From Arizona, the nation’s new cauldron of politically incorrect thought, comes this idea. Make obese adults in the Medicaid system pay a $50 fee as a penalty and an incentive to get into better shape.

Arizona’s Republican Gov. Jan Brewer proposed the idea last week as a way to address ever-expanding Medicaid costs. And the idea is not as bluntly punitive as it sounds. Patients would be required to work with a primary care doctor on their weight issue, and those who don’t meet certain goals would be assessed the fee. Only childless adults would be subjected to the fee.

Brewer also want to target smokers with the same $50 fee. Some 46 percent of Arizona’s Medicaid patients smoke daily. About a quarter of the population is considered obese in Arizona, according the the Centers of Disease Control and Prevention.

Call me a churl, but it seems perfectly logical to attach extra costs to those who don’t engage in healthy lifestyles.

Yet somehow I doubt a “fat fee” have a snowball’s chance in Massachusetts. I suspect a bloc in the Legislature would rise up against it, saying obese people can’t help it and shouldn’t be fined for being fat — it would be a case of victimizing the victim.

Obesity fee: Why not in Massachusetts? | Boston Business Journal

When Arizona governor Jan Brewer proposed that certain participants in the state’s Medicaid program — specifically obese people and smokers who don’t take steps to change their unhealthy behaviors — should pay a fine of $50 a year, it didn’t take long for the reactions to come rolling in.

Those in favor state that people who eat to the point of obesity or who smoke should have to contribute to covering the costs of that behavior. In addition, they note that any money collected through these fees will help the state’s financially strapped Medicaid program and allow it to expand current coverage. Opponents of the proposal say that for some individuals, obesity is the result of occurrences beyond their control, such as accident or illness.

An article in The Wall Street Journal notes that 25.5% of Arizona residents were considered obese as of 2009, and about 46% of the state’s Medicaid participants smoke daily, according to a 2006 survey. Moreover, the Journal added, “Unlike private insurers, which often charge different premiums based on customers’ health status, Medicaid must enroll all those who meet its eligibility requirements.”

Knowledge@Wharton asked two Wharton professors — Katherine Milkman, professor of operations and information management, and Kevin Volpp, professor of health care management — for their thoughts on three issues raised by the Republican governor’s proposal

When Fat Is No Longer Free | Knowledge@Wharton Today

Like many states, Arizona faces a serious budget crisis. But unlike other states, Arizona public officials have shown a remarkable skill for finding ways to address their projected $1.6 billion deficit that are unfair, unjust and cruel. Their latest bright idea is to balance the state budget on the bodies of poor Arizonans who are unlucky enough to be fat or addicted to tobacco.

Gov. Jan Brewer has now proposed levying a $50 fee on state Medicaid recipients who are obese and who don’t follow a doctor-supervised slimming regimen. She also wants to charge those who smoke.

The plan, if approved by the Republican-dominated legislature, would mark the first time a state-run but federally subsidized health-care program for the poor has charged people for unhealthy acts.

The Wall Street Journal quoted Monica Coury, spokeswoman for Arizona’s Medicaid program as endorsing the idea, saying “If you want to smoke, go for it. But, understand you’re going to have to contribute something for the cost of the care of your smoking.”

Opinion: Arizona, stop picking on the poor, obese – Health – Health care – Breaking Bioethics – msnbc.com

Republican Gov. Jan Brewer, as part of a broader package to reduce costs of Medicaid in Arizona, is proposing an annual $50 charge for patients who are obese. The Wall Street Journal called this a “Fat Fee,” though it could go by many other names: Corpulence Cost, Plumpness Payment, Overweight Outlay, Stoutness Setback, Big-Bottom Dollar. Wordplay aside, if her proposal is approved by the state legislature and the federal government lodges no objections, it would mark the first time Medicaid patients have been financially punished for what the state deems unhealthy habits.

The charge would only kick in if the obese patient failed to follow a plan for slimming down. Similar fees would be levied on smokers who don”t quit and people with chronic diseases who fail to manage them as directed. There are also plans to freeze enrollment of certain classes, cut others and use some of the recaptured funds to revive coverage for organ transplants — a cut that got more than a little bad press when it went into effect last fall. All told, the plan is projected to fill in about $500 million of a $1.1 billion budget shortfall.

Arizona’s Flab Tax – Swampland – TIME.com