Fat Fees and Smoker Surcharges

This article, found at Time.com, starts out describing the deal Psychology Professor Anita Blanchard has with her employer for insurance. She works for the University of North Carolina at Charlotte. They guarantee her premium-free health insurance that will cover 80% of her health care costs for life. Sounds great, but there's a catch.

She can't gain too much weight or start smoking, or she could be resposible for an extra 10% of the cost.

Insurance companies have been promoting healthier living for a long time now. Many offer incentives for having a gym membership or not smoking.

Many now are increasing costs for customers who are overwieght or smoke. On the other hand some are keeping costs low when customers enroll in weight loss programs or smiking cessation programs.
Alabama was the first state to pass what critics are calling a "fat fee," in 2008 and several state insurance plans have started charging a $25 monthly fee for smokers.

There are many critics of these plans. Some are taking aim at North Carolina in particualr. Starting in July, state employees who smoke will be moved from a plan that covers 80% of health care costs to a plan that only covers 70%. This amounts to an out-of-pocket difference of about $480.00 per year, unless they agree to enroll in a smiking-cessation program.

In 2011 NC will address the issue of obese state workers. Someone with a body mass index (BMI) below 4o (basically someone who is 5'6" and weighs 250 pounds) can remain on the 80% plan for the first year. After that, they have to have either a BMI of 35 (5'6" and 217 pounds) or enroll in a weight loss program to qualify for the less expensive insurance plan.

Other states, such as Alabama, are offering discounts rather than imposing penalties. Alabama state workers willl get a $30 discount on their monthly premium for not using tobacco products. They have to sign a sworn statement under penalty of perjury. Since the plan was implemented in 2005, there has been a 4% decline in the number of smokers.

There are many other programs like these being offered by various states and insurance companies in an effort to lessen the amount being paid out for claims.

There are also a lot of differing opinions about whether these restrictions are fair to customers.


I know this might not be the popular opinion, but I actually agree with what these states and companies are doing. It makes sense to me that health care costs should be based on what it costs to take care of your health problems. I don't think it's entirely fair for someone who is very fit, in shape, eats healthy and doesn't smoke to have to pay as much as someone who is obese and smokes like a chimney.

People make certain choices about the lifestyle they choose to live and should deal with everything that comes with those choices, good and bad.

I don't want to sound totally heartless about this. I don't think that any of these programs should apply to people with other heath problems or if their weight is caused by a legitimate medical problem. I just think it should apply to those whose problems are caused soley by food choices or the choice to smoke.

I think some of these programs are just the incentive for some people to finally make the choice to live a healthier lifestyle. If nothing else will do the trick, maybe taking their money will.