Should Obese People Pay More?

DrWeil.com
March 2009

Should people who weigh more pay more? The Alabama’s State Employees’ Insurance Board thinks so.

In 2011, the board will begin charging state workers with a body mass index greater than 35, $25 a month for health insurance. The insurance is now free for all state employees. However, the state is giving workers advance warning: If they agree to free health screenings and make progress, they won’t face the insurance fine.

It makes a certain sense. Alabama residents are the second heaviest in the nation (behind Mississippians), and the obesity there costs an estimated $1.32 billion a year in related medical charges, according to a 2004 study by the Centers for Disease Control.

"So while this approach may be worth a trial run, I would be concerned if the measures became draconian - for example, if they extended to people who were merely overweight, rather than obese. Numerous studies have borne out the fact that active, overweight people have better cardiovascular health - and longevity prospects - than sedentary normal-weight people. Providing a financial incentive to become healthier may be prudent, but such measures should be enacted carefully, and take into account that height-to-weight ratio (which is how the body mass index is calculated) is an incomplete measure of fitness," Andrew Weil, M.D.

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