Is Body Mass Index an appropriate measure

From The Bulletin Editor.

In our Oct. 8 issue, we ran an article on changes to the State Health Plan that may reduce coverage for people who smoke or have a high body mass index, and in our Oct. 15 issue we ran the first round of letters from faculty and staff members responding to the changes. This week the conversation continues with more letters from Bulletin readers. Next week, we’ll continue our examination of this topic with a look at a wellness program developed by employees in the College of Natural Resources. And in subsequent weeks we’ll attempt to get answers to more of the questions raised in your letters.
More on BMI

BMI idex has to take into consideration bone density for some groups of people. It paints a broad stroke when that is not considered. Higher bone density means more weight or muscle.

Sakinah S Abdal-Rafi
Infrastructure, Systems & Operations
Legislature Unable to Manage Plan

Governance of the State Health Plan should be insulated from the corrupting influences of political control to the maximum possible extent. The legislature has proven itself unable both to manage the plan effectively and to resist business groups’ influence to hamstring the plan with favorable subsidies. We have a situation where employee benefits are cut to fund unnecessary fee increases to medical providers. North Carolina’s ability to compete for employees has been severely damaged by the legislature’s poor management of the State Health Plan.

Barry Eriksen
Office of Information Technology
Yo-Yo Dieting Harder Than Maintaining Weight

I would also like to voice my concerns over the BMI insurance changes. My family physician says I am perfectly healthy at my weight. Most people yo-yo diet which is much harder on your body that maintaining your weight. I know many skinny individuals who run marathons who have high blood pressure and heart attacks. So I’m not sure how they determine that it causes more health care costs to everyone. I can see the smoking part. But are they going to reduce coverage for everyone who has any kind of health issue (for example, cancer, diabetes, etc.). This seems extremely unfair to me and will surely not draw in good employees as state insurance is one of the main reasons many people stay with extension. I am quite upset with these upcoming changes.

Deidra Hicks
Iredell County Cooperative Extension
Watch Your Co-Workers

Once again cooperative extension is on the cutting edge. The partial socialization of our health care by the state and other employers precedes the complete socialization of our health care by the federal government. This arbitrary decision by state bureaucrats precedes numerous arbitrary decisions by federal bureaucrats once they start to run out of other people’s money. Welcome to the future. The current status of our health care insurance choices is comparable to the Soviet food system of the 1960s.

There is a better way. If employers were not allowed to offer health insurance and each individual was responsible for their own health care, we could make intelligent economic decisions including purchasing health insurance from a larger number of vendors. Then health insurance companies and the marketplace would make the decisions. My health cost as an obese man might still be higher than for the next guy, although in my experience obese people die as cheaply as anybody. Still, if the cost was determined by the free market system, it wouldn’t bother me to live (and die) with that.

By the way, I won’t be losing weight because I have learned during a 32-year battle with obesity that a 10 percent loss of weight makes me fantasize about violence. With me it is always socially acceptable violence like beating up a robber or a mugger or a home invader or tackling a grizzly bear with a baseball bat. Still, I suggest you keep an eye on your co-workers if they start losing weight.

David Goforth
Agriculture Extension
Money, Not Health, Behind Changes

I am a member of one of the target groups: I am obese and have Type II diabetes. I find the new “health” plan discriminatory and punitive.

I’m all for positive programs that promote exercise, better food choices, and good self-esteem in spite of body size. If this initiative had been about health at every size or even about losing to a weight that your body can maintain, regardless of the BMI, I would applaud it. However, I argue that the punitive nature of the plan will increase stress and encourage poor food choices (a friend once tried to subsist on popcorn alone to maintain a weight that wasn’t natural for her), yo-yo dieting, and possibly eating disorders such as bulimia.

The legislation that brought about the changes to the State Health Plan has never been about health; it has always been about money.

Kathleen McBlief
College of Engineering
Plan Overpriced

I am compelled to comment on the article in two ways:

First, why does Rep. Wil Neumann seem surprised that only 25 percent of membership is comprised of dependents? I do not enroll my three dependents simply because the family plan is ridiculously overpriced. Seems it was something around $460 a month! That’s half my mortgage; are you serious?! We shopped around and found comparable independent insurance at a quart of the state plan’s cost. The state plan just doubled the deductable that I moved from the 70/30 plan to the 80/20 plan (after dropping the family from the plan) to get. I moved to a higher plan but essentially it was a lateral move because the state plan upped deductibles this year.

Second, it seems to me there could be some discrimination/invasion of privacy lawsuits at hand if they try to implement this new smoker/body fat plan. I am neither a smoker nor obese, but if I were I would be irate that I have been singled out because of my size. What’s next? African-Americans pay more because they are predominantly at risk for sickle cell anemia? Maybe women of fertility age will pay higher premiums unless they can show that they have been fixed.

Johnnie Wesley Durham Jr.
Dairy And Process Applications Laboratory
Cookie Cutter Approach

It would seem to me that with the SHP, they are trying to cookie cut what a state employee should look like. Of course, they are not going to dictate race, creed, or religious standing but I would not be surprised if they came up with a study saying that braided hair does this or short hair does that. I think it is a mess!

Due to the budget, the benefits of being a state employee are diminishing and this just adds to it. It wasn’t that long ago when a person wanted a state job just for the health insurance.

Ebone’ Henderson
Department of Plant Pathology
Response From Benefits Office

Editor’s Note: Last week, Jones County Cooperative Extension employee Regina Gardner wrote a letter to the editor asking for a list of weight loss programs available off campus, specifically for extension employees. We asked the NC State benefits department to help us answer the question. Their response:

Hi Regina,

There may be options that you can take advantage of although you are not located on campus, such as “ask the dietitian.” Begin by perusing our Web site: http://www.fis.ncsu.edu/hr/benefits/Wolflife/default.asp.

The state has also created a weight management program that may eventually be offered in other counties besides Wake. We will, of course, communicate when or if a program becomes available. Additionally, you can contact Weight Watchers in your area to start a program at work (our office does not coordinate anything related to this program).

I have copied Sheri Schwab and Steve Norris in the CALS personnel office so that they are also aware of your concern.

Thanks.