does this. There's more complex social issues at play for these health issues. E) Probably not. I have no sympathy for them whatsoever. Comments are moderated before they are published. That means they have to go to the local charity hospital for treatment for care. Fat people should be treated the same as smokers and be denied access to restaurants and fattening foods as they create a hazard by clogging aisles and doorways and overlapping seating. A recent article in Health Affairs estimated its annual cost to be $147 billion and growing. Get free updates delivered free to your inbox. Tagged as: The slim & trim one, or the one who's got a medium waistline that goes with their body / or height proportionate, or the 3 pack a day smoker ? Now that's the question you need to be asking. If you do this let's include ALL the circumstances that can shorten life or cause one to need health care. Read Grateful Patient Fundraising: Ethically Problematic or Altruistic? It is an interesting thought about how that would implicate unhealthy people. Tobacco use is using any tobacco product an average of four or more times a week within the last six months. Wal-Mart, which insures more than 1 million people, is one such company. Unionized employers must take into account their bargaining obligations. All this can be prevented, there is no excuse whatsoever for smoking and for remaining overweight and not actively trying to change. However, theres no evidence that higher health insurance premiums encourage people to quit, according to the Commonwealth Fund, a private foundation aimed at improving the health care system. Studies have shown thatmonetary incentivescan significantly increase smoking cessation. thank Jack. Smokers miss an average of 6.16 days of work per year compared to 3.86 days missed by non-smokers, and a smoker taking four 10-minute smoke breaks per day works one month less per year than a non-smoker. And the fat cat CEO's should go on a compensation diet so that more of the money they collect in premiums goes to heath care. Another tax on the poor and middle class in terms of a health insurance "surtax" will not fix the problem. Comparisons are made on the basis of price only and different products may have different features and different levels of coverage. That's why we have tobacco tax. Private health insurance wasn't created so everyone could get healthy it is a financial product in the United States. I know, I know, he shouted while furiously waving His If rates go too high, then a subsidized public option should be available to those who cannot otherwise get insurance at a reasonable price. Use whatever they have on hand as weights. Offering health insurance is a choice employeers can make, so why should employeers have to to pay more for an employee who knowingly chose to live a unhealthy lifestyle? A recent survey found that 2 out of 3 Australians believed that smokers and people with other unhealthy habits should pay more for their health cover. How do I sign up for Medicare when I turn 65? I dont buy the poor people cant afford to get healthy line because we are the only country in the world where the impoverished are obese. How about a history of premature births or child development problems in the family? Heres where the tobacco surcharge runs into problems. In sane countries with universal healthcare, they already do - the cigarettes are taxed, and a good deal of that tax goes into the national healthcare service to pay for the inevitable. He or she can suggest a range of resources that can help you as you cut smoking out of your life. Insurance companies argue that its only fair to charge tobacco users more. Raise taxes on cigarettes and have that money go towards healthcare. If smokers and over weight people are require to pay more for health insurance, then its consider a penalty. If the answer is a choice between free behavior modification/education and wasting money on junk food, and they choose to waste money, this will decrease the money for waste, and encourage adopting behavior to save that money. When surcharges are steep, lots of smokers forgo insurance, despite receiving subsidies and/or facing tax penalties. Many can only afford cheap hamburgers, bologna, potatoes, mac and cheese, and cheap frozen pizzas-Especially in the South where wages are generally lower. Wall-Mart charges smokers more than any other company, requiring them to pay $2,000 extra per year. Hopefully these penalties will get these overindulgent people to quit their bad habits and lead healthier lives thus live longer. Isn't it time somebody DONE somthing about this stuff ?! Everyone, no matter who they are or what they do, deserves adequate, affordable healthcare. Founded in 2004 byKevin Pho, MD, KevinMD.com is the webs leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories. Smokers, along with the tobacco industry, should pay to cover healthcare costs associated with their bad habit. The main problem with the actuarial fairness argument is that different smokers may have different risks. Health insurance companies are beginning to act more and more like banks. Absolutely! I'm not a smoker nor fat. Many people do not belong to gyms and still find other ways to exercise. If your home is large, on a beach, in an earthquake or hurricane zone you pay more. Here is a question for you all? Experts say that smokers disproportionately have lower incomes, so that a premium surcharge will hit them especially hard. If you don't like it, do something about it. This means you're less likely to wind up in hospital with a serious disease caused by smoking; in turn, this puts a reduced burden on your wallet. ET to see if Jack reads your answer on the air. Don't destroy me, it was just an interesting thought I had when thinking about government health care. cy from arlington, va. Survey: Bullying on the Rise; Gen Z Least Likely to Report Misconduct, Study: Majority of Big Canadian Companies Tie Executive Compensation to ESG Metrics, Toxic Environment: When Workplace Behavior Is Problematic But Not Illegal, A Prescriptive Guide to Third-Party Risk Management, Financial Crimes Enforcement Network (FinCEN). Of course, lowering taxes on the rich, which is essentially stealing money from the next generation, means you're a conservative capitalist. Yes they should! If we are to receive adequate healthcare in this very backward country, we must rein the medical industry in tightly. VOTE THE BUMS OUT. On the Ground, Its More Complicated. Jack, let's do the math, if you smoke a pack a day that adds up to $2,190 (@$6.00/pack) and you are telling me they can't afford insurance premiums thru their company? We are delighted that you'd like to resume your subscription. Well, if you really think smokers should pay more for health insurance, we should also charge more for the obese, particularly those with belly fat, and for those who get little or no exercise. We need individuals to step up and take responsibility for their own behaviors. "My answer is no they should not pay more, they already pay far more than there share of the tax if they smoke, now if they are overly-fat then it is different as they eat through greed and nothing more. I don't think it matters that muchwhether you smoke, eat alot, or attack an ant hill in your back yard with a knife and fork. Responsible people who exercise and try to enhance their health should have greatly discounted rates. I excersize daily and I have a positive outlook on life. If they reinstated it and jacked the rates for unhealthy people it might do a world of good all around. Ive had the privilege of knowing more than a few extraordinarily brilliant people from whose mouths seemed to spill spontaneous gems of polished prose. A sign promotes COVID-19 vaccines at Lake Charles Memorial Hospital on August 10, 2021 in Lake Charles . Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. After a string of violent crimes involving mentally ill people who are homeless, New York City Mayor Eric Adams announced a plan for police and emergency medical workers to involuntarily remove people with severe mental illness from the streets and bring them to hospitals for psychiatric evaluation. Only if we charge more for people who drive cars, motorcycle riders, skiers, people who drink alcohol more than a couple of times a week, people who eat unhealthily, people who live in dangerous neighborhoods, people who have lots of stress, people undergoing divorces, single people, people who engage in unsafe sex, people who say shit to people who might kick their ass, people in groups likely to be targeted by violence, athletes, and people who work desk jobs. Jack, Where do you draw the line? Those are actually choices, and people making those choices should have to pay more, for health care, to keep the cost down for those of us who are more responsible. You start slipping down a slippery slope when you single out select segments of the population. Your nonsmoking colleague might pay nothing. There is no question that smoking increases health risks and those who don't smoke shouldn't have to bear the burden of those who choose this insidiious habit. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. We all know that if we do the right things (exercise, eat properly, stop smoking, drink in moderation and take medications to prevent disease from getting worse) we will all spend less on healthcare. A complete guide to short-term health insurance. That is why we are $13 trillion in debt nobody wants to be responsible. In a recent issue of Narrative Inquiry in Bioethics, 12 physicians discuss their experiences with grateful patient fundraising and take up legal and ethical issues. The authors concluded thatreducing smoking and obesity will not save society health care costs. Non-smokers in particular think that smokers should pay higher health insurance premiums: 65 percent of non-smokers expressed this opinion, compared with 38 percent of people who smoke only occasionally and 18 percent of those who smoke daily. I would like to start this counter-debate by saying you see more drunk driving deaths than smoker deaths because news reporters report car accidents, not cancer Smoking increases health risks and should be banned in public places. Walk. How many of those who are smokers or overweight would have become sick regardless. Here are a few tips for quitting smoking: Find your why. So instead, companies are now going to start making these employees pay more. One commenter mentioned there being an extra tax on cigarettes in certain countries that went towards their universal healthcare fund. Another thing to keep in mind: although smoking does not affect your health insurance premiums at the moment, it is possible that the rules could change in future. It always seems people don't do something until it hits their pocketbook. These folks made the decision to smoke, so they should pay more. I believe in following the Doctors instructions to the letter. Insurance comp. The benchmark for all insurance underwriting is computed by an exposure to risk formula. "Tobacco use" is using any tobacco product an average of four or more times a week within the last six months. California, Massachusetts, New Jersey, New York, Rhode Island and Vermont prohibit tobacco rating for policies purchased throughout the individual market. Do we want someone not going to the doctor for fear of their rates going up? Charging a higher premium for established smokers will either at best encourage people to stop smoking immediately in order to access health insurance or at worst deter smokers from signing up for health insurance in the first place. Yes Jack, this is what we need. Who would YOU Hire First ?? Some loss mitigation is appropirate. Should fertile women have to pay more for health insurance than women who can't reproduce? Charging people rates based on their personal risks protects insurance companies against moral hazard, people taking risks without bearing the consequences. However, I don't think there should be a set fee. It's not about health, it's about money. Let me get this straight, "the not poor" buy "the poor" food, while "the poor" buy cigarettes. Secondly fat people don't stay fat because they are starving. I recently watched obese administrative people at a healthcare facility in Massachusetts shovel potato chips and donuts into their fat faces, and I couldn't help but wonder how someone who works in healthcare could be so oblivious to be so self-destructive. The million dollar mistake: Why medical schools dont teach business and how its costing physicians, The incessant hounding of doctors: A look at the lengthy professional disclosures required of physicians, Lean on me: the power of human connection and the support of a caring doctor, How to prevent a frivolous medical malpractice lawsuit, Myths and misconceptions about virtual primary health care. Yes. If Australia responded to popular demand and moved towards a risk-based system, smokers could find themselves facing higher premiums. Compensation may impact where the Sponsors appear on this website (including the order in which they appear). If you choose to inhale smoke and you choose to eat fast food and unhealthy crap in vast quantities, then you choose to pay more for healthcare. Dave from NH. Why not include illegal drug users and alcoholics. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. Please see our FSG. If we want smokers to reimburse the rest of us for the cost of their habit, we should stick with tobacco taxes, a policy that reduces smoking rates without having any direct effect on peoples decisions to purchase health insurance. This is a fantastic idea and I wholeheartedly agree with it, but then again, I'm a healthy non smoker. What do the smokers think? as for fat people, for many, like some of my wife's relatives, it's a medical condition and being charged more for healthcare would be a "double wammy". The onus falls on the employer to be very clear [about] what theyre doing.. Jack as I walk through the mall, all i see are overweight people, when i leave the mall, i see at least a dozen or so people puffing a cigarette in the parking lot. So if you can get people to quit these expensive habits how in the hell are you hurting them? The idea that poor people will be hurt by this is ridiculous. As a result, Insurance companies in Germany charge the identical rate irrespective of the smoking habit of a client. I also don't have an issue with taxing excessive drinkers either. First, the surcharge makes insurance more expensive, meaning it is harder for people to afford. The debate continues, because ultimately smoking is a voluntary act that undoubtedly affects individual health and, in turn, the public and private healthcare system. We deserve the same coverage that our hired help takes for granted. Its also unclear what happens if you complete a required smoking cessation program at work but do not quit. On top of that just tell me how to live my life too. If they participate and make improvements then there is no impact. Lets just stop this nonsense and enact a law that insurers, mortgage companies and oil companies can garnish our wages. Just take it and cut to the chase. I am a smoker for 14 years now and my answer to the question is; YES! Jack, I understand your question but how can anyone afford to pay more for Health Care? And we'd love to know where you're writing from, so please include your city and state with your comment. HELLO. Primary Care, Its about personal choices. Once implemented, the impact of the differential should be monitored to determine if it results in a disparate impact on employees in protected groups such as minorities and specific ethnicities. Cost (the biggest problem with health insurance) might go down (or the insurance companies might just take bigger profits!) If they are lazy and indulge themselves with bad food and refuse to change that! Take this case before a jury of my peers, and the business or health insurance company that charges more for overweight people will lose the case. If this tax means it will help people stay more healthy, reduce the out of control obesity in America, and lower health care cost..so be it! It's a slippery slope. If you have a poor driving record, drive a sports car, or live in a high-theft area, you're going to pay more for your car insurance than [] Social engineering though tax policies never works. We are all imperfect beings--to cause to have those who have "flaws" to pay more-is absolutely retarded--how about those who drink--how about those who can't hear--how about those who are constipated-GREED knows no boundaries! It needs to be a flat rate for everyone. The reason for the move has come because companies are saying smokers cost them more money in medical costs and so the extra cost is just being passed down. But this is not true. This should have been in effect years ago. That is the right solution, not charging people more for health insurance because they have a problem. How will the fiscal cliff affect the way you handle your money. There, I saw firsthand the incredibly high rate of smoking in a population that was mostly hidden from me in my everyday life. Risk does not mean something will happen but there is a chance something may. Where would it end? Lastly I don't want to hear about poor people being harmed by this. It only takes a minute to see how much you could save. They're clearly reckless drivers and are more likely to get into injury accidents. Or a family history of colon cancer? I have no idea how the specifics would play out. METALWORKER in La Salle, IL. Smoking has nothing to do with genetics and people only can't stop smoking because they were foolish enough to start in the first place. Why not Jack? According to the utilitarian argument, charging smokers more will encourage them to quit, which will improve public health and reduce societys smoking-related costs. As for smokers, that is much more clear-cut and it would make sense to raise rates for those. In a recent article in The New England Journal of Medicine, Ezekiel Emanuel and colleagues clearly illustrate the relevance of ethical considerations to policy deliberations concerning public health emergencies. when they need their Health Insurance". Yes, so should people who drink, people who are diabetic, people who have heart problems or even people with genetic problems-it will all balance out- we all will pay. The Affordable Care Act allows insurance companies to charge smokers up to 50% more for premiums. The wellness program must satisfy the following four requirements: Another potential legal problem arises from the Americans with Disabilities Acts prohibition against discriminating in benefits with respect to qualified individuals with disabilities. Many studies have shown that smokers cost the health care system more and that they cost health insurers more. Hi Jack. If they choose to continue these very destructive practices they have no one to blame but them selves! The ABS found that smoking causes 80% of lung cancer deaths and 20% of overall cancer deaths. More importantly, for the purposes of this post, when surcharges arose in 2014, there was a pretty steep decline in the percent of smokers who purchased insurance. For overweight people, it depends on case by case! Voluntary choices are made around individual smoking and eating habits and companies may likewise choose to acknowledge these habits as liabilities. No. Well, it sounds like a good idea but what yard stick would be used to determined to measure fatness or does smoking medical weed count. Even if such a law exists, all may not be lost, as some state laws may be preempted by federal law. Yes, they should. Obviously they use more health care resources than a single employee. Smokers, yes. Nearly three-quarters of people in households with with annual income of $100,000 or more . A couple that smokes one pack each day will spend between $3400.00 to $7300.00 a year. Read Should Ethicists Be at the Table in Public Health Policy Deliberations? RELATED:The surprising reason why more women are smoking than men. Sign In. These cookies ensure basic functionalities and security features of the website, anonymously. Working-age Americans are not legally required to purchase health insurance. Though smoking is often seen as an adult issue, we should continue to support the many excellent anti-smoking campaigns and participate in research that helps us understand how to encourage adolescents that have started smoking to kick some butt. Higher insurance premiums price smokers out of insurance markets. To avoid this unfortunate outcome, rate increases should be kept low enough that they do not lead smokers to forego health insurance. Last week, Dallas County in Texas joined the growing ranks of employers that charge employees who smoke a higher monthly health insurance premium than employees who don't light up. 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