A thought-provoking article in the NYT Magazine asks whether organizations should be able to refuse to hire obese workers or to charge them more for health insurance. At the Cleveland Clinic, they’ve stopped hiring smokers for two years, and heart surgeon/Clinic CEO Delos M. Cosgrove wishes he could legally refuse to hire the obese as well. Or, he suggests, to charge the obese more for health insurance.
The analogy between smoking and obesity is thought provoking. Both are the result of behaviors, both can have negative impacts on health. Many of us would characterize our relationship with food to be an addiction.
So why does this analogy offend me?
For one, it’s relatively easy to not become a smoker: don’t start. But alas, the obese were introduced to their drug of choice when they were mere babes, by their parents no less! The government, in its wisdom, has restricted cigarette sales to those over 18, but even the smallest kid can buy a candy bar as long as they can hand the money over the counter. Nobody has to smoke just the right amount every day to live, but those who abstain from food won’t be doing it for long, one way or another.
How much is unhealthy behavior a choice? And even if it is, do we deny those who make those choices jobs and therefore, in this society, healthcare?
At least if you’re a smoker, you can get a nicotine patch to curb the urge. If someone invented a food patch, I’d be the first in line to get one. But wait, what’s that? Many people smoke to stay thin! Maybe the Cleveland Clinic, in limiting their hires to non-smokers, is actually selecting a more obesity-inclined workforce.
And really, why stop at smokers and the obese? There are lots of other groups who have a higher propensity to use health insurance-the reckless, the drinkers… the opportunities for savings are endless! Get rid of those with heart disease or cancer, too, since even if you have a genetic propensity toward it you should have changed your behavior to avoid those ills.
And once you remove everyone who behaves in a way that may jeopardize their health, you could have a very healthy, virtuous workforce, but it might be rather small. And those healthcare providers might not have much patience for the rest of us more fallible human beings.
But then, I’m someone who until very recently would be categorized as obese. What’s your take?
