In recent weeks, I've heard from more and more friends whose workplaces are considering (or have already put into place) taxes /fees on their pay or health insurance costs - but only if they are overweight or smokers. As a scientist, I think this approach is reprehensible, and here is why:
- Many smokers or overweight people are in a constant struggle - with either their addiction to cigarettes or their body weight (or both). I know of MANY people who repeatedly cycle between massive weight loss and then regaining that weight, or between quitting smoking and restarting. The people who are trying to tackle their health problems themselves do not need their workplace to add to their burden by inflicting financial demerits.
- Biologically, smoking is an addiction and obesity is the result of a complex interplay between genetic disposition and environmental influences (yes, a healthy diet and exercise regime is part of this - but as any metabolism researcher will tell you, its only part. In fact, two people with the same caloric intakes and activity levels can have very different body weights - because their body's metabolic rates are inherently different). So where does this slippery slope lead us? Who else could be added to this list for increasing overall health insurance costs for a company? Older people (statistically, older people use more health insurance dollars than younger people)? Drug users (and without expensive routine testing, how will employers determine this? Its certainly not out in the open like being overweight or a smoker)? People with genetic diseases or cancer or infections?? Females (as the child-bearers their medical costs are probably higher too)? You see what I'm getting at - this type of thinking is akin to any other workplace biggotry or bias.
- Finally, I think there is a different, better approach to tackle the problem of employee health (and the resulting loss of productivity and high cost of health insurance), and that is Incentives. Other companies offer rebates if an employee attends a stop-smoking program, or joins Weight Watchers or a gym. These incentives not only build morale in the workplace, they place less of a stigma on people struggling with their health. And - if the endgame is to improve health and lower company costs, then incentives would surely be more successful than demerits.