Arizona Governor Proposes Flab Tax 978
Hugh Pickens writes "The WSJ reports that Arizona governor Jan Brewer has 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. Brewer says the proposal is a way to reward good behavior and raise awareness that certain conditions, including obesity, raise costs throughout the system. 'If you want to smoke, go for it,' says 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.' Coury says Arizona officials hadn't yet finalized how they would determine whether a person was obese or had sufficiently followed a wellness plan, but that measures such as body-mass index could provide some guidance. Estimates for the costs of obesity in America range from about $150 billion to $270 billion a year. According to the latest CDC statistics, from 2009, 25.5% of Arizonans are obese, about 1.7 million people."
Re:BMI is fucking useless (Score:4, Informative)
Way back when I used to be in the military. Their chart added the same amount of pounds for every extra inch above the base height. Virtually everyone on the planet 6' or taller was obese by that chart. (The idiots that made it apparently assumed an increase in height didn't have an increase in the other 2 dimensions. Something that can only be achieved if you are taffy and not an actual human.)
Just before I got out, they switched over to a different voodoo formula that used your neck diameter and height to make the calculation. Many tall thin people were labeled obese by that, yet ironically, the short fat guy that wobbled when he walked got listed as acceptable weight because his neck was so fat we all called him 'no-neck'.
There are scientific ways that can accurately determine if you are overweight or not (excluding the obvious extreme cases), but those methods will never be used by those idiots wanting to punish fat people. Those jerks just want something fast and easy with which to vilify one segment of the populace, and rack up cash quick.
Re:Where's my reward? (Score:4, Informative)
Obesity does have strong correlations to health problem, but your insensitive stereotypes are rude and unfounded. Making such demeaning caricatures out of heavier individuals is simply not helping the issues. Yes, many people would reap many health benefits from losing weight, but almost as many underweight people would reap similar benefits from gaining weight.
It is always important to remember that the #1 health risk to the obese is not heart problems or diabetes, it is misdiagnosis. So many people and even doctor assume that if you're heavy, all your health problems are caused by that, and so they often miss obvious symptoms of other real, life threatening conditions. It is also important to remember that an unstable weight correlates to health problems even more strongly than obesity. Many heavier individuals are pressured by peers and doctors to lose weight, and they often attempt to do so with unhealthy means, such as various eating disorders. This often leads to fluctuating weight and other problems. If you have to choose between fluctuating weight and obesity, obesity is statistically much safer.
Not to beat a dead horse, but another thing to keep in mind is that correlation is not causation. Many instances in the statistics of obesity can be shown to involve the correlation of "I am sick, and it is making me heavy". When these cases are weeded out, the correlations become much weaker, and it becomes even more obvious that the underweight or inactive are at just as much risk as the obese.
In conclusion, you can decide, if you wish, that obesity is not a responsible way to live. I would accuse you of insensitivity but nothing more. But ridiculing and stereotyping the obese as moronic imbeciles that are out of control and grossly irresponsible is crossing the line. I wouldn't call you quite as bad as a racist, but you would be quickly approaching it. The fact of the matter is that very few of the people who are obese would live up to any of those demeaning stereotypes, and probably just as many (per capita) "normal" individuals would live up to them if you simply looked. But you aren't looking, because you are singling out the obese and deciding to throw your vile at them, when they simply don't deserve it anymore than anyone else.
First, is there a problem? (Score:5, Informative)
Working on either solutions or explanations before knowing if there is an actual problem, is called Tooth Fairy Science. You know, the kind where you figure the market value and profits/losses per tooth type, before even knowing if there is a Tooth Fairy.
In this case, last I've seen a study based on data from an actual health insurance company, it turned out that smokers and the obese actually cost LESS. Summary, for example, here: http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html [nytimes.com]
I don't just mean on the total with pensions and all. Even just the healthcare taken separately, actually cost less. Why? Because they die earlier and need less medicine in the long run.
The problem is that you don't need the most care when you're 30. You need the most care when you're 70, and the latter is for decades if you prolong it.
The fat smokers need expensive chemotherapy or surgery for maybe a year, then die. That is, if they don't just keel over and die of a heart attack. If not the first time around, the second will get them. And that's that. While the guy who was fit and lean and never had any vices, if he lives to 100, will likely be on expensive anti-Alzheimer medication for two decades. Plus various other trips to the doctor as their body is barely functioning and getting worse by the year. The guys who died a horrible death in their 50's just saved you all those costs.
So, really, the smokers and obese actually subsidize healthcare for everyone else just by biting the dust earlier. And that's in addition to paying for a pension they won't get as much of, or at all. And subsidizing the government via tobacco taxes.
So, really, WTF? You'd think someone would at least say, "hey, thanks fatty" ;) The notion that, OMG, let's tax them some more 'cause they cost us money, is provably false, and fucking stupid too.
But it keeps happening because it's two overlapping groups of people who already feel bad and guilty about it, and have been amply proven to be easy to guilt trip some more into paying even more.
Re:Beware of junk science (Score:5, Informative)
The UK for example. They get 10-12 billion pounds per year from tobacco taxes, and they estimate that smoking related costs to the NHS are about 1.5 to 3 billion.
So the smokers pay for themselves and help pay for other people too.
Re:Where's my reward? (Score:3, Informative)
Hold on, I RTFA'd the links and find that the judge did not toss this because he was republican, but because he feels photo radar is unconstitutional. The judge also noted that most people who get caught cannot afford the legal fees to fight the unconstitutionality of the arrest. Over 1000 tickets were overturned by the judge regarding photo radar cases. That does not seem like special favors.
I am all for equal justice and it boils my blood when I read see who rich (Paris) and famous (Lindsey, Charlie) and powerful (pick your wall street banker) get a tap when the plebiscite gets the hammer. Had the DA prosecuted this like a normal case and not tried to embarrass or take to extreme the case, Mr. Mecum may have wound up paying a fine and having to explain his poor driving habits. Now he's a poster boy for a judge's stance on the constitution. Call em out...yes! Cry wolf when it's just a dog...no.