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Arizona Wants to Punish Bad Health Habits

Posted on Apr 3, 2011
Wikimedia Commons

Budget-strapped Arizona is looking for new ways to pinch pennies. Now the state’s Medicaid agency is proposing to smack smokers and diabetes patients who ignore doctors’ orders with special $50 annual fees. —JCL

The New York Times:

Arizona’s Medicaid program, criticized last year when it halted some organ transplants to save money, has come up with another cost-saving measure that has people talking.

Following the lead of some private health plans, which charge premiums to members who smoke or engage in other unhealthy behavior, Arizona’s Health Care Cost Containment System has proposed charging smokers $50 a year and applying a similar fee to diabetes patients who do not follow their doctor’s orders to lose weight, said Monica Coury, a spokeswoman for the state Medicaid agency.

“This is an annual fee that says to consumers, ‘Hey, we’re not going to prevent you from smoking, but you have to put a little bit more into the system because it costs us more,’ ” Ms. Coury said, citing a 2006 survey that showed that 46 percent of the patients in the state’s Medicaid program were smokers.

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By sarum, April 17, 2011 at 3:26 am Link to this comment

Ummmm, when you copy and paste other people’s articles do you not have a legal obligation to also post a link to the original source and give credit where credit is due?

Then again, how these postings relate to the OP article is beyond my comprehension as no direct correlation is either expressed or implied.

If this is the level of dialogue, spamming with unrelated material, I’m so out of here.

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By Nostraden62, April 15, 2011 at 6:03 am Link to this comment

One of the Largest Alcohol consuming states Say’s

One of the more dire consequences of this increase in
drinking among children still in elementary school is
the that it has a greater effect on cognitive
development at this young age. Students who use
alcohol remember much less of their academic work
than those who do not use alcohol. Also, statistics
clearly show that the younger a child is when he or
she begins drinking, the more likely they are to
develop problems with alcohol as adults. According to
a report in the Journal of Substance Abuse, more than
40% of individuals who start drinking before the age
of 13 will develop alcohol abuse problems later in
life (Grant, BF, & Dawson, DA. 9:103-110, 1997).

The cost and consequences of alcoholism and drug
dependence place an enormous burden on American
society. As the nation’s number one health problem,
addiction strains the health care system, the
economy, harms family life and threatens public

Substance abuse crosses all societal boundaries,
affects both genders, every ethnic group, and people
in every tax bracket. Scientific documentation
defines alcoholism and drug dependence as a disease
that has roots in both genetic susceptibility and
personal behavior.


There are more deaths and disabilities each year in
the U.S. from substance abuse than from any other
cause. 1

About 18 million Americans have alcohol problems;
about 5 to 6 million Americans have drug problems. 2

More than half of all adults have a family history of
alcoholism or problem drinking. 3

More than nine million children live with a parent
dependent on alcohol and/or illicit drugs. 4


One-quarter of all emergency room admissions, one-
third of all suicides, and more than half of all
homicides and incidents of domestic violence are
alcohol-related. 5

Heavy drinking contributes to illness in each of the
top three causes of death: heart disease, cancer and
stroke. 6

Almost half of all traffic fatalities are alcohol-
related. 7

Between 48% and 64% of people who die in fires have
blood alcohol levels indicating intoxication. 8

Fetal alcohol syndrome is the leading known cause of
mental retardation.

Alcohol and drug abuse costs the American economy an
estimated $276 billion per year in lost productivity,
health care expenditures, crime, motor vehicle
crashes and other conditions. 10

Untreated addiction is more expensive than heart
disease, diabetes and cancer combined. 11

Every American adult pays nearly $1,000 per year for
the damages of addiction.
Well now i would venture to say it is ALCOHOL….Oh
Yes no doubt..The hiiden Truth because Alcohol is

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By Nostraden62, April 15, 2011 at 5:58 am Link to this comment

SMOKERS ???????????????????????

2002, U.S. alcoholism statistics reported that 2.6
million binge drinkers were between the ages of 12
and 17.

In the United States, almost three times as many men
(9.8 million) as women (3.9 million) abuse alcohol or
are alcohol-dependent.

56% of students in grades 5 through 12 say that
alcohol advertising encourages them to drink.

Alcoholism and alcohol abuse are the third leading
cause of the preventable deaths in the United States.

Statistics reveal that for American employers,
alcohol abuse accounts for roughly 67% of total
number of substance abuse complaints.

Children who are drinking alcohol by 7th grade are
more likely to report academic problems, substance
use, and delinquent behavior in both middle school
and high school.

Approximately 14 million people in the United States
are addicted to alcohol or abuse alcohol.

Alcoholics spend four times the amount of time in a
hospital as non-drinkers, mostly from drinking-
related injuries.

65 people each day die on our highways due to

It is estimated that over 3 million teens between the
ages of 14 and 17 in the United States today are

Approximately 14 million Americans — about 7.4
percent of the adult population — meet the diagnostic
criteria for alcohol abuse or alcoholism.

Girls are beginning to drink at younger ages. In the
1960s, 7% of 10- to 14-year-old females used alcohol;
by the early 1990’s, that figure had risen to 31%.

More than seven percent of the population ages 18
years and older—nearly 13.8 million Americans—
have problems with drinking, including 8.1 million
people who suffer from alcoholism.

In 1988, 25,000 Americans were killed in auto
accidents involving alcohol. More than 500,000 were

Studies have shown that the drinking patterns of
employed women are different from those of women not
employed outside the home, with less abstinence,
increased consumption and greater frequency of
drinking occasions observed among employed women.

Long-term, heavy alcohol use is the leading cause of
illness and death from liver disease in the U.S.
According to alcoholism and alcohol abuse statistics,
the number of people in the U.S. who have a “drinking
problem,” meaning that they engage in abusive
drinking or are alcohol dependent is clearly off the
charts. These statistics on alcohol abuse and
alcoholism statistics strongly

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By Nostraden62, April 15, 2011 at 5:56 am Link to this comment

How Drinking Hurts Women
According to U.S. Dietary Guidelines, women should
have no more than one alcoholic drink a day – the
equivalent of 12 ounces of beer, 5 ounces of wine or
1.5 ounces of 80-proof distilled spirits.

So while you and your boyfriend can both have a
martini, the drink will take a greater toll on your
body than his.

Men are 2-3 more likely to abuse alcohol than women
are, says David Sack, M.D., CEO of Promises Treatment
Centers in the Los Angeles area. “But women
alcoholics are significantly more likely to have
medical complications and develop them earlier in
their addictions.”

f a woman drinks the same amount as a man, she’s more
likely to develop liver-related disease, says Sharon
C. Wilsnack, Ph.D., a clinical psychologist
specializing in substance abuse at the University of
North Dakota School of Medicine and Health Sciences
in Grand Forks.

Although the lower water content of women’s bodies
may be to blame, experts also have two other

They break down acetaldehyde – a toxic byproduct of
alcohol – more slowly, which means it sticks around
longer and damages the liver.
Women’s higher levels of estrogen make some liver
cells more sensitive to alcohol’s toxic effect.

Women drinkers are also more likely to get stomach
ulcers, which can lead to infection, bleeding or even

2. Cancer
The ongoing British Million Woman Study found that as
little as one alcoholic drink a day may increase
their risk for cancers of the liver, rectum, mouth,
throat and esophagus.

That study and others have found a link between
alcohol consumption and breast cancer too. The more
you drink, the higher your risk, Wilsnack says. “The
unanswered question is what level of consumption is
really a significant risk?” she says.

So should light and moderate drinkers give up their
evening glass of Cabernet Sauvignon, especially when
red wine may have some benefits?

It depends on the woman. “What are the possible
benefits?” Wilsnack asks. “Do those offset the risks
for breast cancer?”
3. Heart Disease
Resveratrol, a compound in the skin of red grapes and
plentiful in red wine, is associated with a reduced
risk of heart disease.

But drink more than the recommended one glass per day
and you reverse the heart-healthy benefit.

“Chronic heavy drinking is a leading cause of
cardiovascular disease,” Eskapa says.

Excessive drinkers also face:
A higher risk of damaging heart muscle – and that
occurs earlier in drinking women than in men
Higher triglyceride (fat) levels in the blood
High blood pressure
Heart failure
Cardiac arrhythmia (irregular heartbeats)
Death from heart attacks
Anemia (a shortage of red blood cells, which carry
oxygen to the body)

4. Brain Damage
Women drinkers are more vulnerable to brain damage,
Eskapa says.

Long-term alcohol abuse destroys the cerebellum, the
brain region responsible for sensory perception,
coordination and motor control, according to the
Women’s Heart Foundation.

They may face irreversible damage resulting in slowed
thinking, an unsteady walk and slurred speech.
“Most alcoholics have some loss of mental function,
reduced brain size and changes in the function of the
brain cells,” Eskapa says.

5. Violence
Alcohol doesn’t cause violence, but it can make a
drunk woman more vulnerable to physical abuse because
she can miss danger signs.

“Victimization is really a huge issue for drinking
women,” Wilsnack says. “Sexual assault is also a

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By sarum, April 5, 2011 at 8:32 pm Link to this comment

Amen to that!  I wonder how many people are forced to vent and express their frustration on comment sections such as this - who has time to read it all, except for maybe the Magic Lantern? 

The older I gets the stupider I feels.

Singularity?  Reptilians?  Illuminati?  Poo Poo all you want but something has been seriously wrong for a very long time and now the gloves are off and the dripping claws are exposed and we are trying to figure it out.  The enemy is us theory no longer holds water.

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MarthaA's avatar

By MarthaA, April 5, 2011 at 4:00 pm Link to this comment

Blackspeare, April 5 at 3:20 pm,

Taxes should pay for these organizations, with the people getting
the most benefit from the organization paying the larger amount
of taxes, which is the wealthy.  Organizations that benefit all
people should not be allowed to be relegated only to the wealthy,
like the police department.

Police defend the law, the law is made by corporations and the
wealthy, police are NOT to protect and serve the average person,
they are only to defend the law; currently the average person has
no part whatsoever in the making or enforcing of legislated law
and order; therefore the wealthy should pay the majority of the
taxes, not the unrepresented average person.  And, unlike Japan,
or any other civilized society, in the USA after Katrina, police were
killing people to protect industry, as if the victims trying to survive
after that catastrophe were a nuisance, so that makes it really
plain who the police and the courts of the government are
required to protect.  Also, the Katrina catastrophe made it plain
that the police in N.O. were totally supported by their tickets and
fines.  Without taxes; the fines, fees and permits will enlarge,
because the wealthy will never get rid of their police. 

If the Fire Department isn’t supported they do not protect your
property.  Average people haven’t the money to pay their bills and
support the fire department, therefore their property goes
unprotected; the fire department should be supported by State
taxes, so that the Fire Department is available to all.

Private ambulances charge exorbitant amounts of which the
average person is unable to afford and also should be paid
through State taxes or the Health Department.

All these services benefit the wealthy who pay NO TAXES and
these services are pretty much gone already for the average

The wealthy have no problem denying the average person, but
when it’s bail out time, the average person who makes little
money gets put on the hook for the bail outs of the wealthy, so
that the wealthy can continue taking advantage of the average

If this is to remain a civilized society, it is time for the wealthy
millionaires and billionaires to pay taxes based on a ratio of their
profits and earnings, instead of only the average person’s meager

The United States needs to switch from Private Capitalism to
Socialized Capitalism and all these problems would work out much
better.  The Bank of North Dakota is the example of socialized
capitalism, that should be enacted all over the United States.

The Bank of North Dakota is the only state-owned bank in the
United States, established by legislative action in 1919, to
promote agriculture, commerce and industry in North Dakota. The
Bank acts as a funding resource in partnership with other financial
institutions, economic development groups and guaranty
agencies. The Bank of North Dakota has four established business
areas: Student Loans, Lending Services, Treasury Services and
Banking Services.

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Blackspeare's avatar

By Blackspeare, April 5, 2011 at 11:20 am Link to this comment

The USA is becoming a pay-as-you-go society.  Every service provided by the public sector will be provided at a cost.  That will include police activities, fire department services, ambulance assistance, etc.  As long as such billing is done with a commiserate drop in taxes——no problem.

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By ronjeremy, April 5, 2011 at 8:59 am Link to this comment
(Unregistered commenter)

smoking is bad for you, of course.  however, why do most of the kids that live
around refineries have breathing problems (such as asthma), yet the courts always
say the factories have nothing to do with the health conditions of the children? 
when was the last time that kind of thing was taken to court, by the way?  oh well,
governments love to control plants.  that seems to be the way they make money

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By sarum, April 5, 2011 at 2:47 am Link to this comment

OK Try again - LIKE zonth zonth - truth.

Governor Brewer would do well to fine insurance companies who change their formularies mid-contract forcing the patient to do without the Rx they need because it suddenly became unaffordable.

Governor Brewer should fine Bank of America for every time it tortures seniors and disabled by allowing bogus companies into their accounts to create a cascade of NSF fees, often to the tune of $500 per month.  Yeah!  Torture the people who can least afford it and have the least resources to fight it.

Governor Brewer should take a look around my neighborhood and see all the franchises that are owned from people around the planet while no US citizens were considered worthy of the opportunity and fine all these companies that gave business opportunities to foreigners and not citizens first. 

Governor Brewer should put the courts back in the neighborhoods - not so far out of town that only the rich and big business can afford to go to their own court date.  The courts need to be accessible - not OUT OF TOWN.  Talk about collusion of the haves against the have nots!  If anybody ever thought anything was fair or that they even had a chance the mere location of the courts proves who they serve and it ain’t the people!

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MarthaA's avatar

By MarthaA, April 4, 2011 at 9:21 pm Link to this comment

Fascist oppression and tyranny.

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By sarum, April 4, 2011 at 8:37 pm Link to this comment
(Unregistered commenter)

January 2010 my husbands insulin went from $3.50 to near to $350 with absolutely no warning.  His Medicaid plan instituted a new extremely high deductible and the donut hole combined to create this cost.  There is only 1 insulin that works for him.  We cannot afford to move - we live in the cheapest place we could find anyway and there was no way to come up with the money.  We searched high and low for answers, even following recommendations of TV personalities, trying offshore options with gifted monies and those programs where the pharmaceutical companies help people who cannot afford their Rx?  Social Security recipients are too wealthy to qualify.  Never mind that neither of our Social Security payments are enough to house us anywhere - we are too rich for any kind of aid.

There is only 1 insulin product that helps my husband’s diabetes.  All the other products fail to lower his sugar and they also make him fat.  He has even donated his body to research of experimental products in hopes of finding his answer.  So in 2010 my husband experienced patient dumping because no doctor wanted him if he could not get his blood sugar down and nobody could help us afford the only insulin that does it for him.

After 10 months without proper insulin my husband is now very very ill.  He is very sick and in excruciating pain but now he gets to pay a fee to the state for this criminality?

As far as people smoking. Smoking somehow alleviates tension from physical and emotional pain and suffering.  So that’s right, punish those who are already suffering.  I agree that smoking is bad but a fine is not a true answer - it is just piling on the hate and permitting the hate to exist. True healthcare reform - omg I could write a book about this.

Wanna fine me for being fat?  Hey, there are neuro-endocrine tumors, often resulting from taking pharmaceuticals, that cause fatness.  Nope, the profiteers and their lawyers lying that they are doctors do not want you to know this.  Now a dog or a horse can have this same problem and receive instant diagnosis and treatment but a human gets routinely insulted, marginalized and often dies from lack of diagnosis.  These are called “rare disorders” for humans but a dog doctor instantly knows it as not so rare.  So in addition to all the pain and suffering I have experienced in my own mind wondering what is wrong and not getting answers from your criminal medical system and being marginalized and insulted and discredited everywhere I went you now want me to pay a fine for it?

I can not.  I will not.  Governor Brewer is creating a criminal in me with this law.

The governor needs better ethics advisors.

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By purplewolf, April 4, 2011 at 5:17 pm Link to this comment

So Jan Brewer, the GOP side of smaller government has come up with some brilliant and creative ways to make money. Why don’t we start with cold and indifferent people, like her, and fine them $100,000.00 a year for every cruel and mean things they do.

As for the obesity thing. True some people eat the wrong types of food or over eat and cause their obesity.Then you come to the obese who eat a balanced diet, but far fewer calories than needed on a daily basis and then the human body-especially the female ones-think food is scarce and store every calorie as the body thinks food is scarce and also slows down the metabolism rate in many people down to zero. So that mo matter how much they do on a physical level, they will fail to loose weight and actually keep it.

Another is the fact that poor people have more of a weight problem is because they cannot afford a proper diet as food prices are high and are going higher. If everyone could afford to eat a proper diet, we would see a lot less obesity.Ask any dietitian if you don’t believe this.

Also, in this country it used to be rich men and poor women who weighted the most. Now it is both genders, rich or poor that show a higher rate.

Every wonder if those mega corps that get all the tax handouts have poisoned our foods to cause many of the problems we see today and also have their hands in the money pots from the pharmaceutical side also.This has been discussed on several other news sites geared more to health.

Jan Brewer, the future of American politics???

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By samosamo, April 4, 2011 at 2:51 pm Link to this comment


As usual ‘force’ is applied to achieve an end. I know this is just
too hard for so many to accept, but as one commenter stated,
exhaust fumes are really the cause of a lot of these health
problem, all exhausts but more particular, diesel fumes. I know
this seems outrageous but only because it vilifies people’s
favorite object, the ‘internal combustion engine’.

Improve heath by creating and designating bicycle routes in
towns and all around. Use public transportation and electric
vehicles. If force is to be used, regulate the sell of autos spewing
out exhaust. It does require the proper use of force and geez it
can be made to being in revenue from those noncompliant and
give tax breaks to those who do comply.

But this is just another jaded bunch of crap that too many just
won’t adhere or try to do as it is tantamount to them of having
their vehicles take from them.

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By Joseph, April 4, 2011 at 12:46 pm Link to this comment
(Unregistered commenter)

Arizona should slap a fee on the parents of murders who live in state prisons.  Base the fee cost upon income and position in the state government.

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zonth_zonth's avatar

By zonth_zonth, April 4, 2011 at 9:25 am Link to this comment

How about taxing people for stupidity?

Taxing smokers and fat people seems reasonable.  If it alters their behvavior it may than indirectly alter corporate profit. 

What a funny state of affairs it will be. The system of capitalism and consumerism places demands on individuals to buy and degrade themselves for the perpetuation of the system, however now consideration is given to penalize the consumer if they succumb to the secondary personal ill effects that are byproducts from what the system demands.

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By John G, April 4, 2011 at 1:53 am Link to this comment
(Unregistered commenter)

DHFabian there are so many things wrong with your statement (defense) about smoking, I hardly know where to begin. Smoking is the leading cause of heart disease, not just “breathing related” illness. You are totally wrong: it is the cause of a whole host of diseases and is one of the major contributors to health care costs. “Smokers are an ideal target because there are so few”—that is nonsense. The latest statistics show that 20% of the Arizonans smokes, and that’s supposedly the lowest per capita rate in the U.S. I suspect that is an under counting, but still it’s a heck of a lot of smokers! You must be a smoker, so you’re putting up a phony argument.

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By John G, April 4, 2011 at 1:43 am Link to this comment
(Unregistered commenter)

Surveys show that Arizona has the lowest rate of smoking per capita, but I don’t believe it. I live here in Phoenix, and I think a lot of people are lying. I walk around my neighborhood every evening, and the tobacco smoke is prevalent, especially among the blue collar folks (I live amongst them). Also, I go to the supermarket and see MANY obese people filling their baskets with junk food while they ride around on electric carts. It’s practically an epidemic.

People mess up their health with bad lifestyle choices, then they depend on Medicaid to keep them going. Smokers typically spend many times the $50 a year penalty on their habit, and I can just imagine the cost of all those unhealthy foods that some diabetic people are consuming.

I could say the same about people on Welfare who buy and use pot or meth or other recreational drugs, and I have seen some of them around here, too.

I’d like to hear one good reason why this is not a reasonable and good policy decision…instead of just knee-jerk liberal reactions. Why shouldn’t people be held accountable, and why is this tiny disincentive a bad thing? Maybe some of them would actually heed their doctor’s advice in order to save the $50.

I consider myself a strong and proud liberal. I deplore the faulty (actually criminal) policy of tax breaks to the corporations and the wealthy at the expense of programs for the disadvantaged, but IMO this issue doesn’t fit that pattern of systematic dehumanization.

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By DHFabian, April 4, 2011 at 1:24 am Link to this comment

If we want to punish people for disobeying health dictates, the leading cause of premature death in the US is heart failure, primarily the result of obesity.  Let’s begin imposing significant fines on everyone who is more than 10 pounds overweight.

Massive taxation is already imposed on tobacco, well beyond taxes on any other item. This is, in fact, a fine on every cigaret. Most of the cost of an ounce of tobacco is in taxes, and to my knowledge, this doesn’t hold true for any other product.  Granted, no other product has been subjected to scapegoatism to this degree except, possibly, marijuana.Smoking simply is not a leading health care cost.  Very few smoke, and very few smokers will develop a breathing-related disease as a result. The leading cause of breathing-related disease today is, in fact, traffic fumes.  The most carcinogenic type of smoke is the kind that contains oil particles (cars, not cigarets), and this type of smoke is prevalent. If a smoker develops a breathing-related disease, there is no way to medically determine if it was caused by smoking or other air pollution. Smokers are an ideal target because there are so few, but if our goal was to reduce lung cancer, etc., we would disregard the few who smoke and focus on reducing the smoke caused by traffic. Not only does this smoke clog air sacs in our lungs, but it is actually killing off forests, taking us closer to an environmental collapse. There is little correlation between rates of smoking and rates of breathing-related disease; however, as air quality controls were relaxed since the ‘80s, breathing-related disease has increased (even though smoking rates have decreased). It is time to put an additional health tax on every gallon of gas sold.

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By Alan8, April 3, 2011 at 10:30 pm Link to this comment
(Unregistered commenter)

It’s hard to get worked up over this.  They’ve done worse.

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By felicity, April 3, 2011 at 4:05 pm Link to this comment

I think Arizona should take a page from Bachman’s hate
campaign against low-energy light bulbs and slap a
special, excise tax on them - maybe 20%?

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By TDoff, April 3, 2011 at 3:16 pm Link to this comment

Next thing you know, Governor Jan Brewer of Arizona will be fining all AZ republican politicians $100 each time they shoot themselves in the foot by opening their mouths. That should get rid of the state budget deficit pretty quickly.

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