Quote:Alabama is rolling out a creative but controversial program that will subject its 37,527 state employees to possibly humiliating at-work weigh-ins and fat tests. If they tip the scales, they'll be given a choice: slim down or pay up.

The state is trying to solve two of its biggest problems — health insurance costs and obesity — in one fell swoop.

Beginning in 2010, Alabama, which has the second highest obesity rate in the country, will start charging all of its employees an extra $25 per month for health insurance. (Currently, single workers pay nothing; family plans cost $180 a month.)

But there's a way to avoid the fee: Get a check-up at an in-office "wellness center," where nurses will check for diabetes and hypertension and measure blood pressure, cholesterol, glucose levels and Body Mass Index (BMI).

The idea is to encourage employees to act responsibly, lose weight and lower their health care needs. But critics say it will humiliate and stigmatize obese employees and amounts to nothing short of a "fat tax."

A BMI test uses height and weight measurements to calculate the percentage of body fat in adult males and females. Alabama is using a BMI threshold of 35 — 30 is considered obese, by most medical standards — to determine who doesn't have to pay the automatic $25 deduction.

Health practitioners often factor in skinfold (fat) and waist circumference measurements while calculating a patient's BMI.

Does Alabama think you're fat? Take this humiliation-free BMI test online.

If you're deemed fit, you're exempt. But if you flunk the BMI exam, it's shape up or pay up. Obese workers will be required to see a doctor and will have to show proof of their attempt to lose weight.

The program is optional ... sort of. If you don't take the tests, you'll have to pay the $25 charge.

The $25-per-month fee is not the only way Alabama hopes to discourage bad health decisions by state employees, said the program's creator, William Ashmore, executive director of the Alabama State Employees' Insurance Board. Alabama already charges smokers a monthly $25 insurance fee.

"There are folks walking around with diabetes and hypertension that don't even know it, and it's just a matter of time before something catastrophic happens to them," Ashmore said. "If we can get people to manage their health, we'll have healthier employees and less healthcare costs."

He said employees with a BMI of 35 or higher cost the state 40 percent more than those with a BMI under 35, and the program will help in many ways. "This is not a fat tax," Ashmore said. "It's not punitive."

But that's exactly what critics are calling it: a punitive "fat tax" designed to stigmatize the obese by inappropriately — and possibly illegally — bringing weight into the workplace.

"This is a dreadful, dreadful policy," said Judith S. Stern, an obesity expert and nutrition professor at University of California at Davis. "Overweight and obese people, especially women, feel that their weight is private, and being weighed at work is like having a prostate exam in the hall. It's not appropriate."

Critics also say Alabama's program borders on discrimination by using obesity, which is medically categorized as a disease, as its benchmark.

"I think it discriminates against people with a disease — obesity is a disease," Stern said. "Would you charge more money if they had breast cancer?"

Alabama's program is a dangerous step on a very slippery slope, says Mark V. Pauly, professor of health care systems at the University of Pennsylvania's Wharton School of Business. "The unanswered question is, 'How much you want to do this?'" he said. "If you got lung cancer because you smoked, do we charge you a penalty there? What about couch potatoes? Do we put all the employees on treadmills?"

Medical and social considerations aside, other critics say it's just not going to work. "There's the thought that obese people are weak-willed, and if we charge them more they won't be as fat," Stern said. "This assumes they have control over what's involved, and often they don't."

And there's the cost factor. In its efforts to reduce heath care costs Alabama will spend an extra $1.6 million for health screenings and programs next year.

"From the viewpoint of the employer who provides health care and pension, this kind of cancels out," Pauly said. "What you lost on health care you get back in pension plan, because now these people are living longer."

Whatever the plan, a company's success in lowering health care costs and curbing obesity could depend entirely on how it's framed. Rewards tend to work better than punishment.

"It's possible to set these things up to look like more like carrots than sticks," Pauly said. "And people tend to respond better to carrots."

Alabama isn't alone in its struggle to cut costs and curb obesity. Two-thirds of American adults are overweight or obese, according to a recent report from Trust for America's Health, a nonprofit organization based in Washington, D.C.

Clarian Health Partners, a hospital chain in Indiana, has taken a different approach. In 2009, they will start deducting money from the paychecks of workers who do not meet — and don't show efforts to meet — various health criteria. Smoking without trying to quit will cost $5; high glucose, high blood pressure and high cholesterol levels will cost $5 each; a high Body Mass Index will cost $10.

This is also happening abroad. Japan is monitoring the waist measurements of its policyholders, according to official government websites. Citizens receive jury duty-like summonses to appear for measurements — and if they're too fat, their employer will be slapped with a hefty fine. The maximum waist size allowed for men is 33.5 inches and 35.4 inches for women.

It's unlikely that Japan's program will catch on stateside, but that doesn't mean Americans are off the hook. Alabama's so-called "fat tax" could just be the beginning of a trend.

"A lot of employers are talking about this," Pauly said. "There's the feeling that you have to do something. What you do then is a matter of design and discretion."

As for Alabama, Ashmore is sure that those who have their doubts will soon come around. He encourages workers to swing by his Montgomery office to pick up pamphlets about the program and to learn more about reducing their Body Mass Index.

But to get to his second-floor office they'll first have to make it past the Chick-Fil-A downstairs (average meal: 1,000 calories).

Quote:Is it legal? Well I guess so since it became law, but is it ethical?

Quote:Hi,
Actually, it is fair to ask if it is legal. Just because a law is passed does not mean it will not be overthrown when challenged. However, in this case, given the persecution of smokers as a precedent, they'll probably make it stick. You're free to choose how to live your life as long as all the other monkeys agree.

Jefferson was right. A revolution every few years to remind the assholes that they are public servants, not masters.

--Pete

Quote:However, I think you miss the point in your reference to Jefferson. Frankly, he who pays the piper should be permitted to call the tune, IMO. If those state employees won't find a way to live healthy, why should the taxpayer who shells out the taxes to pay for those salaries and health insurance be on the hook for their bad decisions?

Quote:A BMI of 35 is the stated threshold. :rolleyes: And that, my friend, is not just fat, it is dangerously so!

Quote:You are free to live your life as you choose as long as you don't expect me to pay for your bad decisions.

Quote:Hi,
So, if you get hired at 20, you should not pay for your health insurance at work, but if you get hired at 50 you should?

Quote: If neither of your parents had heart trouble, you get a free ride, but no insurance for you if you didn't pick the right parents?

Quote:And, I reiterate, I damn well don't want to pay for the costs of your bad decisions.

Quote:But the fact remains that obesity, by and large, is preventable and is a product of poor decisions made by the individual.

Quote:Whoa! Whoa! Whoa! Those are some very wide strokes you are painting, and the color is very ugly. Fact is, you don't have any understanding of all the facts. The truth is that obesity is far too complex an issue to just say "eat less exercise more". An alcoholic does not have to drink to live. A smoker does not have to smoke to live. An obese person does have to eat to live. People are able to exercise, and have otherwise fit measures of health, in the presence of obesity. The only "truth" I can derive from your statement is that you have never had to struggle with it nor be the target of the only remaining socially acceptable discrimination.

Quote:"Isn't Bulimia a 'real' disease?" asked one person. "How about Anorexia? These diseases revolve around bad food choices or lack thereof and distortions of self image. Both of these factors seem to be very involved with obesity. People die from Anorexia, from Bulimia AND Obesity - often helplessly. They are just as "real" as cancer. Ask anyone who's had a relative or friend die from an eating disorder."

Quote:The Campaign To Make Obesity A 'Disease'

According to recent statements by a top official at the CDC, the governmental institutions responsible for our nation's health are currently debating whether obesity is somehow its own disease, just like cancer or tuberculosis. This development is due in large part to the corrupting influence of pharmaceutical companies, which see their revenues swelling along with growing panic over the so-called "obesity epidemic." If obesity is a disease, government and private insurance will cover their products. At the same time, if obesity is a disease, Draconian policies restricting our food choices are just over the horizon.

At a congressional briefing last week, George Mensah, acting director of CDC's National Center for Chronic Disease Prevention and Health Promotion, was asked what efforts the federal government is taking to deem "obesity as a disease so that it can then be looked at in terms of reimbursement and payment." His troubling response:

This is being considered this very minute by several health and human services agencies. As you might know, the CDC has requested that this issue be revisited and it's definitely being discussed between CDC and the Centers for Medicare and Medicaid Services, but certainly NIH [the National Institutes of Health] and several HHS [Department of Health and Human Services] agencies.

The issue of obesity-as-disease also came up at an annual American Medical Association (AMA) meeting yesterday. Delegates voted to table for one year a resolution that would have urged the government "to recognize that obesity is a disease unto itself." The AMA's decision to postpone its resolution on the obesity-as-disease question shouldn't confuse anyone about the power of food cops in doctor smocks. Blame-the-food themes infest the AMA's guidelines to help doctors treat obese patients. They pin weight gain on "an overabundance of energy-dense food choices," "easy access to an abundance of calorie-dense, high-fat foods," and "societal pressures that expose individuals to high-calorie convenience foods." Not surprisingly, the Robert Wood Johnson Foundation (RWJF), an eight-billion-dollar food cop, funded the AMA's obesity guidelines. RWJF, which recently announced that obesity "is our highest priority as a foundation and will be [our] highest priority for the next ten years," has given more than $50 million to the AMA.

Interestingly, the woman who asked the CDC's Mensah about government programs reimbursing for obesity treatment works at Johnson & Johnson in "Federal Affairs." And Johnson & Johnson has a huge stake in seeing obesity classified as a disease. The company has invested significant resources in multiple attempts to develop an anti-obesity drug (see here, here, and here). One of its subsidiaries "markets lines of medical instruments for use in bariatric, or weight reduction, surgery for the morbidly obese." And the company reports that "a number of other affiliate companies offer products to help promote weight management and the treatment of weight-related conditions such as diabetes."

Two Johnson & Johnson's subsidiaries are "Sponsors" of the American Obesity Association (AOA). Funded primarily by pharmaceutical companies, the mission of the Washington, DC-based AOA is to push for "reimbursement for obesity treatment and prevention." Along the way, AOA hypes obesity fears at every opportunity. It even called for new "fat taxes" to support anti-obesity programs.

To achieve this goal of classifying obesity as a disease, Johnson & Johnson may also be working through the food cops at the Robert Wood Johnson Foundation. The chairman of RWJF is the former vice president and general counsel of J&J. Of the remaining 15 board members, three more are retired executives of J&J, and one is the heir of the Johnson & Johnson fortune. RWJF hyping obesity could certainly contribute to their bottom line. And since about 60 percent of RWJF's assets are in Johnson & Johnson stock, having obesity classified as a disease would only grow the foundation's assets.

The potential conflicts of interest reviewed above are just the beginning. Stay tuned for more about the troubling connections between the pharmaceutical industry and research that exaggerates the health risks of being overweight.

Quote:Non sequitur. We are, I thought, discussing a measure that will apply to all state employees.

Quote:If you don't like the measuring device used to define obese, fine. :) But the fact remains that obesity, by and large, is preventable and is a product of poor decisions made by the individual.

Quote:And, I reiterate, I damn well don't want to pay for the costs of your bad decisions. You, personally, are not asking. But, collectively, the employees of the state of Alabama are asking for that. The are expecting health insurance to go along with their pay cheques. You may not like that the medical profession is, once again, being asked to be the gate-keeper to validate good health. Heck, I don't like it either. But what measure would you choose?

Quote:Whoa! Whoa! Whoa! Those are some very wide strokes you are painting, and the color is very ugly. Fact is, you don't have any understanding of all the facts. The truth is that obesity is far too complex an issue to just say "eat less exercise more". An alcoholic does not have to drink to live. A smoker does not have to smoke to live. An obese person does have to eat to live. People are able to exercise, and have otherwise fit measures of health, in the presence of obesity. The only "truth" I can derive from your statement is that you have never had to struggle with it nor be the target of the only remaining socially acceptable discrimination.

Quote:And I reiterate that what bothers me most of the Alabama plan is that the 'obese' are being forced to 'do something about their obesity'. Whether it is a health condition or a lifestyle choice, the state does not -- or at least should not -- have that right. If they want those people to pay more, that may (just barely may) be justified. However, that same justification should apply even more to those who don't exercise, since inactivity is, as I've said before, a greater health issue than obesity. And I'll not even go to the issue of unprotected sex.

--Pete

Quote:I think we can hold people responsible for their lifestyle with small negative incentives but should make sure that facts you can't influence are not taking into account (although a true market economy insurer in a country with no government regulation could if it wants only insure people with small risks).
Less regulation of insurers will for sure lead to far worse examples of differences in payment for an insurance policy depending on your health situation.

Quote:Secondhand Smoke

* Enacted in 1995, the statewide workplace law (AB 13) changed clean indoor air laws in California.
* AB 13 mandates that almost all enclosed places of employment in the state of California are to be smoke-free.
* In 1997, an amendment (AB 3037) also made bars, bingo parlors, and gaming clubs smoke-free.
* State law prohibits the smoking of any tobacco product within 25 feet of a playground or tot lot sandbox area, and also prohibits the disposal of tobacco-related waste in these areas.
* State law (AB 846) also prohibits smoking within 20 feet of main entrances and exits at all government buildings, including community colleges and state universities.
o Locally, both Allan Hancock Community College and Santa Barbara City College have designated a limited number of spaces where smoking is allowed on campus.
* Some local communities in Santa Barbara have stricter laws that regulate smoking. These include: the unincorporated areas of Santa Barbara County, and the cities of Carpinteria, Santa Barbara, Goleta, and Buellton.
o For example, 75% of the outdoor seating areas in restaurants in the county areas and the cities of Carpinteria, Santa Barbara, Goleta, and Buellton are to be smoke-free.
o Local laws in Santa Barbara County and in the City of Goleta prohibit smoking within 20 feet of any building or area where smoking is prohibited. Ashtrays are also banned within a 20-foot smoke-free area.
o The City of Carpinteria banned smoking at all of its parks and beaches in 1994.

Quote: I guess before we continue with this line of thought, this really begs the question: so what is the cause of obesity? Is it eating unhealthy? Lack of exercise? Diabetes? Because if the cause is 90% food, 10% other, then why not add an extra tax too all food deemed unhealthy by the state? Then not only do you protect and serve your city-workers, but the entire populace of the state. If the issue is 10% food, 90% exercise, then why not mandate bi-daily jogs for city-workers, or even start a state-wide city to city jog-a-thon to raise awareness of an unhealthy lifestyle? Tell me, how does taxing the individual in a select group of workers who happen to have a bad BMI score solve anything?

Quote:In Holland where everybody is obliged to take a private insurance all these things play or will play a role.

[. . .]

Here in Sweden I see far less obese people than in the US, and we could afford it because our insurance covers everything.......but we pay 50 % tax.....
Anyway, you know I am kind of a socialist so it might be strange getting this opinion from me but the point is that I got tired of right wing and liberal people complaining about paying too much taxes...

Quote:All Swiss animals are equal - but some more so than others

2 days ago

GENEVA (AFP) — Want to get rid of your goldfish? Swiss owners who have been flushing them down the toilet -- still alive -- must now find other methods since strict, new animal protection laws went into effect Monday.

Instead, a fish must be first knocked out and then killed before its body can be disposed of, the law stipulates.

The new legislation spells out in exhaustive detail how all domestic animals are to be treated, whether they be pets, farm animals or destined for scientific experiments.

Wild animals are also covered by the law if they reside in zoos or circuses.

Just like in George Orwell's satire "Animal Farm" however, some animals enjoy more "equal rights" than others.

Not only are goldfish now afforded a more "dignified" death than being dispatched round the U-bend, but it is now also forbidden for Swiss anglers to practise catch-and-release fishing or recreational catching only to throw the fish back in the water, or to use live fish as bait.

In the domestic sphere, common household pets such as budgies and hamsters can no longer be kept by themselves.

The same applies for more exotic breeds such as lamas, alpacas and yaks -- admittedly not your average pet but a common feature in zoos.

Even sheep and goats must have at least "a visual contact with their fellows," according to the new law.

Man's "best friend," the faithful hound, comes in for special treatment as dog owners will be obliged by law to take special classes on how to raise Fido properly so he is less likely to bite.

And Swiss dog-owners wishing to "customise" their pets as a fashion accessory will not be allowed to crop their tails or ears -- nor "force them to have surgery to get droopy ears."

But one cannot help but wonder if the animals would really welcome all the provisions Swiss lawmakers have generously bestowed upon them.

Pigs, for example, are often said to be happiest when rolling around in the mud -- but now they have the legal right to a shower to freshen up.

Quote:Your government not only controls personal freedoms in regards to Health, but apparently it wants to regulate how you treat animals also (i.e. fishing). I can't believe they made it illegal to fish and throw back in Switzerland. This, IMO, is an example of extreme protection, and a good example of control.

Quote:Your government not only controls personal freedoms in regards to Health, but apparently it wants to regulate how you treat animals also (i.e. fishing). I can't believe they made it illegal to fish and throw back in Switzerland. This, IMO, is an example of extreme protection, and a good example of control.