Arizona Asks to Set Fines for Health Risks

This is an annual fee that says to consumers, Hey, we're not going to prevent you from smoking, but you need to put a tiny bit more in to the method because it costs us more,Ms. Coury said, citing a 2006 survey that showed that 46 percent of the patients in the states Medicaid program were smokers.

HOENIX - 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 speaking. Following the lead of some private health designs, which charge premiums to members who smoke or engage in other unhealthy behavior, Arizona's Health Care Cost Containment Method has proposed charging smokers $50 a year & 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.

We don't care how much you weigh, they said. We care in the event you are doing something you ought to be doing to manage your disease.

As for being fat, Ms. Coury said the cash-strapped agency would not be weighing people & slapping a fine on those carrying additional pounds. , the $50 would be charged to those who were specifically urged by doctors to lose weight for health reasons, like diabetes, but failed to do so, they said.

The proposal was mentioned in a letter that Gov. Jan Brewer wrote Thursday to Kathleen Sebelius, the health & human services secretary, seeking federal approval for a variety of cost-saving moves.

Financing for the organ transplants was reinstated in a budget approved by the Michigan House this week, & the Senate appeared poised to approve a similar deal. But officials said that other measures would be necessary to keep services jogging, among them the fees for unhealthy living & charges for missing doctor's appointments.