Some businesses blowing smoke over health care

Dan Bobinski

Soon you might get fired for eating too many Krispy Kreme donuts. Why? To save on health care costs, your company has instituted a policy that allows them to fire overweight people.

As of this writing, the above policy is fictional. However, some organizations actually have policies that prohibit hiring people who consume legal products in the privacy of their own home, and more companies are considering implementing them.

The stated purpose of these policies? Save on heath care costs. They cite research that correlates the consumption of these very legal products with increased health care costs, and therefore claim a right to not hire people who consume these products.

Remember, these products are perfectly legal to buy and sell, but if you consume them on your own time in the privacy of your own home, some organizations will never hire you.

My thoughts on this matter are not new. In 2005 I wrote a column about this very topic, which I titled, “Employer, Yes. Dictator, No.” The title alone should convey my opinion, but to add some data that informs my perspective, allow me to provide information published in reputable news sources as well as from the Center for Disease Control (CDC), and you can make up your own mind about the logic of these policies.

Let’s start first with the epidemic of obesity. According to the CDC, a “normal weight” individual averages $3,400 annually in medical expenditures, with obese people averaging $4,680 per year. The CDC also says nearly 30 percent of all health care spending today is tied to obesity-related issues.

For clarification, an adult whose Body Mass Index (BMI) is 30 or higher is considered obese, and obesity rates in the United States went up 37 percent between 1998 and 2006.

For the record, as long as you can demonstrate an ability to perform a job, employers cannot refuse to hire you just because your BMI is 31. At least not yet.

Allow me now to move on to something more controversial: sexual relations among men. The CDC refers to gay and bi-sexual men having unprotected sex with other men as “MSM” (men having sex with men). Quoting directly from the CDC, MSM “represent approximately 2 percent of the U.S. population, yet are the population most severely affected by HIV and are the only risk group in which new HIV infections have been increasing steadily since the early 1990’s.”

They also report that this 2 percent of the population accounts for the majority of all new HIV infections in the U.S., and “consistently represent[s] the largest percentage of persons diagnosed with AIDS.” It is estimated that 40,000 new HIV infections occur in the U.S. each year.

What does that cost? According to data published by Johns Hopkins Medical Center and Harvard University, “people with HIV can get 24 extra years of life from modern treatments – at a total cost of about $618,900.” Actually, that’s an average price. Research at the University of Alabama at Birmingham shows that treating people with HIV/AIDS is between $14,000 and $34,000 per year, depending on whether the person is newly infected or in the advanced stage.

Spending on HIV-related medical care in the U.S. has tripled in the last 10 years, and the CDC says that “the rate of new HIV diagnoses among MSM in the U.S. is more than 44 times that of other men.”

Finally, let’s look at smokers. The CDC’s most recent statistics show that “cigarette smoking costs more than $193 billion” annually. They also state that 46.6 million Americans smoke. Crunch those numbers and you’ll come up with $4,141 annual health-related costs for smokers. They also note that smoking accounts for between 6–8 percent of health care spending in the U.S.

So, let’s summarize these average annual health-related expenditures:

• Non-smoking, normal-weight non-MSM person: $3,400

• Smoker: $4,141

• Obese person: $4,680

• Person with HIV/AIDS: $14,000 minimum

With these figures at our disposal, isn’t it interesting that to save on health care costs, some organizations are flat out refusing to hire people who smoke in the privacy of their own home? I’m not a smoker, but cigarettes are a perfectly legal substance for adults to purchase.

The question here is “how far will this go?” At what point will companies decide that they’re not hiring anyone with a BMI over 30? Remember, smoking issues are 6–8 percent of our national health care costs, but obesity issues are nearly 30 percent.

Consider also the uproar you’d hear if a company decided to save on health care costs by not hiring anyone who’s MSM.

I don’t care if companies ban smoking in the workplace, but it’s a slippery slope when companies “reduce costs” by refusing to hire people who do legal things in the privacy of their own home.

Refusing employment to an obese person or an MSM who can perform the job is illegal discrimination … and their health care costs are higher than smokers. So what gives?

Dan Bobinski is a management trainer, best-selling author and director at the Center for Workplace Excellence. He makes his home in Boise. Reach him at (208) 375-7606 or dan@workplace-excellence.com.

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One Response to “Some businesses blowing smoke over health care”

1. Bill Says:
   January 26th, 2012 at 10:37 am

   Dan, the reason Idaho small businesses pay out the wazzoo for healthcare insurance (#2 item on the payroll accounts) is that in 1994, in literally the darkened waning hours of the legislative session, Idaho’s idiot legislature (at the behest of the health insurance agents like Sen Dean Cameron & Co) passed one of America’s 5 most onerous “any willing provider” (AWP) healthcare laws. This is a piece of “model legislation” deliberately crafted by lawyers at a Washington based think-tank, and specifically designed to interrupt the business model of an H.M.O. (remember them? the wicked, dirty HMOs?)

   Since that time HMOs have been federally regulated and virtually all of their initially abusive practices addressed in a body of case law nationwide. They now do wondrous things in numerous states, and give a level of healthcare competition for basic coverage Idaho small businesses are totally left without. Idaho has the 2nd lowest HMO census in the nation acc’d to the Kaiser Family Foundation. Along with an absurd income tax system and screwball education policy, Idaho’s healthcare regime is the 3rd leg of the Idaho Legislature’s “Iron Triangle of Poverty”. It’s why the state has fallen from 36th in per capita income in 1980, to just above Mississippi’s today at 49th.