Alabama to link premium costs to workers' health
By Matt Sloane
CNN Medical Producer
MONTGOMERY, Alabama (CNN) -- A new plan that would effectively fine Alabama state employees who don't monitor their health is set to start early next year.
With obesity levels higher than in any other state except Mississippi, Alabama's insurance board chief William Ashmore and his staff of workplace wellness advocates decided it was time for a change.
"Over 10 percent of the people we screen are at risk for one of the factors we're screening for, and the vast majority had no earthly idea they were at risk," Ashmore said.
But the plan, which encourages state workers to have health screenings and to see a doctor if a problem is found, is angering some employees.
"It's penalizing people for being genetically who they are," says E-K. Daufin, a college professor at Alabama State University. "I have a lovely sexy body mass index of 44 right now," a number that would put Daufin in the group that would have to pay. That is, unless she decided to see a doctor about the issue.
The plans works like this: By 2010, each state employee will be faced with a $50 per month health insurance premium, $25 more than they pay right now. Beginning next year, each employee will be offered a free screening for health factors such as high blood pressure, high blood glucose and body mass index.
If they opt not to take the screening, their premium remains at $50. If screeners find something of concern, the employee will be offered a doctor's visit free of charge, and if they forgo the free visit, their premium remains at $50 as well. Fit Nation: Watch more on Alabama's new insurance plan »
However, if an employee undergoes the screening and is found to be healthy or is unhealthy but decides to see a doctor, the premium is discounted to $25.
Similar to a 2004 plan that discounts employees' insurance premiums if they are non-smokers, it is designed to save the state money in the long term.
"It really boils down to managing risk. We know 10 percent of the people are at risk," Ashmore said. "A healthy employee will cost the program less money."
And despite critics from Alabama and across the nation calling it a "fat tax," Ashmore said, the plan is not meant to penalize unhealthy employees but simply to educate them.
"What we want to do is, number one, make the employee aware of any risk factors they may have," Ashmore said, "and then knock down the barriers so that they can go get the services they need."
But the big question many are asking is: Will it work?Emory University physician Dr. David Roberts, who is not connected to the plan, said that if it's done right, it could be a model worth emulating.
"If they're going to penalize them for [being obese], that's wrong," Roberts said. "If they're motivating them to be involved with a physician and be aware of things, I don't think that's a negative."
This is just the beginning. We have stigmatized fat people to the point that it makes it politically feasible for profit-minded people to penalize those that cost them money (and yes, Professor Roberts, it is penalizing fat people [imagine a tax on people who have HIV for costing our insurance companies money for treatment]). They have been doing this to smokers for quite some time now. But this will only be the logical step to the next level. The next level will be prohibiting fat people and smokers from most employment, insurance policies, and basically forcing them on to the welfare rolls, if anything at all.
Once this is accomplished, the people who brought us the commodified industry that drains 1/7 of our GDP for the price of 60 million un/under-insured Americans will then want to "save" on other costs. We will not call it that, naturally. It will all be done under the guise of "wellness," the movement of which is mostly a front funded by insurance companies and associations. The next step will be making sure people with "unacceptable" preconditions (i.e., politically acceptable) will be ineligible for coverage or only on the condition of "seeing a doctor" that will mark them with their medical Scarlett letter and incur an extra fine, I mean encouragement (yes, encouragement, Mr. Roberts). These would include virtually all sufferers of Type 2 Diabetes and, if they can get away with it, probably some cancer patients (particularly those who smoked).
From there, the possibilities are endless. I am sure Mr. Ashmore would not mind a special tax on bald people, since being bald greatly increases your risk for Melanoma.
Of course, it will all be about good health. After all, they are doing such a wonderful job of providing for us now, so long as you can afford it. Who knows, maybe in another generation or two, we can just uninsure or overcharge everyone who is outside of the 20-45 age bracket and not in a Mentos commercial. Then again, if it all goes south for our friends from Nationwide and State Farm (and other industry leaders), they can get on the welfare rolls of our new bailout plan for the remainder of the unconvicted felons on Wall Street.