Mother Talkers

Smoking fees: fair or fascist?

by Erika

Sat Oct 13, 2007 at 10:59:05 PM PDT

We all know smoking is a disgusting, unhealthy and unnecessary habit. But should smokers pay more for their employer-sponsored health insurance?

The Tribune Company, which owns major newspapers including the Los Angeles Times and the Chicago Tribune, says "Yes"-- and they are not alone.

The media conglomerate is drawing fire from its unionized employees for imposing a $100 monthly fee on workers (and their covered family members) who smoke. Company officials say it is a necessary cost-containment effort, as they pay the lion's share of insurance coverage.

Union leaders say the fee is just an additional (and contract-forbidden) premium, and it could lead the company down the proverbial slippery slope. A writer at the South Florida Sun-Sentinel posted this in a blog item:

"Will there be fees for alcohol use? Eating fast food? Having high cholesterol? Not adhering to proper weight/body mass guidelines?" he wrote, in part. "The other thing that gets me is that there’s no reward for not being a smoker. If the company imposed a surcharge on smokers and then gave a proportionate break to all the non-smokers I could maybe be a little more positive about the whole thing. Instead, everyone’s premiums, deductibles, co-pays and out-of-pocket maximums are going up next year...

My two cents:

  1. It's a fact that smokers are much more likely to deal with chronic and expensive health conditions, as well as endanger the health of those around them. I think it is fair to ask them to pay more for insurance.
  1. Smoking is a choice; eating is, obviously, necessary for survival. So while obesity and diabetes and high cholesterol are very real problems, healthy and nutritious food isn't equally affordable or accessible to everyone, thanks in part to misguided government policies and subsidies. So penalizing poor people for eating off the dollar menu at McDonald's isn't a valid comparison.

The health care situation in this country is an undeniable mess, but I am grateful to my employers for offering me and my family insurance. If not for them, I would be uninsurable, thanks to a burst appendix and the emergency surgery that followed 9 years ago.

I do agree with the writer quoted above that rewarding non-smokers makes more sense than just penalizing those who light up. My former employer (another major newspaper company) had a "Wellness Rewards Program" that refunded us up to two months of insurance premiums for doing simple things like getting dental check-ups, regular Pap smears and flu shots; exercising regularly; and not smoking or at least trying to quit.

What do you think? Is it fair to penalize smokers? Is it too Big Brother-ish? And am I the only one who gets irrationally angry when I see some troglodyte tossing a butt out their car window and using the world as their personal ashtray? (In case you're wondering...yes, I believe that my personal feelings toward smoking color my view on the health insurance issue.)

Discuss...and take the poll!

  • ::
Poll

Making smokers pay extra for health insurance is...

39%41 votes
12%13 votes
13%14 votes
35%37 votes

| 105 votes | Vote | Results

Tags: health care, health insurance, smoking (all tags)

Permalink | 31 comments

  • taxes... (0 / 0)

    Here in Oz (I say that too much...) cigs are taxed exorbitantly. And the money goes to anti smoking campaigns and for the free health care that everyone gets, and that smokers will eventually use more of than other people! Not being a smoker (and personally really hating the things), I feel better knowing that people are paying $10 a pack. Serves them right! And if they're silly enough to keep paying that kind of crazy money for something like smoking...well...I just don't have a lot of sympathy.

    My apologies to any smokers...

    by aussieyank on Sun Oct 14, 2007 at 12:38:22 AM PDT

    • well... (0 / 0)

      here is another side to that.  for years we supported the tobacco industry and for years they withheld information.  and even today they get around rules.

      my dh smokes and he smokes alot.  as do several of his siblings. nicotine is one of THE most addictive agents.  and he isn't stupid, he knows the consequences.  he has been through several cessation programs. it is tempting to blame him, believe me i have been very frustrated with him.

      i understand the urge to penalize smokers with higher health care costs. however, it seems to me that the government hasn't done their part to control an industry that for years they turned a blind eye knowing it would have serious overall health costs for our society. i believe this to be a bit of red herring.  penalizing smokers isn't the answer to our health care crisis...and once you go down this road it is a slippery slope.  

      by parentalunit1 on Sun Oct 14, 2007 at 08:19:51 AM PDT

      [ Parent ]

      • my husband shocked me and just quit smoking (0 / 0)

        a few weeks ago- he said he'd never quit, but out of nowhere he went to the doctor and got CHANTIX

        it's working- i never would have believed it.

        he was a very heavy smoker for more than 30 years- 2 to 3 packs a day.  i don't smoke, but i used to keep a pack in the car just in case, because he was unbearable if he was out.

        my kids got used to me yelling "go have a cigarette" at him when he was mean and nasty- they took to doing it too if they thought he was picking on them.

        two days ago he had a miserable day at work and came home and ranted and raved but didn't smoke- i was sure he'd go out and buy a pack, but he didn't.

        anyway, if your husband mentions wanting to give chantix a try, it really is working for my husband.

        by thankgodforairamerica on Sun Oct 14, 2007 at 03:46:13 PM PDT

        [ Parent ]

    • sounds about right (0 / 0)

      Cigarettes SHOULD be expensive. I think Oz has the right idea.

      by Erika on Sun Oct 14, 2007 at 10:34:59 AM PDT

      [ Parent ]

      • Canada does it, too (0 / 0)

        Heavy taxes on cigs and alcohol and those taxes (as well as many other taxes!) subsidize health care for everyone. I remember being shocked at cigarette prices the first time I visited Vancouver. Cigs in the US were about $1.90 and there they were close to $6.

        by GiGi on Sun Oct 14, 2007 at 06:41:12 PM PDT

        [ Parent ]

  • We all pay (0 / 0)

    In the U.S. anyway, we all pay "extra" insurance to cover a whole host of health issues - those that are by choice and those that are not.  Insurance companies  (and big businesses) invest a lot of time figuring out the right premiums to charge to balance out the costs of people who are basically healthy and those who are not.  So, they are not "losing money" on paying for smokers, they are MAKING HUGE SUMS of money on those of us who are healthy and not drawing down very much of our insurance.

    Don't get me wrong - I'm as huge an anti-smoker as you are - but I have little sympathy for the health insurers in this fight.

    by Sue in Queens on Sun Oct 14, 2007 at 04:13:32 AM PDT

    • exactly -- let's not worry about the insurance co (0 / 0)

      on this matter.....let's take a look at their HUGE CEO salaries and then take another view on taxing workers for health insurance they already pay for.

      just another corporate attempt to demonize human rights like healthcare.

      by brave on Sun Oct 14, 2007 at 08:04:26 AM PDT

      [ Parent ]

    • no sympathy for the insurance companies either (0 / 0)

      but I do understand where employers are coming from, as they struggle to deal with rising health care costs every year without passing on too much of the cost to employees, and the health insurers continue raising prices like drunken, greedy sailors.

      by Erika on Sun Oct 14, 2007 at 10:28:50 AM PDT

      [ Parent ]

      • rising health costs (0 / 0)

        because there is no universal insurance from birth, so people go too long without proper proactive care, no social net (ie people don't have $ to feed and shelter themselves adequately), and the insurance companies have bottomlines to feed and if they insure everyone and pay on the insurance they don't meet them!

        employers should urge the government to provide universal health care --- that would cut their costs. not taxing overweight, smokers, diabetics, etc.

        by brave on Sun Oct 14, 2007 at 06:23:01 PM PDT

        [ Parent ]

  • how about help to quit smoking? (0 / 0)

    most people started smoking when they were kids- i don't know anyone who started smoking as an adult.

    maybe the employer could cover the copays on medications which help you quit smoking.

    yes- it's a slippery slope- if you're over a certain weight, i bet you will be the next one to have your premiums raised.

    or if your family consists of more than x number of members, your premium will be raised next.

    by thankgodforairamerica on Sun Oct 14, 2007 at 04:43:42 AM PDT

  • rewarding vs. taxing (0 / 0)

    I guess I can see both sides. I can't stand cigarette smoke and try to avoid it always [pretty easy in my city]. But I also agree that it's a slippery slope and my love of mashed potatoes and gravy would be landing me on the bad list next.

    I guess I prefer the idea of rewarding those who take care of themselves.

    and of course I agree that the real issue is that we ALL need access to quality healthcare [and good, healthy, affordable food].

    by Lisa in Austin on Sun Oct 14, 2007 at 05:57:43 AM PDT

    • yes (0 / 0)

      I guess I prefer the idea of rewarding those who take care of themselves.

      I thought my previous employer's rewards program was a great idea. They even gave you credit for doing volunteer activities, donating blood, and joining Weight Watchers.

      Of course, I'm guessing the CEO, with his giant salary, didn't partake. But for me, getting a refund of two months' premium at the end of the year felt like a holiday bonus. :-)

      by Erika on Sun Oct 14, 2007 at 10:32:18 AM PDT

      [ Parent ]

      • My preference too (0 / 0)

        I don't think making health care harder to get for the people who will probably need it more in the long run is a good idea.  Cessation programs and benefits for not only non smokers, but those who make an effort to lose weight, donate blood, get regular health checks, etc. is they way to go. It shows that it's not "about money" because the healthier you are, the less likely you are to USE health services and therefore save the insurance company money in the long run, etc. etc. etc.

        Course it's IS all about the benjamins, and the fact that smoking is vilified (rightfully so) it's just one more opportunity to make money off people who have been dutifully paying their bills.

        by lilianna28 on Sun Oct 14, 2007 at 07:51:12 PM PDT

        [ Parent ]

  • punishment is not optimal (0 / 0)

    When trying to change behavior, positive reinforcement works better over the long haul than punishment.  So I would be more in favor of premium reductions or credits for those who meet the ideals of healthy behavior, like what Erika described her previous employer doing.

    I tend to feel sympathetic towards addicts.  I'm not sure making their lives harder by adding to their financial burden is going to make it easier for a smoker to quit.  I don't love paying for their added healthcare costs, but I think it's disingenuous to say, It's their choice and they can just stop if they want a lower premium.  Nicotine is known as one of the most addictive substances of all.

    (Having said that, I was a recreational smoker in my 20s and had no problem quitting when I wanted to.  And my father quit when the taxes were raised, so he did respond well to punishment.  Always with the counter-examples!)  

    by mamacita on Sun Oct 14, 2007 at 08:14:21 AM PDT

    • social smoker too.. (0 / 0)

      and it is hard for those who did smoke and quit to understand how someone can't.  addiction is not universal, some get addicted others don't.  i can say with 100% certainty that my dh is addicted and so are 5 of his siblings. interestingly all of them started in their very early teens.  current brain reseach suggests that addiction rates are much much higher when exposure is on developing brains.  goes to the argument about teen drinking..here again as with drugs the earlier they start the higher the addiction rate.

      by parentalunit1 on Sun Oct 14, 2007 at 08:25:15 AM PDT

      [ Parent ]

      • curious... (0 / 0)

        ...has your DH tried hypnotherapy? I know several people that quit successfully, who were pretty addicted.

        by Erika on Sun Oct 14, 2007 at 10:34:05 AM PDT

        [ Parent ]

        • yes and more (0 / 0)

          hypnotherapy twice
          wellbutrin twice
          patch too many times to count
          gum( which btw seems to work the best so far)

          he quit once for 3 months, another time 6 weeks.  we have been at it for 12 years.

          addiction is definitely a part of the family history. i have become impatient with those who claim that "all you have to do is DECIDE to quit and then quit". that works for some, in fact many, but not for all.  believe me my dh and his other siblings would love nothing better than to quit smoking. we can afford health insurance but it makes me crazy to think that others who can't, who are addicted like my family, would somehow be denied.   this isn't the way to solve our health care crisis.

          i follow the notion that a moral society can be judged by how it treats the least forutunate among us.  i happen to believe that poor addicted smokers fall into that category.  perhaps raising the price of cigarettes would help discourage folks from beginning the habit. fine by me.  but punishing through health care is , dare i say this?, yes i will... immoral especially given what we allowed the tobacco industry to get away with.

          by parentalunit1 on Sun Oct 14, 2007 at 11:54:12 AM PDT

          [ Parent ]

          • caveat... (0 / 0)

            i also support ALL legislation that prohibits smoking in public places.  second hand smoke is a killer and no one has the right to inflict that on another person.  i support making it illegal to smoke with children in the car, in offices, in any buildings and even in public outdoor spaces to some degree.

            needless to say dh does not smoke in the house.

            by parentalunit1 on Sun Oct 14, 2007 at 11:58:02 AM PDT

            [ Parent ]

          • Agree (0 / 0)

            i have become impatient with those who claim that "all you have to do is DECIDE to quit and then quit". that works for some, in fact many, but not for all.

            I agree, for smoking and for many other things that are bad for your health (alcohol, drugs, food, spending, gambling, the list goes on).

            It is so easy (and possibly bordering on self-righteous) for those who aren't addicted, have never fought an addition, or just don't have a brain that is predisposed to addiction to say, "Well, if they would just stop doing it."  

            by NJmom on Sun Oct 14, 2007 at 12:10:27 PM PDT

            [ Parent ]

            • HBO Addiction series (0 / 0)

              If you have not seen HBO's documentary on addiction I would urge you to go to the link below to their website.

              http://www.hbo.com/...

               You can not predict who will become addicted and who won't.  But for those who do become addicted and for their families, the information in this HBO special is so hopeful.  I'd urge everyone to watch the special on HBO On demand or at least link to the site above.

              by parentalunit1 on Sun Oct 14, 2007 at 09:02:26 PM PDT

              [ Parent ]

  • Actually, there is the school of thought (0 / 0)

    that says smokers might actually be cheaper to insure as they age...because they tend to die earlier.  

    I think all of us can agree that we don't want the government overly involved in our private lives and we resist the notion of attempted government control of our behavior.  If we don't want government involved, why would we cede this control to the corporate world?

    I'm also against mixing these issues with health care.  When I go into my doctors' offices, I want to be able to be honest.  I don't want to have to lie about any of my activities because I might fear financial or legal ramifications.  

    by tjb22 on Sun Oct 14, 2007 at 08:37:40 AM PDT

  • In this specific instance if these are union jobs (0 / 0)

    these people make enough to eat healthy food.  Just sayin that analogy doesn't apply to this particular case.

    by OldMother on Sun Oct 14, 2007 at 02:15:26 PM PDT

  • Well, I pay more for being a woman (0 / 0)

    which I have no control over whatsoever.  My boss is 12 years older than me, but with our work insurance policy, he pays less just 'cause he's a man.  Is that fair?  

    On the whole, though, I agree getting rewarded for preventative practices makes more sense than penalizing people.

    Nola

    by nojobro on Sun Oct 14, 2007 at 07:49:54 PM PDT

  • Another company... (0 / 0)

    DH works for a big health insurance company. They don't allow smoking anywhere on the property (this includes outdoors).

    They rolled out a big program in the past year. There are free cessation programs for employees on the benefit side, and smoking employees pay more for their insurance on the cost side. (Note that if an employee is enrolled in the cessation program, they don't pay the higher rate.)

    As an insurance company, they know full well what the risks are. And that's the insurer's job -- give low risk folks better rates to get them to sign up and underwrite the higher risk folks (who are asked to pay more).

    by cbfly on Sun Oct 14, 2007 at 08:19:01 PM PDT

  • The good thing about high cig prices (0 / 0)

    is that they discourage young people from starting smoking. This has been widely documented in research.  The higher the price, the fewer young people start.

    For that reason alone I think it's a good idea to tax them to kingdom come.

    Katherine

    by pat of butter in a sea of grits on Mon Oct 15, 2007 at 12:39:53 PM PDT

Permalink | 31 comments