Should There Be an Obesity 'Penalty'?

By , SparkPeople Blogger
Alabama state workers who are obese have one year to slim down—or they'll have to start paying for health insurance.

Beginning in 2010, Alabama, the second-heaviest state in the U.S., will start charging $25 a month if its 37,000 employees don't submit to free health screenings. (Smokers are already charged $24 a month, and that will increase to $25.) Alabama will be the first state to charge workers for being overweight. The health insurance is ordinarily free. According to the Associated Press:

"If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won’t be charged. But if they don’t, they must pay starting in January 2011."

Some other facts to ponder:
There 45.7 million people in the country are without health insurance.

Obesity rates are up in 37 states, and at least 20% percent of adults are obese in every state except Colorado.

Should obese employees be penalized financially? Is Alabama acting a bit too much like Big Brother?

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I honestly think this is a good idea. I see too many people killing themselves with bad food..the same people who will be the first to complain about other bad habits such as others smoking. As high risk individuals who choose to live a unhealthy lifestyle, the cost to insurance companies is high. With any other high risk person, be it smokers, high blood pressure, etc, there are higher premiums. I don't look at this as penalizing those with unhealthy lifestyles, but rather rewarding and incentivising those choosing healthier lifestyles. Report
What will be next? Will you pay more if there is a family history of heart disease, cancer, etc. How about $25 per child for each child and not just a flat rate for family be that one or 10 kids. In fact why not the entire cost above and beyond a single policy. Charge a person of color more because they are more likely to have pancreas cancer and leukemia.

Let's provide incentives and an opportunity to get healthy food not just in the executive offices but also in the plants. Vending machines within the building should not have packaging of more than one serving or greater than 100 calories. Information is on the back of package and cannot be read until after purchase. Report
We are always looking for someone to blame. In the case of the "obesity epidemic", where do you start? We know where we finished, too many Americans overweight and facing health issues.

I think the insurance companies, schools, state govements, etc should be more pro active engaging in prevention.

I know that too many people do not understand the concepts of insurance and risk. Report
I don't know how I feel about it.
I suppose they count progress as lower cholesterol, heart rate etc.
Of course it's good to "fight" obesity, I just don't know if this is the way to do it. Report
Are they really being penalized or is this a benifit for people who stay fit? can be looked at both ways. Also, it's similar to any insurance where high risk will cost more. You pay more for life insurance and car insurance if you are high risk, why not health insurance??? Report
I think it is a good incentive. But I don't see how people can decide what progress has been made? Report
Wow, quite an interesting story and lively views. Is there any update to this story now that it's 3 years later? Report
all i have to say is wow !!!! Report
I don't like the idea that the person must prove they have made "progress" within the year in order not to be penalized. Who defines progress? Does a person who loses twenty-five pounds show progress, or does he miss the mark because he didn't lose the thirty he "should" have lost? As we know, people here lose weight at different rates, depending on many factors including calories and exercise, medications and other health issues.

It might be fairer to have everybody screened for health issues, and then address those health issues within the year, making resources available for various issues.

Referrals to a nutritionist, hypnotherapist, acupuncturist at company expense, a site-sponsored Weight Watcher's meeting, AA and NA groups, an on-site gym or a voucher for membership at a local gym, even psychological counseling for those who would benefit from it -- all these things would address the heart of the issue, unhealthy habits, without pointing a finger of blame at "Fat Charlie" and "Diabetic Gloria."

I am also starting to believe people should have to try diet and exercise before starting to take medication for pre-diabetes, etc.

So I believe this is a fine idea. Sometimes people just have to be forced to do the right thing. Report
Something's gotta get people at high risk to start drinking the water they been brought to. They've been standing there long enough and now it's costing you and I: the taxpayer. If I'm making efforts to watch my weight through healthier eating and exercise why should I subsidize someone who doesn't care how long they sit in front of the tv or computer and what they put in their mouths? They should pay and maybe that'll get them thinking about making the change. Cash talks and bs walks. Report
I live in Alabama but am not employed by the State. I too see pros and cons on this. From my stand point - my tax dollars pay for these employees' salaries to an extent, so as their medical problems increase due to smoking, obesity or what have you, it causes more money to leave the state fund to go towards their "free" insurance offered by the State. However, and also from my personal stand point....what if an employee has a thyroid disorder (as I do) that causes them to be overweight and diet and exercise do not help? Luckily my thyroid disorder has not interfered with my losing weight but there are many people out there that it does affect as do many other diseases I'm sure. I think there should be some stipulations to the program. There are many 'normal weight' individuals that are more unhealthy than many overweight individuals - heart disease, cancer for example that maybe could've been avoided if the individual had chosen to lead a "healthier" just something I hope they have thought through and from what I've seen in this state - they probably didn't think about it that much!! Report
Personally I can see the good and the bad here. But if they're already charging a premium for a personal choice to smoke, then shouldn't they being charging for any other health choice that is made that could damage a person's health? It was pointed out the slippery slope of this situation, but I find it unfair to antagonize those who smoke and not those whose habits are just as unhealthy.

The difference is you can hide being a smoker to an extent. In your annual check up say that you quit and it can explain the state of your lungs or any other symptoms you may have, but you do not have the choice to hide obesity. No matter what it's the first thing the doctor will see during your check up and it will be noticed.

I think it's an interesting idea, and it's something the British health care system does to limit high risk individuals (premiums for smoking etc.) Fair? Maybe to the smokers who feel singled out, but to those who are overweight? I can't say. Report
Yes, I think it is fair. If you take their insurance they have the right to dictate the
terms of the policy. Obesity may be a disease, but it also may be a by product of
cheap abundant food, and the fact that we are a more affluent nation than before.
There are consequences to all our actions, that is just a fact of life. We spend a
lot of money on diets, why not spend some on our insurance if we are unwilling to lose
weight. I don't believe in rewarding bad behavior and to ask the insurance company
or state to reward people when they lose weight is silly. The weight loss in and of itself
is the reward. Report
It will force people to take better care of themselves, which will benefit them, their families, and their company in the end. It will open up the door for folks to challenge themselves, make healthier lifestyle choices, and set better examples for their children. If this becomes a trend, then I imagine that food companies will clue in and try to make their food healthier - otherwise they may no longer be able to compete.

Who defines "progress" at the end of the year? This seems leave a lot of leeway for insurance/the company to screw people (yet again - don't get me started on insurance companies!). Is progress the fact that you lost a few pounds, or do you have to lose 50 pounds a year? People are all very different and complex, and a variety of health issues could be the cause of high blood pressure, obesity, and the other things they will end up being punished for - is it right to punish those who are already struggling with medical issues? I have a real problem with that part. Report
If the state wants to decrease the obesity rate, this could be a first step, however, more motions need to be put in place. How about the ability to submit your grocery bill for cash back?! For every healthy item purchased, you get a percent cash back. As you lose weight, your $25 a month starts coming back into your wallet. I dunno, I agree that a penalty might be an incentive for some people to attempt the weight loss struggle, but I think it oculd work two ways, to have a reward back as an additional incentive to keep going! Report
This seems alright at first glance. If people choose the luxury of excess food knowing that it will negatively impact their health, why should someone else have to pay for it? It isn't like they would have to get outside insurance, which would cost way more than $25 a month, right?

But when you look again, there are some big problems with this. First of all, obesity is a disease. For many obese people overeating has ceased to be luxury or a choice. They aren't intentionally wrecking their health for pleasure, and they need real help, not a penalty.

This penalty is definitely coming from an outsider's perspective, and it misconceives obesity completely. Report
Sounds more than fair to me. Besides, 25/month is nothing compared to what most of us pay in my area. We pay 200/month and that's even low by standards here. Report
Sounds fair to me. Many people believe it's OK to charge smokers more so why not others who have increased health risks. I don't believe obesity is a disease and I know it's not easy to lose the weight once you put it on but it can be done. And maybe this is an incentive for some people to at least try. Or at least a way to offset the higher cost of health care. Report
Sounds fair ..they are giving free check ups free care and there trying to prevent long term problems ..I wish we had that chance here Report
As soon as we start doing the same for any and all other health related illnesses like high blood pressure, high chlosterol, no exercising, talking on cell phones while driving, unprotected sex, gay sex, etc, then yes maybe we should. BUt then wait, if we were all healthy, why do we need health insurance?? Report
I am so disgusted by this. How can a State decided to penalize you because you are overweight. Possibly the reason some people can't lose the weight is because they can't afford to. I have found how expensive it is to be on a certain diet. Yes, counting calories is good, yes some of the other diets out there work too, but there are people on assistance, that can't afford to go to places where they can get the help.
I think that instead of penalizing them, the State should opt for letting people into places like Weight Watchers for free and letting them utilize that programme so that they could lose weight. Penalizing them isn't going to make the problem go away, it will make it worse, because they will not be able to eat the proper foods to help them lose the weight.
This is just one Canadian's opinion. I think subsidized weight loss should be everywhere it is needed. Do only the rich deserve the chance to lose the weight?
No, I do not think this is unfiar at all. We have an obligation to ourselves to do whatever we can to change our lifestyles / health for the better. Report
I have been obese most of my life and I don't have a problem with this particular item. If the state were changing the rules effective immediately I would find it objectionable. However, these people are getting a free screening first and then a year to show some progress. It does not say they have to lose all their weight or get their reading down to normal in that time - just show progress. I think that is more than fair. It is not accurate or fair to compare obese people and the number of times they may or may not visit the doctor to someone who has cancer or other chronic health issues. We need to get people to take care of themselves before they get to that point. Many of us respond to negative incentives more than positive ones - I know I am one of those people. I do respond to verbal reinforcement and praise, but not to prizes and things of that sort. But saving money just might help motivate someone who needs a little extra push to get started. And I would think a wellness program would provide other positive reinforcements. Frankly I wish I had an option like this myself! Report
Recently, our city council wanted to start penalizing people that cut down trees over a certain size, now all of a sudden people are cutting down trees because they think they are getting close to the size. I suggested maybe they should instead reward anyone that has a large tree in their yard.

Well, I think the same concept holds true here. If you reach your goal, then you get a discount, but everyone pays a rate. Then it is a way to make people ask what could I do to improve my situation and would take away all the problems. Rewards allow people to be creative and adapt what they do to their individual profile. Punishments make people try to "get past the system", have anxiety (doesn't that raise blood pressure and lead to strokes), and be afraid to try again is they don't have success the first time around. This system complete fails to address that their are real reason why a person's weigh might not change, but they could get healthier, we aren't all made the same. Report
Hmmm, I'm considered obese but haven't even been to the doctor or hospital for anything since my daughter was born 4 1/2 years ago. Should I still pay?! I'm sure there's "skinny" people who go to the doctor way more than I do. Skinny does not always equal healthy!!! Report
If someone gives me something, then I feel as though there are always strings attached. If my employer offers me "free" health insurance, but the string is to submit to whatever hoops I have to jump to get there, then it's my choice to jump or not. There's never a free ride, and I don't deserve a thing I get in life unless I work to earn it. Report
I think I am going to be unpopular here. The article does say that the program will give people one year to see a doctor at no cost to resolve the issue and that they have to show progress. The program is trying to keep costs down.

The surcharges on tobacco use and obesity can serve two purposes: collect additional funds to offset the higher cost of treating lifestyle-induced illnesses and remind the insured that there is a cost to choosing not give oneself optimal care.

If the program had a way to eliminate healthy overweight people from the surcharge, I think it could be fair.

I am overweight and have PCOS; I have an unhealthy blood lipid profile, too, so if I were one of these employees, I would have to pay extra. I would need services and prescriptions more often to manage my health issues. Report
Talk of positive incentive are fine, but people will work harder to avoid loss than they will to gain something. The state employees in Alabama get FREE health care. If they don't want to change, they only have to pay $25 a month to stay morbidly obese and to smoke. If all Americans only had to pay $25 a month to pay for their health insurance, they would jump of joy. Crying alligator tears over such a minor cost, when it can be avoided by simply making healthy choices is ridiculous. Their health insurance is not "free", the tax payers of Alabama are paying for it and the state employees are getting a free ride at someone's expense. When people have to pay for something, they take more responsibility.

My wife used to work for an HMO and some plans had no copay for treatment and drugs. This led to abuse of the system. When the HMO instituted a modest $5.00 copay, the cost went down, because people stopped abusing the system as much. No one became sicker, they just didn't feel it was worth it to spend "their money" on trivial concerns and get a "free" sick day to go to the doctor and then go to the beach or park afterward. We are more motivate by fear of loss, even a small loss, then we are by a similar positive reward. Report
I think giving people incentives to be healthy is a good idea. It is a well known fact that obesity causes many health problems, so maybe this is what they need to do something for themselves? The people that are already doing the right thing shouldn't be penalized. I think they should come up with some sort of incentive kind of like car insurance. I'm a good driver, so I get discounts. People who are pro-actively taking steps to make themselves healthy should get health insurance discounts. Report
I am from the South and grew up with a very bad diet of fried foods, fatty carbohydrates, candy, soft drinks, biscuits, and overcooked vegetables. I weighed 350 pounds, so I was and still am morbidly obese. I have been working on restoring my health for 3 years. I've lost 50 pounds so far. I was also recently diagnosed with type 2 diabetes, which woke me out of my complacency. I have made substantial changes in my lifestyle: I follow a very healthy diet and exercise 6-7 days a week and my blood sugar is controlled by these changes without medication. My cholesterol is now normal and my blood pressure has dropped.

I see nothing wrong with forcing people to take responsibility for their poor lifestyle choices. We are all paying for the bad habits of those who continue to ignore their health. The Alabama proposal doesn't penalize people who are having regular assessments and who are making changes, just those who choose to continue to ignore the implications of being MORBIDLY obese. It is a factor associated with heart disease, diabetes, sleep apnea, sexual dysfunction, early death, and many other problems. Who wouldn't want to give all of that up to be healthy? If anyone chooses to stay unhealthy, then they should expect to pay more for that choice.

People who over endulge in alcohol, tobacco, and drugs, should expect to pay more for their poor lifestyle choice too.

My personal freedom stops where it affects another persons personal freedom. If my poor choice cost you more, then I have no right to expect you to pay for it. If I am willing to bear the cost for my lack of judgment, then I can do anything that I choose. But if I expect the state or the federal government to pay for my bad choice, then I am asking healthy Americans to pay for my freedom through higher taxes and I am no longer taking personal responsibility. I may have a right to remain ignorant, but I have no right to expect others to pay for my ignorance.

When people from countries with socialized medicine talk about free or cheap medical care, it is a lie. It is not free or cheap. It is payed for by higher taxes; it is not free. If you are not paying for it, then someone else is paying your share. Report
I think this is a good thing with an exception to people that have something that disables them in some way that they cannot loose weight. I totally agree with having rewards for people who loose weight but then it sucks for the people who are healthy. Then they have no way to get rewarded. My sisters company gives people $100 to quit smoking. She does not smoke. So maybe shold she start smoking so she can get $100?

If they are going to be rewarding people for going from unhealthy to healthier why don't they do things for the people who are making good choices?

Also, if the company has a lot of unhealthy people then it can cost the company thousands more per a person for insurance because of their choices. I think this makes people take a little more responsibility for themselves. Plus, what's it gonna hurt? Why is trying to make people more healthy such a bad thing? Yes, so this does it by giving them negative consequences like less money but it's better than down the road them ending up in a hospital.

....Just a thought. Report
I don't agree, instead give a prize if they loose weight. A bike every month. Some items of clothing, a ticket to a movie, a ticket to a concert, a night in an expensive hotel, a book, etc. Report
I don't think they should.It is a little sad. The person is entitle what the person can afford. It is not a crime to eat, and on the contrary at times this could calm a person from doing something wrong.There are amusements that people can not afford, at times perhaps even using the car could be expensive. Food is an inexpesive item at times.I don't think anybody has the right to deprive anybody of something that is legal. Report
There are several companies that are rewarding people (with cash or gift certificates) for their healthy lifestyle, but these are companies that make you contribute to your insurance coverage in the first place. The Alabama state employees are covered at 100%. I don't think the amount they are asking people to pay for their unhealthy choices is unreasonable. With that being said, there are plenty of skinny people who are unhealthy. There are plenty of skinny people drinking excessively and destroying their liver. Or are skinny fat. What about the skinny guy or girl who is still sleeping around excessively sans protection and increasing their risk of an STD? If you are going to target one group you should be fair and get them all. Report
I think the screenings are a good idea, but why single out obese and smokers? I saw a comment that said "obese people use more medical services than those that aren't"...well, that's quite the assumption now, isn't it? During my adult lifetime, I've been obese most of it. My father (now deceased) was underweight his entire life minus his boot camp days. Due to his illness, he went to the dr. far more than I did. People with cancer go to the dr. more than I do. I go for my screenings and check-ups as I am supposed to. However, if you are going to penalize one group for increased use of insurance- to be fair, look at all of them. Don't look at just a 'across the board'. Insurance is a great thing and yes, I can see where increasing costs in consumer use can increase costs for the provider. But, assuming that everyone overweight has diabetes, heart disease or other maladies is well...we know what the word assume breaks down into, don't we? What about people that are within a healthy weight range but have to see a dr. more for heart disease or cancer? People they are out there...I'm just saying that if you do this- do your homework and do it right. Bottom line. Report
This is a good idea. I mean instead of thinking that they are just calling out all overweight people...its more to it. They are even willing to get you free medical help for a whole year in order for you to become healthier. You guys have to realize that even though your insurance is free, it is still costing the company a significant amount to cover your expenses. Besides, you should want that extra push anyway. Report
I too agree that this is not the way to go about this. Government does need to stay out of our personal lives. I agree with another poster who said they should motivate, not penalize. After all, they have no idea what caused the person to be overweight in the first place, or what that person is facing in their personal life. It's just something that the "powers that be" should not stick their hands into. Report
I think its great. I wish I didin't have to pay for insurance. We are responsible for our well being, but if you choose not to take care of yourselves then you should shoulder some of the cost for treatment. $25 is a gift. The state is offering help by giving them a year to make changes and show progress, I think that's great. Report
Discrimination is discrimination no matter how you phrase it. It's still wrong. Those unfortunate people with recurrent cancer, AIDs, chronic health issues unrelated to obesity need constant follow up and are very costly. Some of those issues could have been prevented by lifestyle choices as well. Are they also made to paid? Who sits as judge and jury? Make one "group" pay, they all should pay. Report
I think this is a GREAT idea. People or living lifestyles that lead to early illness, heart disease, cancer, diabetes, etc. That an employer CARES enough to PUSH hard where it hurts the most, in your WALLET is just great. But what they need to do besides chargin their employees $300 a year to stay as they are, a REWARD system would probably work even better. Pool the money they are charging the unhealthy, and plan to give the WINNER the POT of money!!! Could be a LOT!!! The great thing is in the interim you are going to get employees actually working on getting healthy. Those who don't win the POT, would win having thier health back, and $25 more a month back in their paychecks at a time $25 is ALOT!!!! Report
I don't think this is going to work the way they think it will. There was recently a study in the Harvard Business Review about daycare centers who started charging parents who dropped their kids off late. Tardiness actually increased once tardiness became a commodity they could buy, instead of an obligation to the other parents and the teachers out of respect and kindness. So I would beware of that.

They're at least going about it the right way, having a real screening for severe problems that are preventable. That just makes common sense to me. Report
Because I am overweight I do pay a higher insurance premium! It gets to the point where our government is not our parents we have to take responsibility to some extent. Obesity cause more problems health wise next to smoking and the use or recreational drugs. If one loses weight those health risks are diminished. At least they are getting a year to do it. That would be an incentive in itself to lose weight or pay more!!! Report
According to the first paragraph these people don't pay for their health insurance. Think of how many medical problems you can have from being overweight. And they have time after their first screening to improve their helath and they won't have to pay. So $25 a month is cheap. Money is always an incentive to change. Report
Alabama is famous for their fried foods, and other unhealthy choices. Do we really think that they are going to stop eating this kind of stuff? Doubtful. Report
Do you think they'd be overweight if they could stop themselves. Doing something motivational for them would maybe help. But not penalizing them again and again and again. Government needs to stay out of our personal lives!! Report
Do you think they'd be overweight if they could stop themselves. Doing something motivational for them would maybe help. But not penalizing them again and again and again. Government needs to stay out of our personal lives!! Report
My husband's company already charges us $350 a month for health insurance. He doesn't work for a state or federal government. He works for a private company. No we are not obese, just trying to stay healthy. $25/month is CHEAP! No wonder our taxes are so high - taxpayers are paying the premiums on state/federal workers insurance. Report
Also one more note:
If the insurance company does not pay for you when sick...All medical people lose jobs & Hospital's close!
If the insurance does not pay in diaster....All construction people lose jobs, housing markets crash! AND people become HOMELESS!
If the insurance does pay for lost securities.........All financial people lose jobs & Wall Street gets hit hard!
OH! Sorry we did cover that this election year. Point Have we Learned nothing for our mistakes. STOP POINTING THE FINGER AND BECOME PART OF THE AMERICAN DREAM TEAM! Report
Well an interesting thought, but to me it is sort of like HITLER'S theory!
If an insurance company is in business: 1) to provide medical care to you when you need it, 2) you pay a rate every day for that coverage, & 3) you must never need to use that BENEFIT...Then what am I paying for?
From the insurance side of this...I need to open an insurance Company! That way I can make millions taking perfect people for their money & deny my part when or if they get sick.
This is like the 2005 Homeowners insurance SCAM "the year of the storms!" These insurance companies took payment from homeowners for 10-20 years while the weather was fine. The year of the storms when people needed that return I seen what I called a post diaster-Diaster! The pain & suffering caused by that industry was worse than the storm! Has any area been returned to prestorm status as promised when signing up with their insurance company? The Insurance companies have had 4 years now to pay off their promise with money they collected from us before & after this "storm year".
I am a R.N. who does not go to work and expect my "BUSINESS" to have me take care of only healthy people. I do not know how many people in this country have a job where they get to LEGALLY promise FULL SERVICE and deny results!
I hear that the taxpayer will pay back the bail out money in the long run. I want to be given EXEMPTION from paying for the banks mistakes! I also hear there is no Social Security for the "Baby Boomers" yet both my parents worked all their life paying in! My father Died prior to one cent return, andmy mother recieved Social Security for 2 years prior to death. This couple added to the Baby Boom by having 11 children who also paid in for now 20-30 years with promise of no return! There it is Lucky 13 pay in with only 2 year pay out returned. Starting to sound Familer?
So, Food for Thought....Lets reverse that! Can I have a federal promise that no insurance company takes my money until we have audits of monies promised being available & secured in an account that only the ferderal goverment has my deciding control of returns?
My law makers working FOR THE PEOPLE? Welcome to Office President Obama- start here you may be able to fix our ecnomic crisis by recoup of funds that were taken by these companies from THE PEOPLE for the past 20 years alone!
Bottom line....NO NO NO! We are a nation of people working as a team! If I accept that I will pay 1/4 of my life's income to taxes with no return, {to help my children & grand children} then I am willing to fight for the FREEDOM OF AMERICA to choose their lifestyle and willing to pay the price for that! The American Dream is the responsiblity of all not just the military. This is not a BIG BROTHER.........THIS IS HITLER THEORY! I am paying my dues & waiting for my ticket to the GAS CHAMBER! Thats my story & I am sticking to it! Report
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