Will the “Fat Tax” Come to a State Near You?
|December 31, 2009||Posted by Roshawn Watson under Uncategorized|
What is The Fat Tax?
Alabama plans to pass some of the excess costs associated with high blood pressure, high cholesterol, high blood glucose, and excess pounds (body mass index>35) to state employees. Initially, all state employees must shell out an additional $25 per month for health insurance. State employees will be required to participate in frequent health screens, which includes the dreaded weigh ins. Those who get clean bills of health will be refunded their $25 fees. Employees found to have the aforementioned risk factors can get the fee waived by seeing their physicians, enrolling in a state-sponsored exercise or nutritional class, or losing the excess weight in a year. For example, discounts will be offered for participating in Weight Watchers and joining a YMCA.
Implications of the Fat Tax
There are vast implications to this change, as this sweeping legislation will affect 37,527 state employees. To put things in perspective, a BMI of more than 40 correlates to being around 100 pounds overweight, and 7.3 percent of Alabama state employees fall into this category according to William Ashmore, CEO for the State Employees Insurance Board. Their obesity costs Alabama in excess of $5 million per year. Additionally, Alabama has the second highest rate of obesity nationally, just over 30 percent of their state population. Obese people can cost Alabama 40 percent more in healthcare bills than people of normal weight do: $2,000 more per person each year.
This is not the first time Alabama has chosen a punitive route to deal with the ever-rising health care costs associated with preventable ailments. Presently, Alabama already charges smokers a $25 per month surcharge. Ashmore says “the main thing we’re hoping for is to identify at-risk people and provide the means for them to manage their health issues. Many people do not know they have hypertension or are diabetic. We want to try to make sure every employee is given an incentive to figure out what risks they might have.”
Compelling Argument or Creative Spin on a Fat Tax
There is a clear need to promote better wellness, as health care costs are astronomical, and many perfectly capable people are failing to prevent chronic diseases and better manage their health. High blood pressure, high cholesterol, high blood sugar, and abdominal obesity really do represent major threats to our health and big resource drains to our health systems. Particularly, these four health problems are components of metabolic syndrome, which predisposes individuals to cardiovascular disease, stroke, and type 2 diabetes mellitus. Incidentally, better weight control through diet and exercise may contribute to better blood pressure, cholesterol, and blood sugar control.
The main problems with this legislation are that weigh ins are demoralizing for some people and this legislation appears to penalize individuals who may have predisposing disorders that contribute to their maladies, such as thyroid disorders and genetic aberrations. As someone who use to be over 40 pounds overweight, I can tell you that it can be a very sensitive subject. I recall ending a friendship two years ago because someone called me a former porker. Drawing attention to their weight in this way may motivate some to be more healthy just to avoid the embarrassment. Also, there are many underlying contributors both biological and social (i.e. abuse) that may increase someone’s weight. Yes, these do need to be addressed, but I wonder if Alabama will increase their research efforts make sure that they aren’t unfairly penalizing residents who are at a tremendous biological disadvantage.
Although they say the primary goal of this program is to motivate people to be healthier, I wonder if there are better, non-punitive ways to motivate people to take charge of their health. One thing is for sure, doing nothing is not an acceptable option either.
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Image Credit: Sheilla May O. Baes
Copyright 2012, Roshawn Watson, Pharm.D., Ph.D. All Rights Reserved.