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Oh hai blatant discrimination!

Rose tipped me off to some fat discrimination going on over in North Carolina. According to this policy document, the North Carolina State Health Plan (for teachers and state employees) will soon be divided into two sections: one for the "good" folks who don't smoke and have BMIs under 40 and one for the "naughty" smokers or people with BMIs 40 or above. Of course the good folks will receive more coverage at less expense than the naughty ones. Participants in the health plan are required to fill out a form every year that attests that they fit into the good group and they also agree to be subjected to mandatory random screenings for smoking and for BMI.

I am both appalled and terrified by this idea and the precedent it creates. First of all, does this mean that an NCSU employee is subject to being weighed and measured at work whenever HR deems it necessary? What about personal privacy? What about a person's body being their own property and not for their employer to judge? What about an employee being compensated on their performance and NOT their body size? Because no matter how this policy was initially intended, this ends up being another way to pay fat people less for doing the same job, as if that weren't happening enough already.

I hate the idea of the smoking thing as well on the grounds that what I do in my off time shouldn't be any of my employer's business, but at least that's a behavior that can be stopped. A fat person can't just stop being fat, despite the world's erroneous belief that all you have to do is just try a little harder to eat less and exercise more and the pounds will magically melt off. No one has been able to find a method of weight loss that works permanently for more than the tiniest percentages of people, which means that fat people are likely going to stay fat no matter how many crunches they do.

Let's not forget that the mainstream jury is still out on fat and health anyway...even Newsweek isn't sure whether fat=unhealthy anymore. Even if it was proven beyond a shadow of a doubt that fat people are definitely going to get sick, the whole point of a group health plan is that some people are going to get sick and some aren't. By buying into it you acknowledge that you are going to pay the same amount whether you get sick or not and whether other people get sick or not. If we're going to just weed out the people we think are going to get sick, what's the point of group health then anyway?

On TOP of that, what this plan is doing is funneling the people who are (supposedly) the most likely to get sick into a group that gets less coverage! Those who will likely need health care the most are all of a sudden going to get the least amount of assistance from their health insurance company! If this doesn't prove clearly how much more interested health insurance companies are in profits over actually providing health care, then I don't know what will.

Thanks Rose!

There are worse things than being a fat bride | The power of visibility

rachelr's picture
September 17th, 2009 | Link | That's a great distinction

That's a great distinction between smoking and being fat -- you articulated what I was struggling to put into words very well. As well, certain health conditions have been linked to smoking, whereas many of the allegedly "obesity-related" diseases are far more complex in nature, with fatness sometimes a symptom of a larger issue and not the cause.

And as long as the state is assuming fatness to be a choice one can just exercise away... will the state also financially penalize women of child-bearing age (pregnancy $$$) or people who eat meat (stomach cancer $$$), run marathons (knee surgery $$$) or engage in any other choice that may potentially rack up medical costs?

rebelle September 24th, 2009 | Link | I agree there is a

I agree there is a distinction: Smoking is a behavior; fat is a state of being that isn't chosen and isn't inherently evil.

(Oops. I see now that Carrie already made that point. Duh. Sorry).

lilacsigil September 17th, 2009 | Link | And if your BMI is below 40

And if your BMI is below 40 then you become sick and gain weight? They can say you were lying and deny you coverage. I'm so glad I live in a country with universal healthcare.

pani113's picture
September 17th, 2009 | Link | Outrageous! Something

Outrageous! Something really needs to be done about this. We should contact those unions, as well as the ACLU. And in North Carolina of all places. My great great grandfather fought in a North Carolina regiment in the American Revolution. He would be turning over in his grave over what this country has turned into. Not socialism folks but corporate fascism where we are nothing but serfs that exist for the benefit of our corporate overlords. The politicians do nothing but let their campaign contributers pull their strings. I certainly hope that all involved put up one heck of a fight. As soon as I have some free time, I am going to hunt down some addresses myself.

"Fat can be beautiful. Intolerance is ALWAYS ugly!"

CarrieP's picture
September 17th, 2009 | Link | pani if you send addresses

pani if you send addresses to me I will post them - carrie at fatrights dot org

Bree's picture
September 17th, 2009 | Link | Does North Carolina really

Does North Carolina really think this will work???

Bilt4Cmfrt's picture
September 18th, 2009 | Link | Yeah. Unfortunately, they

Yeah. Unfortunately they do.

As pissed off as this makes me, and I don't mean just a little, I was waiting for this to raise it's stinking head out of the dung heap. It was just a matter of who and when. Apparently NC has volunteered itself as the test-case and, since there's no real way to determine measurable gains or losses, I expect several other states to merrily jump onto the party wagon in short order. Really, the only ways I can see to stop this kind of bullshite is at the employee level (Umm. . . Yeah), with grass roots political activism (Umm. . . Yeah), or with activism based on class discrimination (Could work, provided the links between poverty and obesity are accepted as bona fide). Otherwise this kind of crap has too much political currency to ignore. Especially with so many gubernatorial offices taring the furniture apart looking for enough spare change to keep their budgets afloat. This? Isn't worth a hill of post-digested beans, but it looks good on paper. If you glance at it real quick out of the corner of your eye while squinting hard. Still, logic has little to do with any of it.

My hope is that, eventually, when folks start realizing how impossibly hard or simply impossible it's going to be to actually comply with this dog vomit, the Self-hating, the FOBT Cultists, and even the Muscle Heads will get pissed enough to start making some noise. Then, maybe, we'll be able to get some shit done.

Learn how to logic- Lesson #4
Obesity is NOT caused by food addiction.
Stop smoking / drinking entirely and you can go on with your life, smoke / drink free. Stop eating entirely and you starve to death. Death is a problem.

Elm Nehmara's picture
Elm Nehmara
September 17th, 2009 | Link | Sounds like the plan is

Sounds like the plan is running on pre-existing condition b.s. but using fatness as such. I don't want to get political here but I gotta ask, isn't Obama trying to stop this kind of thing with the healthcare reform? It makes me angry that people think fat=unhealthy and quite frankly this kind of legislation really ticks me off.

I just hope that people will see how boneheaded this is.

richie79's picture
September 18th, 2009 | Link | Yes, but as we already know

Yes, but as we already know Obama is no friend of fat people and thinks that the world would be just peachy if we'd all just go away and stop being fat at him. What's the betting that 'self-inflicted' lifestyle / behaviour-related issues will be excluded from any guarantees to cover pre-existing conditions? I agree with Carrie on this one, not least because of the slippery slope implications for ALL employees; if it becomes accepted that our weight and smoking / drinking behaviours outside of work are now the business of the HR dept, what next?

"The reward for conformity is that everybody likes you except yourself" - Rita Mae Brown

osxgirl's picture
September 18th, 2009 | Link | You know, in some ways, this

You know, in some ways, this is a result of real history not being taught anymore. People figure that as long as it doesn't affect "me", it's ok... after all, it only affects those "bad" people that should know better and straighten up their lives. Sheesh!

But real history, and the implications of it, aren't taught anymore at all.

"First they came for the communists, and I did not speak out—because I was not a communist; Then they came for the socialists, and I did not speak out—because I was not a socialist; Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist; Then they came for the Jews, and I did not speak out—because I was not a Jew; Then they came for me—and there was no one left to speak out for me." Martin Niemoller

Granted, the situation was certainly a lot more serious, but the basic idea is the same... people turn their backs, because after all, it doesn't affect me, and "those" people are "bad" anyway. But you know what? The ones who turn their backs find that eventually, it's their turn. Only there's no one left to help them fight the injustice anymore at that point.

I have my doubts that anyone's going to care that this is happening, that we can get this stopped. But it won't stop here.... if they are successful, they will look for other things to exclude, to use to cut back costs and maximize profits.

The thing is, I am not for going to universal health care either - I think that there are too many problems with that model either. But I do think reform is needed. I just don't want the government in charge of my health care.

And to be honest, I think this is a foreshadowing of some of what we might expect if government is in charge. After all, this is the NC State Health Plan doing this. When the government realizes they can't do what is needed and rationing is necessary, this is the kind of thing we can expect to see as a way of rationing.

I expect that fat people will be denied all kinds of care until they "lose the weight", since they are not viable candidates for the care at the higher weights according to the government.

The insurance companies do it... the government does it... so what is the answer?

Personally, I think we should be going back to paying for most health care ourselves (as in the small stuff, the office visits and things like that). And that in turn, if insurance companies were taken out of that level of things, that the doctors would likely be willing to return their prices to something resembling normal and reasonable (think about what they are willing to accept as payment as a set price from insurance companies when they are a "preferred provider" for that plan).

We should be allowed to do health savings plans, tax free, that carry over from year to year... no losing the money if you don't use it. Need-based subsidies for that for those at the poverty level. And buy high-deductible, low-cost insurance that is only for catastrophic, not for the normal, every day care.

Also, instead of insurance companies for that insurance, we need insurance co-ops (for lack of a better word). Think of the difference between a bank and a credit union... an insurance co-op would be to an insurance company like a credit union is to a bank. Non-profit, only there to help insure against and pay for catastrophic events, all profits (with the exception of what profits are needed to run the co-op and do normal expansion) would go back into the co-op, therefore back to the people who have paid into it.

Ok, now that I've taken this conversation into a complete left turn.... can you tell I've thought about this a while, and am REALLY frustrated about the whole thing? I have good health care, too, but... One - I feel locked into the job I have, because I won't get the health care I have very many other places. And two - I worry about what will happen to what I have under the reforms, because right now, I can get whatever care I need, and so can my husband. But we're both fat. I worry that under reform, we will both lose out... a LOT!

pani113's picture
September 29th, 2009 | Link | Rebelle, the point can't be

Rebelle, the point can't be made enough! And smoking was never responsible for the survival of the species. Fat was what got us through centuries of famine! It also has health positives doctors are just beginning to understand. Smoking was not a necessary part of human evolution. FAT IS!!!

"Fat can be beautiful. Intolerance is ALWAYS ugly!"

tante October 2nd, 2009 | Link | Boycott North Carolina

Once again, I call for a boycott of this ridiculous state.

Morrighan's picture
October 8th, 2009 | Link | Ok. I just have to throw

Ok. I just have to throw this in here because everyone seems to have pounced on it for some reason. Smoking is bad (mmkay). We (smokers) get the concept. But this nonsense they're pulling on fat people? Where do you think they practiced that? That's right, on the smokers. What it all -should- boil down to, is that everyone pays into the insurance and everyone should get their covered medical bills paid for when need be. That's what health insurance is -for-, not controlling my, your, or anyone else's lifestyle choices.

How about we try being for -everyone- having the freedom to live their lives, and how they choose to do so is none of the government, insurance companies, or co-worker's business? Yes they want to compare being fat to smoking. That has a lot less to do with the supposed or proven risks of one or the other and a lot more to do with the fact they got away with turning smokers into complete and total outcasts.

And I'm frankly a little surprised and disappointed to see so many here buying into it.

vesta44's picture
October 8th, 2009 | Link | Morrighan - I've wondered

Morrighan - I've wondered for years if those statistics about smoking killing people are actually about the smoking itself killing people, or if it's the surgery/chemotherapy/radiation done to "cure" the lung cancer that actually kills them. The reason I say this is because my step-grandfather smoked for years and years (roll-your-owns) and when he was in his 50's, they found a small spot of cancer on one lung (about the size of a quarter). They didn't operate to remove the spot, they gave him radiation treatments, and the dosage was too high. They burned his lungs, and he was on oxygen for quite while. When the doctors decided he should be weaned off the oxygen, the last time the oxygen was taken off him, a blood clot moved and killed him (the same thing happened to his sister 10 years earlier). His wife (my grandmother) also smoked (the same roll-your-owns) and she quit smoking when he was diagnosed with lung cancer. Five years later, they diagnosed her with lung cancer and removed one lung. While she was in the hospital recovering from that, they gave her a medication she was allergic to, which was clearly listed on her chart, and she had a stroke. Luckily, she survived it all, and lived another 20 years, but I would venture to say that one of the causes of death put on her death certificate was lung cancer, even though she had it 25 years before she died.
All of this is to preface that I think what they've done to smokers is being done to fat people now. They've been doing this to fat people all along, just like they did to smokers, but now they're becoming much more blatant about it, and saying that all diseases can be prevented if one just eats the "right" diet and exercises the "right" amount. Thing is, they don't have a fucking clue how much exercise is enough/too much, much less what makes up the "right" diet for each and every person on the planet, since we are all individuals and we all have different needs and requirements. Not to mention that health is not a moral imperative, no matter how hard they try to push it as being one.
I'm an ex-smoker, but I didn't quit for health reasons, I quit because I couldn't justify spending that amount of money on something that wasn't a necessity for me (and this was back when cigarettes were only $1.50 a pack, and I only smoked a carton a month). I don't preach at people who smoke, it's none of my business, just like it's no one's business what I eat or drink or how much I exercise (or don't).
I keep telling people that I'm 55 (almost 56) years old, and I'm not going to have the same health I did when I was 18, or when I was 25, or when I was 30. And when I'm 75, my health isn't going to be the same as it is now, but that's what happens when one ages, and expecting people to keep their same health from cradle to grave is setting us all up for failure. We aren't meant to live forever, and I, for one, don't want to.

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

CarrieP's picture
October 9th, 2009 | Link | @Morrighan - Well yes, I

@Morrighan - Well yes, I hate the idea of one's employer getting to dictate any type of behavior or state of being that is practiced in one's non-work time. The distinction I tried to draw though was that even IF it were okay for my employer to decide these things for me (I firmly believe it is not), it would be a simpler thing to not smoke than to not be fat, in that one is a behavior and the other is a state of being.

richie79's picture
October 10th, 2009 | Link | I agree with you both on

I agree with you both on smoking (and other behaviours that don't directly impair one's ability to do the job for which they are employed) outside the workplace being no business of an employer. As I've always said, they rent our time and expertise in a particular field; they don't however own us, our bodies, or our minds. I might make an exception for drug testing of truck drivers or airline pilots being randomly breathalyzed but for the average office drone any form of regulation of lifestyle outside of the workplace is complete overkill.

I also think Morrighan makes an excellent point about the similar methods employed by the public health fascists toward smokers and fat people. These people are absolutely not happy unless they're meddling with our individual freedoms and insisting we follow their one 'correct' lifestyle. They cut their teeth on the anti-smoking campaigns but emboldened by their apparent 'success' and forced to change tack by the resultant huge reductions in cigarette smoking in the West, seem to be taking an even more hysterically illiberal line in their approach to 'the obese'. Drinkers will follow in time; eventually they may even run out of targets, but not until we've been legislated and 'denormalised' out of existence.

Anecdatal it may be, but already I'm seeing a noticeable reduction in the visible numbers of the largest people on the streets where I live (for which I suspect a combination of the wider availability of WLS and the shame being levelled at those who remain large is responsible). Given the inevitable result of these public health campaigns (elimination of all but a hard-core of die-hards clinging to their principles / identity despite life having been made almost intolerably difficult by the authorities) the future for fat folk does not look especially rosy - particularly as, as previously stated, it's rather more difficult and potentially dangerous to 'stop being fat' than it is to give up smoking.

"The reward for conformity is that everybody likes you except yourself" - Rita Mae Brown

osxgirl's picture
October 13th, 2009 | Link | I will never agree with

I will never agree with smoking being ok for anyone. I think everyone should stop. I am very biased on the issue - I grew up with both parents smoking and always hated it, hated being around it. I felt like I couldn't breathe. And then my dad has had heart trouble his whole life and ended up with lung cancer which, thankfully, they caught EXTREMELY early, and because of that, they were able to remove all of it before it spread, and they didn't even have to do chemotherapy. He's been cancer-free for 4 or 5 years now. It took the surgery for the lung cancer, and the doctors telling him that if he smoked again that it wasn't a matter of "if" the cancer would come back, it was a matter of "when" it would come back to get him to quit smoking.

All of that makes me hate smoking, and wish everyone would quit. But I also know from my dad and the things he has said and what I've seen that it definitely is an addiction, and I am convinced that the cigarette companies have knowingly made them more addictive.

All that being said... I STILL don't agree with predicating insurance or access to health care on whether or not someone smokes. I just wrote an article for my blog about the health care reform issue, and I even refer to this a little. Just because someone smokes doesn't mean they don't need health care. Yes, it may be a behavior that they could possibly change but... a whole lot of people have behaviors that they could change that end up costing the health care industry. Are we going to start singling them ALL out? What about people who drink? Are we going to start counting how many drinks people have per day? And what about people who ski... that can be pretty dangerous. Extreme sports? I could go on.

And I see them penalizing smokers, but I don't see a whole lot of support for it as an addiction. And it is one. If it is so bad for one's health, why do they not pay for more and better programs to help people stop instead of just denying people care?

The bottom line is... no one else should have the right to delve into another person's personal life that way. Period.

greywolf October 18th, 2009 | Link | There's a plan to make this

There's a plan to make this type of thing national:

Based on the article, there's a bill in Congress that could increase insurance rates drastically for some people (like us fat people, those with diabetes, etc.):

Under current regulation, incentives based on health factors can be no larger than 20 percent of the premium paid by employer and employee combined. The legislation passed by the health and finance committees would increase the limit to 30 percent, and it would give government officials the power to raise it to 50 percent.

I encourage everyone to find more info and contact their Congressperson to voice their opinion.

JennyLinsky October 19th, 2009 | Link | Smoking and fat are not apt

Smoking and fat are not apt comparisons.

An asthmatic or a pregnant woman is not hurt by sitting next to a fat person. However, if an asthmatic or pregnant woman is around cigarette smoke, these people could be seriously harmed. The right to breathe takes place over the right to smoke.

That being said, however, smokers should have warm and well-ventilated smoking rooms in public buildings. They would neither suffer nor force the rest of us to smell like an ashtray. Bars. restaurants, and nightclubs should have no-smoking rooms.

Bilt4Cmfrt's picture
November 5th, 2009 | Link | Not an apt comparison?

Not an apt comparison? Perhaps not. However, as others have pointed out, there's a lot to be learned and the fat community had BETTER take heed of the example America's recent anti-smoking crusade represents.

Yes, 'crusade'. I use the word here in the medieval sense. No other activity, including the illegal use of intravenous drugs, smoking crack, or abusing methamphetamine has seen the kind of fanatical moral outrage or rabid social vilification that the legal smoking of tobacco has in the past 25 years. How many second-hand deaths can be attributed to, yet another, legally abused substance? Alcohol. Yet, where's the outrage? Sure those immediately effected are in the fore-front but when was the last time you saw some one march up to an intoxicated stranger and demand their car keys? Well, if this country becomes puritanical enough in it's moral outrages, it may yet start happening. Could be that we're in for yet another go-round with Prohibition. Considering what's happening to people in this country just because their fat? Could very well be.

THAT's the point here. Not wether smoking is bad or good, but that the TACTICS used so successfully to persuade/shame/block people from pursing a 'bad' activity are now being used to harass people in regards to their body size. Used with the same fanatic zeal, righteous certitude, or panicked disregard for almost all other considerations.

Compared to this, second hand smoke isn't dangerous. THIS? Is dangerous.

Learn how to logic- Lesson #6
Obesity is NOT an indicator of individual life span.
No one knows how long ANYONE has to live. Not your local medical expert, statistician, or fortune teller.

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