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Health Reform 101

with Lisa Zamosky

WebMD helps readers understand their health insurance and the new health care reform law. The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.


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Thursday, February 2, 2012

No Work for Smokers?

By Lisa Zamosky


Last November, I wrote a blog post about an NPR/ Thompson Reuters survey that asked people how they felt about employers charging smokers more for their health insurance than employees who don’t smoke. Nearly 6 out of 10 people polled said, “yes,” smokers should pay a premium for their unhealthy, and ultimately more costly, behavior.

In this week’s USA Today, a set of editorials addresses a growing phenomenon that takes this issue a step further: Refusing to hire smokers in the first place.

The Rising Cost of Health Care

More than half of all Americans currently get their health insurance through their employers, who have seen the cost of insurance premiums rise by 50% over the past decade. This has prompted businesses to search for ways to hold down healthcare costs and has given rise to wellness programs, as well as financial and other rewards for employees who commit to healthy behaviors, among other things.

As the USA Today editorials point out, adopting a policy whereby smokers are refused employment seems to be a growing trend.

Dallas, TX-based Baylor Health Care System and the Cleveland Clinic, for example, both claim that as health care organizations with missions to heal the sick and generally promote good health, supporting people who engage in a habit that leads to 450,000 deaths each year is hypocritical. Still, refusing jobs to smokers is a policy that has been adopted by employers in a number of industries, not just those in the field of health care.

One editorial takes great issue with the practice, and says the following:

“…intruding this deeply into people’s private lives raises questions that bear scrutiny. Companies can charge smokers more for health coverage or ban smoking on the job. But punishing people for using a legal product on their own time crosses a troubling line.”

Dr. Paul Terpeluk, Cleveland Clinic’s medical director of Employee Health Services, who wrote the opposing editorial, defends his organization’s stance on not hiring smokers by saying it does not make sense – particularly for a leading health care organization like his – to support a habit that leads to disease, disability and death.

Smokers as a Protected Class

Twenty-nine states in the U.S., as well as the District of Columbia have laws on the books that elevate smokers to a protected class, thereby making it illegal for employers to refuse a job to someone simply on the basis of the fact that he or she smokes. However, 21 states have no such laws, allowing employers to implement a no-smoking policy when it comes to hiring.

Fair or Foul?

In 2011 the United States spent $2.57 trillion, or 17% of the gross domestic product on healthcare. That number is expected to grow to 20% by the year 2020.

With health care costs placing an increasing burden on the economy, on businesses and on families, is it fair to penalize people who continue to engage in behavior that is well known to drive medical costs skyward? Speak up and let me know your thoughts in the comments section below.

Photo: Photodisc

Posted by: Lisa Zamosky at 12:18 pm


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