Is It Okay to Fire People Who Smoke or Are Obese?

Two years ago, as part of their "wellness initiative," the Cleveland Clinic stopped hiring smokers. When the Clinic's CEO, Delos M. Cosgrove, was asked about the program for an article in last weekend's New York Times Magazine, he said that if it were up to him, he would also stop hiring obese people as well.

Clearly, lifestyle decisions lead to huge medical and financial costs to both the hospital and the country. The logic, according to Mr. Cosgrove and others who justify not hiring smokers and people who are obese, is that punitive sanctions will coerce smokers and overweight folks to live healthier lives. Not hiring them or charging them more money for insurance, according to their logic, would effectively persuade people to change harmful health practices.

These arguments and rationale were explored in the August 16th New York Times Magazine piece "Fat Tax." Since public health campaigns have been successful in reducing smoking, the article asks, shouldn't we use similar tactics to rein in obesity?

A few years ago, the Drug Policy Alliance anticipated that arguments used against smokers today could be used against overweight people tomorrow. We spoke out against a Michigan heath care company that fired four employees for refusing to take a test to determine whether they smoked cigarettes. The company, Weyco Inc., adopted a policy that allowed them to fire employees who smoke, even if the smoking happens after business hours or at home. The company justified the firings because smokers were costing their company more money for health insurance.

At the time, the Drug Policy Alliance created a flash animation that asked viewers to vote on whether the company should be allowed to fire employees who smoke. The flash animation laid out compelling arguments for both sides, explaining that smoking results in 400,000 premature deaths each year. But it also pointed out that smoking is not the only activity that increases health risks and costs. Smokers may be the target today, but who will be next? People who are overweight? People who ride motorcycles? Most importantly, the animation raised a powerful question: should people's private lives be subject to oversight by their employers?

Like most people, I support campaigns to reduce smoking and obesity. I believe in public education campaigns and policies that offer help to people who are trying to quit smoking or unhealthy eating. Positive incentives like gym membership reimbursements, or cessation aids like the smoking patch or Nicorette gum, can be valuable aids to those who struggle with addiction. But by firing workers for smoking or being overweight -- and penalizing them when it comes to their health care -- we will be demonizing and marginalizing those to whom we should be reaching out.

They fired the smokers first. Now they are talking about not hiring obese people. Your personal struggle or lifestyle choice may be next!

Tony Newman is the director of media relations at the Drug Policy Alliance.

Comments

[simplesense]

A thoughtful piece. Kudos! Those that want to usher in the Brave New World/1984 reality must be rejected.

Freedom!

[mirandawilde]

Why is it that people like you and Sarah Palin who reference Orwell and Huxley seem to have no clue about what they were writing about? Why don't you check out some cliffs notes sometime?

[simplesense]

Nice, you got to equate me to Sarah Palin...what a great dig. And original! You are so very, very bright.

Being so bright, you most definitely understand freedom more than most. So, great scholar mirandawilde, I suppose that you would tell us in your wisdom, that it wasn't freedom that they were advocating, but fascism (which in your ignorance you no doubt equate to conservatism in general) that they were decrying, no?

[Laura Walker]

Heck, it seems to me by this logic the most reasonable thing to do is fire anyone who reached middle age. We all know they are on the downward slide into increased healthcare costs. And while we are at it, toss the women of childbearing age too, unless they can prove they are voluntartily sterile, then they can keep their jobs. And anyone in the Guard or Reserves, that's a really dangerous activity these days...they should be out too as far too costly to their employer.

I can understand medical institutions having a policy against smoking but just general corporate USA.......smacks of discrimnation. What's next? Tattoing he wrists of former smokers and anyone supposedly cured of any signiicant disease?

What has become of this nation?

[carmenincali]

How does one determine the bottom line on a fringe benefit? Like health insurance? Benefits are not gurenteed perks or rights to begin with, it's shady to discriminate on habits because of this.

I personally never had a problem with health insurance. People fudge their stats for insurance all the time. "How much do you weigh?" "Do you smoke?" I don't know if insurance stats reflect the obesity rate in America.

But that shouldn't keep someone from being employed, esp if they're a good employee. I also worked with people who did drugs on the job. The reason why i don't mind smoking is because cigs won't lower your inhibitions or slow you down like drugs or obnoxious people will.

I'm in California. I take care of myself, personally never had trouble with insurance. Infact the only trouble I had was with expensive medical care as a result of illegal immigrants draining the system. When our country fixes that problem, then we might take your "concern for our health" a little more seriously.

[eoz]

The only reason an obese person should ever be fired is if they aren't performing their job in an efficient matter, just like the rest of us. It's plain and simple. Same with smokers. Are they healthy lifestyles that should be encouraged? No, not really, but if they can do their job, pay their bills and taxes and are general, law abiding citizens, then what's the harm?

[Oomingmak]

Positive incentives (for whatever social good) are great. Negative incentives (such as firing smokers or obese people) is totalitarian, un-American, and absolutely unacceptable.

[PunKinPai]

If health care costs of individuals are reasons to discriminate in employment, would not pregnancy or disability be also?

[joelaf]

I once blew a job interview, because I answered no to do you have kids? When the employer followed up with why, I said I can't. ackward. He was a Brit in Atlanta, but hated the South.

[BOHICA]

You do know, don't you that any questions regarding marital status, number of children, potential children, plans for children or reasons for not having children are illegal to be asked at job interviews along with questions about age. Doesn't mean they don't get asked, but it does mean that you don't have to answer.

Too late for you now, but sheesh.

Like my mama always said, just because someone asks you a question, doesn't mean you owe them an answer.

[lieslgee]

It's been shown that overweight people are hired less often than normal weight people, and this is going to make it much worse. As it is right now, I am unable to find an insurance company who will sell me medical insurance because of my weight. I'm not sick; I don't have all those horrible things I'm supposed to suffer from. Yet it doesn't seem to matter to the insurance companies. What I have is a risk factor, like so many people of normal weight. I could die of a heart attack tomorrow; so could you. I pay a couple hundred bucks a month for a coupon plan that probably won't even get me in the hospital door, but it's all I can get. That is why I was hoping for a public option so I could at least buy some insurance. Now I'm hearing that there will be income limits, so I may be SOL there, too.

I wonder why it is that our medical insurance has to be connected to our work. Why should it be up to my employer if I can get insurance or not. I'd rather that my ability to earn a living is not connected to anything medical, perceived or otherwise.

[Emmazon]

Absolutely no comparison. Give up smoking and live. Give up eating and die.

[Oomingmak]

Ummm, sorry -- that makes absolutely no sense whatsoever.

[JonShank]

Is It Okay to Fire People Who Smoke or Are Obese?

No - but it IS okay to fire people who smoke obese people!

[overd0g1]

I don't know about you, but I signed a paper saying that I served my employer at his/her pleasure. I could quit at any time for any reason, and they can fire me at any time for any reason. I wouldn't have it any other way ( unless I could swing a guaranteed multi-year contract). So yes, they can fire you for being thin, short, fat, bald, bad dresser, good dresser, black, white, lazy, ambitious, whatever. Or at least they should be able to.

[Mortifyd]

Well, you chose to sign that. "Right to work" is just another way of saying "slave"

[tc2598]

I'm going to assume this person gets paid.

Slaves don't get paid.

So it might be another way of saying "slave" but it's not a very accurate one.

[Oomingmak]

That doesn't sound like a company I would care to work for. And extended to a national scale, it's not a country I'd want to live in either.

[bugsbonzai]

Smoking is a personal choice. Obesity is the result of personal choice. (A tiny percentage of people have a gland problem, not an excuse for the 99% who don't). Smoking and overeating are personal choices that can be stopped if desired. They have both been proven to be deadly.

I don't see anyone complaining when athletes sign contracts that control every minor activity they can and can't participate in during the off-season. If the candidate for the job wants the job, they'll agree to the stipulations.

So I come down in the middle. I have a problem with employers trying to retroactively change their policies to fire existing employees who smoke or overeat. But I have no problem with employers dictating what they want in a candidate for future employment, just like sports teams do. But only if it directly relates to the job at hand.

Otherwise, we need to make it illegal for ALL employers to participate in these restrictions, without exemption or "special consideration" for ANY job. Of course, that's absurd. Or do you want a narcoleptic working traffic control? Why not? That's not even a condition they can control, and you complain about people being barred from positions for conditions they CAN control? There has to be a middle ground.

[Bethab]

Then can we also fire or refuse to hire a**holes? They increase everyone's stress, which is bad for blood pressure. That increases costs too!

[Oomingmak]

LOL. Excellent point.

Reductio ad absurdum.

[robadeaux]

both of these types are really drug addicts and deserve treatment. But maybe we should just jail them like we do other drug addicts... we do have a war on drugs...

[JonShank]

NOW you're talkin' robadeaux. Addiction isn't a disease. AIDS, Cancer, ALS, Alzheimer's, Parkinson's... THOSE are diseases...

[rlugbill]

Right. We should have a war on smoking and a war on obesity. We don't have enough wars going on right now. It should be a crime to smoke or to be obese. Lock em up!

This would help create jobs as prison guards for normally-weighted, non-nicotined Americans who abide by the laws against smoking and overeating.

[CelticMajic]

Lifestyle and universal health care. Should we be forced to pay for the consequences of distructive lifestyle choices?
Smoking?
Obesity?
STDs?
Abortions?
AIDS (as a result of lifestyle choice)
Injuries sustained while committing a crime?
Auto accidents for those judged to be in the wrong?
Drug abuse?

[Dynamohum]

The Hippocratic Oath forbids discriminating based on personal judgments. It is about treating everyone to the best of your ability.

[CelticMajic]

got that. The question is should you personnally be forced to pay for someone who deliberately choose a lifestyle that results in ill health?