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Should companies charge employees who smoke more for their health insurance?

Asked at Massachusetts Street on February 19, 2006

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Photo of Jarrod Holt

“Yes. The long-term effects of smoking make them more prone to having health issues. There’s a reason they put the surgeon general’s warning on the pack.”

Photo of Laura Wood

“I think that could be considered discrimination. There are plenty of unhealthy habits we all partake in. It’s unfair to pick out one to charge them more for.”

Photo of Nancy Weitzel-Burry

“If a company decides to either charge smokers more or give people who don’t smoke a discount, the employer needs to offer some sort of cessation program so that the smokers have an opportunity to quit.”

Photo of Shawn Hill

“I think there need to be specifications how often the person smokes and how long they have smoked if they are going to charge them more for health insurance.”

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redbird 12 years, 2 months ago

Yes they should....yes most of us do partake in unhealthy habits,but are any of them as dangerous as smoking???Alcohol may be one but look how much one has to drink to destroy their body....of course ruling out an accident involving in death....Other illegal drugs are even more dangerous than the above mentioned.Well marijuana you can really injure yourself or others ,depending on the job,most should have butt bruises from having to get a kick in the a** to get going on the job!!! Most of the places that I have dealt with and worked for do offer,through insurance,paids plans for cessation of smoking,some offer the clincal approach for problem on the job drinkers....but it is a one shot a year type of thing,but if you really want to quit,and must,then this would be all it takes anyway.....I know from experience ;>(

Richard Heckler 12 years, 2 months ago

Insurance companies charge women more for being women so perhaps it is within their right to charge smokers more for being smokers.

trinity 12 years, 2 months ago

well and then yes, let's charge more for obese people, for their health care costs sure aren't cheap!

nut_case 12 years, 2 months ago

As a non-smoker, I'm tempted to say "heck yeah!! smoking is not healthy and it's definitely a fact that smoking makes you more prone to illness and disease - charge them for their sickness, not me" But then you stop and think for a second...what if the company next wants to expand that to charging people that don't eat a healthy diet? Well, maybe I had a dounut this morning instead of a bran muffin. Or what if I don't fit the ideal height and weight requirements, or what if later on, my DNA is shown to have a slight disposition to some disease?

It seems like that is the whole point of health insurance is to "spread the misery" so to speak. I pay my premiums every year, but haven't been sick, required a doctor visit or emergency room care for 10 years or more.

Social behaviour engineering through the all mighty dollar...the only ones truely immune are the independently wealthy!

So where does that leave us? Charge em for smoking, just don't dare come after my once-a-month double cappuccino late with extra cream!

classclown 12 years, 2 months ago

Find out who drinks and charge them more. - They might fall down and hurt themselves in a drunken stupor.

Find out who drives sports cars and charge them more. - They might drive too fast and run off the road getting hurt.

Find out who drives an SUV and charge them more. - SAA

Find out who is into extreme sports and charge them more. - Plenty of chances to get hurt there.

Find out who goes to certain clubs where violence is likely to happen and charge them more. - Might get shot or stabbed.

Find out who is just an A-hole in life and charge them more. - They'll probably end up getting their a$$es kicked often. Or worse.

Find out who is too klutzy or just plain incapable to handle DYI projects but does them anyway and charge them more. - Plenty of emergency room trips in the making there.

Anyone that works in a conveinance store (or something similar at night should be charged more. - Higher chance of getting injured while being robbed for $20.00.

Find out who has to drive on the worst streets or have to walk on any of our notorious sidewalks to get to work and charge them more. - Plenty of accident oppotunities there.

Find out who rides bicycles and charge them more. - Cars and bikes can't seem to co-exist so bike riding is a high risk factor. See also roads and sidewalks.

Investigate everyone for any kind of risky or dangerous behavior and charge them more based on whatever it is they do.

As Marion stated above. If you play, you pay. No matter what it is you play at.

Did I miss anything?

classclown 12 years, 2 months ago

I forgot obesity, but trinity took care of that one. And yes... that is a huge health problem.

classclown 12 years, 2 months ago

Here's another one. Charge people more based on where they live. Anyone that "chooses" to live in a rough neighborhood is more likely to be hurt. - You never know when you'll catch a bullet coming through your wall while watching tv or something.

Or maybe they live too close to some business that could possibly be proven to have contributed to higher incidences of health problems.

classclown 12 years, 2 months ago


I fail to see a difference between unwarranted intrusion of government and unwarranted intrusion of private industry. My life is my life and your life is your life. What we do with them and how we choose to live is no ones business but our own. Does private industry have the right to find out who is gay in order to charge more for their insurance because of the health risks involved there?

Try that and the noise about discrimination will be deafening. So what makes it right to be able to single out one group for a risky lifestyle yet not another?

trinity 12 years, 2 months ago

here's a situation that really happened. a couple who were insured by the factory where hubby worked; had a very very sick baby born to them who required extensive, EXPENSIVE care, to the tune of more than a million. insurance paid most all; the sad fact is that the insurer jacked the rates to the other employees so badly that many of them have cancelled their family policies, leaving themselves, their spouses, and their children vulnerable-and the kicker is, SOME but not all of them can get Healthwave due to occasion of spousal employment...the others simply couldn't handle the additional hit on their weekly paycheck of nearly a hundred dollars.

so, how do we predict and/or compensate for such extreme cases? hmm? oh and a sidenote-these kids who gave birth to the ailing child (who has come out of the woods and is currently thriving, thank God) are NOT smokers, partiers, obese, etc; just a healthy young couple who experienced a really scary and bad time when their precious baby was born.

and i feel i need to add-i am NOT in any way faulting or blaming these kids!! please understand that...if anything i am beside myself with rage because of the rest of the people at that place having to do without insurance, because the greedy bastages that run the insurance company have squeezed the employees until they have no choice.

classclown 12 years, 2 months ago

You know what will help keep health costs down? Employers not demanding a doctor's excuse whenever a worker calls in sick. We all have days when we just basically feel like crap and want to take a day off and get medicated and stay in bed and get better.

But because of this policy most employers now have, instead of staying in bed and getting better, you have to drag yourself to the doctors office charging your insurance and paying your co-pay just to have the doctor tell you that you have a cold or the flu and should stay in bed. Where you would have been in the first place if you didn't have to go to the doctor. All just so the doctor can write a note saying you were ill.

How much does that policy cost insurers?

jonas 12 years, 2 months ago

nut-case: The flip side of your anecdote is mine. I'm never sick, and never go to the doctor, so I was lax in getting my insurance. Then, last November, I got a kidney stone out of nowhere, and now have a $3800 hospital bill I have to pay off.

Hope that makes you feel better.

blessed3x 12 years, 2 months ago

Yes. Why should my premiums increase to cover the high cost of treating those who suffer from the effects of voluntary smoking? How is that fair?

bugmenot 12 years, 2 months ago

What about black people. Don't they have higher risks than other groups of people (die sooner, higher rates of diabetes, high blood pressure). Should they have to pay higher rates cause their black. I already agree that obese people need to pay higher rates if they are going to make smokers pay more.

Purell 12 years, 2 months ago

I think thosewho post more than 24" pose a health risk.

Ember 12 years, 2 months ago

Here something that should boggle minds.

Employee 'X' smokes a pack of cigarettes a day, but does not smoke at work. Should the insurance premiums he/she pays through this employer be higher because of what he does when he/she is not at work?

Employee 'X' smokes a pack of cigarettes a day, but only works for the employer for 1 year. Is it right to charge 'X' high premiums when the insurance was never used?

Now for the kicker.

Employee 'X' smokes a pack of cigarettes a day, then quits after 3 years of employment, complete with the higher insurance premiums. Should the premiums be lowered for 'X', and how would it affect the premiums of all the other employees? Would their premiums increase slightly because of 'X' deciding to quit smoking?

There are some fundimental problems here with the insurance companies that sorely needs to be addressed, like the concept of 'high-risk' and the gradient scale on which they base premiums.

I mean, stop and think about it.

Hypothetical, and simplified, situation.

I smoke. That's not hte hypothetical part, though. The base premium for Job 'A' is $100 for insurance. Smokers are charged $25 more per month because of smoking.

Out of the 1,000 employees at Job 'A', 250 smoke.

$106,250 would be the total amount of premiums paid permonth by all the employees of Job 'A'. Now no self respecting insurance company will accept less money than they made the month before if they can avoid it.

Suddenly, one day, all the smokers quit smoking. That drops $6,250, per month, from the insurance premiums, right? Wrong.

Everyone's insurance suddenly goes up to $106.25 the very next month.

Is that fair? My grandmother's insurance premiums went up after she quit smoking. This is the elephant in the living room that no one wants to talk about. I think it is about time it was talked about, if only to make the elephant feel welcomed.

beatrice 12 years, 2 months ago

There are companies that still hire smokers?

Larry 12 years, 2 months ago

Doesn't it seem ridiculous to compare health issues related to genetics to health issues related to choice? As for doctors notes for being sick- I think employees have forced the hand of employers because of the many times they call in sick for every sniffle, sore toe muscle, etc which puts a major burden on the employer and the rest of his/her employees.

In regards to the insurance cost issue - some twenty years ago, I know of a Lawrence couple (still living in Lawrence) who had two children through caesarian at the cost of a local small district (not Lawrence), then canceled their insurance and found a cheaper insurance outside the district - leaving the rest of the school district employees with higher rates. NICE and responsible on their part, huh.

My mother died from emphysema, but I still believe smokers need to pay a higher rate. However - I also recognize that there are far too many insurance people driving around in expensive automobiles as well as living in expensive homes which obviously proves that the insurance companies aren't hurting for money. The rates of insurance are the result of both the insurer and the insured as well as the pharmaceutical companies and lawyers. The real evil - MONEY!

Godot 12 years, 2 months ago

Smokers don't cost all that much more in the long run. They die young. It's those old coggers who live to be 100 that rack up the bills.

classclown 12 years, 2 months ago

So therefore it's the non smokers that should be paying higher premiums since they'll live longer and will in time make that many more doctor visits and suck up that many more prescriptions for that many more illnesses they get over that extended span. Brilliant!

Bean 12 years, 2 months ago

Discrimination? Don't be stupid. Smoking is one activity you can be sure will give you health problems in the future. Not if, but when. Everyone knows it & has known it for quite some time. Of course they should be charged more. They're purposely inhaling poison. All these other things people on here are pointing out are maybe, possibly, could cause health issues.

beatrice 12 years, 2 months ago

I love the spin the HR person at top gave: It isn't making smokers pay more, but rather giving non-smokers a discount. Brilliant!

Redneckgal 12 years, 2 months ago

I work in HR so I feel like I can speak with a little authority on this issue. In our company it is not the smokers costing us. It is the 300 and over crowd. We have had to pay for 2 quad. bypasses in the last year. Both these follows were proud non-smokers. They just happen to weigh about 350 pounds each. We have had 3 others dignosed with diabetes in the last year and have had to pay for all the education and medication that requires. Only one of these folks smokes. We are going to have to pay for a gastric bypass in the near future for yet another person. If they are going to charge anybody more I think they better figure out where the health care dollar is really going. I think in a lot of cases they will find that a bigger percentage goes to overweight folks. I don't really know if its right to charge anyone any extra. But if the companies are going to do it at least get it right.

sunflower_sue 12 years, 2 months ago

While I am tempted to say yes, I have to say no. (Even though I pay $300 a year more on my life insurance premiums because I own a snow-mobile.) It would just be too hard to analyze all the evil we do to our bodies in any multitude of ways. Descrimination, pure and simple. I also believe that health insurance should have to be available to everyone at an affordable price. I don't believe that people should be punished by the health care system because of the way they happened to be born. Health insurance is a big fat rip-off! (But you gotta have it and they know it.)

yourworstnightmare 12 years, 2 months ago

This comment was removed by the site staff for violation of the usage agreement.

Richard Heckler 12 years, 2 months ago

Even intense debate could not convince me why insuring my wife was almost double the cost for me. As daughters become of age you may see an increase. Women also seem to get charged more for clothing. Is this economic rape or what?

corporate_sleaze 12 years, 2 months ago

Once again, Marion presents a succint, sensible essay. I totally agree.

thunderbuns 12 years, 2 months ago

I'm a 600 pound smoker who works as a skyscraper window washer. And my insurance just went up!!!!!!!! What the..........?????

Godot 12 years, 2 months ago

Hey, now, lets get serious about smokers costing health plans less money...

How many of you know a smoker who had a symptom of a serious health problem who refused to go to the doctor because he/she didn't want to face the diagnoses?

My untested, unscientific opinion is that smokers use less health care dollars because they do not want to be confronted about their addiction.

In my humble opionion, of course.

sunflower_sue 12 years, 2 months ago

godot, my hubby's grandmother was what you would refer to as an "old codger." She lived to be 99. She was never in a hospital because she was rarely sick. That isn't exactly correct...she was put into a hosp. just before she died. It was the first time in her 99 years that she had ever been given an antibiotic. (That's probably what killed her:)) Anyway, my point is, healthy people tend to live longer with fewer medical costs. I don't buy your arguement against "old people." Sure, some old people rack up the bills, but many young ones do, too. My young hubby has racked up more medical bills in one week than most people see in a lifetime. (He's also "healthy"...go figure!). Our insurance company rewarded us by giving us the boot. After much ado, we were reinstated (at a higher premium). There is no rhyme or reason to who will need insurance and it is not fair to discriminate. (As much as I hate smoking.)

Godot 12 years, 2 months ago

Merrill wrote: "Even intense debate could not convince me why insuring my wife was almost double the cost for me."

So many reasons. Women are more likely to seek preventative treament than men are. Women are more likely to get pregnant than men are. Women are more likely to have their normal aging processes treated as a disease than men are.

Godot 12 years, 2 months ago

I appreciate your anecdotes, Sunflower Sue, but the statistics show that, on average, the older you get, the more health care resources you consume. Most folks require lots of drugs and services to keep on keepin' on.

Purell 12 years, 2 months ago

It's one thing to have two posting IDs, but having one ID compliment the other is sick. Seek professional help.

Also, succinct would NEVER describe that person's posts. Occasionally sensible, but not the majority.

Purell 12 years, 2 months ago

Here's a picture of me shortly after I quit smoking. Igained five pounds when I quit, but it was worth it. Most people say they didn't even notice. Boy, do I feel better now though.

I'll probably go to Kelly's this weekend.

Linda Endicott 12 years, 2 months ago

Marion, As with any business, if the insurance industry doesn't want any risks, then why be in business at all? That doesn't carry any risk.

Linda Aikins 12 years, 2 months ago

Purell, keep an eye out for Marion. He hangs out there!

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