Poll: Penalize Smoking, but Not Obesity

An NPR-Thompson Reuters Health Poll, which asks whether those who smoke and those who are overweight should be charged more for health insurance:

A solid majority — 59 percent — say that smokers should pay more for health insurance than nonsmokers…  Americans aren’t too keen on higher charges for people who are overweight or obese. Some 69 percent are opposed to that, leaving 31 percent in favor.

HT: Sarah Kliff at Ezra’s blog.

Comments (15)

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  1. Brian Williams. says:

    Shouldn’t insurance rates be based on risk?

  2. Linda Gorman says:

    A poll? Seriously?

    Gee, one would think we’re living in a nightmare in which politicians are pricing coverage or something.

  3. Matt says:

    This seems hypocritical. Because smoking is generally unpoplar people would rather charge them more than have people who are equally at risk, often due to their own choices, pay higher rates as well.

  4. Devon Herrick says:

    I’m with Brian — health insurance should be based on risk or expected costs. That means people with hypertension, high cholesterol or those who are over overweight might have to pay more unless they successfully managed their conditions.

  5. Linda Gorman says:

    Medically underwritten health insurance is based on expected costs. And smokers do pay more as do the seriously overweight and others who have higher than the lowest risk profile. But they are rated on experience with costs, not some stupid poll.

  6. John R. Graham says:

    @Linda Gorman: I trust you enjoyed the NY Times article describing how hospitals are pampering their patients (Jordan Rau, “Test for Hospital Budgets: Are Patients Pleased?”, 11/7/11), which describes how the Centers for Medicare & Medicaid Services (CMS) will hire private contractors to survey Medicare patients on their experiences after checking out of hospital.

    G*d forbid patients should control their own money! I’m sure we’ll get a better signal from them by the federal government hiring private contractors to poll them after treatment!

  7. Brian says:

    Would just being an occasional cigar smoker get you more expensive coverage?

    Also, I think fewer people object to smokers getting charged more because smoking is harder to prove than a person being obese.

  8. Richard Radzik says:

    How do you penalize obesity when there is no proven method to rate someone. The military tried this years ago, but ended up discharging several good troops that were body builders, had large frames, etc., because they used the BMI method. Secondly, do you penalize someone who has a medical disorder, and if not how do you prove whether or not someones has one?

    Smoking in Public not only affects the individual but those in their immediate vicinity. However, if the person wants to smoke in the privacy of their own home, it is their health and it should be their responsibility to report that to their insurance carrier for the higher risk rate. I have no pity for the person who smokes, then lies on their insurance form, gets caught, and is denied coverage. I also believe that if a person is getting free health care from a program they never paid into, they should be penalized twice. Once because cigars and cigarettes are so expensive, that if they can afford them, then they can afford their own insurance or a portion of their healthcare. Secondly, they are putting an extra burden on the tax payers, who are already suporting these people.

  9. Eric says:

    Agreed. Smoking is pretty clearly a behavioral choice (though quitting is admittedly very difficult), whereas the causes of obesity are not always well understood, and may have genetic or other roots.

  10. Lisa says:

    Food for thought,I know many peoplewho have smoked for years and never contracted cancer of the respiratory system. I have known a number of individuals who died of various cancers and did not abuse tobacco. Alcohol is another problem. People abuse it, get cirrhosis, then need a liver transplant. How about people who have risky sex, contract hepatitis C, then someday end up with liver failure. IV drug abusers too.
    Do you see where I’m going with this? Big government will eventually be given the right to invade our personal privacy freedoms…mandatory genetic testing, substance testing, electronic health record, etc… just by adopting the rule that smokers and obese people must pay higher premiums because they “choose” to abuse their bodies. This is the beginning of the end of self determination. Government does not belong in our personal lives, our health plans, our health record, our doctors office,etc.
    We all make choices we have to live with daily…that’s life. Sadly we are human and shouldn’t be penalized for what we put in our mouths or lungs. eating and smoking is not illegal. Drinking is illegal beyond the limit for DUI. I have never heard of a pedestrian being killed by a driving smoker or an obese person simply because the driver was obese or the driver was smoking. I see that the media and general public like to focus with their self grandizations. They are ill-informed of the stats.

  11. Eric says:

    Ah, the old slippery slope argument…how persuasive.

  12. Richard Radzik says:

    @Lisa. I disagree with a little of your view. Smoking is not illegal, but the smoke that you may enjoy, permeats the air and settles on my body and clothing. Now, drinking is not illegal either, but the bi-product of beer is urine. Would you mind if I permeated the air and let my urine land on your body or clothes? I would think not.

    Also, several accidents have occured by drivers smoking, when the ash of the cigarette falls on the drivers clothes and is distracted and have struck other cars. There are also accounts of people being temporarily blinded by smoke from their own cigarettes and in turn causing accidents.

    I agree that government has put regulations on anything that they want to control, i.e. Guns, tobacco, firearms, foods, restaurants, drugs, school attire, etc., etc., etc. I also disagree with the majority of these rules, but until we get back to being responsible for our own actions, and the bleeding heart liberals stop trying to turn us into a Nanny State, we will be stuck with more and more regulations. Remember that when a person jumps out of a normally good aircraft for fun, and there parachute doesn’t open, government will be there to investigate and place another regulation on the average citizen because of the stupidity of one individual, especially if the person is rich, well known, a child, a person with good looks, etc. All of the before listed people’s, are never looked at for their stupidity, but how to blame somebody else.

  13. Lisa says:

    Point well taken. I can agree on some of your statements. I have 25 years of experience as an OR RN. Your urine analogy would be considered legitimate to a layperson…but guess what…contagious diseases can be transmitted via bodily fluids and then there in lies the conundrum. I might contract a deadly or morbidly life altering disease wich would result in attempted manslaughter charges against the person who poured urine on me. It is also considered assault and battery in the healthcare field to purposely expose, pour, splash, prick with a needle, scalpel etc. I totally understand your point on second hand smoke and its unpleasant if not revolting smell. I totally understand the need for a human being to do everything possible to not expose him/herself to toxic chemicals which they themselves are not inhaling or drinling. I donot think you see the “slippery slope’ as mentioned by the other reply I recd. The healthcare reform act is of great concern to me and my colleagues. It is very scary to think that some litlle guy in the IRS is going to have detailed info about one’s personal habita/ health care record. By “labeling” someone as obese, a smoker,an alcoholic, an IV drug abuser according to someone’s idea of what “normal” should look/act/behave like etc and then telling them that their choices are the root of all their healthcare issues so tough… is self serving to those indidviduals who lack human compassion for the frailties of man. What if you are genetically predisposed to having a fatal disease, choose not to have a surgery that would remove tha organ or body part that is carrying that DNA sensitive tissue where the cancer can occur because that body part makes you a male or female and years later you do come down with that cancer. The surgical and medical intervention you would require for treatment at that time would cost 10s of thousands of dollars more than when you were genetically tested…do you tell the patient that sorry tough it out babe you should have had that removed as soon as you found out you were genetically predisposed. So pay your own way. My point is that not all smokers fie of lung cancer, not all obese people die of hypertension/MIs, not all breast cancer victims have a genetic predisposition, I could go on and on. SO we cant allow the government to gain access to information related to what we do with our bodies, healthcare charts, doctors offices, our homes and whether we smoke in or out of them BECAUSE if we start with the polling it is the tiny little tear in the fabric of liberty that has made this country great. Forget the polls. Somebody has to stop that process from even being contemplated. i thank you for you opinion and I am happy we live in a place where we can exchange ideas. Got the point/

  14. Pedro says:

    Because both are blood thinners as a side effcet and both can effcet the stomach, causing gastric bleeding and ulcers. BOTH these tablets are best taken WITH FOOD to avoid complications as much as possible.I wouldn’t recommend taking aspirin and ibuprofen regularly but every now and then should be ok. As long as you have no bleeding, such as when you move your bowels and notice frank blood (new), dark blood or stomach pains.You should also ask your Doctor about this also as I don’t know any of your medical history. For someone very healthy, it would not be a problem if not that often.

  15. Richard Radzik says:

    I totally agree with your assessment. Neither one of these options should stand alone on a basic principal that one is worse than the other. Insurance should be based on risk (total risk), because that is what insurance is all about. It takes a large number of people or incidents, and averages them out to determine what percentages will get a specific illness, when they will die, etc. and where the risk stands. They bundle all of these risks under one major policy group. You may smoke and supposedly be more risk than me for lung cancer, but you may be thin as a rail, and I obese, and I may be more of a risk for heart disease. People do have the option, in many cases, where they can tailor their automobile, life, health, liability policy to their lifestyle, by opting out of a portion of a life insurance policy. However, all being said, this is a private company, and should be able to make a fair profit. The government on the other hand, should have no say in my personal life, unless my actions harm others physically or have a high potential of doing so.