Get Thin or Get Charged

In today’s LA Times, Workers are told to shape up or pay up – “Looking for new ways to trim the fat and boost workers’ health, some employers are starting to make overweight employees pay if they don’t slim down.”

In one of the boldest moves yet, an Indiana-based hospital chain last month said it decided on the stick rather than the carrot. Starting in 2009, Clarian Health Partners will charge employees as much as $30 every two weeks unless they meet weight, cholesterol and blood-pressure guidelines that the company deems healthy.

Aside from the weight issue, cholesterol and blood pressure are only two measures of your relative health. They’re also two measures for which lots of pharmaceutical companies would like you to buy their miracle drug. I wonder if prescriptions for those will go up drastically, costing workers even more money as they attempt to conform to the guidelines? What about other conditions? What about a family risk of cancer? What about people with numerous other risk factors for poor health? What if I don’t eat my government-prescribed recommendation of fruits and vegetables? What if what we think we know about these risk factors changes, as it often does? The whole idea of group health is to spread the risk around, not to arbitrarily charge people more for a couple of measures.

I’m not making any claims about what is a healthy weight, and I note that some companies are providing discounts, rather than additional charges, for employees who meet their criteria. I remain unconvinced that those criteria are necessarily perfect – after all, when I was last on the low end of the normal weight range on the BMI scale, I was suffering from an undiagnosed thyroid disorder that could have killed me. Was I healthier then, simply through the virtue of my weight? Absolutely not. If costs go down as people lose weight, is that because they lost weight, or because they’re eating better or exercising more? In other words, is it actually the weight that was the issue, and is it even appropriate to single out that factor in penalizing employees?

A few folks interviewed for the article seem to suggest that overweight people simply deserve to pay more due to their personal failings. Really, this is about “boost[ing] workers’ health?” No, this is about the bottom line. You know, meth addicts are fairly skinny. Clearly, you’d be so much healthier and cheaper for the company if you took up a meth habit. Other really thin folks – crack addicts, other speed abusers, cancer patients, anorexics. Take your pick, kids, the BMI is god.

[The Crone Speaks has a bit on this as well]