Monday, November 17, 2008

Alabama Set to Penalize Obese Workers

I don't know how I missed this story.

If you're an obese worker in Alabama who hasn't signed up for a free health screening with a doctor by 2010, you're going to get dinged an additional $25 monthly on your health insurance costs.

If you've seen the doc and you've got weight to lose then unless you make "progress" with your weight, you'll get dinged starting in 2011.

Alabama already dings smokers $25 per month.

While they haven't said what "progress" really means, the plan's horribly flawed.

While it may be fine and dandy to suggest that these workers' weights are health risks, unlike smoking, eating is not a choice, and given that there are no gold-standard commercial weight loss programs out there certainly many motivated, diligent and health conscious obese workers are going to fail in their efforts to make "progress" and then get dinged financially for something known to be incredibly difficult for the majority of self-directed and commercially directed individuals - sustaining a significant weight loss.

Sure, ding the smokers, but until you've got a great place to send your obese workers for help and a means to identify those who for medical or pharmacologic reasons may struggle with losing, get your hands out of their pockets.

[Belated hat tip to loyal blog reader Ruth]

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  1. I wholeheartedly agree. Before I figured out the weight loss thing (by myself, I should add), doctor after doctor all my life said, "Lose weight!" but NEVER gave me anywhere to go or any sound advice on how. We need a comprehensive weight-loss program in this country. Penalizing people for being obese only ostracizes people rather than creates change.

  2. As you say Yoni, just more water on the mills of commercial weight-loss scammers,

  3. This comment has been removed by the author.

  4. Sorry for deleted comment above - I had some ugly typos!

    Yikes! Let's hope THIS doesn't spread around the country. People gain weight for about a million different reasons. It's not always about personal choice, nor is it always in one's full control. Even with a dedicated doc behind you (which is almost impossible to find when it comes to weight loss), too much weight is often a symptom of a bigger problem. The $25/month fee is just another social-engineering tactic that makes an entire group of people feel like outcasts. Way to go Alabama. Yet another reason to avoid taking a job in that state.

  5. Anonymous4:49 pm

    It's a good idea with a flawed plan.

    Perhaps individual employers could provide some operational definitions for "progress", such as participation in a "weight watchers" type of support group, or attendance at a the employee gym. Or even membership in a walking group organized through the employer.

    I know that out-put (exercise) isn't everything, but it could atleast get people concentrating on their health more.

  6. Anonymous2:17 pm

    This is all stick and no carrot. It's also premised on the ideological assumption that obesity is primarily a matter of personal choice and responsibility.

    I'm betting on Alabama's tax coffers and waistlines both expanding.

  7. Do you think it's possible for someone to have a BMI of 35 or greater -- who is regularly physically active and maybe never going to be smaller, and cost the state less than someone who has a lower BMI but doesn't exercise, eat well, and do the myriad of other things that help people stay healthy? If only fat people and smokers generated "excess healthcare costs" this would make sense, but there are many healthcare costs that come from just from being human.

    Thanks for your perspective on this (better late than never).

  8. Wellrounded - it absolutely conceivable for folks with BMIs higher than 35 to cost their employers less than folks with BMIs in the healthy range and it's certainly one of the main flaws in this misguided plan.