Sunday, August 24, 2008

Alabama Second Fattest State in the Nation

I used to work for government, so I know how much of a pain that type of employment can be (if you're doing a job that involves case processing, it all boils down to numbers, processing, and supervisors who are ideally the subject of many Dilbert cartoons).

In Alabama, some state government workers are beginning to wonder if things are turning a bit too Orwellian. The state has given its employees (who number more than thirty-seven thousand) a year to get into better shape...or they'll be hit with a $25 surcharge for their unfitness. In short, they'll be forced to pay for their health insurance, which is currently free.

How will all this work? According to the article I read, workers will need to submit to health screenings (I assume these will be similar to the lifeline screening I myself had once--though this was not connected to a job). If the result of a screening is that an employee is determined to be obese, or to have high blood pressure, diabetes, or high cholesterol, then the employee will be required to see a doctor (at no cost), enroll in a wellness program (whatever that means, but possibly meaning a fitness facility), or take their own steps to get in better shape. Progress is rewarded with not having to pay the $25 toward their own health insurance.

Is this fair? Some Alabama state government employees don't think so. And even I have to wonder if their system has some built-in problems. For instance, the insurance charge will apply to anyone with a body mass index of 35 or more. Well, what if you are a five foot six inch tall male but are engaged in the sport of bodybuilding and weigh 200 lbs? That person probably, if they are truly engaged in competitive bodybuilding, has a low body fat percentage and is exceptionally fit. Yet they would be considered obese by these standards.

At the same time, however, I don't think Alabama is necessarily on the wrong track here. Think about it. A great chunk of medical health care costs in this country are derived from diabetes, hypertension, high cholesterol, obesity, and the various conditions that often result such as coronary artery disease and heart attack, strokes, musculoskeletal problems (including arthritis), etc. What Alabama is doing may seem big-brotherish, but, ultimately, it may not only make their state employment system more sound; it may help, over time, to drive down health care costs in general.

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