Alabama Requires Fat Tax

A bunch of Shakers have sent me links to this article (thank you!), and I don't really have time to write a big post about it now, nor does the lovely Ms. Harding, so I'm just going to open it up for discussion with a quickie:

Alabama, pushed to second in national obesity rankings by deep-fried Southern favorites, is cracking down on state workers who are too fat.

The state has given its 37,527 employees a year to start getting fit -- or they'll pay $25 a month for insurance that otherwise is free.

…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.

"We are trying to get individuals to become more aware of their health," said state worker Robert Wagstaff, who serves on the insurance board.

Okay, this? Might be okay, if it were genuinely focused on legitimate indicators of overall increased healthfulness—e.g. lowered blood pressure, increased strength and flexibility, etc.—and focused on it for everyone. Except, guess what?

The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.

The board has not yet determined how much progress a person would have to show and is uncertain how many people might be affected because everyone could avoid the charge by working to lose weight.

So, this isn't so much about lack of healthfulness as fatness—which, despite the weight loss industry's best efforts to conflate the two, aren't actually the same thing. And what about the thin person with high blood pressure? Shrug. Conceivably, a fat person with no health problems could be paying extra, while a thin person who's a heart attack waiting to happen can just go about his merry way without consequence.

That seems both fair and reasonable.

Ahem.

And, in case you need a reminder: Why BMI Is a Crock, in Pictures.