Alabama

It's not a union! Alabama has no public sector labor statutes, so by law, state and municipal employees have no collective bargaining rights.

It's a lobbying group, basically. Or, if you are cynical, it's a company union (or an organization that is nominally pro-employee but in reality serves the interests of the employer).

I mean, not that unions are across the board totally awesome, but in this case, it would be more like "Go toothless employee advocacy group!" rather than "Go Union!" I just hate to see organized labor catch shit when they don't deserve it.

But Paul, it doesn't matter if you have the usual allergies and colds and everyday aches and pains. Alabama has supernatural powers and can tell you're a walking tombstone simply because of your BMI! So if Venus and Serena Williams decide to start working for the state, they'd probably have to fork over the extra fees, and they're probably more healthier many than thinner, non-athletes.

BMI. IS. NOT. RELIABLE.

So, is Alabama going to also start charging workers who like to frequent tanning beds and thus putting them at increased risk for skin cancer, or who engage in unsafe sexual practices? What about women who choose to have a baby -- that's pretty expensive, too. Red meat consumption has been linked to stomach cancers, so should all meat-eaters now pay a premium? What about the workout fanatic who blows out their knee? Recent studies have also shown that youth athletes are increasingly getting adult types of injuries and require surger for them. Should athletic families also have to pay higher premiums for choosing to engage in activities that could put them at risk for injury and illness?

I hope and expect this practice will be challenged and struck down as the discriminatory act it is.

Journaled my frothing, impulse control diminished, invective ladened, rant as a containment measure and to avoid frightening the kids. However, one question seems to have survived the flames and remains salient enough for reasonable discourse. The question;

When did it become OK for a Government AGENCY to tell me, or anyone else for that matter, what we can or can not do with our own bodies?

This, at it's root, is what the Alabama's Government is saying. No, that's wrong. They're more than saying it. They are attempting to regulate a segment of their population's state of being and are prepared to apply punitive action to anyone who does not comply.

Is this not in direct contravention to the principles that the Constitution of this country where founded on?. . . Anybody?

First they ignore you, then they laugh at you, then they fight you.
Then you win. - Mahatma Ghandi

Home improvement junkies may end up with lung cancer due to mold/asbestos/various inhaled home improvement junk, clearly Alabama needs to start screening out homeowners. Cat owners may get an infection from the bacteria in cat litter, Alabama better start charging them. Oh hell, why even bother having free health coverage, why don't they just charge everyone the $25/mo, since everyone has a 100% risk of mortality.

I don't subject myself to "health screenings" unless I know exactly how the information is going to be used. I'd hate to have my employer looking at my cancer risks, my MS risks and all my other risks, deciding that they can keep me for X years, and after that they'd better let me go because they could "lose productivity" due to illness. They won't stop with BMI > 30, this is merely an excuse to incrementally do away with coverage that state employees have always depended upon, and single out "unproductive" workers for arbitrary termination.

This is a major reason we need to call for universal healthcare rather than investing our energy in insurance. Insurance companies are allowed to do risk assessment, and of course, the government voted two years ago to allow them to use such assessment to charge more in premia for people with preventable risks, i.e. the obese. It's also doubly nice that our moral overtones attached to health allow the same corporations to increase their profits even as their greed can masquerade as concern. They are, after all, only helping us, they would insist.

This is just a way for the insurance company (or the state, or whoever is funding insurance for these people) to make more money on the backs of whichever subset of people happens to be out of favor at the moment.

And I suspect wallflower is exactly right and they'll keep adding more and more types of workers to the list of those who are expected to pay extra for the types of things they do outside the office.

Are they seriously expecting to implement this without being sued?

Yes, they seriously expect to implement this without being sued. They are already charging smokers a premium if they don't stop smoking, with random nicotine checks being applicable; so do KY and SC. So yes, they fully expect to get away with this, and will.

My question is, what if you do everything they ask you to do and still don't lose weight -- will they then offer WLS paid for by the state? I mean, if you are going to tell an employee they must do XYZ, are you not obligated to pay for any and all treatments that would allow them to reach said goal?

On the Universal Health Care question -- don't fool yourself -- it's not an answer. Having lived/worked in a universal health care nation -- how would like to be told that you have to wait 2 to 4 years for surgery? any surgery... that's the right of the universal provider -- why don't you ask some people in Saudi Arabia, the UK or Canada how long they have to wait to see a doctor, have a procedure, what the rigamarole involved in changing doctors or obtaining a second or third opinion, etc -- Universal Health Care is not the panacea that the media and politicians are trying to convince you that it is. You should see some of the health care facilities in Saudia Arabia, the UK and Canada.

Things are expensive here, yes, but you have the right to seek care from any provider that you choose in a state of the art facility if you so choose. You do not have that right in Saudi Arabia, the UK or Canada. If you want to see a fairly close example to Universal Health Care and how it would play out in the US -- visit a VA hospital system, that's pretty much it in an eggshell -- and I'm not talking Bethesda or Walter Reid here -- just a regular old VA Hospital that the majority of veterans who access this care are forced to visit if they want their care and medications covered.

Oh hell no, if universal health coverage is going to be like the VA, forget it. DH has his care through them, and while most of it is good, the prescription part of it leaves quite a bit to be desired (Lantus, for diabetes was just added to their list of pharmaceuticals 3 months ago).
As far as charging extra for health insurance because of a so-called higher "risk", well, then they had better be charging everyone who has high blood pressure, high blood sugar, high cholesterol, goes sky-diving, rides a motorcycle, or engages in ANY activity that can be considered a "risk" to one's life and health. Gee, that would be everyone, now wouldn't it, since just getting out of bed and taking a shower/bath can be a risk, as can walking out the door of your house, getting in a car to drive somewhere, or taking a walk, blah blah blah.
If insurance companies had their way (and it seems like they're getting closer to getting it), they would rake in premiums from policy-holders and never pay out anything for any kind of health care. After all, it's not about our health, it's about maximizing their profit. Give them an inch, and not only will they take your foot, they'll go for everything above it until they have it all.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

Yes, they seriously expect to implement this without being sued. They are already charging smokers a premium if they don't stop smoking, with random nicotine checks being applicable; so do KY and SC.

Yes and we wouldn't be here if the anti-smoking crusade had not been so, very, zealous. I understand the dangers of second hand smoke and can see how someone would want to avoid it at all costs. The logic of smoke free environments is undeniable. However, the 'For your own good' tactic so loved by weight loss Concern Trolls is not new.

Stupid? That would be the people out there cheering this crap on and thinking all of this will stop with the Fatties. Not likely. Next will be the casual dopers (cause their so easy to test for), then possibly the sexually promiscuous, then (if the healthist craze maintains / escalates) it might be those that don't eat 'Right' (Perhaps by then technology will allow random stool sample analysis to find out exactly what you've been eating). What a Brave New World that will be. Unless, of course, the Fatties manage to stop this, here.

So yes, they fully expect to get away with this, and will.

They might. They might not. All depends on what people are willing to put up with. A class action suit might be useful in this kind of situation and the government coffers might prove a fat enough prize to draw a decent attorney / Law Firm.

Thing is, I'm a child of the 60's. Was a baby when the marches, sit-ins, & walk-outs, where going down so all I remember was seeing a lot of pictures of crazy people doing crazy things like chaining themselves to fences in protest. When I was little I though it was all pretty stupid but, I'll tell you what. Back then, when the People our government is supposed to serve where unhappy about something, they certainly did FIND ways to let the government know about it. And in no uncertain terms.

First they ignore you, then they laugh at you, then they fight you.
Then you win. - Mahatma Ghandi

On the Universal Health Care question -- don't fool yourself -- it's not an answer. Having lived/worked in a universal health care nation -- how would like to be told that you have to wait 2 to 4 years for surgery? any surgery... that's the right of the universal provider -- why don't you ask some people in Saudi Arabia, the UK or Canada how long they have to wait to see a doctor, have a procedure, what the rigamarole involved in changing doctors or obtaining a second or third opinion, etc -- Universal Health Care is not the panacea that the media and politicians are trying to convince you that it is. You should see some of the health care facilities in Saudia Arabia, the UK and Canada.

Things are expensive here, yes, but you have the right to seek care from any provider that you choose in a state of the art facility if you so choose. You do not have that right in Saudi Arabia, the UK or Canada. If you want to see a fairly close example to Universal Health Care and how it would play out in the US -- visit a VA hospital system, that's pretty much it in an eggshell -- and I'm not talking Bethesda or Walter Reid here -- just a regular old VA Hospital that the majority of veterans who access this care are forced to visit if they want their care and medications covered.

Just wanted to say: This is not true for all countries having some form of universal health care. I have lived in countries with universal health care almost all my life and never had these problems - they are not inherent to having universal health care.

Beanietude - your experiences reflect what I was told about health care in the UK (but I have never lived there, so...)

I wonder though: Does every area, even every rural area in the US have enough GPs? Does no US citizen ever have to wait for an appointment with a specialist? And what about the people that cannot afford private health insurance? Honestly, I might be biased, but I simply cannot imagine NOT having some kind of universal health care. All the other issues - like choice of physician, waiting times, or, most relelvant here, discrimination against fat people seem to be independent issues to me, depending on the specific system, irrespective of if it provides universal healthcare or not. (And in a way making fat people pay out of their own pocket for certain treatments makes healthcare less universal.)

Don't imagine that this is the only step they will take to deny coverage based on obesity/BMI either. Once they are successful with this, they will begin to deny coverage for conditions "attributable" to your obesity - so, if you have hyperlipidemia, diabetes, high blood pressure, lymphedema, dysfunctional uterine bleeding, and so on - they will attribute it to your pre-existing obesity and say no coverage because if you would only lose the weight you wouldn't have these problems.

Is it true, no absolutely not, I treat lots of patients who are thin and have all of these diseases. But this is where it's going. The only thing other than a class action that could stop this freight train, and believe me, once 1 state gets away with it, others will be on the bandwagon in a millisecond, is a federal ruling of obesity as a disease - then they will be required to cover it and all conditions supposedly stemming from it. However, this would also open up a complete can of worms that can't be gone into in just a moment's time which is all I have right now for posting.

The bottom line is - the only way universal health care would work in this country and still maintain a reasonable standard of health care and facility standards, as well as innovation (remember, people are not going to spend money on R and D if they have no hope of reaping a financial benefit down the road) is if it is basically a capitalism-based system and not a government "dole" situation. The state of Massachusettes has pretty much bankrupted itself with Romney care - it would not take a moment to bankrupt the federal and state governments if they take on the big brother role in this situation.

The capitalism-based version of this would also have to have legal safeguards in place however; otherwise, insurance companies will only cherry pick and refuse to insure anyone who submits a claim, develops a chronic illness, doesn't meet narrow guidelines, etc...

Things like this will only encourage people not to buy health insurance and will exacerbate the problem of rising medical costs.

I have a mental disorder and thus am discriminated against by health insurance. I have to pay more out-of-pocket for treatment than that for physical ailments. So I guess the health insurance companies could discriminate against me twice, by including my weight. My mental condition is somewhat disabiling but my weight is not (physically I am healthy - my doctor says I am fine in that regard).

Per Sarahj --- If a nationwide program for health insurance goes into effect, there will be a greater burden on fat people to practice "preventative" medicine, and this could be enforced by the state - kinda like Alabama here.
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And guess what it is not that far fetched to say that - should this go into effect - a nationwide program -- fat people could be FORCED into having WLS once they have run the gamut of other treatment -- it would be, either do EVERYTHING possible to lose weight, including WLS, or you lose your health insurance --

No universal health care is not the grand save all plan that is being touted to people. Once they have control of your health care, there are no limits to their power in deciding what you will have to do to keep it and suddenly your body and your health decisions are no longer yours to make according to your own set of judgments, morals, and life experiences.

Universal health care might work in a country that is small, homogeneous, and generally healthy (like Denmark, for example), but it's not going to work in a country like the United States. We have other obstacles many Europeans countries are not burdened with (illegal immigration is just one example).

Well, I am from Germany, which is not that small population wise (approximately 82 million people). And we certainly do have illegal immigrants (though not as many as Spain or Italy). However, universal health care in Germany does not work like in the UK - you still pay in insurance (in fact you have to), but the respective insurance companies are controlled by the state to some degree, they cannot reject you (in turn you are required to be insured by law), and how much you have to pay depends on you income (in 2006, when I was still studying in Germany, I paid a bit over 50 Euros per month and my insurance covered all medical care and basic dental care, although I had to pay a small fee for medication). The system has problems, no doubt, and there are constantly questions how to finance it - partially because of a rapidly ageing population. But I still did like the fact that I could rely on having medical care whenever I needed it and that I did not have to spend a lot of time dealing with my insurance company since it is largely determined from outside what they have to cover and how much they can charge.

Also, to be honest, I like the idea that citizens of a country express solidarity with each other by making sure that everyone can afford health care when he or she needs it.

Well, obese people like myself (and I am obese to the physicians and the profit-making health insurance nad health maintenance organization) are now tied to our jobs because we cannot even get private health insurance. What creativity is being stifled in the United States now because people don't have the mobility to move jobs or the ability to begin a company? If we had universal healthcare, we could work on accountability, but folks are kidding themselves if they think these corporations with fat profits are accountable to anything else but their monetary bottomline.

If people deemed high risk by private insurance carriers do not have employer sponsored coverage or are non-working senior citizens turned down by Medicare, their only option is to apply for state sponsored insurance for high risk citizens, at a much higher cost with higher deductibles. This is what I had to do after being turned down three times for insurance. Luckily, Maryland's plan has separate coverage for people with lower incomes with lower premiums and deductibles, and I'm on that. What is also interesting is that when I applied for MHIP, obesity was not listed as a high risk health condition. They had all kinds of diseases and conditions listed, and I had none of them. The only reason I was accepted was because I sent them a denial letter from another carrier.

What's also unfair is that if you have a lower income and are childless, regardless of marital status, many low-income basic medical programs run by the state will not accept you. You must be pregnant or have children under the age of 18 to be covered. Some states do have a separate low-income medical plan for childless adults, but in most cases, they are extremely strict and you literally have to be homeless or have no income except cash assistance. I make under $23,000 a year. But according to Maryland's PAC (Primary Adult Care), I make too much money to receive their services. So this really screws low-income full-time workers without employment insurance, regardless of health or waist size.

I live in Massachusetts, and my employer has PHCS. That means if I have to go to the emergency room for *any* reason, I have to pay up to $1000 (after which I'm covered). I learned this the hard way, this summer. Thankfully now I'm only $2 under the deductible limit, but guess what --- my insurance is rolling over at the end of September, and then the $1000 deductible renews. I better hope I don't have an emergency in the next year. My household (my fiance, his teenage daughter, and myself) is $5000 above what Massachusetts considers to be low-income.

I have the chance to switch to my fiance's plan and stop paying $100/mo for my health insurance which is providing me with less than nothing, but we're getting married in the spring, which is nine months away. Massachusetts won't let me go "healthcare-free" until then, although if I had to go to the ER I'd end up with the same bills I had to pay this time around out-of-pocket. As for preventative care, I'm completely healthy --- zero health problems, zero dental problems. My GP saw me last year and told me not to come back for five years, that I was healthy as a horse (and obese, oh noes, I must be some kind of impossible freak!).

So I'm paying a $100/extra tax to a private company so that I don't get fined $921 by Massachusetts come this tax-filing season.

This is the stupidest goddamn plan ever, on the history of the earth. I'm practically low-income, and I'm paying for the procedures of others, since I'm healthy, and I'm paying for my own ER care out-of-pocket.

Dumb, dumb, dumb. But I'll be subject to this $100/mo tax for no services until I get married (his plan doesn't have a domestic partner option).

So yeah, I can't say that my experience with this form of "universal" healthcare which Romney argued was the "free-market" version of "universal" healthcare has been very good. And this is the best we can expect, because we'd get even less of a choice, and pay even higher "hidden" monthly rates due to tax raises, under more standard versions of universal healthcare.

I haven't had time to post lately, just keep up on reading the new stuff. I've found it strange that this thread has degenerated into universal health care bashing.

I live in Canada, which has publicly funded health care. The provinces are responsible for what's covered and what isn't, and I've dealt with the systems of 3 different ones.

Some provinces do have premiums. For the most part, those are covered by employers. In BC, it's somewhere around $100 a month for a family of 4 (it was $75 when we lived there). In Alberta, it's less for the same size family. People on assistance do not have to pay it at all. Most don't cover all pharmaceuticals, but Manitoba has free Pharmacare - once you sign up, you pay up to a deductible and that's it. No one needs to worry about being able to see a doctor (though there are shortages of doctors in some areas, which is another issue completely), or have some company's approval for what course of treatment a doctor recommends, etc. Whether it's an ordinary yearly physical, or years of reconstructive plastic surgery and physiotherapy, it's covered.

Yes, there are problems and flaws, but I am extremely grateful for our health care system. Had we been living in the US or someplace with a similar system, we'd be in serious trouble right now. My husband has been struggling with his health for over 5 years now - though we didn't realize he'd been showing symptoms even longer. With all the doctors he saw, and the long list of special testing he got, we never had to worry about how any of this was to be paid for. We already paid for it through our taxes.

Despite claims to the contrary, Canada does actually have a sort of "two tier" system of both public and private health care. Medicare covers the essentials. Private clinics cover other areas. An example of this would be when I had my surgery. I had a breast reduction - not normally covered by medicare. In my case, my upper back gave out and I was getting skin infections so bad, they were starting to bleed. It was a year after the surgery before the scars faded. I was referred to a private clinic, since hospitals just don't do this type of surgery. Because the clinic puts priority on cash paying customers, medicare patients don't always get in as quickly. I was originally told to expect at least a 6 month wait - they couldn't even book an appt. for me that far ahead. My file, however, was marked urgent because of the severity of my case. So when there were cancellations, urgent files would get priority to call in. My surgery was first bumped up to two months then again to only 3 weeks.

I could go on with many more examples of how we've benefited from our public health care system, whether for our own health emergencies, or for family members - like my father, who had 5 strokes, then got a pacemaker. He got even faster treatment than our Governor General at the time did when she suddenly needed a pacemaker. My dad pays $400 a year for his drugs, and that's it. Considering he takes 4 or 5 pills a day now (and had been taking more, previously), there's no way my parents could afford them on their pensions.

In all our years, with all our moves and many different doctors, I've had *one* doctor - a fat woman herself - give me some flack about my weight. One. When my husband first started going through tests to identify his health problems, he was well over 400 pounds, and not once was he given grief for his weight, or told he should loose weight. Even after his apnea was diagnosed, the specialist talked about weight only because my husband brought it up, and that was to tell him that loosing weight might allow him to reduce the pressure (which it did) on his CPAP, but that was it. He was very clear that my husband would have the apnea no matter his weight. When my SIL, a very large woman, had her heart attack, she was given excellent treatment, with her size never an issue. While she is certainly being monitored for diet and exercise for her health, weight loss itself was never the goal. And on and on...

I know there have been a lot of stories about what's going on in the UK, but please, don't make the leap to blaming this on universal health care. These things are about politics, current popular thinking, and pressures from special interest groups that run contrary to what a public health system is supposed to be all about. I'll take our public health care system over what the US has any day, even though I see a few things in the US system we can learn from. Incidents such as this thing in Alabama is just another reason why.

"When did it become OK for a Government AGENCY to tell me, or anyone else for that matter, what we can or can not do with our own bodies?"

YIKES! No kidding! Good point!! What next? Gov. agencies telling people they have to pay higher premiums if they wear shorts or bikinis because they might get skin cancer?

I'm a Vet and I broke my leg back in 2003. It was September and I called the local VA hospital and they gave me an appointment in... March. MARCH!! (I knew I broke my leg because I could totally feel the bones grinding ~ I was a medic and had felt grinding bone before!) Because I did not have medical insurance I had to try and heal my leg all by myself ~ and I did a bad job of it and that's why I can't drive today or stand up for long or go for hikes or ride a horse with a saddle. Uuuugh!!

Universal healthcare in rural settings in the UK is grand for poor folk like me that can't afford decent insurance because you can see a doctor quite easily out here in farm country...

Without paying a cent, I've had amazing health care while here in the UK as the wife of a British citizen ~ my disabled leg has been tended to with intense and on-going physical therapy. The rotten tooth I had in my mouth for seven horrid years (due to a badly done filling in the Navy and not enough $$ for a dentist) was surgically removed, along with some wisdom teeth, under general anasthesia. Even with the infuriating fat hysteria, all of my maternity care has been free and, as a pregnant woman, I get all medications for free. (The coolest preggo lady thing: If I feel I have a problem with my pregnancy, all I have to do is drop by the maternity ward day or night!! I don't even have to make an appointment!) I can usually get a doc appointment withine one to two days of calling the local clinic and "my" GP is a fantastic, sensable doctor who does not deny that I'm fat but has not ONCE dogged on me about my weight or blamed any of my problems on me "being fat" ~ unlike some of the utter nonsense I've entured through the VA healthcare system where I've been flatly denied much-needed help because, "If you weren't fat you wouldn't be sick/injured.." When a different doctor here on my island felt that I needed to see the obstatrician down in the big hospital both my husband and I were flown down to the bigger hospital several hundred miles away... that particular trip was a total fat-hysteria fiasco but if I ever really *need* that service again it blows my mind knowing that I'll be flown down round-trip in order to get care and if I *really* need high-risk pregnancy care in the bigger hospital I'll be flown down, put up with room-and-board, and kept there until I give birth for FREE. Soon I'll have ocupational therapy coming to my house to help me deal with my serious mobility issues due to this "pubis symphasis disorder" (bascially, loose pelvis because of pregnancy hormones that is excruciatingly painful.) and they will provide a loan of equipment. Yeah, I have my honest gripes about the BMI stupidity that seems to have a firm grip on Britian's universal health care but that's about the only complaint I have! I *do* think that living in a rural setting helps me have quick access to health care though and perhaps living in cities and larger populated areas it's harder to see a doctor when you need one.

I'm totally impressed just the same!! Compared with being a working-class woman in America who went without medical or dental care this is pure luxury!!

I still maintain that BMI. IS. CRAP.

"If you judge people, you have no time to love them." ~Mother Teresa

Referring back to the OP, what really disturbs me about this whole thing is the lack of response to the violation of peoples right to body autonomy.

This isn't a private company trying to muscle it's employee's (Already being done in Fla. With this boost form Al, it will probably go nation wide soon enough). This is a STATE GOVERNMENT penalizing people for the state of their bodies with the justification that this body state MIGHT make them sick at some future point in their lives. Um, excuse me- WHAT?! Admittedly I'm a little fuzzy on what laws a state can or cannot pass in regards to the people it employs but, if I'm not mistaken, Federal Law trumps State. Federal law may not address discrimination as far as fat is concerned but what does it say about being required to change the state of a persons being?

Universal Healthcare? Private Healthcare? From what I've seen NEITHER is any friend to fat people because BOTH have a history of whining about 'how much fat people are costing us.' Bullshit on the play - Fifty yard penalty. Even this tactic and the myth it's based on is not new. As a commenter in a recent MarketWatch article points out, we have YET to reap the vast economic benefits we were promised from all those people who quit smoking after the last crusade.

Did you see your insurance drop when taxes were added to cigarettes? Did you see it drop when the percent of people who are smokers dropped. Taxes do not affect insurance costs. They only add to spending budgets of the taxer, be it state or federal.

I would only add that not only did TAXES not go down but that HEALTHCARE costs continue to rise unabatted. Despite the significant decrease in smokers and presumably smoking related illness. I'm sure someone will probably try to explain it away with 'Yeah, probably because you Fatty's picked up the slack' but i think I've got a better explanation; The rise in Healthcare cost has more to do with insurance company profits than with how many people are actually sick. Fat or otherwise. Which would make the State of Alabama's new edict not just bullshit but Malignant Bullshit. To my mind the question isn't just; How can we fix / change the system. It's ALSO; How can we keep them from shoveling crap like this down our throats while we're trying to do it?

Rarely do we find men who willingly engage in hard, solid thinking.
There is an almost universal quest for easy answers and half-baked solutions.
Nothing pains some people more than having to think. - Martin Luther King, Jr.

Thats sad. What is worse is that New Zealand (where Im from) wont allow you to immigrate here if you are obese because they do not want to pay for the medical costs.
Dan

And they say that sheep are dumb! I think New Zealand would have smarter legislators if the sheep were put in charge.