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Jack Knox: The thin line on taking risks -and paying for them

No buts (or butts) about it: Arizona's governor is going after smokers and the overweight. Jan Brewer wants to charge $50 a year to recipients of Medicaid -the state's health-care plan for the poor -who don't follow a weight-loss plan.

No buts (or butts) about it: Arizona's governor is going after smokers and the overweight.

Jan Brewer wants to charge $50 a year to recipients of Medicaid -the state's health-care plan for the poor -who don't follow a weight-loss plan. Ditto for smokers or those who don't follow a doctor's advice in managing chronic diseases. Why, the theory goes, should taxpayers subsidize people who won't take care of themselves?

"If you want to smoke, go for it," a spokeswoman was quoted as saying. "But understand you're going to have to contribute something for the cost of the care of your smoking."

Or your eating. The obesity crisis is weighing down the health-care system.

The transportation system, too: worried by weight, the U.S. Coast Guard announced last week that it will reduce the number of people allowed on passenger boats. In March, the Federal Transit Authority proposed cutting the carrying capacity of buses. It was also revealed that children's car seats are not being tested properly because crash test dummies are "not fat enough."

Everything from coffins to toilet seats to ambulances are being built bigger. Disneyland reconfigured the ironically named It's a Small World ride after the boats began bottoming out.

You can, literally, watch Americans grow. The Centers for Disease Control website has a colour-coded map that, year by year, shows the fattening of the U.S. In 1995, there was not a single state where the obesity rate topped 20 per cent; by 2009, Colorado was the only one where it did not.

The Deep South, in particular, appears to be one fried chicken away from a massive jammer. (Check it out at cdc.gov/obesity/data/trends. html.)

But before we get all smug and condescending about our supersized neighbours, note that Statistics Canada just reported that one in four adults in the Great (And By Great We Mean Massive) White North is obese. Guess that means we'll have to build bigger entrances to our igloos.

It also means the logic that has Arizona pondering a fat fee could just as easily apply here, which would suit some just fine. Vilification of the obese has become socially acceptable. Higher health premiums?

Hell, let's burn them at the stake. We can use the smokers' matches. Why should the public pay for people who won't reduce their own risk?

But if risk is the issue, why not also penalize people who engage in other activities that up their odds of landing in hospital? What about hang gliders, skydivers, base jumpers or Charlie Sheen?

Maybe we need actuarial tables where the cost of health coverage corresponds with the chances of needing it. Something where high-risk behaviours are paired with penalties like this:

- Skiing out of bounds: $1,000 a year

- Drinking and driving: $2,000

- Drinking and driving a stolen cop car: $2,500, two years

the bears: $80 Feeding

- Feeding the bears while drinking and driving: $1,200, one hand.

- Riding a bike without a helmet: $200

- Riding a bike without a seat: $250

- Skateboarding without a helmet: a quarter ounce of weed

- Wearing a Chicago Blackhawks jersey in Vancouver: $40

- Crossing the road while texting: 15 cents per message, tire tracks on pants

hunting: $30 Lion

- Lion hunting with Dick Cheney: $300

- Pin the tail on the pit bull: $400

- Fishing half a bagel out of the toaster with a fork: $15

- Unprotected sex with multiple partners: No charge. This sin exists in theory only.

- "I'm not paying some stranger $40 to clean the gutters." $60

- "Hold my beer and watch this." $90

- Hitting on boss's spouse at the Christmas party: $75. Succeeding: $150

Truth is, it's not easy to know where the line is when expecting others to pay for our risks.

Gives us something to chew on, though. But don't swallow, not in Arizona.

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