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Alabama Makes Unfit Workers Pick Up Tab For Insurance

Giving up buttered grits for health care? As Alabama ballooned to take the #2 spot (right behind #1 ranked Mississippi) in the national obesity rankings, the state is cracking down on free health care payouts for state workers who are overweight. It's issued a get-slim-or-pay-up ultimatum for the nearly 40,000 workers on the state's insurance plan. They'll have a year to lose weight or start paying $25 a month toward their usually free plan.

Alabama already charges smokers — an incentive that has spurred some to snub out the butts — and other states reward workers for healthy habits. Ohio, for instance, pays workers $50 for getting health screenings and $50 for following the advice.

Not everyone is happy about the plan. To see why,


One size-acceptance advocate says the new Alabama insurance policy will cause stress for workers. She says, "I'm big and beautiful and doing my best to keep my stress levels down so I can stay healthy. That's big, not lazy, not a glutton and certainly not deserving of the pompous, poisonous disrespect served up daily to those of us with more bounce to the ounce." The Alabama program will go by the body mass index chart — anyone with a BMI over 35 will be charged. Research shows that this demographic costs an average of $1,700 extra dollars in health care per year, far more than the $300 an overweight worker will be charged.

Is this plan fair? Is it a good plan to motivate healthy changes, or does it tip the scales in the wrong direction?


Join The Conversation
Cassandra57 Cassandra57 8 years
They are still studying the causes of obesity. It's not as clear cut as "smoking is universally bad for you." There's research into brain function (how the brain recognizes when the stomach has had enough, and how that communication breaks down). There's also the question of metabolism. Also, we must consider whether there are other contributing factors. I have a friend who, although not obese, has put on a little weight because she has rheumatoid arthritis (developed it in her 20's) and it hurts to exercise. I'd love to be able to go to the gym. I don't have time. I have a (desk) job and a family to take care of (chauffeur, et.), and that's more important. How about a surcharge for "Type A" people? They're prone to high blood pressure and heart attacks, not to mention adding unhealthy stress to other people's lives.
jenintx jenintx 8 years
I think they should study these other factors that people have brought up (drinking, pregnancy, birth control, etc) and see how they compare as far as extra cost goes. if people on birth control cost as much as people who are obese, then make them absorb some of the cost as well. i don't think that would be the case with birth control, b/c the $20 or $30 the state is saving me on my birth control a month (which is the generic version and must be mailed-in) is a lot cheaper than me getting pregnant and having a baby a year :) as far as the state offering insurance, i don't actually think it's unreasonable to make this request. i work for the state and i make probably less money a year than anyone else posting. but my benefits (free health insurance, free use of the gym, etc) makes up for my lack of pay. additionally, my agency offers a wellness initiative, in which we are permitted 30 minutes of "work time" to workout. meaning when utilized, you are only working 37.5 hours a week and are being paid for the additional 2.5 hours you are spending at the gym.
MartiniLush MartiniLush 8 years
GeriAnne1932, something along those veins actually happened to me! When I was working for a large, national banking firm, the portion of the premium that we paid for our health insurance shot up considerably one year. Everyone was freaking out and asking why...the answer from HR was that "there were too many women having babies" which had "cost the insurance carrier a lot of money in paying out claims" so they raised the premiums!
jessy777 jessy777 8 years
I too worry that this sweeping arm will become too broad but for now I think this is a great start to getting people healthy. I believe that is the most important thing because we are dying at a high rate of speed compared to our parents. At this rate our children won't survive us.
jessy777 jessy777 8 years
Absolutely. I do not agree with docking pay or job removal which are previous ideas different states have thrown out. I like that this puts the financial burden on the individuals who refuse to do anything about their weight. However, I think that it should be a complete physical evaluation because the BMI scale is not an accurate measurement of health. A person can be thin and have an ideal BMI but still have high blood pressure or cholesterol, all things that cost companies more in insurance payouts. I also think that it would be great if the state would provide weight loss assistance or seminars to get employees moving. It can be hard to do this on your own but it isn't impossible.
Jillness Jillness 8 years
" then expect people who are known to have been drunk even once to be targeted and single women who have prescriptions for birth control might prepare for a second look from the company" The "company" would have no reason to do this unless the health insurance company started charging these people more. For example, Health insurance costs go up when you hit a certain age, and employers many times ask the specific employee to cover this change in cost. I don't really see a difference. I look at this from a fellow employee aspect as well... MY health insurance premiums go up when my co-workers have more expensive health care. Either we are going to have the non-obese people sharing the burden of that extra $1700 a year, or they will have to find a way to make the people who are costing extra pay for themselves. I don't think we should punish people for being obese, but I also don't think we should automatically absorb the extra health care costs. I have read plans about the idea of putting catastrophic illness in a separate insurance plan, so that it doesn't drive up the costs of others in a company if one employee gets struck with a C.I. I wonder if this would work for obesity as well.
True-Song True-Song 8 years
Also agreed on the unfairness of targeting obesity over other factors. That's why I think maybe the better way to go is to just provide health programs, like some offices do their own version of "The Biggest Loser" or reimburse for things like exercise equipment or programs like Weight Watchers.
amybdk amybdk 8 years
"If it's a matter of companies not paying for unhealthy lifestyles, then expect people who are known to have been drunk even once to be targeted and single women who have prescriptions for birth control might prepare for a second look from the company." I agree.... and let's not forget those who suffer from depression or other pre-existing conditions. I am not sold one way or another. But once employers start charging their employees for this, what will stop them from charging for other problems? Anyone have a reliable, un-biased source for health care they'd like to share?
TsuKata TsuKata 8 years
It is an incorrect assumption that once you gain weight, you can lose it without medical procedures. That is true for less than 20% of the population, and those who have that ability are very likely not the ones being targeted by this bill. Dieting is not effective; this has been proven many times. Dieting plus exercise is hailed as the one true way, but it hasn't been proven effective either. It can result in short-term loss, but it's never been shown to maintain that loss over any significant period of time. Seriously, does anyone think that fat people need a "kick in the pants" to know that society frowns on them and thinks they're unhealthy? Please. We have every mainstream media outlet in the country telling us that. You think it's *laziness* stopping people from losing weight? That's such a joke. It's not laziness; it's that losing weight in a sustainable way is a Herculean task. If it weren't so hard to do, there wouldn't be ten million books and at least eight national programs selling like gangbusters trying to tell you how to do it. I encourage everyone to read Fat!So? by Marilyn Wann and also The Obesity Myth by Paul Campos. It's a start to actually understanding weight gain and fat rather than just accepting what you think you know about it.
stephley stephley 8 years
If it's a matter of companies not paying for unhealthy lifestyles, then expect people who are known to have been drunk even once to be targeted and single women who have prescriptions for birth control might prepare for a second look from the company. Anyone involved in any kind of sport - it may help your heart but a lot of people end up with pricy broken bones and torn ligaments, and wear & tear problems in later life. Why should companies pay for physical therapy for people who are just going to go out a ski again?
Jillness Jillness 8 years
The problem is that this isn't about the companies forcing people to be "healthy". It is ALL about the company having to absorb extra medical costs for employees who are obese. At GM a couple years ago, they had to cut back benefits for ALL employees because they were paying so much in cholesterol, high blood pressure, diabetic medication for SOME employees. " If it really costs an extra $1700 per overweight employee, asking the employee to pay $300 a year to offset that cost is not that outrageous, IMO." I agree. And Tsu, I agree with your statements about what needs to be done to address the industry as a whole. (And because I couldn't resist...Obama attacks those problems in his health care policy)
littleblackninja littleblackninja 8 years
Awesome idea. No state should have to pick up the tab for their employees' unhealthy lifestyles. Money is the only language people universally understand, so this may do the trick to get more overweight people to do something physically with themselves.
ilanac13 ilanac13 8 years
i agree with some of you guys that are torn on this one. i think that it makes sense for the state to ask people to contribute if their health issues are as a result of their weight. if they are large and healthy - meaning that they are active and they eat properly - but are just bigger -then that's one thing, but if they are unhealthy and don't take care of themselves and as a result have more medical bills - then they should be asked to contribute. i know that for myself - i'm in shape and rather thin, and i have to pay for my health care - so i think that it's only fair.
GeriAnne1932 GeriAnne1932 8 years
Are they going to charge women who are having sex too? Because, I would imagine that a woman giving birth costs a lot more for the company, so maybe to save money they should just hire thin, fit men to work for the state. (this is my being sarcastic...) I really think that instead of focusing on adults that are far harder to change, the focus should be on children and young adults who can still learn healthy habits and start their lives off right.
Michelann Michelann 8 years
Snowbunny, yes other companies are required by law to give their employees health insurance. If you read carefully, you'll see that I said I don't like this system.
kastarte2 kastarte2 8 years
cab, That's an interesting perspective and I think it makes a lot of sense.
snowbunny11 snowbunny11 8 years
Michelin- as government workers, I would assume it's part of their compensation. Since many private firms offer health insurance to their employees, are you suggesting that state workers should not get it? Tsukata- the post says it costs $1700 a more in costs per year for this demographic. I mean the assumption that healthcare costs are higher for this demographic, on average, is based on the fact that healthcare costs are higher for this demographic. I mean, for example my mom is technically obese, and she has type 2 diabetes. Being overweight severely raised your risk for health issues. Fine, we all know someone who is very overweight and healthy as a horse, we know people who smoke their whole lives and live until 90. The point is that on average these people will have higher health care costs. And I'm not completely blaming mom is on medication that is associated with a very high risk of gaining a lot of weight! I'm not sure that the way they are implementing a punishment for being overweight is that great, but I don't blame them for trying something. If it really costs an extra $1700 per overweight employee, asking the employee to pay $300 a year to offset that cost is not that outrageous, IMO. Still, I'd like to see the state use that extra $300 to pay for a gym membership for these people, or something along those lines!
hausfrau hausfrau 8 years
I'm feeling lazy so please excuse me for not reading all the comments on this before posting. However, I read an article in BusinessWeek a while back that said that it actually costs MORE for health insurance companies to insure healthy people because they live longer and therefore they have to insure them longer and pay for the diseases of advanced age. Overweight people in comparison are a bargain because they bump off earlier. Sounds pretty morbid, but it does seem logical if you think about it.
TsuKata TsuKata 8 years
But if that health care is a benefit of the job that is given out to everyone, why are fat people singled out as the ones who have to pay extra? Do they ask everyone in the state health care if they skydive, drive race cars, skateboard, ski, or do any other risky (and insurance rate affecting) behaviors? Are they asking people who aren't fat to prove that they're healthy? Nope. They're doing this because fat is visible, and being generally unhealthy is let's attack the problem we can see rather than the ACTUAL problem. It's a bad assumption, and it saddens me that so many folks on here seem to make the same assumption. Also, let's be realistic for a moment. The true problem here is that health costs are rising, and Alabama is a state that is having trouble paying its bills. Much as states increased taxes on smokers to make up for bad spending and faulty policies, they're looking for a way to take advantage of another group that has fallen out of favor with the masses to cover up the failing of their systems. So, instead of yet another band-aid, let's fix the healthcare industry. Let's make it competitive so that insurers don't profit from monopolies. Let's make health care providers publish their rates and give estimates the same way any other service provider does...and thus, we can empower Americans to make wise health decisions. It's a bigger solution for a bigger problem...but it's better than going after bigger people.
Jude-C Jude-C 8 years
Agreed, UnDave.
Michelann Michelann 8 years
Snowbunny, if you read my previous comments, you'd know I don't think the state should be giving them "free" health care anyway.
javsmav javsmav 8 years
"I don't mind if you want to practice an unhealthy lifestyle, but don't make everyone pay for your bad habits." I agree. If you want to be fat, you have every right to stuff yourself silly, but just know that it will cost you more. I don't see anything wrong with that. The government should not tell you how to live, but if you want a service it offers, then you have to play by its rules.
UnDave35 UnDave35 8 years
I like that this state is cracking down on the people who are overweight, especially since they are getting free health care. That means the taxpayers are paying for people to be unhealthy. I don't mind if you want to practice an unhealthy lifestyle, but don't make everyone pay for your bad habits.
snowbunny11 snowbunny11 8 years
"Research shows that this demographic costs an average of $1,700 extra dollars in health care per year, far more than the $300 an overweight worker will be charged." That's $1700 per govt worker that you are paying!
snowbunny11 snowbunny11 8 years
Michelin- "it's not the business of the state to be involved in someone's weight." Uh, but it's the state that is giving them FREE HEALTH CARE! I think that a much better idea would be to include gym memberships in the healthcare, and offer incentives for weight loss, or being a healthy weight. The point is NOT that the government cares how much people weigh; rather they will save a TON on healthcare if people start losing weight! And this cost is passed back on to taxpayers.
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