Friday, March 11, 2005

Refusing to Hire Smokers to Reduce Health Insurance Costs

Montgomery County, Pennsylvania, is considering whether to stop hiring anyone who smokes, according to the Philadelphia Inquirer. The reason is to save health insurance costs. The Chairman of the County Commissioners, James Matthews, said, "if we can cut down health care cost by not hiring smokers, let's do it. This is not about taking away anything from anybody."
This is another example of the confusions resulting from having employers pay for their employees health insurance (presumably with money that would otherwise have increased their salaries). A small, but growing number of employers obviously assumes that this practice, which arises from history and tax law, gives them a license to either control their employees behavior or exclude employees whose private behavior raises the risk of bad health outcomes.
Of course, if one takes this to the logical extreme, think of all the sorts of people an employer could refuse to hire on the grounds that their private behavior increases their health risks....

1 comment:

InformaticsMD said...

A classic case of give someone an inch, they try to take a mile.

Employers are allowed to do drug testing screens on the belief that drug abusers represent a danger to the workforce or to customers (I was the Drug Test Medical Review Officer early in my career for the transit authority in Philadelphia, and believe me, you don't want your bus driver high on drugs).

Even then, there was debate about whether private drug abuse at home when not on duty could impair a person's performance hours later on the job, but the consensus was positive drug test = risk = no hire.

Now, employers have jumped the gun to the issue of smoking as a health insurance COST, not a risk to the safety of co-workers or customers (2nd hand smoke issues nothwtihsatnding).

It is actually true that if this rationale stands, anyone with any habit that is a "health risk" could be refused hire.

It could literally get to the point of absurdity where it's judged that people with any habit or medical condition that could cost could be refused employment. Obesity? Poor hygiene (skin infections?) Gum chewers (dental bills?) Skiiers (fractures)? Pilots/skydivers? Cellular phone users (possible correlation of RF exposure with tumors?) Legal gun owners (possibilty of mental breakdown?)

Employment decisions need to remain based on whether a person can do the job for which they are hired, both from a medical and abilities perspective. While I did not approve a person with reduced renal function post-transplant for a safety-sensitive position as bus driver, I had no problem approving them medically as a desk job worker(real scenario).

The current madness must stop.

-- SS