Tribune Company Will Charge Smokers $100 a Month

Answered affirmatively in the blog post.

 

Putting on my day job hat... The post doesn't mention if the Trib is going to test people for smoking (like the company in Michigan -- Weyco -- does). But most companies who are doing this waive the extra fee if you at least participate in smoking cessation. But there are whole health plans designed around various "biomarkers." If you miss them, and you refuse the offer for free help, then you pay. Technically, the total company/employee share of health coverage is the same for everybody. It's just that the ratio gets worse for employees deemed engaging in unhealthy habits. That way, you get around state discrimination laws.

Where does this stop? Hard to tell. A lot of companies, especially small- and medium-sized businesses, are getting pressure from their own employees to do stuff like this, because they're tired of, in their minds, paying for other people's ill health. And companies are desperate to cut health costs by any means necessary. Of course, insurers -- now that one or two plans are dominant in each individual market -- have the sway to do whatever they want. An interesting trend is the large number of single twentysomethings who elect to go without insurance, because it's now so expensive they figure one broken arm a year will cost less than maintaining insurance they probably won't need. So insurers are spooked because healthy people are not buying insurance, thus reducing the available pool of money to pay for those who use it.

The buzzword now is "consumer-driven" health, as in every person is supposed to take "ownership" of his/her health. In theory, that sounds good -- why not be encouraged and rewarded for good health habits? In practice, that means higher deductibles and more incentives to get you not to do anything that would remotely be considered risky or unhealthy. Is the day coming when, say, an insurer won't pay for a skydiving accident? An injury in a car accident that was deemed to be your fault? At this point, anything is possible.

DocTalk can most certainly weigh in very knowledgeably and passionately about this.

 

The company I work for charges more for smokers. It's around $100. But they don't test us if we do smoke and most people who do pay the premium for those who don't.

 

Fat boys and girls watch out. You are next.

 

This is becoming pretty standard practice. Sure hope we don't see virtually every major employer put this is place around the same time. Talk about one pissed off and cranky nation if you've got all these smokers trying to quit at one. Might be a good time from a trip to Europe.

The next frontier is going to be around obesity. You've got inherent challenges in that whereas smoking is a choice, arguments can be made that obesity may not be, so there's a fear of legal reprisal for companies that want to go this route. But make no mistake-- it is being looked at hard, because the top two drivers of 'big ticket' medical costs for employers are smoking and obesity.

 

Obesity is tricky, though.

Based on the height/weight index, most NFL running backs would be considered overweight or obese.

Any serious bodybuilder would be considered obese.

 

Agreed, Ace. That's another of the challenges with obesity--how to measure, where the cutoff point is, etc.

Not sure it will actually happen, but it is being looked at pretty intensely to investigate the possibilities.

 

The BMI scale is a load of crap. It's just some ratio thrown together without a lot of thought about reality. Obesity is much more acurately measured with a simple body fat test.

I have a feeling that if Uncle Sam is going to be the new health care system, you (the generic you) being a smoker or obese will soon be Uncle Sam's business, too.

 

Yeah, but I think businesses would have a problem requiring their employees to submit to body fat testing.

 

The one thing stopping insurers and companies from going whole-hog on this is that there are laws limiting discrimination in employment and insurance. For example, I believe only 21 states allow you to fire smokers. I also believe that in every state, when it comes to the obese, you can charge them more if they don't go to your free weight-loss classes, but you can't charge them more if they don't lose weight.

Ace: the business itself wouldn't have to test body fat. The information might be pulled from claims data, or the company/insurer could require an annual physical under the new plan -- or charge you a greater share of the insurance bill if you don't go.

 

Perhaps. But if it becomes a requirement to qualify for a lower-rate insurance plan, it will happen -- as Bob Cook suggested.