A Tax On Your Genes, Welcome To Alabama

Beginning in 2009, a person who is quantitatively determined to be overweight will face a fat-tax if they are employed by the state of Alabama. Now, I am one of the last people in the world who needs to be reminded of the benefits of exercise and the problems with obesity. It is a fact that obesity yields a greater likelihood of health problems, but this policy in Alabama is the absolute most abhorrent way to promote health. The “fat-tax” takes the form of a surcharge on monthly health insurance premiums. By classifying it as part of an insurance premium it avoids the technical classification of “tax” but I have to call it the way I see it. If it is a government agency requiring it and collecting it, then it is ultimately a tax to me.

The new Alabama policy uses BMI (body mass index) to determine fatness. BMI does not take into account body composition; it only cares about height, weight, age, and gender. This means that weightlifters, body-builders, or naturally muscular people can be taxed for their weight even if they have a nice low 5% body fat. It does not take a rare Arnold Schwarzenegger-type of person to face this kind of problem; any average guy who spends enough time doing heavy weights in a gym can get to this point where the BMI says they are “overweight” but their body composition remains lean. So what is the incentive here? For some people it actually becomes a disincentive to exercise. Some men do not gain much muscle mass when they lift weights, but others naturally bulk up quite readily with even modest lifting. Variations in genetic makeup will determine how lean and muscle-bound a person will get.

The premise of this Alabama fat tax is that if a person is skinny and trim then they are healthy, and being overweight by any amount is unhealthy. In reality we know this is not necessarily true. Some people are genetically predisposed to carry more weight than others, yet they remain healthy and productive well past the average human lifespan. Many of us know of some perplexing individuals that seem to be able to eat junk food in unlimited quantities yet never gain a pound. We also see those others eating miserably healthy diets and keeping very active, yet they stay as round as a pears. Our genes have as much, or potentially more, influence on our weight as do our habits.

Let us also look back at a study appearing in the Archives of Internal Medicine which found that nearly one quarter of normal-weight adults have cardio-metabolic abnormalities, while over 50% of “overweight” adults were actually metabolically normal. The results imply that while the trim and skinny may lean toward being relatively healthier, there are millions of people that are exceptions. It is absolutely foolhardy to assume a skinny individual is automatically healthier than an overweight individual and therefore deserves a lower tax-rate.

Philosophically, I do not accept that punitive measures are effective in promoting the long-term lifestyle changes that people need to be healthy. Motivation for healthy behavior is a complex thing. It revolves around the corporate cultures people work in. It depends on the choices available to them in the cafeterias they frequent. It depends on the knowledge they have accumulated regarding healthy choices. You cannot tax people into becoming healthy; in fact, it is more likely to cause them to have to skimp on nutrition by buying cheaper junk foods.