Back in May I mentioned American Airline’s new charge for checked luggage and asked if people would mind paying for their flight based on their weight. In the comments many people thought this was discrimination against people with a “disability”. Well Alabama is now going to charge fat people $25 per month for insurance unless they are working at shedding the extra pounds. They have a pretty generous definition of who is fat enough to pay the fee–your BMI has to be over 35 (30 is usually considered obese). If you are 5’6″ that means you are probably over 220 pounds. They already charge $24 per month to smokers. What would you think if your insurance gave you $25 for being at a healthy weight and charged you $25 for being extremely overweight?
Sounds a little ridiculous because some people have eating disorders and simply can’t help it but I wouldn’t mind an extra 25 bucks for being healthy, hell it may even help motivate people to get in shape.
I know there are people with eating disorders, but I’m pretty sure that is only a very small percentage of people. I bet they have some type of exception where if a doctor says it is a health risk TO lose weight, you wouldn’t have to pay the fee.
And keep in mind this only applies to people who are very very overweight–far beyond what most people define as obese.
Personally I think if we get to the point where being overweight has the same stigma as having bad body odor it will be better for society as a whole.
Why not charge $25/month to people whose blood pressure is too high unless they’re working to bring it down? Or to people whose blood sugar tests at irregular levels unless they’re working to stabilize it? Or to people whose lung capacity, VO2 max, bone density, daily computer usage, muscle endurance, cardio endurance, or sun exposure are outside of the “recommended” or “healthy” ranges? What bugs me is that focusing on the number on the scale is arbitrary, when there are other measurable numbers (blood pressure, blood sugar, cardio endurance, lung capacity, muscle endurance, etc.) that give a more accurate picture of a person’s overall wellbeing and likelihood of developing health issues. Besides, how do you deal with those who are doing all the right things (clean and healthful foods, daily exercise, etc.) but cannot lose the weight due to other health factors (e.g., Polycystic ovary syndrome)? If their other numbers are good, why charge them for something outside of their control? I dislike this idea because it’s just too arbitrary. Too many factors not considered. Pointing the finger at the weight number *only* is a shortcut, and a highly fallible one at that.
I laughed my head off when I saw that the Google ad included in the feed for this article was for weight-loss surgery.
Obesity is due to a lot of factors that may or may not be related to overeating or lack of exercise. Some people have food intolerances that they and their doctors don’t know about (web sites about the Specific Carbohydrate Diet are educational). Some have autoimmune diseases. Some doctors have theorized that it’s the overload of fructose in the processed American diet that overwhelms people’s bodies and makes them fat even if their caloric intake is reasonable. Some people’s metabolism has been altered by medication given to them for other problems–I started putting on weight in my teens after I was treated with cortisone for poison ivy. In 1962 doctors didn’t know a lot about cortisone.
If the extra charge paid for a comprehensive health evaluation that would include an unbiased look into the person’s entire lifelong medical history, the possible effects of medication, the likelihood of food intolerances (not allergies) that don’t show up in standard blood tests, and an eating plan that was within the person’s budget and family’s needs, I wouldn’t have a problem paying it (yes, I am both overweight and diabetic). But the usual weight loss programs don’t deal with the whole person, and work environments don’t adapt well to special needs (hell, at my last job, my boss refused to even try to understand a diabetic’s dietary limitations).
Fat people are about the only group left who can be laughed at with no social consequences. The problem is that in the USA today, everybody’s got a real good chance of getting fat.
@Marissa – Keep in mind they aren’t basing it on your weight. It is based on your BMI (body mass index) so it is a bit more accurate. People with PCOS definitely need to have some type of plan to control their weight or they are going to have a host of other problems.
I think this is a wonderful idea. I think that unless your doctor can verify that you should not or cannot lose weight, there’s no good reason not to lose it.
A fat tax is brilliant. And as for people counting obesity as a disability as mentioned in the article, I think that’s insulting to people with actual, incurable disabilities like amputees and paraplegic patients.
Fair enough–I did specify only weight rather than BMI in my response. I still question the validity of the BMI as a threshold, though, for the same reasons I question weight. It simply fails to account for too many other variables; it assumes too much. I’d be far less concerned if the initiative was looking at a broader picture of health (more along the lines of what infmom described) so that people could be guided toward real solutions to health issues. I advocate looking at a larger picture when it comes to wellness and health, and there are simply far too many exceptions to the rule for BMI to be a reliable shortcut to identifying the most severe health risks in a pool of individuals.
This has been a long standing debate in the insurance world. Unlike auto, home, and life insurance, health insurance isn’t able to underwite based on individual characteristics like weight/BMI, BP, current or past health conditions, etc. Unable to actively delineate between people, insurance companies are forced to do passive, pricing-based segmentation by offering highly differentiated plans that have a hard time serving anyone’s needs completely.
I’ll be the first to admit that underwriting based on individual characteristics leaves a lot of room for discrimination and gaming of the system by the insurance companies. But the current system leaves quite a bit of room for gaming by the insured. My two person household is currently covered by something like $6,000 worth of medical insurance per year (including the employers’ contributions). We consume a great deal less than that. Rather than being refunded to the person footing the bill (either the employer or the employee), the balance goes to the basis of our current health insurance system: paying for other people.
My insurance payments, whether they come out of my pocket or my employer’s, go to pay off medical bills accrued by someone else. Many will immediately ask “So? Its not your money, so why do you care?” I care because every dollar my employer spends on healthcare is a dollar that they can’t spend on something else, a dollar that doesn’t go towards better food in the cafeteria (ironically enough), a dollar that doesn’t go towards hiring more people and growing the business, and a dollar closer to having to lay more people off.
While its true that some percentage of people have eating disorders or other medical conditions that severely affect their weight (hypothyroidism, for example), these people are the exception rather than the rule. Depending on how you slice it, a quick look at Wikipedia suggests that less than 10% of Americans are afflicted with eating disorders. For those people I’m sure we can devise some reasonable way of accounting for those things that are outside of their control. Poor vs. healthy concerns might be addressed by some sort of sliding scale that takes into account your relative station in life.
The carrot only model has been tried multiple different ways. Humana offers a program that gives you cash against how far you walk on a monthly basis (you wear a pedometer). Many companies have instituted team-based challenges for people to out-walk other teams, with prizes as the incentive. Virgin Healthcare is doing something similar, using store gift cards as incentives against easily measurable physiological values (BP, steps taken, and I think cholesterol).
The problem with all of them is that they end up rewarding the people who need to be rewarded, the people who are living healthy in the first place. The unhealthy people are the ones that don’t participate. So they’re removing money from the system (to pay the healthy people) but not reducing the cost burden (the unhealthy people aren’t changing at all). Which is ultimately why these program don’t work as well as they should.
I’ll have to agree with @Marissa – there should be some comprehensive evaluation to determine your risk category, some combination of BMI, BP, blood panel, stress test, or whatever, that puts me into one of a handful of categories.
Also, why not track me over the years? Whether it be every 3, 6, or 12 months, make me go get a physical. If my numbers are trending towards the good, give me a break on my insurance; if they’re trending towards the bad, then impose a penalty. There are a bunch of different ways we could institute a combination of sticks and carrots to coax people towards either becoming more healthy – and thereby reducing the cost burden – or pay more of their fare share.
The downside to this – and the upside to focusing on BMI – is that the more parameters we put around it, the harder it will be to understand. By keeping the requirements simple (Do you smoke? If yes, pay $25), it makes it that much more likely for a greater number of people to easily comprehend and – more importantly – derive actionable items from.
What’s the solution? Honestly, I don’t know. But I think talking about it is a step in the right direction.
@Marissa – Just out of curiousity, what percentage of people with a BMI of over 35 in Alabama are that way even though they eat healthy and exercise?
Keep in mind that the idea is to encourage people to do what they can to stay healthy. Everyone who smokes can quit smoking. Everyone who has a BMI of more than 35 can work to bring that down. (I’m not aware of any type of condition where having a BMI or more than 35 is more healthy than a BMI of less than 35.)
The way the plan looked to me, if you have a BMI of over 35 you go to your doctor and say, “I need to bring this down. What should I do?” The doctor then gives you a plan and you follow it. As long as you do that you don’t pay the $25 monthly fee–regardless of how much you weight. It is the people who say “I don’t care that I’m unhealthy and I don’t care what the doctor says, I’m don’t want to change anything!” that pay the fee.
Now most people can probably bring their BMI down simply by taking smaller portions and getting some daily exercise, but for the very small percentage of people who have some type of medical condition that is pushing up their BMI, the plan just says they need to be following their doctors recommendations.
Here is another way to look at it: People who choose to make unhealthy choices (smoking, not exercising, etc.) are basically stealing from the people who do make healthy choices because the healthy people subsidize the the healthcare for the people who choose to be unhealthy. Most people don’t have a problem subsidizing health problems that can’t be prevented because that is what they hope insurance will do for them if they get sick. But they have a very big problem paying for healthcare for people who are choosing to be unhealthy and could do something about it. Alabama found that it cost an extra $1,700 each year to take care of someone with a BMI over 35 compared to someone with a BMI of 25. That is quite a bit of money that healthy people are paying to care for people who aren’t trying to take care of themselves.
Alabama is doing the same program for people with problems with smoking, blood pressure, cholesterol, obesity, and glucose so it isn’t just limited to people who are overweight.
Eating disorder my foot! Take this simple obesity test: Close your eyes, turn around twice, reach out your arms at right angles to your body, now open your eyes…
If what you can see is in the USA then you are probably obese.
@Sam: “What’s the solution? Honestly, I don’t know. But I think talking about it is a step in the right direction.”
I agree. This isn’t an easy topic, and open discussion is vital to figuring something out. (Great response, too; well reasoned, and lots to ponder.)
@Mark: I would be only guessing if I tried give any percentages–so I won’t! I truly don’t know. I agree with you, that the intent at the core here is to encourage folks to become/stay healthy. And that *is* a good thing. I don’t mean to detract from that; I absolutely support a quest toward well-being. If the program works as you describe (go to the doctor, follow the advice he/she gives on fitness and nutrition, and avoid paying the $25 as long as you’re working on that plan), many of my objections fall away. My objections become more strenuous if there is some time limit imposed or if a person’s effort toward wellness stops being enough. If that happens, a lot of the motivation for the individual disappears–if a person with a high BMI knows that by continuing to work on fitness & diet, even if he’s not getting thin, he’s still obtaining some insurance benefit, that can provide some motivation. If that same person knows that it only matters if he’s losing a certain number of pounds (or doing so by a certain deadline), the motivation disappears as soon as he fails (“Why bother?”). I’d much rather have people consistently striving for better fitness and health, because I think a lot of benefits come from the work to get there (even if your weight or BMI never actually gets to the “right place” on the charts). If the program allows a constant motivation without a deadline of some sort, I’m much more in favor. The worst thing would be for it to become an anti-motivator, leaving people thinking, “I’m trying to work out and eat right, but I still have to pay the $25–so why bother with the working out and eating right if I’m penalized anyway?” I would want to avoid that–it would run contrary to the intent of the program.
Finally, Mark, I do appreciate you posting this and opening this topic for discussion–and I appreciate your dialogue with me. I’m always nervous about posting responses to posts dealing with weight because they tend to become “flame-y” so quickly. But I love the chance to kick ideas back and forth–even ideas that are contrary to mine!–with others. So, kudos for approaching a sensitive topic, and kudos for encouraging a debate and discussion. Good stuff.
It’s not about the weight it’s about the money. If you think for a second you would actually get 25$ discount for being under target I have a bridge for you to look at. It’s money, money, money. The government at every level has ceased to be servants of the people, we are now the servants of the government. If you don’t believe this is another cheap shakedown just remember where the money from the tobacco shakedown went. Check state by state the difference between where it was promised to go and where it actually went. We the people are once again being bent over and butt raped by government.
When will the majority of people in the USA learn that draconian penalty does no good?
I would suggest doing something like charging even more but providing access to a personal trainer, nutritionist, motivator/therapist, and gym membership. Set some goals, and allow them to earn the money back as a motivation and a punishment. Not only would that help those who need the assistance and motivation of a trainer and nutritionist, but over the long run it will be cheaper to the insurer and the economy in general. Most people that are overweight are not happy with their situation, but do not know how to get out of the situation.
You weren’t born all knowing and if you have healthy habits, they were instilled in you from somewhere. I assume that most people that read a blog called Productivity501 might not be able to understand how some may not be able to help themselves, but sometimes obese and overweight individuals just don’t know how to tackle the situation.
Great commentary, and interesting debate.
I agree with a lot of the comments, and the overall quest for more well-being.
I think that, on a very basic level, those who engage in unhealthy behvavior (smoking cigarettes, for example) should expect that they should pay more for life insurance. It’s simply accountability.
I also agree, however, that specific sticks and carrots ought to be tied to individual cases. It may not be healthy for a person to shed weight, or achieve a certain BMI, given their specific health case. A broad solution, in other words, just isn’t going to fit everybody.
@Marissa – I appreciate your input and enjoy hearing different points of view.
@Mark – I’m not aware of any condition where it would be healthy to have a BMI above 35. I’m also not a medical professional, so take it for what it’s worth.
I still stand by my original argument – that wellness incentives need to be tailored to the individual’s health to be the most effective. Broad initiatives will necessarily encourage some more than others depending on what metric they target (and perhaps even discourage some).
Practically speaking, it may be more realistic to stick to BMI as a standard metric, given the logistics of rolling out a program for a mass audience while maintaining a degree of individualization.
The question then becomes: who, if anyone, would be discouraged? Is it a disproportionate amount of people with a BMI above 35? If so, the program fails its original intent.
I’d be interested to see some test cases at different companies in different areas of the country. If there’s one thing the U.S. isn’t lacking (unfortunately) it is obese people.
@Matt – Are you aware of any condition where it wouldn’t be healthy for someone with a BMI of 36 to try to bring it down to 34? I’m not.
There seems to be a misconception that it is healthy for some people to be obese. (Keep in mind that a BMI of 30 is considered obese so 35 is well beyond this.) I think this is what is driving the idea that being fat is a disability.
There are some types of diseases that make it more likely for a person to gain weight, but that just means they need to work extra hard. It doesn’t mean that it is somehow healthy for them to let their BMI go above 35. (Obviously I don’t know about every possible disease, so maybe there is some type of condition where this isn’t the case, but even if there is, I’d bet it is pretty rare.)
@Marc – The Alabama program says that everyone has to do a health screening and get recommendations. They should all have plenty of information on how to deal with their issues whether it is cholesterol or obesity.
Also if people don’t know how to keep their weight under 35, I’d say they are almost intentionally ignoring stuff. It is a pretty hot topic in the US. Also keep in mind that the people referred to in Alabama are people who have an insurance program with a free wellness program.
This is so wrong it’s not even funny. Your gonna charge people because they have trouble controlling there eating habits. This is just stupid plain and simple. What about obese kids your going to charge them to, what about there parents? How about we charge skinny people for being skinny unless there trying to gain weight. I am utterly discusted that anybody would even think to come up with an idea like this
@Anonymous – Obese people cost an extra $1,700 in healthcare costs. This program charges them an extra $300 per if they refuse to work on eating right and getting some exercise. The rest of the cost is still paid for by everyone else who is healthy.
You seem to be advocating a system where people can be as unhealthy as they like and their healthcare should be paid for by the healthy people.
On a base level my disagreement is this: I believe people should take responsibility for their own actions and am in favor of changes that help encourage this. You appear to believe that people should be able to ignore responsibility for their own actions.
With such a fundamental difference in ideas, we would probably have very little ground in common to even begin a discussion.
While I am not obese, I grew up with a mom who is and has been since giving birth to me (35 years ago). She has “tried” everything with very little results (WW, shots, pills, shakes, etc.). Nothing seems to work for her. The reason why? She has tons of candy in the freezer that she snacks on every night, she has the mentality that she needs to clean her plate at every meal (thanks to her grandmother) and they eat out most meals. I’ve given her tips, etc. throughout the years like having restaurants put 1/2 your meal in a box, drink a full glass of water before starting to eat etc. She picks & chooses what she likes & moves on. She’s always taught me that you should only have 1 starch at a meal with at least 2 vegetable servings, that sugar causes issues etc. You should exercise regularly (she has a lifetime membership at a gym). She just doesn’t seem to have the willpower to choose to eat best for her body, or exercise regularly. She’ll only go in the pool to exercise for a little bit & then relax in the whirlpool. She tells me that if I lived close, she would work out with me, but I’m now 2 hours away. It’s unfortunate b/c I now watch her with knee problems, ankle problems, high blood pressure, etc.
On the other hand, I have a co-worker who is in the same boat (severely obese). A couple of years ago, her boss offered her $100 for every 25 pounds she lost & he would pay for her WW 100%. She started going to WW faithfully every week. She started losing weight. She got the first $100 & then had a couple of injuries followed by a heart problem and completely quit…gaining back everything and then some. The partners at work beg her to go back, but she just won’t. She says that there is a problem with her thyroid & she just can’t lose the weight…even though it was working out great for her when she went to WW.
All-in-all a person has to have an incentive to lose weight (monetary, health, wedding, whatever). They have to be taught how to lose weight. They need encouragement (maybe a friend going to meetings with them or exercising with them). And finally they have to get excited about losing the weight. If they are ho-hum about it, they aren’t going to lose it no matter what others say. Yes there are many out there with eating disorders, but I highly doubt that if you could prove that you have a BMI of above 35…35!!! due to some highly irregular physical ailment that the State of Alabama would continue charge you the $25. In your article you state that a person of 5’6″ would have to weigh about 220 pounds to have a BMI that high. That is a severe problem.
I want to thank you for the back & forth conversations about this issue.
I would think that many chronic over-eaters (people who binge) would also fall into the “eating disorder” category. In fact, many anorexic people were once overweight and most bulemic people are not very skinny. Eating disorders are more about the mind-set than the actions, so someone who is scary-thin is at the opposite end of the same eating-disorder spectrum as someone who is obese as a result of binge-eating. In the former case, the eating disorder action is starvation, and in the latter it’s binge-eating.
Quote: “People who choose to make unhealthy choices (smoking, not exercising, etc.) are basically stealing from the people who do make healthy choices because the healthy people subsidize the the healthcare for the people who choose to be unhealthy. ”
Comment: That’s true, but then how about people who choose to engage in sports or other activities with a high risk of injury? Are they stealing from more “careful” people when they break their necks falling off horses or diving out of airplanes? And how about people who engage in risky behaviors like having unprotected sex? When they contract HIV or other STDs, aren’t they “stealing” from the responsible people who use protection?
It seems to me that unless you’re going to levy charges against everyone for every possible thing, targeting obese people seems kind of unfair. No one is perfect, and while the obese person “wears” their “imperfection” you can have a bunch of skinny people who are also driving up health care costs with their actions and behaviors.
Since you could come up with a “charge” for almost everyone (the skinny person who puts salt on everything even though they have high BP, the skinny person who has high cholesterol, etc.) I think it’s easier and nicer to just keep things the way they are. Very few people are perfect, so someone would usually be getting charged for something.
@PJK – If you read the article you’ll see that they are doing they same thing for smokers, people with high cholesterol and a variety of other measurements that people can improve by changing their habits.
The US spends somewhere around $140 billion (yes that is right billion) dealing with issues caused by people being too fat. That means about 6% of all healthcare costs are related to people being overweight.
If people who rode horses required an extra $1,700 (the amount Alabama found fat people cost over normal people) in healthcare costs each year than non-riders, I’d be all for insurance companies charging them extra if they want to continue riding horses.
People have gotten so accustomed to not having responsibility for their actions that they get upset at the suggestion that those with poor self-discipline might have to pay a small portion of their extra healthcare expense.
@ Paco – spoken like someone who has never tried to lose weight. :-)
I think adding a surcharge for being fat is discriminatory and does not address the real problem.
I would be considered fat by many (5′ 3″, 180), yet my blood pressure is a very normal 118/60 and my cholesterol level a very reasonable 140. I work out 2x a week and take two yoga classes weekly. I am a belly dancer and rehearse several times a week for my own practice and, when prepping for a show, often have 2 or 3 rehearsals a week. Earlier this year, I decided to phase in vegetarianism and do not eat beef or pork (taking it one animal at a time) ;-) I do not buy or eat junk food. I do not smoke.
Still think I am a health risk and a drag on the insurance system?
It would be more accurate and fair to add surcharges for such issues as smoking and *untreated* high blood pressure – issues that can be directly addressed by precise measures (nicotine patches, blood pressure medication, etc) and for which results can be directly linked to the treatment.
@Amy – If you have an average BMI for your height and weight, you are still under 35 which is the threshold Alabama set. (30 is considered to be obese.) You would have to gain around 20 pounds to reach 35 and if you have a lot of muscle mass your BMI may be much much lower.
But to answer your question, yes, if your BMI is above 35 and you don’t do anything you would be a statistical abnormality if you had lower health care costs than the average of a group of people with a BMI of 25. (This is particularly true if your BMI goes up as you age as it does with most people.)
Also the Alabama plan isn’t just for people with extremely high BMI. It also addresses people who smoke, have high cholesterol, etc.
@Mark – but you are automatically equating high BMI with health problems, which may or may not be true. I don’t know my BMI (hmmm…wonder if my insurance would pay for that?).
But recent studies show that fitness may be a far better indicator of health than BMI. See http://www.nytimes.com/2008/08/19/health/19well.html
I think you can be fit and fat. And you can be skinny and unfit. And have serious health problems.
Again, my point is that you shouldn’t automatically penalize people who match a certain arbitrary measurement, that may in and of itself be inexact. Just as you shouldn’t assume that all people with, say, a certain IQ number are automatically going to have cognitive and functional problems. That has been proven untrue time and again.
@Amy – I suppose you’re mostly right. During college I gained about 30 pounds and had stopped growing vertically. It took me about a year to get back to a weight that I was happy with and get rid of my gut. I realized early (though not as early as I should have) that I was in danger of sticking with unhealthy habits and possibly becoming obese.
I’m pretty self-motivated, but for some, this kind of monetary motivation could be the thing that helps them move in the right direction.
And the fact that you sound like you’re at a pretty reasonable weight and seem happy with how you’re doing, I’d have to say no, you’re not dragging me down. And I hope it stays that way.
@Amy – The article you linked to is interesting, but tends to support what Alabama is doing. They are requiring people to get screened for most of the things mentioned in the article. Also the article says:
Which seems to support the idea that 35 is a pretty good threshold for people to make sure they avoid. I believe Alabama set the threshold this high in order to not penalize anyone who is healthy, but still has a higher BMI than normal.
It does say that being overweight in the 25 to 30 range isn’t an indication of being in awful health–which makes perfect sense and seems to be recognized by what Alabama is doing.
Some people who smoke don’t get lung cancer and somehow seem to avoid other health problems, but that doesn’t mean it isn’t a good metric. I still think you are going to be very hard pressed to find someone with a BMI over 35 who would not benefit from activities designed to lower their BMI.
Regarding the IQ analogy it sounds like you are saying that someone with an extremely low IQ can function in the same manner as someone with an IQ of 100? I know Mensa members (top 98%) and I know people in the bottom 25%. There is a very big difference in what they are functionally capable of. I’m not sure what studies you have seen that prove otherwise.
Our basic disagreement is over whether or not a BMI of 35 should require someone to see a doctor and follow the doctors recommendations (along with other wellness indicators). I say, “yes”, and you say, “but there might be a healthy person with a BMI of 35–measure something else”.
And regarding your BMI it is almost certainly well under 35. If you have a lot of muscle mass from your frequent work outs it probably even below 30.
@Deb – I think your experiences most accurately reflect the majority of what is going on in people who are extremely large and don’t lose weight.
I have yet to meet anyone who is in the 35 BMI range who eats healthy (type of food and quantity) and gets even a moderate amount of exercise (walking 20 to 30 minutes a day). I’m open to the possibility that such a person might–just might exist, but it is probably very very rare.
How come 25 or 30 years ago there was no health food and no one
worked out and there were less obese people. Any ideas.
I don’t like this at all. The last post says 30 minutes a day. Well
do you know that an obese person might not be able to walk for 3o minutes and what if I don’t want to. Yes I am obese. But what if its much harder for me to be thin than you . You can exercise if your thin
but it harder for heavy people. Then how do you know if I did it or not.
I could say I did and it didn’t work , How would you prove someone
worked out. Wouldl you want to be required to take a drug and alcohol test everytime you went to the doctors to prove you aren’t
drinking or drugging. What about people who work out too much.
Are we going to test them for drugs like steroids to make sure they aren’t abusing something that would make them need rehab that us people who don’t drink or do drugs have to pay for. I know people
who are skinny and are not healthy. My mother was always skinny
but drank and smoked. My ex was always skinny but took drugs
so you would have to charge everyone who had a bad habit that
would cause extra money to be spent on health care that most
people wouldln’t do.Would we charge men who have kids they don’t take care of for bringing too many kids into the world that
tax payers have to support. Would we charge people who drive fast and get too many speeding tickets? Would we charge people who like to party and drink. What about people who like to skateboard
and ski and snowboard because they get hurt more than people who don”t do dangerous sports. Why don’t we charge people who eat meat because that is associated bad health. If your not a vegetarian you will be charged.
like to
@jemapel – Good question about why there were fewer obese people 30 years ago. I think there were probably fewer sedentary jobs back then.