Fining the Fat People

[JoyJoy]

The Arkansas Medical Society recently interviewed State Experts about what they feel are "Urgent Health Care Issues" that need to be prioritized by the State's medical community, as published in the May issue of their Journal (not available online). One of those interviewed was the Arkansas Surgeon General, Joe Thompson. In his interview, he made the following statement:

"We're working through schools and through our health care system to address this obesity epidemic that we're in. We're the only state that can say that we've halted childhood obesity; at the same time we were seeing health insurance premiums go up because of the large number of people with chronic illnesses caused by obesity.

Seatbelts and the trauma system (an issue he addressed earlier in the interview) are tied together closely, but these two issues (obesity and health insurance premiums) are farther apart. We're working to bring them together. For example, for state employees who have taken the health risk appraisal, we've added new benefits to their insurance plan so they can participate in a nutrition or weight loss program. We've looked at how premium increase is caused by people's risk factors. We have in place some premium differentials based upon behavior.

With this, we're trying to tie economic issues to behavior to align incentives. When incentives aren't aligned - as they have not been - we've told people "it doesn't matter what you do, how much you eat, how much activity you get, we'll pay for it when you get sick." To achieve what we want, we need to align incentives and say, "we will pay for it, but it may cost you more if you haven't taken care of yourself."

By my interpretation, this is saying to me, "If you choose not to lose weight, you will end up paying more for your medical care than average (and obviously healthier) people, even if you think your health is fine, because we know there's just no way you can be healthy and fat. We know what's best for you, so if you won't do it yourself, we'll find ways to make you do it."

I'm curious to see what others think of this statement.

 

[Tad]

 

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[JoyJoy]

 

[pani]

 

[bbwlibrarian]

 

[olwen]

 

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[Tina]

 

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