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

[taxpayer]

Fat people will come up with all kind of reasons as to why they are fat,,except one,,,,,that they eat toooooooo much.

[Responsible for my health]

" . . . . if they don't take steps to address their health problems."
This is the caveat that allows for reasonableness.
Seems like the folks who object to this see themselves as victims.
Good for Alabama. I hope this sets a precedent.

[Jed]

They could make one change and save some grief. Raise the rates for everyone, then give a $25 discount to folks who take care of themselves with diet, nutrition, etc, as measured by body mass, blood pressure. etc.

Isn't allowing folks who take care of themselves to subsidize other folks bad habits a form of discrimination? This is no different to me than a non-smoker discount.

[Eli]

Tough love will be what saves the overweight people who change as a result of this policy years from now. And don't think it won't work. Many will be motivated by the concept of having to pay more - even if it is only $25 - due to the awareness it arises.

And keep this in mind: No one will be complaining after they've lost a bit of weight.

[TRS]

I can't wait for the bald men tax. Certain male patterns of baldness have been linked to heart problems.

[Suzanne]

I agree with an earlier post that brought up the fact that the American work day, often including a long commute, can make it nearly impossible to exercise and/or cook nutritious foods (notice that I said *nearly), especially if you have a family and both parents work. I only work until three each day, and I don't have any kids, but I still find it difficult to fit in everything that's good for my health. When you throw in things like growing your own healthy vegetables, an hour for yoga, and eight hours of sleep all in an effort to lower your blood pressure - well, good luck finding time to do all that. Maybe instead of punishing people who, for whatever reason, are struggling with health issues we should be looking at ways to enable people to overcome these issues - starting with this arbitrary 40-hour work week and the long commutes that go with having a job. Who came up with 40 hours anyway? It's too much, Americans are giving over their entire lives to their jobs and I think it's reflected in our collective poor health.

[Fabrisse]

I'd feel better about this premium if it a) took into account people who are fit but overweight and b) made allowances for people who have physical issues (side effects from medications, thyroid issues, etc.).

I've lost over 40 pounds by changing my medication and altering my lifestyle. However, were I living in Alabama, I would still be subject to this premium. My doctor wants me to lose between 1/4 and 1/2 a pound per week so as not to strain my heart. I'm meeting that goal. This means that by the tables mentioned in the article, I would have another two to three years to match their expectations: two or three years when this "fat tax" would replace my exercise classes in my personal budget.

There have got to be better ways to address this issue.

[Buddesatva]

Call it a tax or a surcharge. If you smoke, you should pay more for insurance. If you are overweight, diabetic, hemophelic or subject to depression you should pay more. If you twitch when you sleep or have a family history of cancer you need to pony up. If fact, lets have all the perfect people on this side of the room and all the rest of you on the other and arrange your selves by height, age and hair color.

[John, St. Petersburg, FL]

Its about time that people are held accountable for their health. If every american
lived a healthy lifestyle there would be be many doctors out of jobs. Our health care costs would decrease significantly.

[John McCain]

The employees of Alabama need to have full 'fitness therapy' insurance benefits which will increase their health insurance premiums rightfully so-it will increase everyone's insurance premiums because the system has overlooked 'fitness therapy' so so many generations that only CAM (Complimentary and Alternative Medicine) insurance policy 'add ons' will carry it. Get real-Alabama can be an example to all States with 'fitness therapy' benefits and is long over reality as America evolves into a moderan millenium and future generations take over important sedentary work for international worldwide commerence.

[PChow]

The AL Government is taking the right path. However, if they are penalizing people who are overweight, they also need to penalize the food industry, which benefits from people eating more of their unhealthy products. Please see "Omnivore's Dilemma" for a full critique of the American food product supply chain. For instance, food companies need to stop adding chemical such as high fructose corn syrup to everything and pumping antibotics/corn (which is not their natural food)/ hormones into our cows!

[Bass Player Keith Hall]

I have found a way to cure belly fat. I have been on the Chew Chew diet for 5 months and has lost 50 pounds. That's 10 pounds per month. All I do is not eat breakfast and chew each bite 32 times.
http://bestfreediet.blogspot.com/

[Michael Gompertz]

When this case goes to court, I will be in the vanguard of those arguing that the State of Alabama has violated the fundamental rights of state employees. There is, after all, is a "fundamental right" to eat as much as one wishes. See Griswold v. Connecticut (right to contraception), Roe v. Wade (right to abortion), and their progeny. In the immortal words of Griswold v. Connecticut: "The foregoing cases suggest that specific guarantees in the Bill of Rights have penumbras, formed by emanations from those guarantees that help give them life and substance. . . ."

[Gail]

Oh my. They are going after the obese now. How does it feel? The smokers have been outed for several years now. Quit whining and just do it, or you will be shunned like the smokers. My, has the tables turned now.

[Julie Pruiett]

This is very wrong... I was sick, I was on 100 mgs of prednisone for 5 years.. I gained over 100 lbs due to the medication.... Unless youve been there, you just dont get it....

[R. B.]

Some people are overweight because they have a medical condition. Some people are overweight because their metabolism doesn't work efficiently. Some people are overweight because they overeat. Some people are thin because they have a highly efficient metabolism...they never work out, eat like pigs, but never gain an ounce. Some people are thin because they have an eating disorder. Some people are thin because they eat healthy food and some of them even exercise. But some overweight people also eat healthy food in reasonable proportions, exercise and still gain weight. Like it or not, this is a complex issue and to make a blanket statement that all people are fat because they overeat is short-sighted and not factual.

I personally don't believe it makes sense to take a putative approach when administering health insurance coverage. I would rather reward people for making healthy choices. This would eliminate the fat/thin debate and would instead reward all body types for doing what they can to contribute to their own overall health.

[Elizabeth]

I guess we need to hit everyone's bad habits then. An additional tax on those who appear tan in the summer, even higher if they look tan in the winter. Additional tax if you have high cholesterol, etc.

[Nathaniel]

You opened up Pandora's box when you let them get away with the. smokers issue and letting them replace your right to drive with it's a privilege to drive.

Now it is whether the self-appointed God's like your weight or not, next it will be if they approve of your religion or not. They will be controlling what you think and what you do -- -- after all, -- -- a presidence has already been set with a smoker issue.

The new younger generation gives away our rights and freedom like it is garbage

[Hizzy]

This tax is rediculous. There are people out there who cannot afford to lose the wait, can't, or even - gasp! - want to be big. The government cannot limit a person'a wants and needs like this. Being taxed because you're too fat? That's like taxing you for being left-handed.

Plus, the BMI is faulty. It doesn't take into consideration muscle mass, which is heavier than fat, so body builders are obese? Gasp! That's a new one.

[Heather]

I work with a research and development company and has helped 100 thousands of people return to normal lean body mass, tested by a dexa scan test, which measures lean, fat and bone mass; because increasing bone mass will also offset BMI. High cholestrol is not a family trait, it is totally diet, atfer all who taught you how to eat. You are what you eat, eat junk you feel like junk, your blood looks like junk,and your body looks like junk PERIOD! It is all about lifestyle change and people want it all. "With road to heaven is narrow" Take care of your body because where are you going to live when it wheres out.

[Amber]

This is really stupid! Who cares if they are fat or not? We all are different in our own way. If everyone was the same there would be no reason to live. Who came up with this theory we are suppose to be skinny in order to be loved? Look at the greeks. Look at their paintings and sculputres! Do you see a skinny frail thing? NO. You see a girl who has some meat on her bones. We all are born different and have different bone types. If your fat, your fat. If your skinny, your skinny. If you are this way, you are that way. This is a form of discrimination and is another way to get more money in the bosses pocket. We already are in a economic crisis! Why cause more chaos!? If you don't like someone because their fat and if you agree with this tax, then shove it. The day I am taxed because of my weight or what I look like, I am so leaving this country. This is not what america stands for. May I remind you all of what is in our ammendment! "We all are created equal."
If we are so equal, why are people being taxed because of weight issues? This is sickening.

[poweranni]

What makes people overweight?

1. overeating
2. lack of activity
3. eating processed foods
4. eating foods that are pure sugar, salt and grease.

Why do people make so many excuses?

Yes, there are those with thyroid problems. But does 60 percent of our population become obese because the European, Asian and African genome dealt them a bad hand?

Go to Africa, Asia and Europe? Do you see a large percentage of the population that are so fat that they need to be pushed around in electric wheelchairs? Do you go to schools and see children who are twice as heavy as they should be?

So ... these are nothing more than excuses. Obesity costs a lot of money. Who pays for it when a morbidly obese low income person goes to the doctor about hypertension, diabetes, aches and pains, asthma? The Tax payer ... and when the doctor asks them what they eat? Twinkies, cheetos, soda ... Medical professionals pull their hair out over the fact that they are given sound medical advice, and sooner or later, they are back in their office, asking for another bottle of tax-payer supported medications, not having changed a bit ....

Looked at your paystub recently? Your social security and medicare .... that is what it pays for. Yes, they have the freedom to eat themselves to death, as long as they aren't doing it on your dollar.

[tracey chatham]

You can always spot the ignorant people who stomp on the ground waving their hands screaming "ITS NOT OUR FAULT, ITS IN OUR GENES!!!"

The only problem with this argument, obvious to anyone with ANY semblance of intelligence is...100 years ago, OBESITY WAS PRACTICALLY NONEXISTANT. So who did you inherit these nasty "genes" from?!?!?!?!?!? uhhhh... well... duhhh (munches on a twinkie) aliens??!!? The simple sad but true fact is, "inherited metabolism" or "genetic factors" VERY VERY RARELY play a role--but Everyone loves to use it as an excuse for their sloth.

And don't give me any of this you "can't afford to lose weight" or "can't afford the tax because you don't have any money" because thats just a joke.

YOU WOULD SAVE FAR MORE MONEY IF YOU DIDN'T BUY SO MUCH FOOD. If you stopped spending so much at the grocery store / fast food chains, you would MAKE EXTRA money in spite of the tax! let ALONE how much money you'd save yourself and the rest of us for the rest of your life in health costs!

and then there are the people who whine and complain that taxing obese people is like the persecution of jews by hitler. Here's a news flash for you "geniuses". Punishing people for acts THEY ARE RESPONSIBLE FOR is what we do in this country EVERY DAY in our court system.

You people need to be held accountable for your actions, whether it be over feeding yourself, over feeding your kids, or poor parenting in general! Its called being a responsible adult, and if you can't handle it, you don't deserve the respect and privileges that come with being one.

[Texas Gal]

You and all the other idiots out there are ignorant to the term genetics. I was born fat and have fought with my weight my whole life. My mother, her mother, her sisters, and brothers all have health issues related to diabetes, high blood pressure, heart disease, kidney problems, and yes obesity. Don’t tell me or any one else that genetics doesn’t have anything to do with it.

Also my sister died at 34 of colon cancer, she was a size 8 when she was diagnosed, when she died she was a 3X. Are you going to say that she was a sloth or a human pig? No because she had cancer. But think about it how many people under 55 get colon cancer and gain weight. Not many. Most people get colon cancer and die very thin. Why was she thin before she had no children, she was bulimic and worked out 4hrs a day. She had my father’s and my mother’s genetics, she got the colon cancer that he now has and the weight problems her whole life. She also had all the same issues when she was pregnant and so did I. We both had high blood pressure and gestational diabetes. After researching my family history I found that every woman on my mother’s side of the family had the same issues during pregnancy and a few years later after having children.

Another genetic defect is Dyslexia. My daughter has it and there are now studies that show it is genetic. I didn’t have any knowledge of anyone in my family having it until about 4 weeks ago. I told my mother what my daughter’s Dyslexia teacher said, and she told me she had a great aunt that everyone thought was crazy because she couldn’t see things the way others could.

I have been on hundreds of diets, the only time one worked was when I seventeen and on Nutri-System. I ran 3 miles every day during the summer and only lost 19lbs over an 84 day period. When I started school my senior year I had to be at school at 6:30am and didn’t get home until 7:45 to 8:00pm in the evening, it didn’t hardly leave time for homework must less a workout. I was trainer and very busy.

I am now 35 with two children whom I had major health problems with when I was carrying them. I have tried everything even as far as going to an over night clinic for 2 1/2 weeks to prove that if I eat over 800 calories a day that I will gain weight. I can eat a 1000 and maintain but eating the 1500 to 2000 that the nutritionist wanted me to eat was crazy. However I did their in-patient program. We had to sleep for 8 hours, drink a protein drink, workout for 1hr, shower, eat breakfast, then do the activities they had scheduled, drink another protein drink, workout for 1hr, eat lunch, more activities, drink again, workout again, eat dinner, then they same thing again the next day. I did this for 2 ½ weeks and gained 16 ½ lbs. They had camera’s everywhere and we had to wear monitors everyday and night. They told me after doing all the blood work and the program that it was in my genetics. They also did a genetic screening of both sides of my family and told me about the colon cancer 6 years before my sister had it….

I work with a woman that has had 3 children and she looks like she has never given birth. I met her mother and she too looks like she has never given birth. She also eats 3 Butterfinger candy bars a day. She does not work out and she doesn’t have a weight problem. So are you saying that she is a sloth or a human pig? No you wouldn’t say that about her if you saw her walking down the street. Why; because she is thin. It is in her genetics just like her mother and so on.

By the way Tracey Chatham have you not seen the pictures of historical figures? Just to name a few that had weight problems and other problems that were not diagnosed. Because the technology was not there 100 years ago!

Leopold I, Henry VIII, Catherine of Aragon, Thomas Cromwell, Edward II, Queen Victoria, King William IV, King George II, King James I, Queen Elizabeth I, Queen Anne, King Edward V, King Richard II, King Edward III, Henry III, King Stephen,
And the list goes on.

They didn’t have preservatives or the synthetic hormones placed in their foods. Dairy products, poultry, beef, and even pork all have synthetic hormones and preservatives. Fruits and vegetables are all processed differently than in history. Grow your own tomatoes and buy one, blind fold yourself and have someone feed tomatoes A and tomatoes B to you. You will be able to tell the difference. The population has grown to the point that food companies have had to speed up the productivity to deliver the food to the grocery stores.

In the colonial times, if you were fat, you were considered rich. This was because most people couldn't afford to eat at their leisure like the rich people in society did. Skinny people were looked down upon. Also the poor suffer today because they can not afford expensive foods. It is cheaper to buy frozen dinners, bread and bologna than organic foods. Most of the poor work 10 to 12hr shifts have children and are single so by the time they get home make dinner, help with homework, and do chores they are so tired they can hardly stay awake. Their days start between 5:00 and 6:30am and end between 10:00 and 11:00pm. When should they sleep if they include a workout? By the way some of them don’t even get a lunch break. Yes I know it is illegal, but they need their job so they don’t complain.

So no Mr.Wingman and Tracey Chatham’s of the world you don’t understand genetics history, or economics of obesity. You and the other people out there are not Dr’s, historians, or financial advisors and you are arrogant, egotistical A-Holes. Not every one over eats…So before you try to be an expert do your homework….

By the way why don’t we charge you a tax for being ugly, blonde, having zits, having plastic surgery to look younger, having allergies, asthma, or dyslexia etc. Come on your on a roll, how about we charge a tax to the person who is blind, deaf, or in a wheel chair after all they have to have special accommodations everywhere they go. Guess what idiots most of them where born with their disability. Genetics had nothing to do with it!!!!!(Sarcastic remark) The world went to war over Hitler’s discriminations. Is that what you want to happen again?

[veenna]

tax is no way. but what matters is the type of insurance. And the PRIVATE INSURANCE is needed in this case!! where the health insurance is adjusted according to the risk of the client. So when you are obese you will pay more because of additional healt problems. Society cannot bear the cost of society in the form of pool insurance. Some obese people are obese because of genetics,ok. It is not their fault. But is it fault of the others?? Of course not. Communism is the PAST. I cannot pay for others for their obesity, unemployment. the TAX IS NO WAY, only private type of insurance.