A bill that would increase insurance premiums for public employees who are obese would be a blow to the pocketbook. But it also might be an incentive for at-risk workers to slim down.
State lawmakers have not figured out how to administer the proposed new policy. A Senate Finance subcommittee delayed voting on the plan until details could be worked out.
The bill's primary sponsor, Sen. Greg Ryberg, R-Aiken, wants to tie the surcharge to employees' body mass index -- or BMI -- a weight and height measurement. Any worker whose BMI exceeds 30 -- the threshold for obesity -- would be charged an extra $25 in insurance premiums per month.
Ryberg said he would be willing to rewrite the bill as an incentive program rather than a punishment. Under that plan, premiums for all state workers would rise, but fit workers would receive a discount.
Either way, obese people would pay more. And Ryberg says that is justified because obesity is a significant contributor to health problems such as heart disease and diabetes. Ryberg claims that health problems associated with obesity cost the state as much as smoking-related diseases.
The state already has a policy -- due to take effect Jan. 1, 2010 -- to charge smokers and employees with dependents who smoke $25 a month more than non-smokers. An obese smoker, then, would have to pay $50 more if the Ryberg bill passes.
Policing obesity might be harder than keeping tabs on smokers. Weight can fluctuate over a short period of time. Does the state intend to conduct monthly weigh-ins?
BMI also is an inexact measure of a person's fitness. For example, a highly trained athlete in perfect condition can have a very high BMI simply because muscle weighs more than fat.
For the most part, however, the state should be able to determine which workers are obese and which aren't. And it makes sense to charge them more for health insurance if they are at higher risk of health problems.
The best outcome, of course, would be to encourage public employees to lose weight. South Carolina ranks fifth nationwide in both adult obesity and diabetes, with about 30 percent considered obese and one in 10 coping with diabetes.
If lawmakers approve this bill, we hope they include a lag time to allow workers the chance to slim down before the new rules take effect. But those who choose not to exercise and to continue to overeat deserve to pay more because they contribute significantly to the cost of health care for everyone.