None of us can escape the rising cost of health care. Even if we have the best insurance in the world, even if our health is perfect, we still pay a price, including a price for the insurance itself.

So when people are something less than optimally healthy — less, even, than “healthy” in the most relative sense — the financial reality hits home.

Starting next January, state employees who are obese will have to pay more for their health insurance — $25 a month more — if they refuse to take part in programs designed to address their condition.

The state already has a similar program for smokers. Still, smoking is a behavior that, while difficult to change, is narrow in nature. Obesity, on the other hand, can be — physically and psychologically — complicated and resistant to a single approach.

How serious the problem is among state workers was driven home by an article in the Montgomery Advertiser this week. A new study by the State Employees Insurance Board found that 45 percent of state employees are obese — and almost half of those are considered “morbidly obese.” Alabamians as a whole suffer from obesity in greater numbers than the citizens of all but one other state. But even state residents as a whole have an obesity rate of 30 percent. That means that the obesity rate among state employees is 50 percent greater than among the state’s general population. The impact is serious. Obese individuals have more health problems, and those problems cost money to address. In addition, as a result of their health, more state employees are taking early retirement than before. That, too, costs the taxpayers. In short, the state’s approach is more than justified by the situation. And it’s not slapping the $25 surcharge on anyone overweight. The fee will apply only to those obese employees who refuse even to try to overcome the problem.

A natural question is why? Why are state employees 50 percent more likely to be obese than non-state employees. The answer — if anyone is interested in finding it — will require study, and a portion of the study must address whether culture, used in its broadest sense, may play a role. For now, the emphasis is on tangible steps to address the problem. If obese employees didn’t care before, having to pay an extra $25 a month may get their attention.

No, this is not a gentle, tolerant approach, but state officials owe the state’s taxpayers some measures that have at least a chance of producing the desired results.

-The Huntsville Times