# Fat Tax

**URL:** <https://boards.straightdope.com/t/fat-tax/553852>\
**Category:** Great Debates\
**Created:** [September 15, 2010, 2:36pm UTC](https://boards.straightdope.com/t/fat-tax/553852 "2010-09-15T14:36:43Z")\
**Posts on this page:** 20\
**Page:** 3

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**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\
**Post date:** [September 15, 2010, 8:32pm UTC](https://boards.straightdope.com/t/fat-tax/553852/41 "2010-09-15T20:32:10Z")

</div>

> [@TriPolar](#):
>
> Some employees are being required to contribute more to the health insurace shared by all employees for totally arbitrary reasons. And the company is profiting from it, whether they apply the additional fee to the insurance costs of not. They might as well be allowed to charge employees a fee for belonging to certain religions or political parties.

No, smoking is not the same as religion. Get a grip.

> [@](#):
>
> In addition to that basic unfairness, and abuse of my tax dollars, there is absolutely no relationship between a specific BMI figure and health, or annual health care costs.

Tax dollars…?

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**Author:** ![Morgenstern](https://avatars.discourse-cdn.com/v4/letter/m/f9ae1b/32.png) [@Morgenstern](https://boards.straightdope.com/u/Morgenstern)\
**Post date:** [September 15, 2010, 8:35pm UTC](https://boards.straightdope.com/t/fat-tax/553852/42 "2010-09-15T20:35:42Z")

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Older workers clearly require more medical attention than the younger ones. Should they face a higher premium too due to their age?

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**Author:** ![DigitalC](https://avatars.discourse-cdn.com/v4/letter/d/ebca7d/32.png) [@DigitalC](https://boards.straightdope.com/u/DigitalC)\
**Post date:** [September 15, 2010, 8:40pm UTC](https://boards.straightdope.com/t/fat-tax/553852/43 "2010-09-15T20:40:02Z")

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Uh… yes?

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<div class="post-metadata">

**Author:** ![Skammer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skammer/32/143_2.png) [@Skammer](https://boards.straightdope.com/u/Skammer)\
**Post date:** [September 15, 2010, 8:44pm UTC](https://boards.straightdope.com/t/fat-tax/553852/44 "2010-09-15T20:44:57Z")

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> [@Spiff](#):
>
> Simple solution: Your company just needs to raise premiums on everyone, but then offer _discounts_ to non-smokers and those with BMI \<40. 😃

I am a Benefits Manager at a large corporation. And this is pretty much what we do.

Actually we go further than that. In our plan, the normal insurance copay is 70%. However, if you fill out a Health Risk Assessment and talk to a health coach or participate in our disease management program, you are eligible for an 80% copay.

Non-smokers get a premium discount ($25/month I think).

I’ve worked at companies that also gave discounts for pledging to wear your seatbelt or exercise 3x a week. (Of course these could not be enforced, it was done on the honor system).

Medical costs go up and up every year (10-12% for 2011). Companies have to get as creative as possible to keep the costs affordable for the company and for employees. Providing incentives for employees to make healthy choices is one way to do it.

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<div class="post-metadata">

**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\
**Post date:** [September 15, 2010, 8:45pm UTC](https://boards.straightdope.com/t/fat-tax/553852/45 "2010-09-15T20:45:43Z")

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> [@Morgenstern](#):
>
> Older workers clearly require more medical attention than the younger ones. Should they face a higher premium too due to their age?

> [@DigitalC](#):
>
> Uh… yes?

So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.

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<div class="post-metadata">

**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\
**Post date:** [September 15, 2010, 9:09pm UTC](https://boards.straightdope.com/t/fat-tax/553852/46 "2010-09-15T21:09:22Z")

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Death tends to be prejudiced against age. Don’t hate the playa, hate the game.

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<div class="post-metadata">

**Author:** ![treis](https://avatars.discourse-cdn.com/v4/letter/t/bc79bd/32.png) [@treis](https://boards.straightdope.com/u/treis)\
**Post date:** [September 15, 2010, 9:11pm UTC](https://boards.straightdope.com/t/fat-tax/553852/47 "2010-09-15T21:11:14Z")

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> [@Duckster](#):
>
> > [@theR](#):
> >
> > Duckster’s example of NFL player BMIs also seems bad. NFL players are notoriously prone to long-term and debilitating health problems like arthritis, excessive weight gain, sleep apnea, cardiovascular disease, and more. Being the size of NFL players and staying in shape after you retire seems extremely uncommon. From what I can tell, most players that stay in shape after retirement have to lose weight, not just keep exercising. All other things equal, a lighter NFL player should statistically be more likely to be healthy than a heavier NFL player. Some of these links have information about the health of NFL players. [http://judiciary.house.gov/issues/issues\_nfl.html](http://judiciary.house.gov/issues/issues_nfl.html)
> > 
> > The way a person stays fit matters, not just that they stay fit.
> 
> Why is it bad? The OP is stating their business will determine their employee’s health based on a BMI and nothing more. My post has nothing to do with long-term health issues of a particular profession and training program for that profession.
> 
> Taking the OPs comments at face value, everyone at their business will probably be asked to step up to the scale where they will be weighed and measured. Each will be assessed whether their BMI is above or below the mark. Above pays the fine. Below the mark does not. No mention of the overall fitness or health condition of an employee by a competent and qualified person appears to be part of the assessment. A current NFL player could just as easily stand in the employee queue and be assessed as a failure, even though they are, at that moment, probably in better heath condition than anyone else in the same line.
> 
> Unless all the employees are wusses, I can see a lawsuit coming out of this. BMI is junk science.

It’s not junk science, you just don’t understand how or why it’s used. Let’s start at the top, you posted [this link](http://www.npr.org/templates/story/story.php?storyId=106268439). Starting from #1:

> [@](#):
>
> 1. The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.
> 
> The BMI was introduced in the early 19th century by a Belgian named Lambert Adolphe Jacques Quetelet. He was a mathematician, not a physician. He produced the formula to give a quick and easy way to measure the degree of obesity of the general population to assist the government in allocating resources. In other words, it is a 200-year-old hack.

No shit. No one uses the BMI to measure fatness in a person. It is used as a proxy for fatness, and it is a fairly accurate one at that. If I say “someone has a BMI of 35”, no you can’t conclude that they are necessarily fat. But since 99%\* of people with a BMI of 35 are fat, it gives you a big honking clue. In this case, I can’t say there is a person with a BMI of 40 who isn’t fat, but I’d be shocked to find one.

\*I made this number up

> [@](#):
>
> 1. It is scientifically nonsensical.
> 
> There is no physiological reason to square a person’s height (Quetelet had to square the height to get a formula that matched the overall data. If you can’t fix the data, rig the formula!). Moreover, it ignores waist size, which is a clear indicator of obesity level

What? This is just bullshit. Ideal weight doesn’t increase linearly with height, so why should we expect the formula to just use height?

> [@](#):
>
> 1. It is physiologically wrong.
> 
> It makes no allowance for the relative proportions of bone, muscle and fat in the body. But bone is denser than muscle and twice as dense as fat, so a person with strong bones, good muscle tone and low fat will have a high BMI. Thus, athletes and fit, health-conscious movie stars who work out a lot tend to find themselves classified as overweight or even obese

No shit. BMI isn’t good for exceptions for the rule, but it is pretty accurate for normal people. No one who uses BMI is not aware of the fact pointed out here. Using it as an argument against BMI is just stupid.

> [@](#):
>
> 1. It gets the logic wrong.
> 
> The CDC says on its Web site that “the BMI is a reliable indicator of body fatness for people.” This is a fundamental error of logic. For example, if I tell you my birthday present is a bicycle, you can conclude that my present has wheels. That’s correct logic. But it does not work the other way round. If I tell you my birthday present has wheels, you cannot conclude I got a bicycle. I could have received a car. Because of how Quetelet came up with it, if a person is fat or obese, he or she will have a high BMI. But as with my birthday present, it doesn’t work the other way round. A high BMI does not mean an individual is even overweight, let alone obese. It could mean the person is fit and healthy, with very little fat.

This is just wrong and stupid logically, and ends up repeating the same argument from 3.

> [@](#):
>
> 1. It’s bad statistics.
> 
> Because the majority of people today (and in Quetelet’s time) lead fairly sedentary lives and are not particularly active, the formula tacitly assumes low muscle mass and high relative fat content. It applies moderately well when applied to such people because it was formulated by focusing on them. But it gives exactly the wrong answer for a large and significant section of the population, namely the lean, fit and healthy. Quetelet is also the person who came up with the idea of “the average man.” That’s a useful concept, but if you try to apply it to any one person, you come up with the absurdity of a person with 2.4 children. Averages measure entire populations and often don’t apply to individuals.

I don’t see how this is different from #3, so the answer is the same.

> [@](#):
>
> 1. It is lying by scientific authority.
> 
> Because the BMI is a single number between 1 and 100 (like a percentage) that comes from a mathematical formula, it carries an air of scientific authority. But it is mathematical snake oil.

This is just stupid. Anyone with an air of scientific authority uses BMI correctly. As a screening indicator and fairly accurate proxy for fatness. The only people that consider it mathematical snake oil are the ones that don’t understand how and why it is used.

> [@](#):
>
> 1. It suggests there are distinct categories of underweight, ideal, overweight and obese, with sharp boundaries that hinge on a decimal place.
> 
> That’s total nonsense.

What? This is just retarded. No one suggests that people with 24.9 BMIs are perfectly a-ok and people with 25.0 BMIs are fatties.

> [@](#):
>
> 1. It makes the more cynical members of society suspect that the medical insurance industry lobbies for the continued use of the BMI to keep their profits high.
> 
> Insurance companies sometimes charge higher premiums for people with a high BMI. Among such people are all those fit individuals with good bone and muscle and little fat, who will live long, healthy lives during which they will have to pay those greater premiums.

No they won’t because no insurance company is retarded enough to put the cut off where “fit individuals with good bone and muscle” will be lumped in with fat people.

> [@](#):
>
> 1. Continued reliance on the BMI means doctors don’t feel the need to use one of the more scientifically sound methods that are available to measure obesity levels.
> 
> Those alternatives cost a little bit more, but they give far more reliable results.

Generally speaking they don’t cost a little more, are more difficult to self report, and are less consistent from person to person. It takes a minute to measure and weigh someone, and everyone who performs that test will come up with the same result. Waist size, for example, is more difficult to repeat because not everyone will necessarily measure the waist at the same spot. Especially on fatter people.

It isn’t as though there is a vast BMI conspiracy. BMI is used because it performs its task well, is cheap, and is fast.

> [@](#):
>
> 1. It embarrasses the U.S.
> 
> It is embarrassing for one of the most scientifically, technologically and medicinally advanced nations in the world to base advice on how to prevent one of the leading causes of poor health and premature death (obesity) on a 200-year-old numerical hack developed by a mathematician who was not even an expert in what little was known about the human body back then.

Translation: I ran out of semi-legitimate arguments at 9 and had to just make up something.

> [@Duckster](#):
>
> Perhaps you might want to calculate the BMIs of the 1,600 athletic and very fit players of the National Football League. How many of them are honestly obese and unfit?

> [@Duckster](#):
>
> Why is it bad? The OP is stating their business will determine their employee’s health based on a BMI and nothing more. My post has nothing to do with long-term health issues of a particular profession and training program for that profession.
> 
> Taking the OPs comments at face value, everyone at their business will probably be asked to step up to the scale where they will be weighed and measured. Each will be assessed whether their BMI is above or below the mark. Above pays the fine. Below the mark does not. No mention of the overall fitness or health condition of an employee by a competent and qualified person appears to be part of the assessment. A current NFL player could just as easily stand in the employee queue and be assessed as a failure, even though they are, at that moment, probably in better heath condition than anyone else in the same line.
> 
> Unless all the employees are wusses, I can see a lawsuit coming out of this. BMI is junk science.

I took a quick look through the NFL combine results, and I saw 3 out of the several hundred players that had a BMI of 40 or over. The highest being 42.7, and he is most definitely and unequivocally fat. [link](http://www.google.com/imgres?imgurl=http://www.usposttoday.com/wp-content/uploads/2010/07/terrence-cody-weigh-in.jpg&imgrefurl=http://www.usposttoday.com/terrence-cody-has-failed-a-fitness-test/&usg=___cQD25UXtgFWQyVM5C4EbxiG30w=&h=640&w=471&sz=65&hl=en&start=0&sig2=XsOmnTNcO871K3kUgK3saw&zoom=1&tbnid=9c5kVyfX1b5i8M:&tbnh=130&tbnw=97&ei=ajSRTKiMHZHQjAeWsLzxCw&prev=/images%3Fq%3Dterrence%2Bcody%26um%3D1%26hl%3Den%26safe%3Doff%26client%3Dubuntu%26sa%3DX%26channel%3Dfs%26biw%3D1024%26bih%3D398%26tbs%3Disch:10%2C1&um=1&itbs=1&iact=hc&vpx=228&vpy=45&dur=1593&hovh=262&hovw=193&tx=104&ty=279&oei=ajSRTKiMHZHQjAeWsLzxCw&esq=1&page=1&ndsp=13&ved=1t:429,r:8,s:0&biw=1024&bih=398).

Insurance is based on easily measurable, repeatable, and identifiable numbers, not on expensive, difficult to measure, and not perfectly repeatable numbers. This is why smokers are docked for being smokers without a lung examination. And it’s why old people are docked for being old, and men for being men, and whatever other factor comes into play. There’s nothing wrong with using BMI as another factor, since it has been highly correlated with a plethora of health problems.

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<div class="post-metadata">

**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\
**Post date:** [September 15, 2010, 9:25pm UTC](https://boards.straightdope.com/t/fat-tax/553852/48 "2010-09-15T21:25:32Z")

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> [@](#):
>
> 1. It gets the logic wrong.
> 
> The CDC says on its Web site that “the BMI is a reliable indicator of body fatness for people.” This is a fundamental error of logic. For example, if I tell you my birthday present is a bicycle, you can conclude that my present has wheels. That’s correct logic. But it does not work the other way round. If I tell you my birthday present has wheels, you cannot conclude I got a bicycle. I could have received a car. Because of how Quetelet came up with it, if a person is fat or obese, he or she will have a high BMI. But as with my birthday present, it doesn’t work the other way round. A high BMI does not mean an individual is even overweight, let alone obese. It could mean the person is fit and healthy, with very little fat.

I’m not going to say that BMI is a great tool – of course it has very sharp limits – but this guy isn’t even quoting the CDC correctly.

The CDC’s web site says, "[Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.](http://www.cdc.gov/healthyweight/assessing/bmi/)

The word “most” is conveniently left out, and the whole mention that it is only a screening tool is not even mentioned.

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<div class="post-metadata">

**Author:** ![emacknight](https://avatars.discourse-cdn.com/v4/letter/e/3ec8ea/32.png) [@emacknight](https://boards.straightdope.com/u/emacknight)\
**Post date:** [September 15, 2010, 9:29pm UTC](https://boards.straightdope.com/t/fat-tax/553852/49 "2010-09-15T21:29:49Z")

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It’s been said a few times and obviously ignored: A BMI over 40 is seriously fucking fat. We’re not talking about a little pudgy, or the bullshit about Lance Armstrong. We’re talking morbidly obese.

I even doubt many NFL players would fall into this category. But even if a 5’ 11" man was over 290lb of muscle, there is a good chance he’s using substances that are also adversely damaging his health.

In short, BMI works just fine when used to measure morbidly obese.

But on a personal note, women of child bearing years cost waaaaaaay more. Good luck touching that one.

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<div class="post-metadata">

**Author:** ![CurtC](https://avatars.discourse-cdn.com/v4/letter/c/ce73a5/32.png) [@CurtC](https://boards.straightdope.com/u/CurtC)\
**Post date:** [September 15, 2010, 9:46pm UTC](https://boards.straightdope.com/t/fat-tax/553852/50 "2010-09-15T21:46:35Z")

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> [@Der\_Trihs](#):
>
> So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.

Your idea of insurance is different from mine apparently. To me, insurance is simply a way to avoid the risk of a catastrophic (or at least unpleasant) expense by estimating the risk and paying someone else to assume it.

If you’re wanting to give everyone a consistent rate regardless of the risk to the insurer, well, that’s a social program, not insurance.

Health care coverage started out in this country as plain insurance, but it’s been moving more towards the social program model. At this point it’s still primarily insurance, so you shouldn’t be surprised to hear people saying it’s OK to charge higher-risk people more. That’s just what insurance _is_.

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<div class="post-metadata">

**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\
**Post date:** [September 15, 2010, 9:53pm UTC](https://boards.straightdope.com/t/fat-tax/553852/51 "2010-09-15T21:53:29Z")

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> [@Ravenman](#):
>
> > [@TriPolar](#):
> >
> > Some employees are being required to contribute more to the health insurace shared by all employees for totally arbitrary reasons. And the company is profiting from it, whether they apply the additional fee to the insurance costs of not. They might as well be allowed to charge employees a fee for belonging to certain religions or political parties.
> 
> No, smoking is not the same as religion. Get a grip.

[/quote]

Neither smoking nor religion have anything to do with this fee. Smoking and BMI are as arbitrary as religion would be.

> [@](#):
>
> In addition to that basic unfairness, and abuse of my tax dollars, there is absolutely no relationship between a specific BMI figure and health, or annual health care costs.

Tax dollars…?  
[/quote]

Businesses do not pay taxes on the insurance costs. This is the whole basis of the health insurance business and the company health plans. Tax exemptions decrease tax revenue, and increase the taxes we pay or the debt we owe. The only reason the current system works is that the cost of health insurance for business is not deductible if the benefits are not available to all employees. Before those tax laws were implemented, businesses had been deducting the costs of health care benefits for executives and other privileged employees without offering the benefits to other employees. I haven’t looked into the details of the tax code in over a dozen years, so I don’t know the current details, nor what the recent health care bill has done, but I have little reason to believe it will make this system fair.

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<div class="post-metadata">

**Author:** ![theR](https://avatars.discourse-cdn.com/v4/letter/t/977dab/32.png) [@theR](https://boards.straightdope.com/u/theR)\
**Post date:** [September 15, 2010, 10:21pm UTC](https://boards.straightdope.com/t/fat-tax/553852/52 "2010-09-15T22:21:45Z")

</div>

> [@Duckster](#):
>
> > [@theR](#):
> >
> > Duckster’s example of NFL player BMIs also seems bad. NFL players are notoriously prone to long-term and debilitating health problems like arthritis, excessive weight gain, sleep apnea, cardiovascular disease, and more. Being the size of NFL players and staying in shape after you retire seems extremely uncommon. From what I can tell, most players that stay in shape after retirement have to lose weight, not just keep exercising. All other things equal, a lighter NFL player should statistically be more likely to be healthy than a heavier NFL player. Some of these links have information about the health of NFL players. [http://judiciary.house.gov/issues/issues\_nfl.html](http://judiciary.house.gov/issues/issues_nfl.html)
> > 
> > The way a person stays fit matters, not just that they stay fit.
> 
> Why is it bad? The OP is stating their business will determine their employee’s health based on a BMI and nothing more. My post has nothing to do with long-term health issues of a particular profession and training program for that profession.
> 
> Taking the OPs comments at face value, everyone at their business will probably be asked to step up to the scale where they will be weighed and measured. Each will be assessed whether their BMI is above or below the mark. Above pays the fine. Below the mark does not. No mention of the overall fitness or health condition of an employee by a competent and qualified person appears to be part of the assessment. A current NFL player could just as easily stand in the employee queue and be assessed as a failure, even though they are, at that moment, probably in better heath condition than anyone else in the same line.
> 
> Unless all the employees are wusses, I can see a lawsuit coming out of this. BMI is junk science.

I’m not saying I agree with the employer’s policy. I’m just saying that, all things being equal, a skinnier person is statistically more likely to be healthy than a heavier person. A current NFL player that is 6’ and 250 pounds is much more likely to have health problems than if that same player is 6’ and 170 pounds. I guess I could be wrong, but the added weight is almost never a benefit regardless of the fitness of the individual.

All that said, BMI is meant as a statistical tool as far as I know. It is not meant to judge fitness of individuals, but rather populations. For individuals, it serves as a way for a quick estimate of health. If an insurance company wants to charge different rates based on health, BMI is a poor way to measure an individual’s health.

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<div class="post-metadata">

**Author:** ![BrotherCadfael](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@BrotherCadfael](https://boards.straightdope.com/u/BrotherCadfael)\
**Post date:** [September 15, 2010, 10:29pm UTC](https://boards.straightdope.com/t/fat-tax/553852/53 "2010-09-15T22:29:05Z")

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> [@Spiff](#):
>
> Simple solution: Your company just needs to raise premiums on everyone, but then offer _discounts_ to non-smokers and those with BMI \<40. 😃

While it sounds silly (because it comes to exactly the same thing), this is the correct solution.

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<div class="post-metadata">

**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\
**Post date:** [September 15, 2010, 10:44pm UTC](https://boards.straightdope.com/t/fat-tax/553852/54 "2010-09-15T22:44:14Z")

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> [@Der\_Trihs](#):
>
> So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.

> [@Ravenman](#):
>
> Death tends to be prejudiced against age. Don’t hate the playa, hate the game.

> [@CurtC](#):
>
> Your idea of insurance is different from mine apparently. To me, insurance is simply a way to avoid the risk of a catastrophic (or at least unpleasant) expense by estimating the risk and paying someone else to assume it.
> 
> If you’re wanting to give everyone a consistent rate regardless of the risk to the insurer, well, that’s a social program, not insurance.
> 
> Health care coverage started out in this country as plain insurance, but it’s been moving more towards the social program model. At this point it’s still primarily insurance, so you shouldn’t be surprised to hear people saying it’s OK to charge higher-risk people more. That’s just what insurance _is_.

Except that people from the start in this thread were saying that charging more was OK because people could just eat less or stop smoking. Suddenly, when matters people can’t control come up it’s all about risk assessment. As far as I can tell, the real, unspoken standard is “whatever screws the employees the most and costs the employer the least is right, as long as you don’t admit that’s what you are doing”.

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<div class="post-metadata">

**Author:** ![elfkin477](https://avatars.discourse-cdn.com/v4/letter/e/a9a28c/32.png) [@elfkin477](https://boards.straightdope.com/u/elfkin477)\
**Post date:** [September 16, 2010, 12:22am UTC](https://boards.straightdope.com/t/fat-tax/553852/55 "2010-09-16T00:22:47Z")

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BMI isn’t a perfect measurement for muscular people, but it’s not so very much off that the bar being set at **40** is going to unjustly penalize people who are merely fit. I’m a lot heavier than most women with my measurements because a fair amount of my weight is muscle. According to my BMI my body fat is 26.5% and according to Height-to-Waist it’s 20%. The discrepancy isn’t nearly big enough to make me believe that it’s possible for a non-body builder who isn’t legitimately overweight to have a BMI 15 points higher than someone at the same height with a normal BMI.

> [@emacknight](#):
>
> But on a personal note, women of child bearing years cost waaaaaaay more. Good luck touching that one.

I wouldn’t be so sure it’s waaaaaaay more. Most women in the US only have two kids and according to [this study](http://www.aolhealth.com/2010/09/13/c-sections-more-common-at-for-profit-hospitals/?icid=main%7Cmain%7Cdl10%7Csec3_lnk3%7C170595) about the profits to hospitals for c-sections vs natural births, you’re only talking about the hospital making $2,500-5,000 off each woman for two births. I suppose it’s possible that the costs in CA are freakishly low, but I doubt it. And besides, don’t men 18-40 generally have higher rates of injury through various activities like car accidents, fighting, and work accidents than women of the same age range?

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<div class="post-metadata">

**Author:** ![DigitalC](https://avatars.discourse-cdn.com/v4/letter/d/ebca7d/32.png) [@DigitalC](https://boards.straightdope.com/u/DigitalC)\
**Post date:** [September 16, 2010, 12:36am UTC](https://boards.straightdope.com/t/fat-tax/553852/56 "2010-09-16T00:36:24Z")

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> [@Der\_Trihs](#):
>
> > [@Morgenstern](#):
> >
> > Older workers clearly require more medical attention than the younger ones. Should they face a higher premium too due to their age?
> 
> > [@DigitalC](#):
> >
> > Uh… yes?
> 
> So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.

Should people should be punished for being younger when buying auto insurance? That’s how the freaking industry works, get over it.

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<div class="post-metadata">

**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\
**Post date:** [September 16, 2010, 12:38am UTC](https://boards.straightdope.com/t/fat-tax/553852/57 "2010-09-16T00:38:34Z")

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> [@DigitalC](#):
>
> > [@Der\_Trihs](#):
> >
> > So they should be punished for being older? I suppose you think if they were just determined enough they wouldn’t age.
> 
> Should people should be punished for being younger when buying auto insurance? That’s how the freaking industry works, get over it.

Then people shouldn’t try to justify it by blaming the people having to pay more.

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<div class="post-metadata">

**Author:** ![Duckster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/duckster/32/1244_2.png) [@Duckster](https://boards.straightdope.com/u/Duckster)\
**Post date:** [September 16, 2010, 1:06am UTC](https://boards.straightdope.com/t/fat-tax/553852/58 "2010-09-16T01:06:50Z")

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Getting back to the OP if a business is making a pass/fail medical decision based upon non-medical professionals using a controversial and single junk science number, and not familiar with the medical and health conditions of each employee, woe be that business.

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**Author:** ![treis](https://avatars.discourse-cdn.com/v4/letter/t/bc79bd/32.png) [@treis](https://boards.straightdope.com/u/treis)\
**Post date:** [September 16, 2010, 1:09am UTC](https://boards.straightdope.com/t/fat-tax/553852/59 "2010-09-16T01:09:58Z")

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> [@Duckster](#):
>
> Getting back to the OP if a business is making a pass/fail medical decision based upon non-medical professionals using a controversial and single junk science number, and not familiar with the medical and health conditions of each employee, woe be that business.

So, you’re planning on ignoring the long posts demonstrating your position to be incorrect and just repost the same lame arguments?

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<div class="post-metadata">

**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\
**Post date:** [September 16, 2010, 1:16am UTC](https://boards.straightdope.com/t/fat-tax/553852/60 "2010-09-16T01:16:48Z")

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> [@treis](#):
>
> > [@Duckster](#):
> >
> > Getting back to the OP if a business is making a pass/fail medical decision based upon non-medical professionals using a controversial and single junk science number, and not familiar with the medical and health conditions of each employee, woe be that business.
> 
> So, you’re planning on ignoring the long posts demonstrating your position to be incorrect and just repost the same lame arguments?

treis, you are adding more illogic to Duckster’s statement. The OP made it clear that this is not a medical decision. It is a decision by the business to improve their bottom line by arbitrarily charging employees a fee for nothing of value in return. The companies health insurance costs are unaffected by this fee in any way.

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