[coachwife6]

SMOKE SCREEN
Companies looking for ways to cut health costs are targeting behavior, on the job and off
By ILAN BRAT
THE WALL STREET JOURNAL

Scotts Miracle-Gro Co. is taking its campaign to stamp out smoking among its workers to an unusual length: It's threatening to fire smokers beginning next fall.

The threat represents the latest attempt by an employer to try to reduce health care costs by targeting smokers. In January, four employees at Weyco Inc., a small medical-benefits administrator in Okemos, Mich., lost their jobs after they refused to be tested for tobacco use. Scotts, which has 5,300 U.S. workers, is one of the largest companies to put an outright ban on smoking even off the job.

With medical expenses rising, corporations are increasingly focusing on the employees who they believe account for the majority of health care costs. Some companies have tried to lower the number of smokers in their work force by offering employees money and counseling to quit smoking. In April, Humana Inc., a Louisville, Ky., health insurer, asked its employees whether they had used tobacco in the previous 12 months. Those who said they hadn't got a $5 bonus in their paychecks each pay period. General Mills imposes a $20-a-month surcharge on the health benefits of smokers.

Weyco announced a tobacco-free policy in September 2003. It used a device similar to a breathalyzer to test for tobacco use. In January, four of its 190 employees chose not to take the test and were forced to leave.

Scotts offers to pay for smoking-cessation programs and products. But the October ultimatum "is way over the top by today's standards," said Helen Darling, president of the National Business Group on Health, a coalition of major corporations. "Most employers are still in the mode of 'You've got to have positive incentives.'"

Firing workers who won't stop smoking is illegal in the 30 states that have laws protecting smokers, according to the National Workrights Institute, a nonprofit organization that focuses on human rights in the workplace. But elsewhere, unless workers fall in one of a few protected classifications defined by state and federal laws, employers have more leeway.

Some lawyers said Scotts could be vulnerable to disability challenges if it fires people who smoke. "Once you start regulating outside conduct, the question is where do you stop?" said Marvin Gittler, an employment-law specialist and managing partner with Asher, Gittler, Greenfield & D'Alba in Chicago.

Smokers who are "really trying" to quit, even after the deadline, won't have to worry, said Jim Hagedorn, Scotts' chief executive. "If you work with us, and we know you're working with us, I don't think you're going to end up getting fired," he said.

Still, Scotts stresses that it expects employees to make a good-faith effort to improve their health. Scotts estimates that about 30 percent of its workers smoke.

The Marysville, Ohio, company said that in October it will begin randomly testing about 20 percent of its work force nationwide where it is legal to do so. (Ohio, like Texas, is among the states that don't have specific smoker-protection laws.) The company says it hasn't worked out the details of how to test employees. Workers found to still be smoking or using other tobacco products habitually could be fired, Scotts says, if they work in states where such termination is legal. In states that have smoker-protection laws, employees who are on the company's medical plan could see their health care premiums become "substantially higher," although details aren't final, the company adds. The tobacco initiative is part of a broad wellness program that includes a $5 million fitness gym and health clinic that opened last month near the company's headquarters. Employees on the company's medical plan will have free access at the clinic to a physician, nurse practitioners, diet and fitness experts, and a pharmacy with generic drugs.

In return, every year employees will face a strict requirement: Take a health assessment through a program affiliated with medical-information Web site WebMD Health Corp. -- or pay $40 extra a month in health care costs. The health assessment starts with a form to be filled out online. Then, a "health coach" contacts the employee and arranges a treatment regimen for any health issues.

CARROTS AND STICKS

Ways employers are trying to get their workers to quit smoking:

Bonuses for not smoking.

A $20-a-month surcharge on the health benefits for smokers.

Free smoking-cessation products.

Free counseling.

Firing employees who test positive for tobacco use.

http://www.dfw.com/m...al/13488846.htm

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That really is just a little ott, i dont think anyone should smoke but the compny you work for shouldnt be able to dictate what you do outside work. But it would never happen here, because we have a national health system, i agree with charging people extra if they smoke that seems fair, but this should raise the question why do people in the richest most powerful nation in the world do not have free nationalised health care for all.

[warriorscot]

That really is just a little ott, i dont think anyone should smoke but the compny you work for shouldnt be able to dictate what you do outside work. But it would never happen here, because we have a national health system, i agree with charging people extra if they smoke that seems fair, but this should raise the question why do people in the richest most powerful nation in the world do not have free nationalised health care for all.

[coachwife6]

I read somewhere else that someone asked..."what's next? are they going to say how much you can weigh or how much you can eat?"

[warriorscot]

Some MP here tried to do that, refuse treatment on the nhs for obese people. Fat chance that was going to happen.

[Kat]

I think it's wrong. Employers can not fire you if you choose to smoke. If I smoked, and if I worked for a company who fired me for it..you bet your life I would sue them. Matter of fact, if they tried to charge me more for my insurance than they did someone else...I'd have a problem with that, too. Who is the employer to decide what is good or bad for their employees? What about the CEO who eats donuts every morning, and clogs his arteries? What about the secretary who drinks a kazillion sodas a day, upping her sugar levels? I mean seriously. If they are going to do this to smokers...they better be prepared for major lawsuits. They need to step back and realize that EVERY employee in their respective companies eats/drinks/smokes...whatever....things that are "unhealthy" for them in some way or another.

[warriorscot]

Smoking is in a whole different league of bad for you, it is very bad for you and it does increase significantly the chances that you wil require incredibly expensive treatment from a health plan and if its a private health plan its fair if you do something that only serves the purpose of making you ill then you should pay more, although firing people is a bit harsh.

You should help people not to smoke, its disgusting and you shouldnt smoke cigarettes at all, costs a fortune as well.

[loophole]

If they are going to do that then as CW6 said

what's next? are they going to say how much you can weigh or how much you can eat?"

Cant speak for other countries but in the U.S obesity is the leading cause of health problems by a longshot. Smoking isnt even close simply because so many people are overweight (last I heard it was 75% of americans are overweight) and less than 35% of americans smoke.

[coachwife6]

I think businesses are forcing these decisions because they are desperately seeking ways to cut the cost of providing health insurance.

[loophole]

Very much agreed. This is the problem with the whole health care system in America.

[warriorscot]

Well simple answer stop voting conservative and start voting for the guys that want to give you a nationalised health service.

Obesity is a big problem here as well, but a session at a gym and a diet book doesnt cost £50, 000 a go chemotherapy on the other hand does, a single patient can cost an insurance company well over a million bucks and if thats preventable you can see why they would want to stop that happening, but they should help people stop i cant see why anyone in their right mind would want to continue smoking especially if they are offered help to stop.

[loophole]

Putting down the cigarettes and not smoking doesn't cost anything either. The problem with the healthcare system isn't the people put into office, the problem lies with the healthcare providers who are continually driving thier prices up.Until thats limited this will always be a problem. And since three fourths of the political contributions in this country come from these people ,what politician is going to change that.

I am not for or against smoking. People do what people do. I agree there should be help for them to stop but to get back on topic If your going to go after smokers then you better go after everybody that does anything unhealthy.

[warriorscot]

Yeah but like i said, a patientwho has had a heart attack can be treated for his condition for life for the price it would treat someone with lung cancer from smoking just ONCE, cancer drugs cost alot of money, the newer better ones can cost more that £50,000 per treatment(almost $90,000 US) and a person needs alot of these treatments and there is still no guarantee of success.

So i can see why they should charge more for a smoker. People often say here that smokers get taxed more for cigarettes so they are paying for there treatment, but it is so expensive and the risk is so high they could charge a tenner for a 20 pack and would still be lucky to cover the costs.

[coachwife6]

Some additional food for thought from the Fort Worth Star Telegram editorial pages.

Going too far? editorials

Fort Star-Telegram

Dec. 29, 2005

Escalating healthcare costs are eating up the bottom lines of U.S. companies
large and small.

Corporate presidents, CEOs and benefit providers are seeking strategies that
will encourage their employees to make healthy lifestyle choices to avoid
the absenteeism and medical costs associated with heart and lung disease,
obesity and diabetes -- all linked to bad choices.

Smoking cessation programs, in-house workout facilities, discounted
memberships to the local YMCA, free counseling, even cash bonuses for those
who shun tobacco -- all are positive reinforcements of healthy choices.

But how far should company officials go to lower healthcare costs? As far as
Weyco Inc. of Okemos, Mich.? Four employees of this small medical benefits
administration firm were fired for refusing to take the company's test for
tobacco use.

Nonsmokers may be tempted to cheer this method, as punitive as it is. After
all, why should they carry part of the financial burden of increased
healthcare premiums because of a coworker's inability -- or unwillingness --
to break a nasty habit?

Consider this: The healthcare costs associated with obesity rival those of
tobacco-related illnesses. The World Bank estimates the cost of obesity in
the United States at 12 percent of the national healthcare budget, nearing
$103 billion annually.

Should benefits administrators become diet monitors, tracking the caloric
and fat intake and exercise levels of employees? Should employees who fall
into the overweight and obese categories in the Department of Health and
Human Services' Body Mass Index be fired?

Companies can and should set policies that are fully defined during the
hiring process. Pre-employment testing for illegal drug use is a standard
hiring practice. The day may be approaching when testing for use of tobacco,
although a legal product, may be standard. But retroactive enforcement of a
new policy is another issue, especially when it can result in an employee's
termination.

Denial on the part of smokers, sedentary citizens and consumers of unhealthy
foods won't change the fact that smoking, excessive drinking, high-fat diets
and lack of exercise contribute to certain illnesses and disease.

From lost productivity to high-dollar medical treatments, the effects of bad
lifestyle choices go far beyond the individual involved.

Every year, more companies that offer medical plans are requiring all
employees, and not just the high-paid executives, to undergo annual health
assessments. It's either that or discontinue healthcare benefits.

ON THE WEB

Calculate your BMI: www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm
<http://www.cdc.gov/n...i/calc-bmi.htm>

[dsenette]

there's a hospital here in knoxville (Baptist Hospital to be exact) that does a nicotene test along with a drug test upon hiring...if you test positive yo udon't get the job...even if you test positive because you're trying to quit ( I.E. the patch or gum)

[nick_mi]

What about the CEO who eats donuts every morning, and clogs his arteries? What about the secretary who drinks a kazillion sodas a day, upping her sugar levels? I mean seriously. If they are going to do this to smokers...they better be prepared for major lawsuits. They need to step back and realize that EVERY employee in their respective companies eats/drinks/smokes...whatever....things that are "unhealthy" for them in some way or another.

Is it harmful to others though, you have to ask yourself that. I know there are usuallly designated areas, but you still get second hand smoke, regardless.

And to be honest, if they charge you more, I am 100% fine with that. Some people call it discrimination, but when you go to court and they whip out their high paid lawyers and medical experts who will prove that smoking is extremely bad for your health and that it justifies the higher cost for health insurance. . . I don't see it standing up in court.

Cant speak for other countries but in the U.S obesity is the leading cause of health problems by a longshot. Smoking isnt even close simply because so many people are overweight (last I heard it was 75% of americans are overweight) and less than 35% of americans smoke.

35% . . . . . I doubt if you include all the babies and kids out there who have yet to try a cigarete it would not even be that close to low. I would say at LEAST 70% of the people in the united states smoke. And yes, 75% might be overweight but the obesity level is no where near that. There is a difference between being a little pudgy and being "obese".

If your going to go after smokers then you better go after everybody that does anything unhealthy.

Again, smoking is an extreme. EVERYTHING is unhealthy. It is deteroation of your body that will kill you in the long run. But some things are much more unhealthy then others, and those should and do have higher priorities.