Pudge Police coming

As we’ve known was coming, employers and state governments providing health insurance to employees are increasingly requiring American workers to undergo regular metabo check and evaluations of their diets and lifestyles, and to participate in corporate “wellness” programs… or else.

The Atlanta Journal-Constitution reports this week that city employees of Kennesaw, Georgia who are fat, smoke or have been “identified by the company’s wellness consultant as being at high risk of health complications” are looking at their health insurance premiums doubling under a plan scheduled for a vote on Monday. The city’s health insurance program is underwritten by LifeWell, a managed care company focused on ‘wellness’ coaching and disease management, as part of the growing field of “lifestyle medicine.” It incorrectly tells its corporate clients: “The majority of chronic illnesses are lifestyle related and can therefore be diagnosed early and prevented.”

According to the news, twice a year, employees are already required to undergo a screening to determine their risk factors, said Miranda Jones, assistant to Kennesaw’s city manager. Those employees who refuse to participate in their wellness program, said the mayor, should be hit with higher premiums. “It’s just a good incentive to help…owners of the plan to save money,” he said.

Not reported is that the evidence shows such plans don’t save money or lower costs for employers, but are most designed to make money, with the core profits being the weight programs and the drugs to treat health indices. Lifewell’s four key partners are, accordingly, pharmacy benefit managers. As with all such wellness programs, the risk factors most targeted are weight, cholesterol, and other metabo indices which have proven to be poor predictors of future health or those at higher risk of premature death. Nor are they measures of, or appreciably amenable to, ‘healthy’ diet or lifestyle interventions. They are primarily reflections of aging, along with genetics and class. JFS has examined at length the medical evidence behind the most popularized beliefs, such as type 2 diabetes, cancers and heart disease, blood pressure or obesity, said to be caused by bad foods, diets or lifestyles; or able to be prevented by ‘healthy’ diets and lifestyles.

Nevertheless, the premium charges were recommended as “an incentive,” said the city manager. “The noncompliance comes from if you are determined to be a ‘high risk’ employee [and] make no effort to do anything about it.” She explained that “a report on an at-risk employees participation in the wellness program will be provided the benefits committee which then can determine the surcharge non-compliant employees must pay.”

Other Georgia cities, according to the newspaper, are moving to Kennesaw’s model.

States and city governments across the nation are currently looking at compulsory diets, weight loss and lifestyle management for workers. WIS-TV in Columbia, South Carolina reports that its Senate has made state employees’ weights a legislative issue. A subcommittee is looking at legislation to penalize state workers $300 a year if they’re fat. Family members on the state employee’s health insurance plan will also have to pay the fee if they’re fat. “Among the questions, would there be "pudge police" and how do you determine who is fat and who is just a little fluffy?”, the news reported.

Senator Greg Ryberg told WSPA that the penalty will be based on employees' BMI — weight and height. Clearly a believer of the populace myths of fat people and obesity stereotypes, he said: “It is actually trying to stimulate people to think that what they put them in their mouth is causing them an unhealthy lifestyle and in many cases the back injury and knee injuries that people incur are a direct result of decisions they make at the dinner table.”

According to the news, the State Employees' Insurance Board in Alabama approved a plan last week to charge state workers if they don’t comply with health screenings. Even if workers have the evaluations, should their blood pressure, cholesterol, glucose or obesity numbers be marked unacceptable, they’ll have a year to see a doctor, enroll in a wellness program, or “take steps on their own to improve their health”— a euphemism for lose weight and take prescription drugs to get their numbers to the new normal levels. If their health indices aren’t in line by January 2011, the employees “must start paying.”

Yesterday, the Charlotte Observer reported that lawmakers in North Carolina are similarly targeting state employees who are fat or smoke. “Legislative leaders introduced a bill Thursday that seeks to keep the State Health Plan solvent by reducing some benefits and raising premiums,” the paper said. With aging members, younger people are not part of the plan. Subsidies for basic eye exams are being cut, copays raised 8-fold, deductibles increased $300 to $600 and basic premiums increased nearly 8% per year. The plan also has a new pharmacy initiative to encourage more cholesterol lowering drugs because “many members who should be taking the drugs aren’t.”

Smokers and fat people would be “forced into the coverage option that carries the highest deductibles and co-payments.” Fat people would have until July 1, 2011 to become an acceptable weight, and smokers to quit, in order to stay on the regular plan, according to the bill. The only exceptions to those who fail to “fit the standard” would be ‘overweight’ people who can prove they have a medical reason for their size.

A smoker would be hit with a $2,000 penalty and any employee who weights 35% or more than is considered “fit” — a 5’10” man weighing 135-175 pounds or a 5’4” woman weighing 112-146 pounds — will incur a $2,360 penalty. Apparently, politicians believe that humans, regardless of their age and genetics, should all have the same body type, height and weight. There would be no exceptions for smokers, said the paper, and special sanctions for those who lie about smoking are being suggested.

Not one politician or journalist has made any attempt to examine the scientific evidence behind employer wellness programs, and diet and lifestyle interventions to learn there is no evidence that they are effective in reducing costs, improving clinical outcomes, or even for long-term weight loss. Nor are employees being allowed a chance to give an informed consent. They aren’t told that half a century of evidence on weight loss by the National Institutes of Health and recent evidential reviews have concluded that most studies and the strongest evidence show weight loss interventions can actually increase risks of premature deaths, heart disease, stroke, type 2 diabetes and cancers — by as much as several hundred percent — as well as put them at risk for a vast range of adverse events.

If you’re fat, older, picked the “wrong” parents, or don’t want to eat and live how politicians have determined best, you are noncompliant and they want you to pay.