Fat Fees and Smoker Surcharges: Tough-Love Health Incentives

More states adopt tough-love wellness initiatives

Photo-Illustration by Kelly Blair for TIME

Correction Appended: Nov. 23, 2009

Psychology Professor Anita Blanchard has a pretty sweet deal with her employer. Even if the 40-something mother of three leaves her job at the University of North Carolina at Charlotte, the state of North Carolina guarantees her premium-free health insurance that will cover 80% of her health care costs for life. But's there's a hitch: she can't gain too much weight or start smoking. If she does, she could be on the hook for an additional 10% of her health care tab.

Companies have long promoted healthier behavior by subsidizing gym memberships and smoking-cessation...

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