Our internet friend Amy sent us a link to a short article which just goes to show, we are with fat people now where we were with women about 80 years ago:
Companies are cracking down on the health of their employees. IBM recently said that starting next year it will pay employees $150 if they sign up their kids for a program to fight childhood obesity.
Clarian Health recently revised controversial plans to penalize workers for smoking, having high blood pressure, or body mass index over a certain limit.
The moves are part of a trend among a growing number of employers to monitor their workers’ health. After all, it costs more to insure smokers and overweight people.
Where do we begin?
So, companies want their workers to take better care of their bodies, since healthy workers are cheaper to insure. All fine and understandable and business-like.
But the logical extension of this is that workers who are more expensive to insure will have a harder time getting a job.
It’s not OK to discriminate in hiring on the basis of gender, sexuality, religion, or race, because what is important is whether the person can do the job.
It should not be important how much it costs to insure them.
And do not even get Francesca started on the idea of penalizing workers for being fat . . . because, you know, the social pressures, the difficulties dating, and the parents and aunts and uncles who put us down for years worked real well to keep our BMI’s in the “normal” range, right? Negative reinforcement sure works wonders, right?
Right?
Francesca says: This is not a political blog, but I am compelled to point out something important. I spend much time in countries with socialized medicine, and have seen the benefits of it. It is absolutely ridiculous what happens in the United States, wherein businesses consider it their issue whether a worker smokes or is obese — not out of genuine concern for whether they are well, or even for how many sick days they might take, but rather because the employer has a connection to the health insurance. And it is ridiculous that one can only easily get affordable health insurance if one is employed by someone else — someone else who will now be keeping an eye on how often one’s children go to the gym.
Francesca says: She would rather pay for national health care and have fewer amenities in the doctors’ offices, than have to put up with this sort of crap.
Francesca hath spoken.
AMEN!!
Comment by Pamela — November 4, 2007 @ 4:33 pm
Health insurance these days is ridiculous… I just turned 22, and *despite* the fact that I am still a full-time student (working unpaid internships and whatnot in an attempt to be more employable post-graduation) my father’s health insurance is no longer going to cover me. Also, I have had several people tell me, when I mention this, that that same health insurance company covered them until they were almost 30!
A friend of mine owes over $100,000 to a hospital because she is an actor (thus, no insurance). She was in a car accident in January where she nearly died, and no less than 7 other car accidents happened on that same stretch of road because the city had not gotten around to plowing it that particular morning! Yet, this is now her problem. Insane.
Comment by Sarah — November 4, 2007 @ 4:37 pm
I’d rather the employers stay out of employees’ private lives altogether. Yes, there are certain people who cost a lot of money — premature babies, drug/alcohol/mental health inpatients, persons with head injuries — but unless the company is relatively big (more than 500 employees), the medical costs of the company’s employees is not considered in setting the premiums. (At least it wasn’t when I was in the business 20 years ago.)
I am not eager for the gov’t to take over health care, either. I won’t go into the details, although there is a lot of documentation showing differing survival rates between the US and Europe for various conditions. Suffice it to say that if you think the Post Office always does a better job than FedEx or UPS, you would be happy with gov’t-run medical care!
(I would like to see the documentation on fat people costing more. That wasn’t even a question we asked in underwriting. Where are the studies on this?)
Comment by class-factotum — November 4, 2007 @ 5:39 pm
If Francesca thinks hiring preferences are meant to influence anyone’s behavior and further if Francesca actually truly deep-down believes that corporate America cares about or is responsible for Francesca’s feelings of self-worth, Francesca is sorely mistaken. Hiring preferences are meant to influences costs.
Comment by Janice R — November 4, 2007 @ 10:31 pm
Between the bossy HR lady threatening to penalize me unless I magically lose weight, and the government bureaucrat threatening to fine me or telling me I will be ineligible for surgery until I magically lose weight… honestly, I would rather deal with the evil HR lady. At least I can quit the job if they’re too obnoxious.
Comment by jaed — November 4, 2007 @ 10:33 pm
@ class-factotum: Junkfood Science has several great articles about the paucity of evidence linking fat with increased costs. The writer, Nurse Szwarz, also writes about how certain industries – particularly the insurance and pharmaceutical industries – have an interest in creating and perpetuating the belief that obesity is causing outrageous health care costs. (http://junkfoodscience.blogspot.com/)
Personally, I think it is a brilliant economic strategy to (1) recognize that, for a variety of reasons (some great: like increased access to more nutritious food) people are larger than they used to be (2) label it a completely preventable epidemic and then (3) charge fat people more money for providing the same or even less services. Evil, but brilliant.
Comment by dangermouse — November 4, 2007 @ 11:16 pm
The biggest irony here is although the insurance companies want you to loose weight, almost no workplace healthcare plans will pay for obesity (bariatric) surgery because they consider it cosmetic. Guess they would just prefer overweight people to quit their jobs and go off somewhere and die quietly. Seems they can have their cake and eat it too.
Comment by gemdiva — November 4, 2007 @ 11:21 pm
Alas Francesca dear, the national health service is not the answer. Not only are there fewer services available, and longer waiting lines to receive them, but in the United Kingdom the doctor may refuse to treat you if you are obese or a smoker:
http://www.timesonline.co.uk/tol/news/uk/health/article1722284.ece
One must pay into the system, like it or not. There is no other place to go. And still they may refuse to treat you. Truly it is the worst of all possibilities.
Comment by Annalucia — November 4, 2007 @ 11:24 pm
I’ve heard plenty of horror stories about “socialized medicine” in the American media – stories that no connection at all to the reality of the health care system we enjoy in Canada.
Comment by Sniper — November 4, 2007 @ 11:44 pm
Here’s an interesting website. Out of 221 countries rated in descending order (highest rate at top-lowest rate at bottom) The USA is 180 in infant mortality rates. The reasons given overall is lack of available health care to the poor or self employed. The 41 countries with lower mortality rates are primarily countries with excellent socialized medicine (Iceland, Norway, Sweden, etc… for example)
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
Comment by Jennie — November 5, 2007 @ 2:28 am
Oh! This site too! Universal Health Care only sux if the country’s entire infrastructure sux (Russia for example…)
http://en.wikipedia.org/wiki/Universal_health_care
Comment by Jennie — November 5, 2007 @ 2:41 am
http://en.wikipedia.org/wiki/Universal_health_care
Here’s more….
Comment by Jennie — November 5, 2007 @ 2:43 am
How nice for you that you’re willing to do without “amenities” — whatever that means — and are willing to see the rest of us sacrifice them as well!
The U.S. government is the world’s No. 1 purveyor of anti-fat propaganda. You think that’s going to magically change once we’re forced into government health care? You think the government will not consider that it has a compelling interest in every damn thing you put in your mouth?
And a lot of your anti-fat-indoctrinated fellow citizens will happily cooperate in your persecution. You think people scorn and harass fat people now? Wait until they’ve been taught to believe you’re taking money out of their pockets. It’s already happening.
An employer can refuse a fat person a job. Government health care can refuse a fat person life-saving medical care. You think, in our current state of anti-fat hysteria, that this won’t happen? It’s already happening in other countries. (And smokers, of course, can just crawl off and die.)
Anyone who actually wants to give the government greater power over anything — much less life-and-death decisions — is, I’m sorry, out of his or her mind.
I am, incidentally, in wretched health and uninsurable privately. Before I was fortunate enough to get a job with insurance, I had to depend on L.A. County for my health care for a dozen years. So I know exactly what government-run health is like. And if you think it’ll be one bit less miserable just because everyone is forced into it, you’re kidding yourself. On a very serious matter.
And Manolo for the Big Girl just turned into a lefty blog. Too damn bad.
Comment by Bridey — November 5, 2007 @ 7:57 am
Jennie,
That study is often cited but the numbers don’t mean what you think. See this article for an explanation:
http://www.nytimes.com/2007/11/04/business/04view.html?ex=1351828800&en=7abf86ba1f3f353d&ei=5124&partner=permalink&exprod=permalink
The same reasons an employer may ration health insurance will also drive government rationing. Only with employer rationing you can change jobs or insure on your own. With government rationing not so much.
Comment by Kathy — November 5, 2007 @ 8:30 am
BRAVA! I completely agree with that. My view is that if you are not working with small children or delicate/dangerous machinery, you shouldn’t be pre-employment drug testing.
As for the weight issue – my health is better than the days when my BMI numbers were barely legal (under 21, rimshot here).
I also have issues with our employee health division. I’m all for “the exercise and win a prize” contests, but they have ridiculous weight loss or even maintaining contests. Which all of us know, are really unfair.
Our employee health liaision has just left, and I am going to do my damnedest to urge the hiring committee to hire someone who believes in the “health at any size” model. It probably won’t fly, but dang it, I’m going to try.
Comment by dowdydiva — November 5, 2007 @ 8:53 am
What really bugged me about this was that they equated BMI with health. The emphasis was on external fatness, not on things like cholesterol level, unhealthy internal abdominal fat, triglycerides, etc. I was gratified that, in the end, the company was forced to back down. I felt that the policy was the equivalent of refusing to hire me because cancer runs in my family.
Also, any good child psychologist will tell you that positive reinforcement is the only way to get anybody to change their behavior. I like the idea of providing incentives for healthier lifestyles; that can benefit anybody at a company, regardless of body weight or health history.
Did anybody else read the recent study linking obesity to cancer rates? The study’s authors are suggesting that people have BMIs of around 19. 19! I’d be dead if my BMI was 19.
Comment by amy — November 5, 2007 @ 12:51 pm
Alas, Francesca, although I agree 100 percent with your desire that employers quit badgering their employees about their weight, etc., here’s the latest news from that socialized-medicine paradise, the U.K.:
http://www.thisislondon.co.uk/news/article-23419630-details/Santa+told+to+slim+down+for+Christmas+to+'set+a+good+example'+to+children/article.do
Same old officious fat-badgering, same old fat employees (department-store Santa Clauses, no less!) threatened with loss of their jobs if they don’t slim down. And same old national “obesity” problem, or so we are told.
Comment by The Charlotte Allen — November 5, 2007 @ 1:34 pm
I am waiting for the lawyer smart enough to see the opportunity for a massive class action lawsuit here. If insurance programs (public or private) deny care for unscientific reasons (BMI, etc.) then surely they can be sued.
Comment by Sniper — November 5, 2007 @ 1:50 pm
“And Manolo for the Big Girl just turned into a lefty blog. Too damn bad.”
Oh for the love of Krispy Kreme. Francesca expressed an opinion, one you apparently disagree with. Her blog, her opinion. Get over it.
Universal health care is the answer. Here’s one reason why:
http://content.nejm.org/cgi/content/abstract/349/8/768
I don’t know if the govt. will treat fat people more fairly than private insurance, I hope so. They could hardly treat them worse.
Comment by Abigail — November 5, 2007 @ 3:20 pm
It’s not illegal to decline to hire someone because of their weight. The only laws I know of that apply to that sort of discrimination exist in California.
Newsflash…people are now not only discriminated because of their race, their CREDIT, their looks, now it’s weight. Pretty soon you’ll have to be 5’9, blonde, beautiful, thin, tan, and have a perfect credit score to get a job. It’s not fair, but the people that can truly make a difference with these things don’t care. Welcome to the United States folks!
Comment by Angel — November 5, 2007 @ 3:21 pm
Amy, do you have the citation for that study? I’d love to take a look at it, because their conclusions sound preposterous. At my very thinnest ever I had a BMI of around 21. My hair fell out, my boobs shrank down to nothing, I lost all my curves and I looked like crap. I shudder to think what I’d look like at a BMI of 19. No way in hell could I be healthy at that weight.
Comment by Melissa — November 5, 2007 @ 3:24 pm
“The USA is 180 in infant mortality rates.”
Ah, yes, but that is because (according to my neo-natal NP sister), many countries do not count as live births children who die soon after birth (like up to a year), because many people come to the US specifically because they have high-risk pregnancies (remember the lady with sextuplets — quints? — who came to the US from Canada a couple of months ago?), because we will try to treat sick babies that many countries would let die and because we create more high-risk pregnancies with assisted fertilization procedures.
Comment by class-factotum — November 5, 2007 @ 5:00 pm
Sure, Melissa. I could be misinterpreting it; somewhere I read 19, other places I have read “the low end of healthy.” (That’s 19, right?) And I agree: when my BMI was 21, everyone was asking me if I was eating. It seems like such a crazy measure.
Here are the recommendations; there’s also a link to the full report on that site. The specific rec is “Be as lean as possible without becoming underweight.”
http://www.aicr.org/site/PageServer?pagename=dc_home_guides
Comment by amy — November 5, 2007 @ 5:09 pm
I just read the report, and frankly this American Institute for Cancer Research doesn’t sound very credible. Here’s their blurb: “Since its founding in 1982, the American Institute for Cancer Research has grown into the nation’s leading charity in the field of diet, physical activity and weight management as it relates to cancer prevention.” Sounds like an anti-obesity group that’s disguising itself as a cancer research organization. And I don’t think you misinterpreted their recommendation, Amy — “normal” BMI is 18.5-25, so 18.5-19 would be “as lean as possible without becoming underweight.”
I think I’ll listen to my real doctor about what’s healthy and what’s not, thanks. When she tells me that my BMI of 22 is putting me at risk for cancer I’ll listen, but somehow I doubt she will.
Comment by Melissa — November 5, 2007 @ 11:33 pm
agreed, melissa! it didn’t even occur to me to check what the “institute” actually was – i was just reading all the media reports. thanks for the fact-check and i agree, best to consult with your own physician.
Comment by amy — November 6, 2007 @ 3:29 pm
“The USA is 180 in infant mortality rates.”
It’s true that this statistic may be slightly skewed by data collection processes between different countries, but the US’s major health care indicators are still below many other countries that have socialized medicine. We SHOULD be #1 on those, considering that we are the #1 spender per capita on health care, by a *large* margin. I’m not saying that socialized medicine doesn’t have its flaws, but “oh no, we might have to wait in line!” is not really a flaw of the system, it’s a flaw of a country that expects instant gratification in all things. What does our health care dollar go towards, if not our health? What are we getting for the $2 trillion we spend on health care each year?
I’d also like to add that providing a mother with full prenatal care costs less than a single day of ICU care for an extremely low birthweight baby. Every $1 spent on prenatal care saves $3 in the long-term health of the child. This is an excellent book on the current state of our healthcare system:
http://www.amazon.com/Health-Care-USA-Understanding-Organization/dp/0763736252/ref=pd_bbs_sr_1/104-3174081-3524749?ie=UTF8&s=books&qid=1194381006&sr=8-1
Comment by Jen Graf — November 6, 2007 @ 4:35 pm
Having read the Mankiw rebuttal to the infant-mortality statistics earlier today, and the discussion here, I thought: there has to be some study that looks at infant-mortality statistics controlling for some of the points Mankiw cites — chiefly, age and health of the mother. I didn’t get very far in a PubMed search: this was the closest-sounding study.
Anyway. I have recently been reading Good Calories, Bad Calories, which looks over a series of previous studies on obesity and health and suggests very strongly that (a) it’s not as simple as “calories in, calories out”; (b) there’s not a huge correlation between fat intake and obesity; (c) the most dangerous things for you seem to be starches and sweets. One of the chapters explains how the federal government, when making up diet regulations in the 1970s, was rather strongly dependent on one particular scientist who was bucking some previous research trends. I worry that if the government were the central provider of health care there would be graver cases of misdirection.
I’m with Francesca that the corporation should not be in charge of paying for its employees’ health care. Single-pay it or find another solution, but don’t make me have to judge a job on the quality of the health insurance that might come with it at least until HR finds some known-only-to-them reason to switch.
Comment by Jessica — November 6, 2007 @ 10:44 pm
Just in case people are curious, yet another study (this one funded by a comparatively reputable govt agency) found no link between cancer and obesity, unlike the study discussed above:
http://www.cnn.com/video/#/video/health/2007/11/07/gupta.obesity.study.cnn
Comment by amy — November 7, 2007 @ 2:50 pm
I would love for the folks who want to measure health by BMI to come to my workplace. On my unit, we have two competitive fitness-bunnies who are about my height (5′ and change) and who each have BMIs in the “obese” range. They wear a size 2 and 4, respectively.
One of my other coworkers rows as a hobby. She has a size 16 top and a size 6 bottom and a borderline obese BMI.
I have a BMI of something like 31, but I run three miles in under 24 minutes and lift weights four times a week. The size-14 jeans I buy fall off my waist and fit my squatter’s thighs, but just barely.
The only two people I can think of that might fit the government’s recommendations for BMI are both marathoners, both men, both middle-aged, and both scary-skinny. We’re all quite fit on my unit–I’m the only one who’s overweight, per se–but all of us have BMIs in the unhealthy to obese range.
*sigh*
It would be worth it, to be measured and tested and run through the wringer, just to see a government researcher’s head explode.
Comment by Jo — November 7, 2007 @ 5:55 pm
I used to work for IBM. They’ve offered these “incentives” for years. I was told that I’d get paid $100 to quit smoking (I don’t smoke) and another $100 to lose weight (on their terms). My managers told me just to go ahead and sign up for both programs to get the discount, but I didn’t like the idea of having to report my “progress” to someone in the company. It amazes me that more people don’t have a problem with this kind of Big Brother-ing.
Comment by Jen — November 9, 2007 @ 12:09 pm
Angel, Michigan has laws protecting individuals from bias based on weight too.
However, that’s 2 of 50 states.
Bridey, one opinion was stated on universal health care. That doesn’t automatically make this a “lefty” blog. As you can see by the comments, everybody is given a chance to express his or her opinion too.
Comment by Sarah — November 11, 2007 @ 4:33 am