Should smokers pay a greater share of their health-care premiums?

Wal-Mart has announced that it will start requiring employees who smoke to pay a higher percentage of their health-care premiums. More than one in four large employers do the same. Today’s Question: Should smokers pay a greater share of their health-care premiums?

  • Clark

    Yes, unless you are a wall street protester, then the rich should pay for the health care off lazy slob freeloader smokers.

  • John

    Yes, and so should overweight people. Overweight people cost society much more than any other group. Its easy, just weight everybody. People would be forced to eat and drink more responsible.

  • Kara

    If insurers charge more for smokers, and if they also support programs to help smokers quit so they can presumably avoid the cost, then it makes sense to pass that insurance cost onto only the affected population. But what is a ‘smoker’? How would an employer know? Does an occasional party indulgence count the same as a consistent habit? And does the health risk of smoking really justify the insurance rate increase, especially in working age people? I would assume that most of the real costs of smoking (COPD, heart problems) don’t occur until after retirement, or come as death not disease (that needs care). These are costs that the insurers wouldn’t pay…

    A similar argument might be made about obesity, except the causes are much more complex and hard to separate from societal ‘norms’, at least at this time. Anyway, I think some of the previous comments to this point are pretty thoughtless and offensive.

  • Dwayne

    That’s a trick question right? Of course they should. Their insurance premiums should already reflect there chosen lifestyle choices. Is this a great country or what ?

  • Wade

    YES. Did you get that? Let me say it again……..YES they should.

    Let’s leave the overweight people out of this. Unless we find a better method than BMI to determine the ranges. BMI is not a good indicator of health.

  • Bob Moffitt

    I think that private health insurers in Minnesota should fully cover the costs of the 7 smoking cessation medications recommended by the American Lung Association (full disclosure, my employer).

  • Rich in Duluth


    The smokers I know don’t want to smoke. This is another attempt to find a simple solution to a complex problem. Paying more only punishes people who are already struggling with this addiction.

    Companies should provide, and encourage smokers to participate in, smoking secession programs without a co-pay. Spread the cost over everyone in the healthcare plan, just as other diseases are covered.

  • Steve the Cynic

    Why does Wal-Mart have to be in the health insurance business, anyway? If we had a rational health care system, like they do in just about every other industrialized country, this wouldn’t be a problem.

  • Larry M.

    I would give them a year to use the healthcare to get help in quitting smoking, make sure the insurance covered nonsmoking medications like Zyban and Chantix and other supports. If they follow the program and quit, then they should receive the nonsmoking discount.

  • Alex

    Yes they should. They drive up healthcare costs. But, I agree that they should have the chance to quit before they are charged more.

    Most insurance companies offer a free smoking cessation program.

    Smoking is expensive.

  • Joe Schaedler

    If smokers pay more, then over-eaters should pay more too. I wonder which group costs the health care system more, both in terms of costs per person and as a whole group?

  • J

    Yep, along with soda drinkers, alcoholics, fast-food eaters, couch potatoes, people who drive …

  • david

    Doesn’t matter. They’ll just use it as an excuse to raise some people’s rates a lot, not lower the other people’s, and then miraculously show giant profits the next quarter. All while still refusing to pay for anything, forcing giant deductibles, and still raising everyone’s rates every year regardless. As long as our politicians are nothing but shills for industry, and the voters are dupes for the medical industry propaganda, nothing will be done for the people except drain them of every last penny so a precious few can reap great rewards.

  • Philip

    I’ll tell you what smokers ought to do – stop littering with your cigarette butts. Stop throwing them out the window, stop flicking them in the grass, and quit dumping your ash tray out at the stoplights. In other words – STOP LITTERING!

  • suzie

    To add to J’s list – drug abusers should also pay higher insurance. If they can afford the drugs, they can afford the insurance costs.

  • Mark G

    No, I don’t think smokers should pay a greater share of their health-care premiums. Smoking is a choice, and a risky one at that, but every one of us takes risks every day of our lives……just being out among other people puts us at risk of picking up viruses which could jeopardize health. Walking is risky – people fall down and break bones. Overeating, climbing ladders, sleeping too much, sleeping too little…..all of these put people at some level of risk. How would we determine the level of risk? Are these avoidable risks? Where do we draw the line?

  • Kyle

    Yes. Insurance works by the insured pooling their money and their risk of medical issues together. Smokers increase their risk of having medical issues, forcing everyone else in the pool to pay for their (optional) habit.

    I agree that there should be an option for getting help to quit smoking, but if people don’t take it or are unable to quit it remains the case that those smokers will drive up costs for everyone while also draining a disproportionate share of the pooled money compared with what they pay in.

  • Greg of Saint Paul

    There are none more rabid than a reformed smoker – unless it is a smoker demanding his “rights.” I am a reformed smoker, 2 packs daily at my worst, but I don’t think I am all that rabid today. Rather, I would just look at the actuarial data. Skydivers take unsual risks, as do BASE jumpers and motorcycle racrers. So do smokers. So based on acuarial findings alone, smoking behavior should be assessed for the associated risk. But smoking also should be acknowledged as the addiction it is. Health care coverage should cover smoking cessation treatment at 100% for care and medication. Moreover, because it is an addiction, more than one regimin of treatment should be covered. (Three? [as in three strikes] Four? [as in four downs]). Beyond that, the smoker does need to acknowledge and pay for the additional risk he brings to himself, and burden he brings to the healthcare system. So, yes, they should pay more while they are actively smoking. When they quit, and that cessation can be documented, then they can enjoy a premium reduction.

  • Jason

    Yes, if it’s proven that overall this form of behavior does cost a disproportionately larger amount of health care dollars. Because it is an addiction I would like to see the money go more to prevention and treatment of the addiction before it leads to one or more of the serious ailments. ‘Mark G’ also makes a good point.

  • Jim Shapiro

    In lieu of a logical single payer plan, of course smokers should pay more. There is substantial, indisputable evidence as to the health care risks associated with the behavior.

    And where do we draw the line? When we have behavior- consequence data.

    You have accidents, you pay higher auto insurance rates. In what strange logical paradigm should it not be similar for health insurance?

  • kimMN

    Why does Wal-Mart have to be in the health insurance business, anyway?

    Maybe because back in FDR days, he instituted price and wage controls. Did that temporarily thwart the free market? Nope, it was that so called Progressive policy that set the stage for the government to permanently interfere by choosing which sectors of industry and commerce would succeed and which would fail. I can’t buy health insurance for my self from another state if it is not a state government approved company. Yet, I can buy any auto insurance from out of any state. Why is that?

    The Walmart insurance to employees as is all companies insurance buying is in place from the effects of FDR. During World War II the War Labor Board decided that wage and price controls did not apply to “fringe benefits” such as health insurance, so employers offered benefits to reel in better employees,such benefits as health insurance since they couldn’t legally offer higher wages. No wonder the great depression lasted so long.

    Moving along, employers were later given the tax deduction incentive for offering health insurance instead of letting employees buy their own insurance where ever they want, such as using across state lines competition as we can do for auto insurance! Companies got the tax break instead of giving the employee the tax break for buying insurance.

    The government couldn’t “control” the insurance industry lobbying machine that helps them stay elected without these sponsored employer health insurance. Walmart controls to a minimal extent which health insurance benefit they can purchase so long as it is from a list of state approved insurance companies operating within the state borders.

    Discriminating against smokers by having them pay higher shared premiums means they can later raise everyone’s costs under the ruse of some ” unhealthy” risk factor.

    How would a company determine how much is too much drinking as a risk factor? How would they measure that? Same thing with smoking_ chain smokers vs. a 3-4 cigarette a day person or a one cigar a week after a football game as so many American men seem to enjoy.

    It is a messy system when ever the government gets involved.

    Again this whole issue is just another example of how a liberal government over controls and interferes in the market which causes more problems down the road.

  • kimMN

    The question of raising health premiums for some is a rather risky issue for the Progressive democrats that endorsed The Reid-Obama health reform bill that now sits before the Supreme Court to be ruled on as to being unconstitutional. These things happen when too many Americans are not aware of their Constitutional Rights yet they can recite the weekly TV shows plots. Some studies show that 9 of ten high school graduates have no idea what the Ten Amendments are or who is their vice president and speaker of the house.

    Obama and Reid claimed that ” if Americans liked their current health care plans they could keep them.” Now, however, the Obama administration is issuing further restrictions against those previously protected plans, resulting in the loss of 49 to 80 percent of small employer plans, 34 to 64 percent of large employer plans, and 40 to 67 percent of individual insurance plans (Federal Register Vol. 75, No. 116). Meanwhile, employers losing their grandfathered status will face steep penalties, increasing their costs and negatively affecting wages and job growth.

    The conservative’s effort to reverse Obama Care and stop this loss of coverage will continue this fall as House Majority Leader Eric Cantor recently announced his plan to repeal restrictions that will cost people their current health care coverage.

    Until then, Walmart and other companies will be cutting their costs anyway possible.

  • Amy

    Absolutely not ….NO.

    Smoking is an addiction, a disease. It’s not a choice. It WAS a choice prior to that first cigarette you tried as a teenager, but once you catch the nicotine bug you’re going to be in a constant struggle the rest of your life to try and kick the addiction. (P.S. Try Allen Carr’s book – it saved my life)

    Is Wal-Mart going to punish other drug addicts? Are they requiring people that tan regularly to pay more? How about regular drinkers? What about the out-doorsy types that are bitten by wood ticks on a weekly basis? Have they checked the living conditions of their employees? It’s possible that they CHOSE to live in an area that is dangerous, or in a house infested with mold. What about the employees with vehicles? What if they choose to drive over the speed limit?

    Smoking is an ADDICTION people. Do you supporters not understand that? Can you not have empathy for the person that is struggling, addicted and now being forced to pay more on their premiums? It’s just out-right wrong, and another fantastic example of how corporations keep taking more and more from the little guy.

    And…I think what frustrates me the most is that the “little guy” is typically all for it.

    Mind Boggling.

  • Justin

    Insurance is collective risk. Everyone who buys in takes an equal share of the risk. Whether it is smokers or people who are too old yet decide to have risky pregnancies, the costs are spread across all plan members. Why should smokers pay more if people with bad genes are allowed to dump their long-term risk into the pool without facing additional charges?

  • Jim Shapiro

    Maybe we need a new tax to pay for the commissioning of the BOO HOO IT’S HARD TO QUIT SMOKING symphony (lots of violins of course).

    Yes, it’s an addiction. The most difficult to kick there is. Damn the manufacturers. But there are many reasonably priced, readily available proven remedies.

    Life is challenging, and we all need help sometimes. But to ask me to pay for your challenge via higher insurance rates if the challenge is behavior related is unfair to me and only further demeaning to you.

  • Jim B.

    Yes, as long as the health plan includes access to quit smoking programs.

  • Steve the Cynic

    Employer-provided health care goes back farther than WWII. It was the WWII-era wage & price controls that led to it becoming an institution, but that isn’t how it started. Fringe benefits like that were originally conceived by big-business capitalists as a way to head off a socialist revolution, which was looking dangerously likely after the crash of 1929. They figured if businesses provided their employees some of the things the workers’ movement was demanding be taken over by the government, the employees would consider that good enough and not stage a full-blown revolution. In other words, the idea was for business itself to take the place of a socialist state in workers’ lives.

    Employer-provided health care was never a good idea, and the time has long past to do away with it. That’s one of the few planks of John McCain’s platform I agreed with in the 2008 election.

  • uptownZombie

    I actually don’t agree. The idea of healthcare, in my eyes, isn’t really to point out bad decisions and monetarily penalize people for those, but rather to provide healthcare to all and a standardized price that everyone pays, not change that price depending on your life choices.

    Should we also charge people who ride motorcycles a higher premium? How about those who eat too much salt? how about people that use plastic in microwaves?

    It can be taken too far.

  • Maya

    There have been a lot of good points made, such as the fact that ANY unhealthy life choice should be penalized if smoking is. So being obese, smoking, excessive drinking, narcotic use, etc., should all incur penalties. And conversely, these factors are inherently built into group premium rates, assuming that as a general population, X people smoke, X partake in risky behavior, and X don’t eat properly. So there really should be additional premium costs to those X people on the plan.

    I think that the better incentive is what my husband’s insurance does for us – you receive a *discount* if you DON’T smoke. Also, if we pass certain critical biometric areas on our annual physical exams (i.e. BMI, Cholesterol, Blood Pressure), we receive further discounts on our premiums. If we don’t pass any biometric measure, we are allowed to enroll in free programs that will help us attain the set out goals. This has definitely been cause for our household to continue eating healthier, and exercising more regularly, when we can potentially save $1200 a year by doing so!!

    So rather than penalize people further for their addictions/weaknesses, reward those who have overcome (or work towards overcoming) those areas of their life. Over time, with these incentives in place, overall healthcare costs should inherently go down, and the premiums should in turn reflect that.

  • Kevin VC

    Short answer is yes.

    The ‘choice to smoke’ has consequences.

    Now if the smoke realizes the concept of addiction and tries to quit, then I would say if in 5 years they stay clean one should remove any burdens.

    Of course one could address it like congress does on Student Loans, NEVER FORGIVE THEM.

    So be it.

  • GregX

    Nope- we should recover those costs through “burden added taxes” or BAT .. which is the sister of the “value added taxes” or VAT. We could determine that national cost of TOBACCO related medical costs and … assign a BAT on all TOBACCO and TOBACCO-related) products to cover those costs. The BAT revenues would delivered to a GOVERNMENT managed account to pay for private sector medical services. We could devise BAT’s for alcohol, motorcycles, automobiles, bicycles, guns, fatty foods, … based on actuarial tables, But I suppose someone will say NEIN, NEIN, NEIN

  • Deb

    Absolutely not. For anyone who thinks this is the end you are wrong. There are plenty of people who take risks – skiers can break a leg – hikers can trip, unprotected sex, invitro fertilization resulting in multiple births and high risk care for premies and moms. It’s popular to ostracize smokers but I suspect the dollars spent on their last days of life is no more then what is spent on an overweight or obese person’s life time of care. Should they be denied. Ridiculous.

  • kimMN

    Should any company charge more based upon some variable when they purchase group plans for a discount to begin with and then they take the tax deduction vs. the employee? Bah. What’s next in over control ideology? Use a DNA test to check for biological dispositions of one’s heritage?

    And where are the extreme liberals revolt, those that would otherwise be crying out, ” discrimination” ??? Studies show Blacks have higher rates of diabetes and sickle cell anemia than other groups. So should Walmart charge that group as well for higher rates??? ouch!

  • Steve the Cynic

    In case you hadn’t noticed, kimMN, smoking is a choice. Being Black is not.

  • Aaron

    Can anyone explain why a personal choice is the concern of fictional organizations controlling a country? The belief that currency is a falsity in this reality is growing stronger. It’s just another excuse for walmart to rake in the millions and deprive yet another culture of a hopeful future. However there is a bad side to media, too.

    Students at a revolutionizing university, located in central Minnesota, have much to ponder about from the last few months. Most adults (but not all) in the community are still living in the glory days of the riots in the late 1980’s. A handful or two who are employed by the university have their minds on a wire, making budget cuts and unexplainably firing an employee; just a few recent problems to notice. One problem has slipped many minds after realizing it’s just a humorous show.

    The tobacco ban on campus has done nothing but aggravate smokers. Personally there is no idea what the motive is behind the act. Persuade those who smoke to live a healthier lifestyle? Pardon, but there were no questions on the survey handed out from the student government about health choices or lifestyle. Only asking if you smoke and how much per day. Now the university has designated smoking areas which were only listed on the internet. What’s this about converging media? The argument has grown tired of the smoking ban on campus but still brings a thought to most. Health risks are evident because of smoking tobacco. However many people still live healthy lives while choosing to smoke. Just because there are those who disregard their health more than others mean we have to be constrained to areas for our indulgence? Perhaps they think we’ll soon be extinct and decided to make a zoo…

    Smoking may not be the best alternative and I was on the pro side for a debate team in a class last semester on the topic of increasing tobacco advertisement restrictions. Still I stand on the side for a recreation that has existed in many cultures through thousands of years. Slavery probably exists somewhere; wouldn’t that be a larger concern? Be it a university or walmart, tobacco use is a choice. Then again, so is voting.

  • Charles Hawkins

    The story I recall is that Minnesota Blue Cross and the state of Minnesota sued the tobacco companies for the extra medical costs created by smokers.

    The state got it’s money and so did Blue Cross. The only ones not getting any consideration out of this are the addicts, the victims of these avaricious marketers of death in small doses.

    Has any smoker successfully sued for their personal loss? Tobacco is the most heavily taxed product and the best information I can find is that the money is going to schools, sports stadiums and pretty much anything other than helping the addicted. Instead, smokers are villified and belittled and dehumanized.

    But isn’t that the American way, blame the victim?

  • Fran

    End the War on Drugs and we won’t have this problem.

  • Steve


  • Steve


  • Joel

    Well, of course. Are frequent traffic offenders charged higher premiums for their unsafe behavior that unbalances the risk pool?

  • Ariel Geberth

    Impressive, will be expecting to go through far more posts from you.

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