Alabama to place 'fat tax' on obese state employees

Alabama officials are warning state employees to shape up or pay more for health insurance.

On Friday, the State Employees' Insurance Board announced a new plan beginning next year in which state employees will be required to receive medication screenings for several conditions, including body mass index. Those considered obese or who have high blood pressure, high cholesterol or high glucose will have to pay $25 a month more in health insurance beginning in January 2011, if they don't take steps to address their health problems.

The new rule will affect more than 37,000 people employed by the state. Alabama is the first state to issue a so-called fat tax. The state already charges smokers a $24 per month surcharge (which will increase to $25 next month).

Alabama has the second highest obesity rate in the country, according to the U.S. Centers for Disease Control and Prevention. Just over 30% of the population is obese, ranking just behind Mississippi. Still, a fat tax?

Alabama state officials say they will offer programs, such as Weight Watchers and YMCA discounts, to help the employees get in shape and avoid the penalty. But health experts aren't so sure a punitive approach is the best way to lower healthcare costs. The American College of Occupational and Environmental Medicine has published a list of tactics employers can use to help fight obesity. The list is made up entirely of positive incentives; nothing suggesting fines or penalties.

Jeffrey Levi, executive director of Trust for America's Health and a health policy expert at George Washington University, told WebMD that the Alabama requirements could be interpreted as a genetic penalty for those who are predisposed to weight or cholesterol problems. "We need to recognize the complexity of these things," he says.

-- Shari Roan

Photo: STR/AFP/Getty Images

Comments

[Aaron]

It's probably also illegal - these things smell like discriminating on the basis of disability. Sure, a lot of obese people need to cut back on the donuts (says I as I look at the cupcake on my desk). But the cholesterol thing especially is troubling - some people are genetically disposed to higher cholesterol. Are they also going to single out people who have juvenile onset diabetes?

This will probably not survive if it's ever challenged. There are better solutions out there.

[The Flem]

Hooray!!!

[v]

It is just what they need and I am from alabama

[Raymond]

A lot of folks are fighting the good fight on the flab front. But, an hour out of the day (half hour for exercise, and half hour for changing clothes and showering) is a lot if you have to spend two hours a day in the car. People are working more than the 40 hour week and taking short lunch breaks. Too many people hit the fast food joints instead of preparing home-cooked meals. Very few people get enough sleep these days. It is killing them.

Exercise reduces appetite and improves sleep. So, if you have to sacrifice a few meals a week to splurge on a health club, do it.

Twenty-five dollars a month is a pittance, really. But, how about giving a break to the folks who work out at health clubs or take long walks.
How about employers giving longer lunch breaks. And how about giving more health club benefits...

[Alex Baran]

alabama's measure is wrong and misguided. I read this editorial about it here (http://www.projectweightloss.com/index.php) and it says it all: unless repelled immediately, this measure may hurt a lot of innocent people.

[Wingman]

At long last we have a government entity willing to take a stand.

I for one am tired of Americans making every excuse under the sun for what boils down to gluttony and sloth… and having to absorb other people’s bad habits in my health insurance premiums.

This nonsense about “genetic predisposition” is nothing more than an excuse for lack of personal discipline and accountability from an ever weakening pool of human pigs.

News Flash! Life isn’t supposed to be easy. If you need to be a little hungry to lose the weight and keep it off, so be it!

Stop whining and lose the weight.

[mifori]

why or how is that punitive? if you wreck cars regularly do you not pay a higher insurance premium than those who do not? if you are in the public opinion shaping business, why not drop some of the cultural conditioning that puts people in this position where they assume because it says so in the paper that they have zero personal responsibility for the cost burden that they put on the rest of society when they have zero understanding of the relationship between their body, the way it functions, food and physical activity.
great step in the right direction. now that the ice has been broken perhaps they
have an edge on introducing a tax on things like doughnuts and potato chips.
this would be a step in the right direction.

[Matty Walker]

You have got to be kidding me. Taxed on high cholesterol? This condition can be hereditary. Why doesn't the state tax parents for giving their children the problem? Why don't they tax all the people that drink too much? They won't do that because of the liquor lobbyists. Too much money will be lost. Or what about the people that continually self medicate with prescription drugs? Won't do that. Because of the drug companies and their lobbyists. It's easier to attack people than to change health care. What a bunch of bull.

[Agnostic Free Thinker]

Hip, hip, hooray! It's about time that someone started addressing the problem of the incredibly high obesity rate in this country. One of the best ways to modify someone's behavior is to hit them in the wallet. There are so many obese people out there who are that way for the simple reason that they eat like pigs and are too lazy and undisciplined to reduce their massive food intake and to get off their butts and exercise. This genetic predisposition excuse is a bunch of crap.

[Robert Baldwin]

Boy, is this policy going to bring on the hate mail! But it's a great policy and it should stay. As someone who's overweight myself and needs to lose it, I'd rather fork over the $25, keep my health insurance and have another reminder that I need to lose that weight *now*.
Cholesterol, as mentioned above, is to a significant extent genetically determined - I'm an example of that. But in my case it also responds sharply to diet and excercise - it spikes *fast* with even a handful of "normal" American meals, but declines and balances better (good/bad ratio) with diet and daily excercise. Those just happen to be things I need to be healthier.
I do agree that employees in this program should be encouraged to go for a run etc at lunch, allowing them to add a few min at the end of the day and take 60-75 min for workout (including shower, change, elevator from 12th floor etc). That's enough for a 5-7 mile run, which is a short workout for folks under 50.

[john galt]

Define 'obese.' If you use the Body Mass Index, Emmitt Smith was considered obese during his all-NFL years, when his body fat was about 6%. Without a fitness gauge, defining 'fat' is almost meaningless.

[Tim]

Finally. Being overweight is not hereditary - it is a choice. People choose to overeat and become fat. How hard is to stop eating? I mean if you notice you are gaining weight, just stop! Its not like you become fat overnight, its a process. people who are overweight are weak minded.

[Mike]

Well it's a refreshing change. In a state that consistently ranks near dead last (to Mississippi) in every qualitative measurable index this is a start in the right direction. That place as one of the worst school systems, the fattest people, high levels of poverty, etc, etc. What an awful place to live!

[Pauli]

Alabama's proposal will never pass legal muster; the disproportionate impact on racial minorities alone should be enough to kill it. Besides, Alabama would be more successful in curbing obesity by slapping a "fat surcharge" on junk food. How about a $5 surcharge on that greasy $2 drive-thru burger, $10 surcharge for topping it with cheese OR bacon, $50 surcharge for those reckless enough to add cheese AND bacon...

The article also seems to be missing any mention of taxing employees whose BMI falls BELOW normal. Are there no bulemics, anorexics, or compulsive dieters in Alabama, or do they not also run up enormous medical expenses there like they do elsewhere?

[Bobby]

Well, Hitler would be proud. Thinness uber alles! Forget the master race, now it's all about the master weight. Why let people make their own choices? That's stupid. Let's just tell them what to do and punish them when they won't do it. Would anyone like some toilet paper? I heard the constitution is available. Land of the free? Not anymore. Let us call ourselves "Land of the thin!" Celebrate Diversity? No more, Celebrate Bulimia and Anorexia! Celebrate Gastric Bypasses, celebrate $80 an hour personal trainers. Let's create a nation of gay gym clones!

[Billy Joe]

Wow...how did 30% of the population in Alabama become obese? 1 out of every 3 people in Alabama are obese?! How did this happen?

How about a fast food tax?

[LauraK]

Why not tax the chemical companies for hormone disruptors which end up in the food and water supplies and contribute to obesity by changing how the human body processes food? What about things like high fructose corn syrup hiding in nearly everything we eat, even things that are not sweet (more sugar in ketchup than in ice cream)? Many medications, including ones for diabetes and depression cause weight gain.

It's easier to blame individuals alone, and let the corporations who are cashing in on the unhealthy food and the dangerous chemicals off the hook. Individuals share responsibility, but are not solely to blame. Heredity also plays a part, of course, as do food choices, but poverty (unhealthy food is much cheaper than fresh, whole foods) and corporate greed are probably more to blame. Corporate greed is also responsible for the fact that lunch "hours" are no longer an hour, and that people are not paid a living wage so must work more than 40 hours/multiple jobs just to get by, leaving no time or energy for cooking.

The obesity epidemic is accompanied by epidemics of autism, asthma, learning disabilities, mood disorders, etc. Coincidence? I doubt it. Something is dreadfully wrong with the food supply and the environment we live in, not with peoples' willpower.

[DP]

Studies have shown that "healthy" people cost the health care system more than obese people, due primarily to the fact that "healthy" people use the system longer. On that basis, wouldn't it make more sense to penalize the people who actually cost the system more?

The government really needs to reassess its definitions of "obesity". I'm 6'5", 300 pounds and am in better shape than most people my age. I could probably lose 30-40 pounds and still be healthy. According to the government, I would have to lose over 50 pounds to be classified as "overweight", and over 100 pounds to be considered "healthy". I would die of malnutrition if I were to weigh what the government says I should.

[Robert T.]

The L.A. Times does a disservice calling this a tax.

This is not a tax. It is a co-payment on premiums. Thus it is an increase to the premiums on employee health insurance for some employees.

Presently many employees in the U.S. pay different premiums partly based on the number of dependents, and a co-payment. The state is expanding the concept of co-payment into attempting to identify what categories of people use the insurance more. They then should pay more, if they can be held responsible for the adverse health condition, and the associated increase to insurance costs.

In part, it is an attempt to allocate the costs of insurance to those who cause the costs, and not to everyone else. It may actually be a fair approach.

If these affected employees are in unions or employee associations that negotiate employee contracts with the state, then their employee associations must have agreed to it.

This action by the state may be copied by other governments and the private sector, and expanded into other health conditions.

[Jennifer]

its seems fair... but there are some people that are sick... for instance i have a thyroid problem and i am little over wieght.... i eat only but healthy food. go to the gym 6 times a week? so why should i (or any other) sick person be charged more?

[Tim]

The individuals are the ONLY ones to blame. No one else is at fault except for the guilty (overweight parties) YOU CONTROL WHAT YOU PUT IN YOUR MOUTH. NO ONE FORCES YOU TO OVEREAT. What is so hard to understand about that? Why should I pay higher costs when I eat right and exercise.

[pedro]

Aaron,
I did not know that being fat was a disability, I believe is a choice and life style.

[SC]

I find this totally wrong! I am an older woman who has thryoid issues; due to that I have a weight problem - have been fighting this all my life. I don't over eat, exercise 45 minutes to 1 1.5 hours a day, and I am still overweight. My cholesterol is also high, due to no fault of my own. Shame on all of you who say that overweight people are all lazy and eat too much! I also have smog-related asthma - shame on all of you who drive cars and add more to my grief!

[Victoria]

There are lots and lots of studies that talk about how much obesity costs in health care. Studies have shown it costs billions of dollars to treat diseases like diabetes, etc. But those studies do not compare the health costs to the alternative - which is staying healthy, living a really long time, and then dying of old age.

What costs the average citizen more - someone who was fat all of their life dying in their sixties or seventies of diabetes, or someone who was thin all their life dying in their nineties of alzheimers after their personal money has run out?

If someone dies quickly it saves us money. If someone dies before they start taking out social security for two decades, it saves us money. If someone dies before they have to spend a decade in a nursing home - it saves us money.

Sure, we should all be healthy, but we should stop complaining about how someone else's obesity costs us more money. It really doesn't.

[Victoria]

I think they should have a thin, healthy people tax.

Sure thin people don't cost me more in insurance premiums, because they don't get sick before medicare kicks in. But man! They do cost me a lot more in taxes. They live forever. I have to pay social security to them for decades, then after their personal money runs out, my taxes go to pay for them being in nursing homes and to treat their alzheimers or whatever old-age diseases they get.

At least fat people have the decency to die earlier before they cost me all of those taxes.

Sounds ridiculous, yes?

Obesity does not cost John Q. Taxpayer more. I noticed one thing about those studies on the cost of obesity. Those studies lumped together the cost of treating diabetes, heart attacks, and other obesity-related diseases, but they conveniently forgot compare those numbers to the alternatives. What costs more? Someone dying in their sixties or seventies of diabetes, or someone who has a healthy body that just won't quit and dies in their nineties of alzheimers?

So all those people who are complaining about obese people costing them money, you can relax now. Fat people are actually saving you money.