This is so the worst thing you're going to read all day.

[Trigger warning for fat hatred.]

Wall Street Journal: "Arizona Proposes Medicaid Fat Fee."

Arizona's [Republican Gov. Jan Brewer] on Thursday proposed levying a $50 fee on some enrollees in the state's cash-starved Medicaid program, including obese people who don't follow a doctor-supervised slimming regimen and smokers.

The plan, if approved by the Republican-dominated legislature, would mark the first time the state-federal health-care program for the poor has charged people for engaging in behavior deemed unhealthy.

..."If you want to smoke, go for it," said Monica Coury, spokeswoman for Arizona's Medicaid program. "But understand you're going to have to contribute something for the cost of the care of your smoking."

She said the proposal is a way to reward good behavior and raise awareness that certain conditions, including obesity, raise costs throughout the system.

So once again, obesity is treated as axiomatically synonymous with bad behavior. Awesome.

And, naturally, axiomatically synonymous with bad health: "Ms. Brewer's surcharge would apply only to only certain childless adults: Those who are obese or chronically ill, and those who smoke. They would need to work with a primary-care physician to develop a plan to help them lose weight and otherwise improve their health."

Never mind if you're obese (and let's remember what "obese" looks like) but not chronically ill, or in bad health at all. The idea that someone can be fat and simultaneously healthy evidently doesn't exist in Arizona.

Of course proponents of this shit will argue that being obese inevitably results in a greater strain on health services in the long run, but research that purports to prove this narrative fails to take into account the reverberating effect of fat hatred even among healthcare providers, which not only discourages fat people from seeking preventative and palliative care, but also results in fat patients receiving a lower quality of care when they do seek treatment. That lower quality of care can manifest in myriad ways, from improper drug dosing to a failure to diagnose actual illness and injury because the diagnostician can't see beyond the patient's fat and wrongly attributes an ailment to obesity.

It is quite genuinely impossible to assert with certainty that obesity itself makes fat people are a "drain" on any healthcare system when disincentives against self-care and sub-par healthcare aren't addressed. And it's dishonest, if one quite reasonably considers access to quality healthcare part of maintaining good health.

Which is why the reflexive conflation of "fat" and "unhealthy" is inserted into the discussion under the auspices of a moral failing, a choice. Except:

State Sen. Kyrsten Sinema, a Democrat, said such a fee would unfairly penalize those who can't control their weight. "If someone is obese because they're severely disabled or can't exercise, we shouldn't be punishing them," she said.

Or, you know, because that's just the way their bodies are built.

And, you know, as an aside: I'm a former smoker. I smoked for 14 years, and not long after I quit four years ago, I read an article detailing the hundreds of additional chemical additives, many of which are addictive, that had been added to cigarettes just in the time I'd been smoking. I call total bullshit on the same government that allows tobacco companies to make their products more addictive then turning around and charging the addicted consumers money because they can't quit. It's the height of temerity to tell people that smoking is a choice while supporting regulations that actually undermine how much of a choice it actually is.

[H/T to Shaker Jabes.]