Some people will deride it as a "fat tax." The State Employees Association of North Carolina already describes changes to health-care coverage as "an invasion of privacy."
The State Employees Health Plan is about to reward people who take better care of their own health with lower costs. Those who smoke, or who are obese, will pay more. Beginning July 1, 2010, the 600,000 state employees, retirees and teachers in the plan will be enrolled in either of two packages. In one, they will pay 20 percent of their medical costs. In the other, 30 percent. Also starting that day, smokers will be enrolled in the more expensive program. A year later, the obese will follow them into the more expensive plan.
State workers and retirees get a good deal. The state covers the full cost of what is a good health-care plan. The workers pay to cover their families, if they choose. It is reasonable, therefore, for the state to provide incentives for state workers to be healthy. The coverage costs the state $2.6 billion last year.
Across the country, employers are requiring more healthful living from their employees. Companies are refusing to hire smokers and are helping their current employees wean themselves from tobacco products. Many help overweight workers to lose pounds, and others encourage better nutrition and exercise habits.
North Carolina is not breaking new ground here. It is doing what is smart for both its workers and its taxpayers. Other states already differentiate in their health-care coverage based on smoking.
SEANC may not get very far claiming that testing for tobacco use is an invasion of privacy. At many state offices, state employees are allowed smoke breaks.
For those overweight, the state will use a very high score on the body mass index, a widely accepted gauge of one's appropriate weight, to determine obesity.
Programs exist to help employees with both smoking and obesity.
In the future, if individual state employees choose not to take care of themselves, that is their own business only to an extent. While the program may seem harsh to some, state employees are using a plan that costs taxpayers billions of dollars a year, and those taxpayers have a right to expect that employees will help keep costs down. They can do so either by living healthfully or by paying a little extra.
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