Two Things

1) As most of you already know, the state of Alabama is going to start charging its fat employees $25 a month for insurance that would otherwise be free.

The State Employees’ Insurance Board earlier this month approved a plan to charge state workers starting in January 2010 if they don’t get free health screenings.

If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program or take steps on their own to improve their health. If they show progress in a follow-up screening, they won’t be charged. But if they don’t, they must pay starting in January 2011….

The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.

Discuss. And thanks to the many people who sent me a link.

2) On a happier note, one of the Shapelings named Rowan just mentioned our beloved rhino tee in an e-mail, and I discovered that Threadless has stock in all adult sizes again — up to 3X unisex and 2X girly. Yay! I totally just bought one. And I will totally be wearing it to the gym.

Posted in Fat

114 thoughts on “Two Things

  1. So, Big Moves Boston is gearing up for our fall show, Hot Buffet (a dystopian musical satire). It’s set in the US in 2028, with a society that has gone completely right-wing/police state, including around fat, weight, and food consumption. The tagline is: “When self-denial is the law of the land, the pursuit of pleasure will be a crime.”

    When I was writing the script and sharing it with some of my performers, I kept hearing, “That’s frightening. My god, if that ever happened…” And I kept telling them that it’s NOT far from the CURRENT truth, never mind what could happen in 20 years if we don’t get our collective brains properly seated in our collective head. The government is already getting intrusive into parents’ care of fattie kids. There is already rampant discrimination against fatties. They are already doing crazy scientific experiments on mice, seeing what might or might not prevent “obesity”.

    And now this.

    Art cannot possibly keep pace with reality, when it comes to community standards of jack-assery.

  2. It’s not just going to start charging “fat employees”–it’s going to charge anyone with a BMI over 35. So if you leave the NFL and are looking for a job, or if you’re the next Cheryl Haworth and need a day gig, it’ll cost you $25 a month if you work for the state of Alabama.

    Clearly, of course, most of the people who are going to be targeted by this are fat employees with >35 BMI, regardless of their fitness levels. Which is outrageous right there. But applying a BMI number like that isn’t necessarily even going to limit the targeting to actual fat people, which just highlights the craziness and arbitrariness of the policy.

  3. This is preposterous (using that word makes me giggle)!

    Say, theoretically, I have a BMI (you know, the arbitrary number supposedly meant to construe your ENTIRE level of health) of 36, but it’s because I’m (like my boyriend) short and muscular. I also have a family history of high cholesterol, so that’s up a bit. I already eat a lean diet, but it hasn’t brought my cholesterol into a range that makes my doctor happy. However, I’ve heard about all the side effects those cholesterol drugs have, and I don’t want to put myself at risk when I’m otherwise very healthy.

    You’re telling me I’m going to be FORCED to take one of these drugs to bring my cholesterol down, or be charged for it???

    I remember Al Gore mentioning once that the reason he opposed making abortion illegal was that once we allowed the government to make ANY decisions about our bodies, their control would become unlimited. Looks like Alabama found a backdoor way into that.

  4. And of course, if they actually believe their own rhetoric about how deathly ill BMI>35 employees must be, then they want fat people to pay $25/month in addition to the extra prescription meds they must all be on. Double whammy. Seriously, these people who are so determined to demonize “poor health” — don’t they think “poor health” is punishment enough? (…for the sin of being fat.)

  5. The part about the employees not getting charged if they ‘show progress’ reminds me of concern trolls…sure, people may be naturally fat, but that doesn’t mean they shouldn’t still try to be thin…bullshit.

    And as an employee of one of the other states that gives financial incentives for participating in ‘wellness’ programs mentioned in the article, this makes me all kinds of paranoid. I’m totally thinking that this is going to be the next step and that they’re going to use the information that we provided to the wellness thingies against us (especially considering that the new governor thinks that publicly screwing state employees is a great way to boost his approval ratings). Luckily I avoided the in-person screening.

  6. Well, and here’s the irony of this: the costs related to “ill-health” that an Employer Group Health Plan would have to pay, are generally the preventative costs. That is, these are the costs of employees going to see their doctors and being prescribed medications.

    When someone’s health reaches the point where they are no longer able to do their job, they may go out on disability and lose their benefits. If they are offered COBRA (as is it is the responsibility of every employer to offer an employee who is leaving due to disability), they often will not be able to afford the premiums, which can run $300-$400 per month.

    So, that person loses their commercial health insurance and can’t find or afford any other commercial coverage…if they are not making enough money they maybe can get on Medicaid, or if they have a qualifying condition they can apply for MediCare.

    So the reality is that employers are often not paying for those with “ill health,” and even when they are, they often do not penalize them. I work with dialysis patients, some of whom can and do work full-time. Let me tell you that there would be a horrendous uproar from the ADA community, if employers began charging chronically ill populations who receive expensive treatments more for their Employee Group Health Plans.

    But, gee, I guess that with “obesity” it’s okay!

  7. I was born and raised in Alabama. I used to be rather proud of that fact. Not so much anymore. This is absolutely ridiculous. This is a very serious form of discrimination in my opinion. I mean the history books are wrought with tales of what happened when government decided they would take a hand in the physical characteristics of its people. The latest I believe involved a government preference for tall, thin, blond haired blue eyed people who were christian and heterosexual. I think it was called the Holocaust. There have always been fat people. ALWAYS. Yes we have more fat people now. We have more people now. Why do scientists keep missing this crucial point? *bonks self on head V8 style* Duh.
    For this being the land of the free, they sure like telling us what to do. Next we’re going to be given a dress code. Welcome to Luau Fridays! Hope you have hawaiin print shirt!

    My question to Alabama is this…if you’re going to charge your employees extra money for their “unhealthy lifestyle” (that is more likely caused by genetics than choice of lifestyle) does that include people who have lung cancer (because EVERYONE with lung cancer must smoke, right?) have liver problems (because they must drink), have an std (because if you have one of those its your own fault too, blood transfusion or no). And what about the people with genetic diseases? If you have the breast cancer gene and the fat gene will you get charged double? What if you carry the gene for sickle cell anemia, but don’t have it? Will your children be charged extra? I mean come on! If you’re gonna charge for genetic dispositions be sure you’re covering all the bases.

    *In case you missed it, that last paragraph was entirely sarcastic.

    I am so glad I no longer live in Alabama. But I feel horrible for my family that still does.

  8. We just had our benefits meeting yesterday at my office and the rep for our medical coverage was telling us we’d be getting a postcard reminding us to go online and take a wellness survey that’s “completely confidential and there to help you make decisions about your health”

    Really? So are you saying you won’t aggregate this information and decide, for example, that people in city X have higher risk factors for heart disease so you’ll raise their rates… really? that’s not how this information will be used… well that’s good to know.

    Oh and our deductibles doubled… of course I’m thankful to have any coverage at all but it still makes me shake my head… I started here not even to years ago and our deductible was 35% of what it is now.

    Yay for rhino tee’s!

  9. killedbyllamas: Not to mention, even if people are going along with all the dieting etc. to try to be thin to avoid the fee, what happens to them when they don’t lose weight, or when their weight rebounds as is usual? They’ll get blamed (and charged) for not making progress and it will be assumed that they aren’t trying.

    *grr*

  10. Penalizing people in the workplace for non-work-related conditions/activities is wrong. I don’t care if it’s charging extra for health benefits for fat workers or smokers (no fan of tobacco or smoking here, but it’s not the employer’s business) or drug testing for furniture salespeople (yes, I was once asked to take a drug test when I applied to sell pressboard furniture part time) or sanctioning workers for being members of political groups…if it happens outside of work, doesn’t prevent the worker from doing her/his job, and isn’t resulting in absenteeism due to extended legal troubles, it’s not work’s business.

    Are they going to start charging a fee to people who happen to get cancer, thus causing the insurance plan huge amounts of money? How about people who develop asthma later in life? People with ‘normal’ BMIs who happen to have high cholesterol or blood pressure?

    While some aspects of health can be affected by our personal choices, there’s no guarantee. One person can smoke like a chimney, eat greasy food and no vegetables, and get 75% of their exercise by picking up the remote to change channels and live a long, healthy life. Another person can eat an organic, vegetarian diet, exercise by growing most of said diet, never touch alcohol or tobacco, and drop dead at 35 for no apparent reason.

    Lifestyle is a choice, yes, but health (and weight) is a crapshoot. Nobody should be penalized going into a crapshoot.

  11. Ah, yes, because fat people totally need more work harrassment. My health issues have no place in the workplace insofar as they do not affect my work. Health choices and changes are up to me, and they are *private.* My body is *private.* I loan it to my employer for a wage, not for judgment, not for them to decide its acceptability, not for them to “help” me. If my government did this, I’d be looking for another position right now. My goals are mine; it is not up to them to set goals and measure my “progress.” The state (especially Alabama!) has better things to do. Like deal with poverty, food shortages, lack of health care (hah!), environmental health, good roads – should I continue? Encouraging employees to be healthy – to get plenty of sleep, to take classes and be mentally engaged/aware, to have time to cook meals and enjoy them, to spend time with families, to have ergonomic keyboards and good light in their space – all of these take far more precedence, and would do much more for health and morale than arbitrary measurements.

    GRRRRRR.

  12. Being a lazy fattie, so I’m posting my reply to the Alabama topic I did at BFB:

    It’s not fair to deny or force people to pay more for insurance simply because they are fat. The health conditions mentioned in the article can affect anyone of any size, not only fat people. I also find it extremely disturbing that the state will require people with a BMI of 35 and up to provide vitals and pressure them to lose weight. Has someone in Alabama been in contact with the UK?

    I also posted this at BFB, but I’m doing it here as an addendum to show you how screwed up health care bias is:

    I have been turned down three times for regular health insurance due to weight, despite having no severe physical or medical conditions. I finally had to apply for MHIP, which is Maryland’s state insurance plan for “high risk patients.” And guess what? They do not list weight as a high-risk condition on which to approve insurance for. But since I sent them my most recent denial letter, I was accepted. It’s higher than other health plans, but I was able to get approved for their program for lower-income individuals.

    When will Alabama and others around the nation and world learn fat is not the enemy?

  13. You know, we have to do this stupid “get healthy” thing in order to avoid paying a higher premium already. It’s not based on BMI as far as I know but you’re supposed to have a “wellness coach” and talk to people on the phone and so on. Naturally the enrollment period for this year fell when I was in the nursing home so I did not qualify for the waiver and I have to pay a small amount every month (about $30 for myself and my husband). I’ll be interested in seeing what happens when the waiver period comes around again and what I have to do to qualify for it.

    I work for the commonwealth of PA, by the way.

  14. drug testing for furniture salespeople (yes, I was once asked to take a drug test when I applied to sell pressboard furniture part time)

    Yes, it’s just all part of the same nanny-workplace coin, isn’t it? I’d add to this credit checks – I once worked at a place where they insisted on doing credit checks for new employees as if, somehow, your personal finances were any of your employer’s business at all.

  15. Longtime lurker. Poking my head up to say my shirt is ordered. It’s a visual message everyone needs to see. Love to Kate, Sweet Machine and Fillyjonk. You ladies do amazing work. Thank you.

  16. LilahMorgan, I didn’t get a part-time job at a freaking pet accessory store because of a credit check. Obviously I’m applying for a second job because of my questionable divorce-related financial situation. Yeah, makes sense.

    Buttercup, they don’t penalize us for not doing the wellness program, but yeah, the stupid wellness coach calls me too to quiz me about my weight and whatnot.

  17. If i understand this situation correctly, it is only going to impact people who are employed specifically by the state government. So if, for example, you work for a privately-owned IT company in Alabama, this will not affect you.

    However, that does not lessen the impact or importance of this issue. Quite the opposite. Since it does not affect everyone, it is less likely to face public outcry. Once the precedent has been set, other states/countries can start putting similar policies into effect. At that point, it’s only a matter of time before we start seeing similar policies becoming mandatory for non-governmental employees.

    What i’ve been wondering, is how many state employees will be voluntarily looking for new jobs when this is put fully into effect? Given the current state of the economy, i recognize changing one’s job can be a terrifying prospect, and not always feasible – which does make me wonder about the timing.

  18. Sounds like Alabama is looking for some lawsuits. Are they charging smokers? People with DWI’s? People with other health issues? The mentally ill? Looks to me like this is a case of some very selective fat prejudice going on.

    One of the interesting things is that poor states, like Alabama, have higher numbers of unfit… probably because the poor are always told to extend food with rice and bread, and most food pantries hand out carbs over good food choices.

    If Alabama wants to help defer health care costs, they should be able to do it in a non-prejudicial way… if they are really motivated to.

  19. Yeah, this Alabama thing is such a crock of shit.

    My health insurance has a similar penalty, though, where you get charged an extra $20 a month if you don’t register with their “wellness” programs and take whatever advice they give you….lucky for me, I can afford $240 a year to protect my fucking privacy….but you can be damned sure I lodged a protest, in addition to tearing down every fucking poster in the office for Weight Watchers or their stupid “get extra health dollars if you lose weight or quit smoking” in-office advertisements. Grrrr.

    I really feel for the people who *can’t* afford $300 a year to protect their privacy and/or stand for an ideal, though. Crying fucking shame.

  20. On point 2 I say YAY!!! That is totally on my list of shirts to buy. And any word on the “Joy-fish” shirt making an appearance in the store here? :)

  21. I will totally be using this for ethics class to show that being fat is NOT a moral and I dont care what any of my classmates will think! I’ve recently gained 20lbs due to an illness and my so-called BMI is now 35, I would be so screwed if I lived in Alabama.

  22. Yes, it’s just all part of the same nanny-workplace coin, isn’t it? I’d add to this credit checks – I once worked at a place where they insisted on doing credit checks for new employees as if, somehow, your personal finances were any of your employer’s business at all.

    Or this new trend of deputizing every employer as a remote ICE field office.

    I’m fairly sure that Alamaba doesn’t have a state labor relations act, so unfortunately their public employees are non-union, which is too bad because the union would have a shit fit about this. But I am almost positive of two things: 1) Somebody is going to challenge that AL regulation in court; and 2) it’s going to be invalidated. If they can’t find a state insurance or employment law to cover it, it could get tossed under constitutional grounds as being an overinclusive and ineffective exercise of a state’s power to regulate health and welfare. My con law is a little rusty, granted, but it’s hard for me to see how this can stand.

  23. Yes, there’s a $20 a month surcharge for smokers already in effect in Alabama. I am an employee of the State of Alabama – and really beginning to think the private sector might be a better option.

  24. unfortunately their public employees are non-union, which is too bad because the union would have a shit fit about this.

    There’s not exactly a union, but there is a “lobbying group” (the Alabama State Employees Association), which somehow didn’t throw a fit, and the spokesperson of which is quoted as saying it’s a “good thing.”

  25. Slightly off topic with my apologies.And, just in case you think things are better in the UK with the National Health Service: I just saw a friend with gall stones. Needs keyhole surgery but, due to her weight, it’s a risky business and was told there was a 30% chance she won’t survive the operation. She did ask how much weight she would need to lose to have the operation but the expert didn’t seem to know. He was, however, willing to offer weight loss surgery…

    Alabama will only change it’s ways when the unhealthy thin people with the acceptable BMI levels begin to need expensive procedures.

  26. I work for the state of Minnesota. Seems like Alabama state workers are getting a deal. Only $25 a month and only if BMI classifies you as obese?

    I pay $170 a month, $22 every time I or my two kids set foot in a clinic, I have a $1000 yearly family deductible to meet along with a $500 per individual to meet (I can’t figure it out, either). Insurance wouldn’t cover my tooth implant (but would have paid 60% if I’d destroyed two other teeth and had a bridge) and only covers 60% of crowns. I’d spent over $2000 out of pocket by June.

    They made us do a wellness interview thing and said a nurse would be following up with a phone interview. Never happened. They won’t give you a break on gym memberships, either.

  27. How about doing the opposite? Charge people with healthy lab results less and see those that decree only BMI is the proper litmus test for health cringe

  28. There’s not exactly a union, but there is a “lobbying group” (the Alabama State Employees Association), which somehow didn’t throw a fit, and the spokesperson of which is quoted as saying it’s a “good thing.”

    I will be the first to admit that union’s can be problematic organizations that often privilege their own continued existence over the best interests of the employees they purport to represent, but they are definitely more like to throw appropriate shit fits than lobbying group/employee associations that, epecially in a decided anti-worker state like Alabama, tend to function more as company unions than actual employee advocacy organizations. I guess, in summary, the ASEA’s inaction does not surprise me in the least.

  29. Forget smokers, I wonder if they catch you sky diving or riding a motorcycle or hunting with dick cheney if you’ll be charged extra. Or if you donate a kidney to your dying child or have unprotected sex.

    After all, those non-work related activities increase your risk for injuries and even death and since most state benefits include life insurance, how dare we increase the risk that we might someday DIE!

    I wonder what this will do to potluck days at work?

    I mean how can people not get how truly ridiculous this is?

    Even if you take out the fat issue which is horrendous, this is just an example of the state pandering to the already unethical practices of insurance companies, just like the federal government does.

    I’m a fat, healthy state employee in Oklahoma so this seriously hits home and I’m PISSED.

  30. Argh. This is why I not only have saved enough to cover our insurance deductibles and a few month’s mortgage payments, but enough to carry us for *eight or nine months*. It’s not just an emergency fund, it’s a FUCK-YOU fund. If an employer gives me shit for being fat or female or what-have-you, I can tell them to fuck themselves, get out and be okay while I’m job-hunting.

    Yeah, this means are cars are older and we don’t have the toys my coworkers all do (seriously, most of the guys have boats) but the reduction in stress from knowing I’m NOT dependent on the next paycheck is amazing.

  31. sage, I’m a state employee, too, and our benefits are such crap that I actually pay to be on my husband’s policy. It’s slightly higher employee contribution but we make that up in lower deductibles and co-pays, and more comprehensive coverage, in about three months. I enjoy disabusing people of the notion of state workers and their “excellent benefits.” (I do get a paid day off for President’s Day, though!)

    But, still, I would hate for this AL reg to stand and give any other state governments any ideas, because you know damn well they’d see all the fatties on the employee rosters and jump all over the chance to cut their budgets. Then you’d pay $195 a month instead of what you’re already paying now.

    Also, like I said, Alabama has a shit record for workplace rights so I don’t begrudge their state employees for getting a break on health insurance in the least bit.

  32. I do wonder when the AARP and ACLU is going to realize that a lot of “numbers” like BMI, cholesterol, blood pressure, and so on tend to increase with age. Which means this is going to disproportionately affect older workers. You would think they would get lawyered up.

  33. sage, I’m assuming it’s an *extra* $25/month, not a “free vs. $25 health care”.

    Wisconsin’s better than Minnesota – there’s a choice of plans, and I pay ~$35/month for quite excellent coverage for myself. I think family coverage is 60 or 75, but I can’t remember. You can choose plans that have a gym break – even better, there’s a CSA break. (Not much, but something.) Some insurance groups offer classes, although ironically, few are in a location that’s good for state workers.
    Any way for you to commute to La Crosse? :)

  34. lexy-

    I would take that survey and mess with all the answers. Make your city look completely fit and healthy. really mess with them.

  35. I do wonder when the AARP and ACLU is going to realize that a lot of “numbers” like BMI, cholesterol, blood pressure, and so on tend to increase with age. Which means this is going to disproportionately affect older workers. You would think they would get lawyered up.

    That’s a really great point, Jenk. Fat discrimination may not be illegal (except, perhaps, in D.C., is it?) but age discrimination often is.

    I remember a lot of law students on this forum last time the topic came up – anyone looking for a student note topic? :-)

  36. OTM, my partner gets insurance through the carpenters’ union (which costs, we added it up, $17,000 a year for 80/20 and a deductible, you pay the same whether you’re single or married and have 10 children) which does not, in its infinite wisdom, recognize us heathen civilly-united same-gender couples. Neither does the state, for that matter. It did for a brief period of time, but the legislators threw us under the bus to get Timmy P to approve something-or-other.

    Anita, I’d have thought so, too but the first sentence of the post says “$25 a month for insurance that would otherwise be free.” LaCrosse is far from the Cities, but it is nice. :)

  37. FYI, Washington’s King County (largest by population in the state, home to Seattle & Microsoft) has had “wellness” plan for quite a few years. However, it focuses on BEHAVIORS not BMI.

    From an article in the local paper: ( http://seattletimes.nwsource.com/html/health/2002321032_healthincentives08m.html )

    King County workers will be switched over to a new health plan in 2007 that will tie their out-of-pocket medical costs to their health habits. Here’s how the three-tier system works.

    * Bronze: no participation in health-risk assessment (highest cost to employees)
    * Silver: Employee must fill out an assessment and follow at least one healthy habit.*
    * Gold: Employee must fill out an assessment, complete the personalized action plan (for example, eat healthier or exercise more) and follow at least two healthy habits.* (Lowest cost to employees)

    Possible examples of healthy habits:
    * Driving within 5 miles of the speed limit
    * Walking 30 minutes three times a week
    * Using sunscreen when outside for more than 30 minutes
    * Wearing a helmet when skiing or riding a bicycle or motorcycle

    What gets me about this is that:
    A) ~400lbs me could easily be “Silver” under this plan, WITHOUT ANY CHANGES other than filling out their forms. Possibly “Gold”. Somehow I doubt that’s what was intended.

    B) I wonder just how un-private the “confidential” information from “health-risk assessments” are.

    C) I wonder how much the program is costing to administer, and how much MORE it’s costing to run the program than employees are paying in extra premiums.

  38. jenk: Ah, but who would be CREATING the “personalized action plan” that you’d have to follow to get “Gold”? If it’s not you, I bet there’s a good chance that ‘lose weight’ would be highly placed. (GRRF)

  39. I fail at reading comprehension. Sigh.
    Wisconsin doesn’t recognize same-sex partners, either – apparently the claim is that the lack doesn’t negatively affect anyone, and our union isn’t doing anything because there’s no way it can force a change. (The union sucks.)

    I’m troubled by this idea that health insurance is something that only healthy people get. WTF? You must earn the right to your care? By being thin, straight, white, probably male and male-identified, and privileged with excellent genes and childhood medical care? WTF? Who does that fit?

  40. Bald Soprano: Oh, I don’t doubt that “lose weight” would be the intent of the plan, hence my “maybe I’d qualify”.

    But if the plan actually said, “Eat 4-5 fruits/veggies a day and exercise 30 minutes / day on average” – I already DO that. Why should I bother to burst their bubble by telling them that? :)

    Hell, the whole thing’s on the honor system anyway. So it’s only the honest, or those who want to maintain their privacy, who would potentially get penalized.

  41. I’m sure what I think has already been said, and probably more eloquently, by somebody else, but this I have to say it anyway. This is the most stupid effing thing I have ever heard of! I have a very high BMI but my blood pressure is “normal” (whatever in the hell that is) and I also don’t have type II diabetes – the other disease “they” use to scare fat people with. So if I lived in Alabama I would be penalized even though I don’t have “fat related” health issues. What a crock of s#@T!
    I hope some very fat lawyers sue the hell out the state of Alabama.

  42. Squeeee!!!! I just got my T-shirt.. I am so excited to wear it ! I already have the “I have a pretty face” t-shirt we must get more of these awesome FA type shirts so I can proudly sport them out and about!

  43. jenk, I can see a problem with that. If it’s on the honor system, what could you do if they didn’t think you’d filled it out honestly? Because everybody knows those dreadful fatties don’t exercise or eat their veggies, and also they’re liars, so obviously you’re just saying you fit their healthy checklists to avoid paying extra.

    This is why employer-mandated checklists are never a good idea. If I see a doctor for the arthritis in my knee, but I have a desk job so my knee’s health isn’t necessary to perform my job, am I then scamming my employer? My husband is on my policy, and he was just diagnosed with MS, so more MRIs and a spinal tap are probably in his future. Should my employer refuse to pay for his care because he doesn’t work here? No and no, because as human beings we deserve health care. Employer-provided health insurance doesn’t cover only those conditions that might prevent an employee from working. (This kind of sticky wicket is why I think the U.S. should get away from employer-provided and for-profit health insurance. From a business perspective I can see restricting what’s covered, but I have MORALS AND A SOUL that prevent me from advocating any kind of restriction on health care.)

  44. I was having a little bit of a problem with the “blood pressure, cholesterol, glucose” part of the deal because, as was stated above, blood pressure and cholestrol problems may come with age. But as for “or obesity” ????? *headdesk*.
    If you’re obese and DON’T HAVE high blood pressure, cholestrol or glucose — how can you be penalized? You are HEALTHY!
    Preaching to the choir again, I know.

  45. I too got the rhino shirt! Yay, Rhino! Yay for wearing around my Weight Watchers-employed mother!

  46. Maewyn,

    what could you do if they didn’t think you’d filled it out honestly?

    Not sure they’d even know. The county has a separate contractor handling the health-risk assessments, developing the plans, and so on. Unless the assessments are handled in person, who’s going to know I’m fat? And really, if we did meet in person, and we went through my various numbers and I finished with, “and here’s the program my doctor has me on” – what government contractor ISN’T going to say, “Oh, let’s just use that then”?

    From what I’ve read, it’s common with these “wellness programs” to have them administered by someone who’s NOT the employer, for ADA reasons. It’s a new industry that is quite happy to tell employers “Oh, hire us, and we can help your employers lower their health risks.” I’m sure this costs a LOT in the short run, and in the long run – well, it MIGHT reduce or delay some illnesses, but it mostly costs money. (Which is kind of the point for the “wellness” industry.)

    Re: health insurance being paid by employers, you can tell it wasn’t a *planned* thing. IIRC it evolved from employee wage caps in WWII – employers couldn’t pay more, so they offered more benefits to entice employees.

  47. Okay, WTF? That is infuriating. Even if obesity is a “voluntary risk” (which, as we well know, it’s not), why aren’t those taking other “risks” also having their insurance raised? Case in point: I’m a recreational long-distance runner. I love it, it has many benefits, both mental and physical, and I have no intention of stopping. HOWEVER, a good 3/4 of my medical visits in the past 5 years or so have related to conditions caused by running. This includes not only doctor visits and physical therapy associated with injury recovery, but things as serious as a colonoscopy at age 25, as I have an exercised-induced gastrointestinal condition (fortunately it turned out not be serious, but they had to do the colonscopy to figure out that it wasn’t something worse). If obesity is seen as genetic, discrimination would be prohibited by GINA (Genetic Information Nondiscrimination Act), which was enacted this May.

    My BMI is nowhere near 35, and I probably couldn’t physically get my BMI up to 35 without making an all-out weight gain effort for a sustained amount of time, and even then, I don’t know if I could sustain the weight gain because of my particular set point. However, this is not true for everyone, and I recognize this. There are plenty of wonderful, HEALTHY people out there with a BMI over 35, who probably cost the health system less than I do, and who may very well cost the health system less in the future as well. This is targeted discrimination of a particular group of people the government doesn’t like, plain and simple. It’s infuriating and scary as hell that Alabama would do this to its citizens.

  48. If the screenings turn up serious problems with blood pressure, cholesterol, glucose OR obesity…

    What if you’re thin and have higher blood pressure and cholesterol naturally?

    What if you’re ‘obese’ and are actually HEALTHIER than your thinner co-workers because you have none of the other “health risks”??

  49. “What if you’re thin and have higher blood pressure and cholesterol naturally?”

    Well, you’re thin and that seems to be what counts here…

    I must say I’m quite shocked at this… what happened to the ‘Land of the Free’ that kids over here learn so much about in English class?

  50. Just a note. Most full-time state employees in Alabama that I know do get free health insurance if it’s just them. It costs extra if you want to add spouse or children. And now, apparently, if you don’t allow your workplace to dictate your personal life.

    However, the relative cheapness of the current system doesn’t mean unfair regulations should get to stand. It’s not as though most Alabama state employees are rolling around in extra cash. And even then, it’s the principle of the thing.

  51. Note on the Rhino tee – I just got mine in the mail, yippee! I got the 2X girly size, and I normally wear between a 12 and 14 on top. It is TIGHT on me. I got a 1x in another style and I’m concerned about it fitting over my tummy. Just an FYI to all. Also it is awesome AND I love it AND it’s pretty well-made. AND it’s on sale! There’s another funny, sort-of-FA shirt that would be good for working out: a carrot and broccoli turning a jump rope with a Hostess cupcake jumping (and sweating adorably). http://threadless.com/product/948/Skip_Dessert

  52. I am concerned enough about this that I called the Alabama Chapter of the ACLU and left a message. And then, of course, the moment I hung up I thought of about a dozen OTHER things I should have said.

    In essence I said that I was concerned about this new proposal, that I felt it violated privacy of the individual state employees and interfered in doctor-patient confidentiality and relations. I said I didn’t know if they were already looking into it, but it was a concern. Then I left my number.

    I don’t know if this is the ACLU’s usual thing or not, but I felt I had to do SOMETHING.

  53. Note on the Rhino tee – I just got mine in the mail, yippee! I got the 2X girly size, and I normally wear between a 12 and 14 on top. It is TIGHT on me.

    Welcome to the wonderful world of American Apparel, where someone who wears the size worn by the average American woman can barely squeeze into a 2X.

    The irony of FA t-shirts being sold through Threadless, which only offers the ridiculously-sized American Apparel products, lols my fat.

  54. I just took the opportunity to replace my XL rhino tee with a 2X, so if anyone wants an XL worn and washed perhaps four or five times for free, I have one going begging. Send an email to wantmyxlrhinotee@writeme.com if you want it. I’m a pretty reliable 14, 36DD and hippy; the XL I have is viable on me, but I prefer my tees a bit less clingy at bust and hip.

    I’m horrified and outraged by the wellness bullshit. This was predictable.

  55. However, the relative cheapness of the current system doesn’t mean unfair regulations should get to stand.

    Totally. Not to mention that an extra $300 a year can be hard to swing at many income levels if you have a tight budget.

  56. Welcome to the wonderful world of American Apparel, where someone who wears the size worn by the average American woman can barely squeeze into a 2X.

    Okay, the weird thing for me is that I’ve bought several shirts on Etsy that are from AA, and the chart always advises me to buy an L or XL (at most places I wear an M in t-shirts; other styles usually don’t accommodate my rack at M). But I never know in advance if the size the chart tells me to get is going to be right, and I’ve had it err in both directions (i.e., in some styles I need a M but in others I need an XL). I realize I have a big rack, but if your size chart claims to give the chest circumference, it would be nice if that had, you know, any relation at all to how big the chest is on the actual shirt. Grr.

    So yeah: rhino tee is awesome but buyer beware in terms of what size you should get.

  57. If Alabama pays anywhere near as crappily as the state government that I worked for previously (many of the caseworkers were eligible for the same benefits for which they were evaluating people), $25 a month is a huge freaking deal.

    And it also lols my personal fat that an FA tshirt is being printed on AA tees at all…I’m sure creepy whatshisname would be thrilled.

  58. Note on the Rhino tee – I just got mine in the mail, yippee! I got the 2X girly size, and I normally wear between a 12 and 14 on top. It is TIGHT on me.

    Yeah, Threadless runs pretty small. I normally wear a size small or medium on top, and when I ordered another shirt from them in a girly medium a few years ago, I had to return it and get a large. Their girly shirts fit kind of weird, too; they’re just made to be tight, not really made to fit a woman’s body. The shirt is kind of, um, tight across the boobs and looser around the tummy. This could also be because of my linebacker shoulders, which often cause problems with clothing, but that’s a whole other gripe of mine…

  59. My dad is stick thin, runs 3 miles a day, his idea of a sweet snack is eating one cookie, he only drinks water, and he has high blood pressure. If I were to hand them his blood pressure info without anything else they would say he was unhealthy. If i were to introduce you to him without the blood pressure info you would say that there is no way that he is unhealthy.

    We have got to start insisting that the medical industry stop using false endpoint diagnosis. We need to arm the general public with a better understanding of research methods. And avidly point out where correlation is being falsely misrepresented as causation.

    Teach people logic – Every poodle is a dog, not every dog is a poodle. Some unhealthy people are fat, not all fat people are unhealthy.

  60. Just FYI, and I mentioned this at Shakesville and it didn’t get pointed out, but if you read the original article posted there, smokers who work for the state have to pay an extra $25 a month too.
    Not that the policy isn’t bollocks; and I disagree with it completely. I’m just pointing that out.

  61. This makes me think of an insurance commercial that played during the Olympics that I thought was creepy as hell. It’s the “carrot” part of this idea – it shows a guy walking along talking about all the deductions he got off of his health insurance by playing ball with the guys, walking to work, eating a salad at lunch, etc. You’re supposed to be impressed that he’s racking up the benefits just by going through an average day, but all I can think of when I watch it is “Yeah, but the insurance company can’t give him the benefits if they don’t know he’s doing it, which means they’re monitoring him every minute of the day. Creepy, creepy, wrong.

  62. Same as any other form of discrimination. Same as taxing someone for being Black, Jewish, Mexican, or otherwise. We’re supposed to be able to change our size? Again, would people ask people who appear ethnic to bleach their skin?

    It is beyond disgusting. It is simply government enforced hatred. If the thin people care so much about fat people’s health, then they should pay the extra tax. Let them be penalized for their hatred.

  63. Personally, I don’t find Threadless anything to get excited over. Their Girly 2X is about the size of an Old Navy large (12-14). Big fat deal.

    This really, really pisses me off something fierce. I’m Australian so I don’t even know what American Apparel is (although a cursory google has informed me that they now have an Aussie online store selling it’s grody 80s clothes). I was really excited when the girly 2XL appeared, as I don’t like men’s tees unless I mod them; the crewneck feels like it’s choking me.

    So according to the size chart, the girly 2XL is … 19.5inches across the chest? AWESOME. For the fail, Threadless. >:[

  64. the girly 2XL is … 19.5inches across the chest

    Whoa. This explains why I have never, ever found a girlie tee that didn’t look ridiculous on me.

  65. Bahhhh American Apparel. I bought a shirt in the store and it was an XL and fits fabulously. I loved it so much that I ordered three more of the purportedly exact same ones in different colors (checked the damn item number and everything). The three I ordered cut the circulation off of my arms and stick to my stomach. WTF?

    Also, I usually wear large to begin with. Why so tiny AA? And why tinier in the mail?!?!?!

  66. Ummm… not to be a pain-in-the-can-noob, but I am still new to all of this and have followed the links to the story of the Rhino, and then followed THAT to Fat Girl on a Bike shutting her blog down. I see that her blog is still down, and wonder if she has any other incarnations of her blog. You see… I am a Fat Old Lady Who RUNS! And I keep hearing the crap about My poor poor joints (notably NOT from my doctor who runs and thinks I’m doing great) etc etc…

    Is she blogging somewhere else? Am looking for fat athlete blogs, and feel just sick that I have missed hers. Have I?

  67. Okay, the XL rhino has found a Shapeling adopter. :-) Kate, FJ, SM, I apologize for using the blog for exchange purposes; I just so hated to see it go to waste.

    Thinking about how much I would like to talk tee shirt quests, and also about Hera’s suggestion about a broader support venue earlier this week, I wonder if maybe at some point we should talk about a more forum-like offshoot site where we could take certain longer-term perennial conversations so as not to derail the blog’s motion. I know I don’t comment that much here and I don’t mean to be all officious and upstartish, nor to suggest that what we’ve got is broken or inadequate when SP is so neither of those things … you’ve no notion how much you’ve changed my life (insert several paragraphs of fulsome drivel here pls thx). It’s just a thought which I will now leave the better experienced in this corner of the net to mull.

  68. Sage,
    I teach in Alabama public schools. We pay comparable premiums to what you describe. The $25 is a surcharge, on top of what we already pay out. Still a nanny-state move if there ever was one!

  69. OK, mini-thread hijack:

    Would the people interested in forming a size-wise support forum please e.mail me? I want to get started talking about it, how/where/what, etc.

    If you click on my nick, it will take you to my blog, and my e.mail addy is in my ‘about’ page.

    On topic: As long as health care is a private for-profit industry, we’ll be looking at nonsense like this. Not that the government would automatically be better (wasn’t it one of them who said something like ‘obesity is a greater threat to our country than terrorism’?), but if the profit motive was removed, there *might* be less of this kind of crap.

  70. I could weigh no more than 179 then (I am currently consistently within about a 2lb range of 195 on my scale at home, last time I went to the doctor their scale puts me at 203- not because I gained weight, my scale is just a bit off from theirs.)

    heh. Kind of funny since even with high blood pressure that is medicated- that only runs me about 1 dr appointment every 6-12 months and some cheap generic pills.
    On the other hand, my birth control is far more expensive, though still at 1 dr. appointment every 12 months.
    Whereas anxiety related health care needs excluding the blood pressure which my doctor has said caused by anxiety- not Teh Fat! run… well, let’s just say lots more. Because of anxiety caused physiological symptoms I’ve had to be hooked up to heart monitors, had Cat-Scans, and MRI, blood work, back and forth appointments with my internal med doctor who kept sending me to different specialists, and all the trial and error drugs, including new expensive ones, where I was getting a new prescription every week it seemed. And regularly appointments with a therapist as well as 2 with a psychiatrist (who thought I was doing find and sent me away). And then there was the dr appointment when it caused insomnia and the prescription for that.
    I do have a non-anxiety-related sleep disorder that I’m not trying to get treatment for- thus far I’ve gotten 1 doctor appointment and a 15 pill supply of a cheap generic drug. However I’ve been referred to a sleep clinic which will run another 2 dr visits minimum, and I will need a new prescription after I run out of these 15, and because of the longer term use may have to get bumped up to a new expensive medication.

    All in all, I think my weight is the least of my medical expenses. But then, you can’t see my anxiety or sleep disorder by looking at me. (and i could always lie to doctors if I felt I needed to about both as well.) As always it has less to do with health than the visibility of our bodies.
    Not that I’m advocating that people with anxiety get any more trouble with getting medical treatment than their already is.

  71. Well, unless they are doing the same for employees who smoke, are alcoholics, have a family history of health problems, are depressed, are over a certain age, experiencing stress, or are too thin, they are completely vulnerable to lawsuits.

    Idiots in action. Hey, lets put them in charge of an entire state! Excellent.

  72. Okay, going out on a limb here with a slightly contrary point of view.
    What the state of Alabama is doing is wrong.
    If they need more money to cover the costs of insuring their employees, they need to charge everyone the same, as commenters above pointed out that health is a crapshoot, and no one knows when or what dice they will throw.

    Part of my work can be called “worksite wellness.” My job is to help worksites change so that employees can actually do those things that help them have the best health they can. Such as, people who want to work out during the day can flex their schedules to do so. There is so much that employers could do to help encourage people to have healthier lives that has little or nothing to do with “outcomes.”

    King County is indeed in the forefront, and in brief, their plan sounds ridiculous. But they have been experimenting with ways to encourage and promote better health without attaching it to particular outcomes (such as BMI).

    In my opinion, the choices are:
    - Employers pay insurers for health insurance, and if they can’t afford it, the don’t offer it to employees. There are things that employers can do that reduce their costs that have to do with not stressing out their employees, by making sure their employees have access to things that help support them (such as showers onsite or gym subsidies and the flexible schedules needed for busy people to access them). The cost of health insurance is rising, and it’s employers and employees who are pained by these costs, while insurers are making tons of money.
    - Everyone has access to health insurance (the cheapest way is for the state to provide coverage) as a universal benefit. There are downsides to this approach, depending on implementation, and it doesn’t protect people from “lifestyle coaching” or worse, but everyone is covered.

    Even under the scenario where health insurance is no longer only for those who can afford it (through their jobs or by paying or by being old enough, sick enough or poor enough) — employers still care about “productivity,” “absenteeism” and “presenteeism.” Which is why that “no duh” study published a while back is still important.

    Many of us don’t have as much time to do things that bring us vitality — and improve our health in the broadest sense. If employers can help people identify where they might benefit from some minor changes (for me, having the time/energy/access to strength training fits this definition) and make it possible for those already interested in making these changes they can help people improve health (not achieve perfect health) without having to make anyone who does not want to participate do so.

    (ducks head, prepares for onslaught).

  73. When I worked for the (county) government in Ohio, all of my health insurance was absolutely free, and we had no wellness programs forced upon us (although they were an option). I was also one of the lowest-paid employees in the entire system. I thought it was awesome.

    That was, however, more than two years ago, so things may have gone all to crap. Oh well.

    Ridiculous, of course.

  74. Im LIVID. The ‘health system’ (read: religious-industrial complex) i work for is ramping up to this as we speak. Theyve already sent out the ‘totally confidential” quesionaires, harassed & taxed teh smokers (how can you give someone the fucking false option to wear a patch or take their drugs? Fuckin Jim Jones much, assholes?? “Just shut up & drink the Kool-ade!”)… when some employers started trying to do this a few years back, they also had sexual preferences & outside activitieson the list..but were hedging them back due to legal advice that it may be going to far. It’s ALL going too far.

    Im sorry; i just couldnt take any more bad news today, people. Im bankrupt, scratching to make the bills, have insurance & cant afford to even pay the lousey copays to use it (& deducts –especially for dentistry, it’s enormous, & im presently selfmedicating on ibuprofin b/c i feel im losing a tooth –& i cant even afford an extraction! which im mortified about), just turned 40 & have lost any hope for a future… cant afford future schooling, my employer humiliates me daily..ive cut everything i can & the thought of getting hit with even more fees like this , to drive me deeper into a hole, im just exhausted.
    The is country is going to shit in a handbasket.

  75. Ya know, I hope somebody sues the bejesus out of them. Even if they don’t win (which, let’s face it, unless they’re a millionaire, they won’t), they just might get the message out to some fraction of the population that eugenics is not a good business model.

    Because that IS what we’re talking about here. They can call it ‘healthy choices’ or ‘lifestyle changes’ or any other thing they want to, but financially favoring one segment of the population over the other, with something as basic as HEALTH CARE COVERAGE, is just a circuitous kind of genetic engineering. In other words, fat people will have to pay more for health care, which means fewer of us will be able to afford it, which means fewer of us will get regular health screenings and preventive care, which translates to more of us dying.

    Can’t wait to see the spin on this one.

  76. Hera, I agree with you. I heard that Hitler started his campaign against the Jews, by claiming they were causing people more money. History repeats itself.

  77. Jackie, it is NOT THE SAME. None of the forms of discrimination you listed in your first comment are at all the same, either. Those differences are hugely important. It’s not helpful or illustrative to keep comparing different forms of discrimination and saying they’re the same, it’s been made very clear that it’s upsetting to many people, and it’s expressly against the comment policy. You’ve been called in it before, and I don’t know why you keep doing this! And this time it’s Jews and the Holocaust.

    Like half my relatives were slaughtered in the years leading up to the Holocaust or during it. I know fatphobia is horrible and this new policy in Alabama is enraging and dangerous and discriminatory. It makes me angry. But it is not the same.

  78. wellroundedtype2, there is nothing in what you’ve listed that has anything to do with penalizing people who weigh over a certain poundage because of said poundage.

  79. Jackie, it is NOT THE SAME. None of the forms of discrimination you listed in your first comment are at all the same, either.

    Arrrrgh! Thanks for saying this, Lynne. Fat discrimination is plenty bad without false equivalencies. I’ve just read of yet another WOC fat blogger who is drifting away from the fatosphere – can’t imagine why.

  80. Thank you, Lynne. Jackie, this is not the first time you’ve been called out for this kind of comment — but it may be the last time. Consider this a ban warning, both for egregiously conflating fatphobia with racial discrimination and genocide, and for thin-bashing in your original comment.

  81. I second the thank you to Lynne and the ban warning to Jackie.

    Jackie, I have seen you in threads where the offensiveness of false equivalencies has been discussed. You know full well that that shit is not okay.

  82. (((mermaidfarts))), I’m so sorry for what you’re going through. The country is going to hell on the fast track, but you’re not alone. Is there any way you can find a job where you have a better working atmosphere? I know that with the economy it’s really hard to think about switching jobs but I’m hoping there’s something better for you.

    I was in a bad situation at my previous job and while my new one isn’t great it’s at least better and not quite so stressful employer-wise. Plus I have health insurance – I hear you on the co-pay though. I broke my wrist (badly) in January and between the co-pay and deductible I owe about $4,000 which I’ll be paying off for the next five years. However, without the health insurance I’d have been paying a fuck-ton more.

    It sounds like you’re dealing with depression (and with damn good reason) as well. Can you afford to get on anti-depressants? Maybe you’ve tried and they don’t help or maybe you’re on them and they aren’t helping enough. I just know that they help me to not feel *so* hopeless. Please don’t give up. Things do get better eventually, it just doesn’t seem like it in the midst of a multitude of problems – especially when you’re in pain.

  83. um…about the sizing on the t-shirt: is the threadless girly 2x a American apparel men’s 2x or “girly” (ugh) 2x? I didn’t see a size for AA girly 2x.

  84. Wellroundedtype2 – If my employer wanted to both pay my gym costs and give me time to work out, I’d be all over that. Giving people choice is good. Wellness initiatives are sort of different than penalization initiatives, especially in an under-insured community.

  85. sorry — I typed that before I read the entire list of comments. Does anyone have experience with the guy fits of AA tees? (baggy/sleeve length/width/long, etc.? ) Basically, will I be paying $18 for something that looks like I stole it from my husband?

  86. sorry — I typed that before I read the entire list of comments. Does anyone have experience with the guy fits of AA tees? (baggy/sleeve length/width/long, etc.? ) Basically, will I be paying $18 for something that looks like I stole it from my husband?

    Gina, I wear the AA 2x men’s tees and while on me, they’re form-fitting, I think if you’re under a size 24 and don’t have a belly like I do, it would be loose-fitting. It’s definitely not cut for the “hourglass/girlish figure”, if you will. It probably will look like you snatched it out of your husband’s closet. :-)

  87. I haven’t yet read the comments, so I could be totally redundant here, but:

    “If the screenings turn up ***serious problems with blood pressure, cholesterol, glucose or obesity****”
    headed this.

    BUT THEN:

    “The board will apply the obesity charge to anyone with a body mass index of 35 or higher”

    Um…just because we’re fucking FAT doesn’t mean we have “serious problems with obesity.”

    WTF?!?!

  88. I didn’t see a size for AA girly 2x.

    As you’ve figured out, there is one. And btw, that’s what I ordered (before this thread came along), and it seems like it’ll be highly unlikely to fit me, so we might just be having a Shapely Prose T-shirt giveaway for in-betweenies.

  89. I didn’t realize the shirts over at Threadless were manufactured by American Apparel. That certainly explains some things. It also ensures that I will NEVER buy anything from them. I think there was a post not long ago about the fellow who runs that company. Mmhm.

  90. Godwin’s Law reaered it’s head AGAIN!

    I’d rather my employer did what Arwen suggested with one difference – an ON SITE gym, with time to use it.

    I’d also gladly trade workouts, nutrition and sleep for paid days off each year. hat would be much more motivating to me than charging me more for being fat and active.

  91. Sorry if somebody mentioned this before, but I wanted to post before my laptop ran out of batteries–

    What do you think the reaction would be if the fine were $25 / month for not vaccinating your kids? Many of the things on the list require medical interventions–fining someone for not taking care of such a problem is, in my mind, coercing medical decisions. And most hospitals have LOTS AND LOTS of paperwork surrounding this issue precisely because sane people generally agree that’s a bad idea (although some with heads up their asses don’t want to apply that to women or the disabled–but that’s a whole other thread…)

  92. Cindy – on-site gym FTW! With only 30 minutes for lunch, there’s not enough time to change, go to the gym, cool down, shower, and change even though the gym is only about .25 mile away.

    My husband and I applied for life insurance through Primerica. He had a seizure disorder for 14 years, but has been seizure-free for 6 and med-free for 4. (Or something like that.) Primerica kept calling us to ask for more info about his disorder. We kept telling him that his neurologist went out of business several years ago, and we don’t know what they did with the medical records.

    We recently received a letter rejecting coverage. Him for a neurological condition within the past 10 years and no medical documentation. Me for my height and weight. For which they made ZERO phone calls and asked for ZERO medical records (not that they would have helped much, but most of my issues haven’t been weight-related!). This world is sooo messed up!

  93. HERA On topic: As long as health care is a private for-profit industry, we’ll be looking at nonsense like this. Not that the government would automatically be better (wasn’t it one of them who said something like ‘obesity is a greater threat to our country than terrorism’?), but if the profit motive was removed, there *might* be less of this kind of crap.

    I would like to think that as an Irish citizen, I am lucky enough to have a free state-sponsored health-care plan, but this is being increasingly buggered up by a few real world facts, which I have been reflecting on lately.

    I couldn’t believe more strongly that the profit motive/free market philosophy has no place in healthcare. And this for a very simple reason. While most of us can exercise at least some choice when it comes to buying, say, a T-shirt, a restaurant meal, a gym membership (and all of these include the choice NOT to buy it at all), we DO NOT CHOOSE to get ill. Therefore, if we are ill we are immediately at the mercy of those who can supply the treatment or cure. This is not a “free market” situation. NOT buying the treatment isn’t an option (at least it isn’t an option for anyone who values human life over profit).

    However, since healthcare is being supplied to us on the free market commodity model (and I’ll get to how this affects a public health system in a minute), we are being sold the idea that we, the consumers are, in fact, choosers. We are told we can “choose” whether we become ill, therefore it is appropriate that we “choose” the level of coverage we need, and we “choose” the level of care we receive. All of these levels of “choice” are an illusion. We are simply a flock of geese and our illnesses their golden eggs – they have but to lay in wait and gather them in.

    But the carefully tended illusion of “choice” does allow insurance companies and other stakeholders to avoid noticing how immoral their nakedly greedy profiteering from our illness and distress is. So how does this affect a public health system? Well, a public health system has to buy medicines from private drug companies, doesn’t it. It has to buy medical equipment from private suppliers. And, these suppliers, with their profiteering views, can easily get access to the ear of the health minister. And because our own health service has now come under the sway of a health minister who is a real “free market” idealogue, our tax euros may increasingly have to purchase hospital management, cancer diagnostic and other services from private suppliers too. (We recently signed a contract with an American company, which has admitted to fraudulent reporting, to screen all Irish cervical smears).

    So, it is all part of a piece, we are being taken for all we’ve got when we are most vulnerable, and our public health services are also being taken for all they’ve got on behalf of their most vulnerable. We are all grist to the health profit mill.

    Phew – sorry, that was a bit of a mouthful.

  94. Agreement with Cindy. In addition to the fact that this is blatent fat discrimination, the people in charge of these programs have obviously never opened a textbook or taken a class on anything having to do with motivation.

    It has been proven, time and time again, that punishments do not work. If anything, they make people fearful and intimidated, but overall only work to decrease the overall mental well-being of the people involved. On the other hand, positive reinforcement like rewards or other incentives works much better.

  95. Okay, brief review FWIW/YMMV:

    Not all the tees from Threadless are American Apparel – it all depends on the design, and I’m not sure what the logic is behind which brand is chosen. They have their own label t-shirts, as well as Fruit of the Loom (unisex fit). http://www.threadless.com/sizechart

    Regarding the men’s shirts, I got my husband a large Threadless brand men’s tee. As a 12-14 on top myself, and a hippy 16-18 on bottom, it fit me funny. Definitely baggy sleeves, which are probably 14-16 size up top.

    Also, the 2X AA tee and the 1X threadless tee – both “girly” – fit me about the same. 2X was barely larger. Both are too long, I think – lots of bunching around hips.

    First time I ordered and was quite satisfied with customer service. Wish I’d thought twice about AA size-wise and company-anti-feminism-wise, though.

  96. 2. It’s cute but not as cute as the cow/chick. I broke down and bought one. And I’m not going to wear it to the gym. :) But I will think of you at the gym when I’m wearing it.

  97. I am an employee with the State of Alabama. I received the news about this just a few weeks before it made MSN’s Money page. I was just livid.

    Right now, my BMI is something around 35. However, my BP averages around 110/65, my overall cholesterol level was 138 when checked back in May, and although I have PCOS, I am not diabetic.

    Some of the departments have gyms, but they are very limited, and the equipment is quite outdated. My department is about to start another WW program. At the beginning of the year, a program called Scaleback Alabama runs, and it monetarily rewards the group who loses the highest percentage of weight.

    There are wellness checks, but they are not currently mandatory. I suppose if they’re going to go through with this, they’re going to make them mandatory. 1984, anyone?

    I just really don’t see how they are going to be able to get away with this. They did it to the smokers, but I haven’t noticed it causing a decrease in the number of smokers standing around the building outside during the lunch hour.

  98. Ummm, can someone explain the American health system to this Australian girl?

    We have medicare which give us a rebate on health services and occasional free services depending on what doc you’re seeing and why. Then we also have private cover which seems to be what you guys are talking about here. If you don’t have private you pay a medicare rebate that comes out of your tax. If you do, which I do, it costs a shit load more than $25 a month.

    Other than that I find the idea wrong. I can understand what they’re aiming for but it would be far better achieved via incentives. Your average teacher could have told them that. Offer free gym use, and extra day or two leave a year for hitting goals. Penalising only makes people dig their heals in.

    I’d actually like to see the full policy for this.

  99. misstwist, here the public system is only available to those with very low incomes or who are past retirement age, more or less. oh and people with children who would otherwise be uninsured. there are some other people eligible, too.

    but to make it extra stupid, private insurance is usually provided to your workplace. workplaces buy into insurance plans for large numbers of people as a group because it lowers the premiums, and then employees can opt into the insurance. usually they still pay some percentage of the premium. at some places that’s on a sliding scale with income, at others it’s a flat percentage. usually you have a few private plan options (e.g. an hmo, a ppo, etc.). sometimes if you opt out there is a rebate that gets added back into your paycheck, but it’s generally small. if you’re unemployed, or your workplace doesn’t provide insurance (increasingly common, since it’s gotten so expensive), you can buy insurance yourself individually. that usually runs many thousands of dollars a year.

    sometimes a workplace has a large enough number of workers and/or enouh funds to cover basic insurance entirely; the only people who pay, then, are the ones who pay for extra coverage (this often includes coverage for spouses and/or children, or maybe a better plan for yourself – often the “free” plan is crap). this surcharge is a fee added on top of what is otherwise “free” insurance for state workers in Alabama. that may sound like a ridiculous thing to protest if you have to pay for your premium up front, but when its covered the cost of healthcare is basically coming out of people’s paychecks inviisibly here. I’m sure I wasn’t the only one who barely saw a raise in the past few years, even to match inflation, because the health insurance costs were skyrocketing.

    does that help at all?

  100. Oh god, that’s an awful set up.

    I knew the health cover over there wasn’t great but that’s just messy beyond belief. Doubly so as I know minimum wage over there sucks beyond measure compared with here :(

    I hope, beyond all else, that that is one bill that doesn’t get through.

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