Healthier state may come with incentive plans rather than fees
If a proposal by the S.C. Budget and Control Board that’s endorsed by Gov. Mark Sanford and state Sen. Hugh Leatherman of Florence is approved, state employees who smoke may have to pay more for health insurance.
Starting in 2010, workers covered by state health plans and HMOs who use tobacco products — or have family members on their policies who do — would be charged an additional $25 a month. The surcharge could affect tens of thousands of employees and save the state millions, according to the S.C. Budget and Control Board.
Sanford said those who choose to smoke should shoulder more of the burden of caring for ailing tobacco users.
That makes sense — on the surface, anyway.
Following this logic, will state employees who drink alcohol or overeat be required to pay surcharges, as well? After all, the health hazards of alcoholism and obesity and their economic impact are just as well-documented as those for smoking.
The need for some people to smoke, drink and overeat also is treated by many health care professionals as an addiction born more out of physiology than personal choice.
If that’s the case, would it then also stand to reason that people with such conditions as cancer be required to pay more for health insurance? Cancer, after all, isn’t necessarily triggered by a person’s lifestyle and is extremely expensive to treat.
Considering all these points, does it really make sense to punish people for poor health?
A far better idea would be to offer state employees incentives for achieving and maintaining good health. Maybe a health insurance discount is in order for state employees who join fitness clubs or complete smoking cessation classes.
It’s true that just because someone has a fitness club membership, it doesn’t mean he or she is actually going there to participate in regular exercise. And just because someone has taken a smoking cessation class, it doesn’t mean he or she is cured of the nicotine addition forever.
But it sounds like this proposal by the S.C. Budget and Control Board doesn’t include a sound enforcement plan, either.
To be exempt from the tobacco surcharge, state workers would have to sign an affidavit saying neither they nor anyone covered by their plan uses tobacco. Officials said they have not decided on a penalty for falsifying an affidavit.
Some states, such as Indiana and Kansas, employ random testing. Alabama, Georgia, Kentucky, South Dakota and West Virginia are the other states with tobacco surcharges. States began implementing tobacco surcharges to their health care plans in 2000.
By jumping on this bandwagon, Sanford said South Carolina is able to “tailor-make incentives and penalties … that begin to lead to more in the way of health and less in the way of cost.”
Is smoking less damaging to one’s health than drinking alcohol to excess or overeating to the point of becoming morbidly obese? Are any one of these things more hazardous to the public’s health than the others? Depending on the statistics you choose, alcoholism and obesity can be considered even more deadly than smoking, so it doesn’t seem fair to single out smokers as the root cause of South Carolina’s health and health care woes and expenses.
By no means do we condone smoking. We’re all for making South Carolina a healthier place to live.
We don’t think imposing a punitive fee on 24 percent, or 58,560, of the state’s more than 244,000 health care policyholders, however, is the best was to accomplish it.
Morning News
August 26, 2008