More workers must pay for unhealthy habits

Smokers are the first to feel the financial wrath of employers desperate to find ways to cut their health care costs.

By Mike Norbut, AMNews staff. March 20, 2006.

Businesses long have offered the carrot of bonuses or gifts as incentives to employees for participating in wellness and prevention programs. But now, in response to spiraling health costs, businesses also are reaching for the stick.

They're charging extra for health insurance or even not paying for it at all for employees who engage in unhealthy habits -- most notably, smoking. They're also saying they won't hire employees who use tobacco, or will fire those who do.

Medical societies for the most part have not set policies on companies using punitive methods regarding wellness, though generally doctors say punishment shouldn't come without a company offering assistance to employees to help them break unhealthy habits, something companies generally do. AMA policy states that health insurers should pay for smoking cessation efforts.

A growing number of businesses see wellness as not just good for the employee, but good for the company's bottom line, and they have less tolerance for those perceived unhealthy employees who would drag it down.

"I found the carrot doesn't work," said Howard Weyers, president and CEO of Weyco, a medical benefits company based in Okemos, Mich., which has attracted media attention for its heavy use of the stick on its 200 employees. "When you're using the carrot, you're dealing with fewer people. You have to get after the high-risk people, and if there's no consequence, they don't do it."

Weyco has all but eliminated smoking over a three-year period through a gradual, penalty-based process. Applicants who test positive for tobacco are not hired, and employees who test positive after a random tobacco test are sent home for a month without pay, said Weyers, who says he has never smoked. Four employees who refused to take the test were fired.