Arizona is planning to fine fat people who don’t do as Nanny says. It’s all to do with costs, they say. And fat people cost the state money. At present, it is welfare claimants who are in the firing line as they are the ones covered by Medicaid, the government funded insurer. Presumably, the private insurers will come to their own arrangements with their clients, and I suspect that if they tried something like this on, their clients would seek an alternative provider – and, insurers will weigh the costs of care against the life expectancy of the patient, so you may well find that premiums don’t differ that much. The Medicaid folk have no such luxury, so are hostages to fortune.
And how to avoid this fine – small though it is at the moment?
Now the state of Arizona is proposing a radical idea. It wants to impose a $50 annual fine for overweight Medicaid recipients who don’t follow a strict health regime developed with their doctor. Those with children, and people overweight due to a medical condition, would be exempt.
Naturally, smokers get a look in, too.
Smokers and diabetics who ignore their medical advice would also have to pay.
So there you have it, the state is mother, the state is father, Nanny will tell you how to live your life or you will be punished. I do find it odd that diabetics are lumped in with smokers. Those diabetics I’ve known have been fastidious about their regime, not because of the cost to the health service but because they would like to stay alive, thank you very much.
Monica Coury, assistant director at Arizona’s Medicaid programme, says the aim is to change behaviour using a carrot and stick approach, in the same way that increasing cigarette taxes reduced smoking.
Well, I can see the stick. Where, precisely, is the carrot? And, frankly, it is not the place of the state to engage in such social engineering anyway. If someone is obese, then their life expectancy is reduced. The same applies to other high risk lifestyles. Therefore they will be less of a drain on the healthcare resources having popped their clogs before they end up spending a decade or so dribbling incoherently in some state funded nursing home. Cheap at half the cost, I’d say.
It couldn’t happen here? Oh, I don’t doubt for one moment there’s a bureaucrat somewhere in Westminster positively salivating over the idea. We have been bombarded for some years now with advice, guidelines and recommendations on everything from the amount of fruit and vegetables we should eat, to salt, alcohol and tobacco. And, given that the vast majority of us use the NHS for our healthcare, we are similarly hostages to fortune as are the Medicaid people across the pond. Also bear in mind the oft-repeated canard about smokers and fat people costing the NHS despite the fact that these people pay handsomely for any care they might receive. Its a meme that has taken hold in the public consciousness to such a degree, that it would be implemented with barely a murmur of dissent not to mention an unbearable aura of smugness from the tofu munchers of Islington.
As for me, I always eat my recommended amount of fruit and veg – the amount recommended by me. I always comply with the maximum allowed portion of salt – the amount decreed as okay by me. These limits may vary according to my mood on any given day so cannot be accurately measured in any meaningful way. I don’t smoke and I don’t drink, but the increasing intrusion by the state into the most personal and private spheres of our lives is in danger of driving me to both.