressure cuff large enough to go around my arm. I'll agree that other indicators such as blood pressure, cholesterol, etc are good indicators but BMI is some statiticians invention so they can look at the figures on a damn bar graph without otherwise measuring physical performance to determine if someone is fit to perform required tasks. Time for a snack:D

I agree totally with JM.....BMI is a bunch of bullshit :rolleyes:

GB TFS :munchin

[uscav_scout]

I read those studies, they were all done by fat doctors.;)

Morbid Obesity is the same as smoking, you choose to do it.

There is NO genetic predisposition forcing one to eat three Big Mac's, two Biggie Fires and a diet Coke.

One out of one million might have a TRUE medical problem relating to overeating, the rest are just pigs.

But don't take my word on it, just do some traveling and visit some countries where people work hard and don't over eat.;)

TS

TS,

You and I see eye to eye on this one.

I don't even care what your predisposition to eating is, genetic, emotional whatever.

Humans are not supposed to be fat. Humans did not evolve to be morbidly obese. (That is why obese people can look so misshapen, and obesity has such a negative effect on health). We are not supposed to be this way.

10,000 years ago, you hunted to survive, you might have to burn 1500 hundred calories, tracking, killing, etc, to get a good sized meal. Here all we have to do is pop it in the microwave, or go through the drive through.

Even if you do have a "real" eating problem, just burn more calories than you consume, I mean you may have to get off your fat ass and run, but hey you can't eat your cake and have a six pack too...

[GreenSalsa]

BMI is a bunch of bullshit

Absolutely

Arnold Schwarzenegger at 6ft 2in and 235lbs has a BMI of 30.2, therefore according to the "experts"--obese.

Tell the "Terminator" to loose some weight! :eek:

[Defender968]

Not here in the people's socialist republic where no one can be turned down for health care insurance and the companies are forbidden by law from charging unhealthy people more for their premiums. As a result I pay $911.23 a month for my families health care insurance the same exact amount that someone who has cancer, heart disease and diabities pays. Wonderful, ain't it?

WOW, yea that's affordable, somebody call HRC and BHO and explain that number to them and then tell me how their universal health care is going to work :confused:

Ok back on topic, I'm all for the fat tax, I don't for a second buy that it's genetic, if it is purely genetic then why is it you never see a fat Ethiopian, Kenyan, etc. It's very simple like others have said burn more calories than you take in and you will lose weight. The problem is most Americans are lazy, period. They simply don't exercise enough. I just wish they would own up to it instead of blaming it on their genetic makeup, but it's just another example of our victim minded society, everyone is entitled to everything, no one's at fault for anything, everyone's special, and everyone gets a trophy just for showing up! I mean when you’re 450 lbs with a 65 inch waist, you need to put down the fried Twinkie and go for a freaking walk , a very long one. It's funny I’ve seen morbidly obese AF civilians walking around with a 44 oz weight watchers jug filled with diet coke eating a little Debby ho ho, talking about trying to lose weight, and what really kills me is when they then get upset when I look at them, laugh and say you’ve got to be sh#$%ing me! :p

[greenberetTFS]

I've read the posts and I agree with most of the comments....A short background to give some explanation of my current situation. I was 17,6 ft tall and 245 lbs, played hockey as a defenseman and had a 31" waist. I was in dam good shape. Entered the service at that weight and had no trouble with PT. I'm going on 72 now and have a 48" waist and weight almost 290 lbs.....Most of that weight was gained by my having to take steroids for an auto immune problem. However,no excuses,if you'd see me now you would probably say "there's a lardo". Sometimes looks can be deceiving if people aren't aware of the circumstances.....:(

GB TFS

[sg1987]

I'm going on 72 now
GB TFS

Sir,
At 72 you have the seniority to merit an increase in size if you so choose. Not to mention the medicinal condition you’ve referenced.
I believe the “fat tax” as it were, should apply to younger Americans who are out there still in the age range to be in the work force (paying premiums) and are morbidly obese. They need to get off their younger, lazy, and otherwise healthy 4th P.O.C.
The condition of many of these folks is a growing unnecessary parasitic load on our healthcare system.
On the contrary, I can say from your past accomplishments, you sir, are shining example that we all should seek to emulate. We owe you a debt of gratitude.Thank you for your service to our country.

[Jack Moroney (RIP)]

played hockey as a defenseman

So, how much time you have in the penalty box? I think I have more box time than ice time:D

[GratefulCitizen]

Two things: the economics of healthcare and the general increase in obesity among Americans.

The economics of healthcare:
-Why is the obsession with from where/how much money to pump into the healthcare system.
-What about the supply side?
-Why doesn't government focus on pumping money into educating/licensing more healthcare providers?

The general increase in obesity:
-This seems to be a reflection of the culture.
Specifically, there is a culture of hedonistic indulgence with the expectation of avoiding consequences.
-Why is "sugar free" and "fat free" even necessary?
-Isn't a small portion of sweets enough?

Along the "sweets" line of reasoning:
-Didn't Coke used to come in 8 and 10 oz bottles?
-How big is the latest super big gulp? (64 oz?).

Consuming massive amounts of carbohydrates doesn't seem like a useful diet for any creature other than a hummingbird.
If you want to fatten up cattle, pen them in and feed them grain.

[Jack Moroney (RIP)]

The general increase in obesity:
-This seems to be a reflection of the culture.
Specifically, there is a culture of hedonistic indulgence with the expectation of avoiding consequences.-.

Whose culture? I would think that to define the US as a culture of hedonistic indulgence with the expectation of avoiding consequences a little broad-unless of course you are talking about politicians. I would submit that there are segments of the population that have this problem defined by lifestyle or indifference but not necessarily by a national culture.

[GratefulCitizen]

Whose culture? I would think that to define the US as a culture of hedonistic indulgence with the expectation of avoiding consequences a little broad-unless of course you are talking about politicians. I would submit that there are segments of the population that have this problem defined by lifestyle or indifference but not necessarily by a national culture.

Point taken, Sir.

I stand corrected.

[Jack Moroney (RIP)]

I stand corrected.

Oh hell, I am not trying to correct you, I just do not agree with your position. Besides, anyone who uses phrases like"hedonistic indulgence with the expectation of avoiding consequences" without so much as a hiccup is way out my leaque for corrections:D

[Roguish Lawyer]

Life insurance premiums commonly are discounted based on risk factors including those ascertained through blood tests (cholesterol, etc.). I don't see why you couldn't do the same thing with health insurance.

I do find all of this stuff very funny, though.

[Guy]

I do find all of this stuff very funny, though.I don't...I plan on getting fat when I get back home.

NO NEW TAXES!!!

:D

Stay safe.

[greenberetTFS]

So, how much time you have in the penalty box? I think I have more box time than ice time:D

JM,

Funny you should mention that because like you I did spend more time in the box than I should have....Every defenseman should protect their goalie and that I did.
I'd nail anyone who would try to go after my wingmen also. When I played in the early 50's we had to pay for all our gear,only things furnished were a jersey and socks. My CCM blades were my biggest expense. The pads and the rest of the gear could be used year after year,but not skates they had a one year life cycle. We also played without helmets,they didn't exist than.......:cool:

GB TFS :D

[greenberetTFS]

Sir,
At 72 you have the seniority to merit an increase in size if you so choose. Not to mention the medicinal condition you’ve referenced.
I believe the “fat tax” as it were, should apply to younger Americans who are out there still in the age range to be in the work force (paying premiums) and are morbidly obese. They need to get off their younger, lazy, and otherwise healthy 4th P.O.C.
The condition of many of these folks is a growing unnecessary parasitic load on our healthcare system.
On the contrary, I can say from your past accomplishments, you sir, are shining example that we all should seek to emulate. We owe you a debt of gratitude.Thank you for your service to our country.

sg1987,

Thanks for your comments,after reading most of the posts I thought I'd come out of the closet("Fat mans",that is,not gay mans). I too believe that the young people today are really out of shape and maybe a fat tax might be the answer....:rolleyes:

GB TFS:munchin

[ZonieDiver]

Whose culture? I would think that to define the US as a culture of hedonistic indulgence with the expectation of avoiding consequences a little broad-unless of course you are talking about politicians. I would submit that there are segments of the population that have this problem defined by lifestyle or indifference but not necessarily by a national culture.

Educationally, we have certainly developed a culture of "nutritional-physical stupidity"! "Experts" bemoan the lack of physical fitness and the rapid spread of obesity and diabetes in our young people at the same time they are eliminating PE from the school curriculum. While the cafeteria at my school tries to serve a fairly nutritious lunch, the lines are longer at the "snack bar" where the kids can get a "burger and fries" or "chicken strips and fries".

We got a new PE teacher - and she actually had the kids in her class running a mile for time on the second week of school - and it was still quite hot. With the encouragement of our new principal, the PE teacher and I are organizing a team of students and staff to "run" in the PF Chang's Half Marathon in January. I did it last year, injured my fat body training, and did poorly. Now, I have lost 25 pounds and am training again. It is amazing how those 25 pounds being gone reduces the pounding on your knees - and hips!

The older I get, the harder it is to lose weight and stay fit. As 60 approaches, this FOG wants to be where I was physically when I left the USAR in '83. Now or never. The main motivation now is that my older daughter - with her SF boyfriend - is back to running and has finished a couple marathons, triathlons, and "adventure races" - and wants her old man to run in the Dublin, Ireland Marathon with her in October, '09! That gives me a year. Pray for me!

[Jack Moroney (RIP)]

JM,

Funny you should mention that because like you I did spend more time in the box than I should have....Every defenseman should protect their goalie and that I did.
I'd nail anyone who would try to go after my wingmen also. When I played in the early 50's we had to pay for all our gear,only things furnished were a jersey and socks. My CCM blades were my biggest expense. The pads and the rest of the gear could be used year after year,but not skates they had a one year life cycle. We also played without helmets,they didn't exist than.......:cool:

GB TFS :D

Looks like we played during the same periods. We thought we were a big deal when we finally got to "semi-pro" status which only meant that we were good enough to draw a crowd and did not have to pay for ice time anymore. But like you, we still paid for all our gear and I still have my CCM's and until a couple of years when my legs started to fail I used them religiously on the pond here at the house until the snow got too deep to remove. I think the biggest expense of expendables for most of us was for friction tape:D