Today in Accessing Healthcare While Fat

by Shaker FK, a fat woman with disabilities who lives in the US somewhere between the coasts.

[Content Note: Fat hatred; disablism.]

The insurance I receive at my job has introduced a pedometer initiative. People can sign up to receive a pedometer to "get active" and the pedometer reports back to the main office how many steps are recorded per day. People who rack up a certain number of steps per day get money put into their account to use to defray medical costs. People who don't participate, don't get money. It's not presented as a tax on people who can't/don't walk, but it essentially is.

Additionally: The incentive money isn't based on a raw number of steps per year (which could at least defray costs for temporarily-disabled people, if not for permanently-disabled ones). There are "activity tiers" that you have to reach in order for the day to 'count' – the minimum tier is 7000 steps. If you only get 6999 steps before midnight, you don't get points for the day. High tiers get more points – the next tiers are 12000 and 20000. The whole system is setup to be difficult to attain.

You may be thinking: What about people who can't walk? That's a good question. We have to get a doctor to fill out a specific form from the insurance company establishing that we are disabled, and then we have to fill out an "activity form" every single day to certify that we're paying attention to the Proved Link between Activity and Our Health. If we do that, we are given the points for the minimum tier – the higher tiers are literally closed off to us once we register as disabled. Again, this isn't presented as a tax on disabled people or an undue burden – the whole thing is marketed like a favor to us.

And if you're temporarily disabled, like sick or with a broken foot, you are just screwed because a doctor won't sign a notice of disability over that. So in addition to your medical expenses for being sick/injured, you get to be taxed for not "being active" those days.

And you probably already know this, but pedometers are notoriously controversial as measurements of activity – the women at work who do REALLY high intensity yoga, way harder than a novice could do, get basically no "steps" on their pedometers because they're not shaking it enough. I don't know that you'd call that a tax on women, but it's effectively working out to precisely that at my workplace.

Oh, and I should mention that there's a clause in the registration process for this that if you "cheat" on your pedometer, they'll fire you. Even though you wouldn't think that insurance issues should be tied to employment at the workplace providing the insurance.

Anyway, I think I mentioned that wearing a pedometer wouldn't work for me because of my disability. I couldn't get my doctor to sign the lawyer-speak disabled notice (despite the fact that I have a handicap license for my car AND handicap parking at work), so I've had to rig up a motor to "bounce" the pedometer to the necessary steps per day to get the minimum tier. And even then, I have to remember to do this every single day when I get home from work, or I won't get the healthcare money that several of my co-workers get just for walking to their desk from their car. (Not that all of my co-workers park their cars 7000 steps from their cars. But some do.) I do have to confess that they look healthier than I do, though! Clearly I should have been more active in the womb and I wouldn't have been born disabled!

I don't know what more to say about this except that it stinks. And it makes me feel angry, that I have to choose between being a 'cheat,' or beg for recognition of a visually-obvious disability, or just pay more for my already-more-expensive healthcare. I don't like being confined to those choices.