The Times West Virginian

Opinion

October 29, 2009

Why consider punitive action in bid to lower health costs?

Dissenters have called it the “Fat Tax” — a proposed discount program the state Public Employees Insurance Agency is considering.

The program, if approved by the PEIA, would ask its more than 200,000 state workers, retirees and family members to submit certain health information to determine whether they would be eligible for a discount on premiums. The insured would be asked to provide information on their blood pressure, blood glucose and cholesterol levels and — the source of the nickname — waist circumference.

If insured people hit all the “magic” numbers — or if they can provide a note from their doctor explaining they are working on a healthier lifestyle — they could be eligible for reduced rates. The amount of savings has yet to be determined — the PEIA board will host a public hearing next month before making a decision on the discount program.

We could see both sides of this argument. While the PEIA certainly wants to encourage a healthy lifestyle among the people it insures, we’re just not sure that this is the appropriate way to handle it.

In fact, it seems a little like grasping at straws to balance a budget as health costs soar.

“Fat Tax” is a catchy name that those who do not support the measure have coined. While we wouldn’t go that far, we can also see those with high risk factors would see this as financial punishment for failing to be as genetically balanced as the guy in the next cubicle.

PEIA administrators have compared this program to the $25 charge that smokers have to pay on top of regular PEIA premiums. But we would argue that smoking is a conscious choice. You decide you are going to light a cigarette. And while that decision may eventually trigger a chemical addiction to nicotine, the initial responsibility belongs to you.

But consider the risk factors that PEIA wants to reward some of its customers — high blood pressure, high cholesterol, diabetes, obesity. Doesn’t genetics play strongly into each one of these risk factors? Why don’t we just start taking swabs from newborn babies and determine the health issue they are most likely to suffer from and charge them extra for it?

Here’s a thought. Why don’t we start charging higher premiums to people who frequent tanning beds or refuse to use sunblock? How about those with poor driving records, a habit of not wearing their seat belts or who have had more than one accident? How about customers who consume more than three alcoholic drinks per day? People who run with scissors?

The point is that almost every person insured under PEIA engages in an activity that could be considered a health risk. Why consider punitive action against those who fit into a certain category?

PEIA already has eight distinct programs in place that focus on healthy lifestyles and helping its insured lose weight, quit smoking or other tobacco problems and exercise more, among other programs.

Gov. Joe Manchin is upset about public reaction to the discount program.

“If you look at our track record, we’ve never proposed penalizing or shaming anyone,” he told The Associated Press on Tuesday. “Since the beginning, we’ve been about improving healthy lifestyles. So why, all of a sudden, are we getting kicked in the teeth?”

Obviously there are two sides to this issue, but common sense tells you that it’s not really politically smart to tell your employees “You’re fat, and I’m gonna charge you for it.”

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