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Discussion: “If you smoke or are overweight, then you cost me money and I cannot hire you.”-Fair Or Not?

health-insurance

With Obama’s recent visit to the Cleveland clinic, who will cease hiring smokers as of September 1, the Today Show is speculating that this may become a corporate health care trend.

Here’s the message from Dr Delos Cosgrove, CEO and President at the Cleveland Clinic:

While we are on the topic of smoking, I understand that there are differences of opinion about our recently announced policy to stop hiring smokers as of September 1st. Many people have told me that they totally agree with the idea. I have also seen and heard comments that what we are doing is discriminatory….Some have questioned the wisdom of our new hiring policy….

But we are not the first organization to implement such a policy.The World Health Organization, American Cancer Society and more than 6,000 companies across the country have adopted similar policies in an effort to promote a healthy workplace. It’s a growing trend; one that will likely keep gaining momentum. Some also have claimed that our new policy is not really about health, but about saving money….

First, with our new policy, any applicant who fails the nicotine screening will be referred to a free tobacco cessation program that we pay for. Those who are successful in quitting will be encouraged to reapply after 90 days.…We also are committed to taking a lead role in shifting the national focus from “sick” care to “health” care. As a true “health care” provider, we must create a culture of wellness that permeates the entire institution, from the care we provide, to our physical environment, to the food we offer, and yes, even to our employees…..Secondly, no one can deny the staggering cost smoking places on society.

The U.S. Centers for Disease Control and Prevention estimates that smoking costs more than $75 billion annually in direct and indirect medical costs, and that businesses lose approximately $3,400 each year for every employee who uses tobacco because of increases in health costs and decreases in productivity related to smoking breaks….

While current employees will not be tested, I encourage any employee who smokes to please consider enrolling in a tobacco-cessation class.

I think it is fair to also note that obesity and smoking do drive up healthcare costs, thereby burdening the employer who usually subsidizes the group health insurance at yourplace of employment.

From CNN:

A government-sponsored study recently estimated that medical spending for obesity reached $147 billion in 2008, almost doubling in the past decade. It’s not surprising. About 32 percent of American adults are obese, a condition linked to diabetes, heart disease, even cancer. As the story above illustrates, obesity can also do a number on your bones and joints.

If you want an idea of how big $147 billion is, it’s roughly 6 percent of all health care spending in the United States.

How about smoking? Almost 21 percent of American adults are addicted to cigarettes, according to the Centers for Disease Control and Prevention. That’s more than 45 million people. The estimated health care costs pegged to smoking: $96 billion.

It’s virtually impossible to live in the United States and not be aware of the health risks associated with smoking, yet the addictive habit continues – with tragic consequences for smokers and an immense burden on the health care system.

If this trend continues, then the conversation between employer and employee could look like this:

Employer to potential employee: “If you smoke or are overweight, then you cost me money and I cannot hire you.   If I hire you then you will go into a smoking cessation program (or weight loss program) I invest in your health-you invest in my bottom line.”

Do you think this is fair?  Why or Why not?

My position?  I think it can easily become discriminatory without certain laws in place as this could become a slippery slope to discriminate against every condition under the sun that costs the employer more money.  And, according to the Kaiser family Foundation:

Women… have more complex health needs than men. In addition to pregnancy and related reproductive health needs, women also have a higher incidence of chronic illness for which they need ongoing medical treatment (38 percent of women versus 30 percent of men). Women are also at a much greater risk for maladies such as osteoporosis and autoimmune diseases like lupus, multiple sclerosis and rheumatoid arthritis—all of which require ongoing treatment.

In addition, women tend to live longer and therefore use more health care services throughout their lives. Women have also been shown to be the major decision-makers on health issues for their family, thus making their access to all facets of the health care system essential.

Tell me what you think in the comments area.

Resources:

  • stariana

    ” I think it can easily become discriminatory without certain laws in
    place as this could become a slippery slope to discriminate against
    every condition under the sun that costs the employer more money.”

    In some cases, obesity may be a result of hypothyroidism or other diseases, but generally, obesity and smoking are **lifestyle choices**. Similarly, health insurance companies charge customers who choose to regularly do dangerous activities, such as skydiving and bungee jumping, more money.

  • http://orggit.com Cecelia

    This is definitely a controversial subject, and I can really see both sides. Not sure exactly what I think yet…

  • http://www.thoughts.com/kirstinemacomb/blog Kirstine Macomb

    I also think that it is just fair. It is but normal for employers to prefer hiring people that practice healthy lifestyle over those who are smokers. But when it comes in becoming overweight, well, that is a different story… it is okay for me to hire an overweight person provided that he or she had previous work credentials.

  • http://energyfied.com energy drinker

    I think that is a fair statement. As a small business owner I think that your smoking demons can quickly become my financial monsters. I already have a non-smoking policy at the office, and with the insurance rates the way they are I am lucky to have a non-smoking staff. I think smoking decreases energy and productivity of my potential employee, not to mention their health. Just my 2 cents.

  • http://www.dijla4h.com ??? ????

    i think that everybody today should quit smoking, because lots of debates are going on on that subject, so why not quit smoking? it could make your life much easier !

  • http://meandthecomputer.blogspot.com me and the computer

    Overweight people tend to be lazy. And smokers tends to take a lot of smoking breaks.

    It does cost a lot of money.

    Just my humble opinion.

  • http://www.debtconsolidation.vg Sam

    There should be programs made available to employers in which both the employer and the employee can pay for whatever healthcare need is required such regular hospital visits to see the doctor. This might reduce the hefty expense on the employers in general.

    I don't think smokers and the overweight ought be screened as undesirable by employers.

  • http://www.americaneer.com Encee

    I think the use of the term overweight in the title post is a bit misleading. It should be excessively overweight or obese.

    I was at an event this summer where I saw a mother feeding her toddler daughter Cheetos. At an another event I saw parents flushing down a hotdog along their child who already looked headed towards becoming obese; (healthier options were available on the menu).

    The human body is precious.

  • http://www.reversenumbersleuth.com Mary

    I don't know that this will really do anything to help the core problem of obesity or smoking though. Smokers, for example all know that their habit is killing them – yet they continue to smoke. How much more pain can you expose someone to in order to get them to change their behavior? Isn't death pretty much the ultimate pain.

  • sarah

    Of course smokers should die. Forcing a company to pay for their healthcare violates the company's right to make a profit. Fat people deserve to die for the same reason, even if is a genetic condition they have no control over. I'm a diabetic. My expense to my company is completely unforgivable, and for this I deserve to die. Everyone who lives near the toxic waste superfund site in San Gabriel Valley, northeast of downtown Los Angeles, deserves to die because drinking the water harmed their health. For that matter, everyone in Los Angeles should die for breathing that smog-filled air.

    My apologies to Creationists, but America is engaged in an economic Darwinism: Survival of the richest. Sonia Sotomayor has diabetes and will live because she has health coverage at the Taxpayer expense, and some unemployed latina will die from diabetic complications. Money, alone, is what decides which of them will live.

    Who can look at physicist Steven Hawking, who is almost completely paralyzed from neuro muscular dystrophy, and doubt that the vast expense of keeping him alive has been more than paid off from his contributions to science.

    Smoking is an addiction. When obesity is not genetic, it can be caused by psychological problems where the alternatives, bulimia and anorexia, cost even more for health care. People with fast metabolisms can can be thin as a rail, while still eating steaks and ice cream, and never be discriminated against, even though their cholesterol-choked arteries will bear a very heavy health care cost. Beyond the harm to their own bodies, binge drinkers pose an ever greater cost to health care from DWI accidents, yet they get the job if they show up sober.

    African Americans are genetically predisposed to glaucoma (http://www.glaucoma.org/learn/africanamerican.php… is anyone seriously considering discriminated against they because of their increased health cost?

    Don't even think about judging smokers and obese people, because with DNA testing we ALL have reasons to be denied health care. I forget who said it, but this quote says it best:

    "Judge not, that ye be not judged. For with what judgment ye judge, ye shall be judged: and with what measure ye mete, it shall be measured to you again."

  • http://www.fatloss4idiots.co.uk FatLoss4Idiots

    A new study says that “extremely obese people” (which is defined as being more than 80 pounds overweight) die as little as three years and as much as twelve years sooner than normal weight individuals. There could be a lot of reasons for this. The more obese a person becomes, the less they are probably moving around, exercising, and taking care of themselves. It’s like a snowball effect on your health and something that needs to be addressed now.

  • http://wealthisgood.blogspot.com Meg

    If companies are going to have to pay for health care expenses for their employees, I think it's their right to screen them as they see fit. Of course another solution would be for companies to not have to worry about their employees' health care costs by establishing a system where they don't have to pay for them.

  • tc>

    There are two very different issues here. People who smoke have the option to quit. People who eat do not have the option to quit eating. While it is very easy to say "don't eat so much", the cost of being obese is already to high to the individual that you would expect people to control their weight, but they don't. That suggests something more is going on that people are too lazy to eat less. Recent research on weight loss also suggests that obesity is a disorder, not a "lifestyle choice."

    I would also not minimize the difficulty people have quitting smoking. Successful smoking treatment programs are still perhaps 40% effective — that is, most people go back to smoking. My wife made six serious attempts (and dozens of less-serious ones) before she finally beat her habit. We should be focused on helping people who want to quit, not punishing those who haven't quit. The (entirely reasonable) ban on second-hand smoke is disincentive enough.

    Finally, the underlying argument stinks. Fertile women consume more healthcare. (See, e.g. http://women.webmd.com/news/20090511/women-more-s… Should an employer be able to say "Sorry lady, you cost me more, I can't hire you"?

  • http://gimpgirl.com Jennifer Cole

    My concern is the same as yours, that it will become a slippery slope. As a woman with a disability, its nearly impossible to find employment now. My disability is likely very expensive to any employer, but there is no cessation program or weight loss clinic that will change that. This focus on the bottom line continues to highlight the "problems" in hiring someone like me, and these issues cost people with disabilities jobs every day despite there being laws in place against it.