The plan is actually to raise the rates on ALL state workers (move them to the 70/30 plan) and then allow them to prove that they are NOT obese by submitting to a BMI assessment and that they are a nonsmoker by submitting to random ’smokerlyzer’ tests.

Can you imagine? The smoking police? And besides the indignity you’re submitting a whole workforce to, one obvious consequence is you’re not going to have 100% of the non-obese non-smokers certify for the better rate. It’s just statistically impossible.

http://pulse.ncpolicywatch.org/2009/04/20/house-should-stand-strong-on-state-health-plans-flawed-wellness-provisions/

The penultimate para in the Time article seems like a ray of hope though. I like this quote: ‘Says George Huntley of the American Diabetes Association: “This is not a wellness program. It’s a penalty for failing to achieve a specific health status.”‘

Thanks for writing these kinds of stories.

Good comment. I read Bagaent’s column and thought it was really great. Thanks for sharing it. I thought your summary was great.

Is cutting down on smoking and obesity a good idea? Sure. Is creating a financial incentive a good way to get people to change their behavior? Absolutely. But it does seem cruel at times to tax the little pleasures that people who are struggling use just to get by.

Yes, a cigarette would fall more heavily upon the poor as they do smoke more. However, a detail that you excluded from your discussion is that cigarettes kill a huge number of poor people every year. About 440,000 people die in the US from tobacco use and if you figure that 2.4 million people die each in the US each that means that almost 1 of every 5 deaths is related to smoking. That is more than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined. This is to say nothing of the non-fatal health problems related to smoking chronic bronchitis, emphysema, heart disease, and cancer.

Since it is the poor who smoke disproportionately, who then suffers the health effect and costs of tobacco use disproportionately? The poor of course! If they can be encouraged to not smoke it is they who will reap the benefits. I will not even talk about how much money they will save by not spending money on cigarettes.

Now a simple Pigovian tax (on both the cost of cigarettes and in this case on insurance permiums) has been shown to effectively reduce smoking. However, if this tax is combined with low cost smoking treatment programs, then the benefits, to the poor, will even greater. Most of the insurance premium reduction programs you mentioned include this provision so it is not like smokers just pay more, they are also given programs to help them quit smoking.

Weight reduction is a bit more complicated but the same basic ideas apply.

On the whole, it is a very good idea.

If you’re poor, there are very few things that offer a refuge from the relentless attack of Money. Food and cigarettes are a couple of the legal things that let you escape.

There’s a nasty mean streak in American politics, equally present in what passes for the Left, that makes me believe the poor will be taxed until they can’t walk. It lets everyone else off the hook. Besides, who is going to defend the them–aside from the odd reporter–compassion is seen as a weakness, something a lot of people don’t feel they can indulge.

Too, condemning–then taxing for their own good–someone who is overweight or smokes feels good, and appealing to middle class smugness will win you a lot of votes. Everybody, well almost everybody, wins.

That’s a bumbling summary of Bageant has to say. I’d urge anyone to check out his work. The man can write.