The Fat Tax

[HURAKAN]

The Fat Tax
Alabama tells its workers to slim down or pay. What's wrong with that?

TheRoot.com
Updated: 2:56 PM ET Oct 22, 2008

Oct. 23, 2008--The state of Alabama has issued a warning to its state workers: Get fit or pay up.

In August, the Alabama State Employees' Insurance Board approved a plan that will charge workers an additional $25 to cover their insurance premiums, if they don't take advantage of free health screenings available to all state employees. The program, to begin in January, will require state workers to receive medical screenings for body mass index and health problems such as high blood pressure, high cholesterol and obesity.

Critics have panned this as a "fat tax" that unfairly punishes people for their genetic predispositions. Others argue that the measure amounts to lawful discrimination that infringes on the right of free will, much like the state's 2004 decision to offer a discount to non-smoking employees.

Nonsense. This is an opportunity, not punishment. It is an important step toward better preventive care at a time when health costs are soaring and Americans are in increasing denial about their ever-ballooning weight. And the state is offering a free—yes, free—jumpstart. Under the plan, state employees are being asked to go to a free health screening, and if necessary, a free doctor's consultation. If those screenings show that a person is predisposed to illness due to their weight or other conditions, they will be offered help to begin to address their health issues. Only if workers fail to take advantage of the free screening will they be charged the additional $25.

Alabamans are clearly in need. Varying reports place Alabama with the second or third highest rate of obesity in the country. The Birmingham News confirms this southern state has the country's highest rate of stroke and third-highest rate of infant mortality.

Americans shouldn't feel ashamed of owning up to their fatness. The war on obesity has gone international. In Argentina, the Senate recently passed an Obesity Law, declaring obesity and eating disorders as diseases eligible for treatment under the state's health-care programs. Meanwhile, Mexico is hard at work pushing "Vamos Por Un Million de Kilos" (Let's Lose a Million Kilos), a national campaign to get Mexicans to cut the country's collective weight by nearly two million pounds. The project is one of several new efforts to prevent Mexico from joining the United States as one of the world's fattest countries.

Of course, governments are not taking these steps out of mere concern. It makes sense for their bottom lines as health costs surge. But what's wrong with bottom-line motivations if it helps people? It may be a financial ultimatum, but it's not a state-mandated diet. It may affect individual choice, but it's being done to prevent an even heavier strain on an already burdened system that must cover many.

We already know that mass denial has resulted in rising obesity rates in both adults and children. Childhood obesity rates have soared—leading pediatricians to begin treating young patients with hypertension, sleep apnea, diabetes and orthopedic issues. As a nation, we are also pushing our neglectful lifestyles and habits off on our children. What is the point of promising a better life to our kids, if we are setting them up to be physically unable to enjoy it?

African Americans should be particularly concerned: The Center for Disease Control (CDC) says that nearly half of black women are overweight or obese, and black people overall are 1.4 times more likely to be obese than non-Hispanic whites. Now is not the time to resist efforts to make us healthier. Fat and happy is out. And in Alabama, at least, death and taxes are in, if in reverse order.

[coriolis]

Hmm. On the one hand, it does make sense for people to pay based on their risk factors, and other types of insurance already do that.

On the other hand, it starts a movement towards people telling us how to live our lives. Would women pay more because they're more likely to incur OB/GYN and maternity expenses? Where does it end? Should insurance companies start to base premiums on genetic propensity for disease? If they got really good at it, the whole concept of "group risk" would go out the window, and everybody's rate would be different, with the ultimate result that the people who are most likely to get sick would be paying so much that there would be no point in buying insurance.

But yet again, how is it fair for the people who take care of themselve to get penalized by the people who don't take care of themselve?

I don't have the answer.

[Dionne]

Someone please tell me whats wrong with a free health screening?

We have health insurance. It's expensive. We have deductibles and co-pays. NOTHING is free.

We are both survivors. My wife is about to end her year long treatment for breast cancer. In '05 I survived a pulmonary embolism. Even with insurance the amounts we pay out of pocket are enormous. Neither of us are "fat". We both exercise and watch our nutrition. Life threatening health issues are like a sucker punch.....you can do all the "right stuff" and still get nailed.

I do have some answers regarding health insurance. First off....once you land in major medical it should not expire at the fiscal year end. Talk about kicking someone when they are down! Next, we need continuity at the hospitals level. Why should one hospital accept 60% as payment in full when another hospital gets 90% and comes after you like a bad dog for the remaining 10%?

It's endless....I could go on a long rant.