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Fox, WashTimes, Misunderstand Obamacare's 50% Smoker Surcharge, Says Man Behind It
Their Assumptions Are Wrong, and Their Source is Questionable, Says Public Interest Law Professor John Banzhaf, the Man Who First Developed (With The NAIC) - and Then Promoted - the Public Health Concept of Differential Health Insurance Premiums
By: Public Interest Law Professor John Banzhaf
A major purpose of the 50% surcharge is to provide smokers, often for the first times in their lives, with a clear compelling reason to quit – by forcing them to begin accepting financial responsibility for the huge costs their habit now imposes on others. As reported in the Wall Street Journal, the British Medical Journal, and elsewhere, imposing a smoker surcharge by requiring smokers to pay more for their health insurance – as the Affordable Care Act [ACA] provides – can slash smoking rates among employees by 50%.
This is consistent with hundreds of studies showing that making smoking more expensive – usually through higher cigarette taxes – is one of the most effective ways to reduce smoking, and the only one with a net return (rather than a huge cost) for taxpayers. But the doom-and-gloom articles assume that a person's status as a smoker is fixed, even though there are already more ex-smokers than current smokers.
While some may initially try to avoid quitting by paying a fine rather than obtaining insurance, the fines are progressive, so eventually virtually all smokers will have to sign up. The question then is whether they will be willing to pay the surcharge – which, by the way, is far smaller than those of 300% based upon age or residence – or quit, thereby saving their employer over $12,000/yr on the average, and helping to slash the enormous $300 billion a year unnecessary costs smokers now impose on the economy.
Some articles suggest that smoking is addictive, and therefore (like drug or alcohol addiction) should be considered a pre-existing condition for which no additional charge can be levied. But the addiction – if in fact that particular smoker is truly an addict – is to the drug nicotine, and not to smoking itself.
Since the fraction of smokers who are truly addicted can obtain their drug of choice by using nicotine gum, patches, inhalers, etc., they are not entitled to be excused because of a so-called “addiction.”
Also, the obese are not required to pay more for health insurance because the federal government ruled, in a legal proceeding Prof. Banzhaf brought, that obesity is a "health status" which is protected by law, whereas smoking is simply a "behavior" entitled to no protection.
Articles attacking the smoker surcharge usually cite a major national health organization, but fail to note that it may simply be more concerned that its own funding, for antismoking-
It's also interesting to note that the major health organizations have opposed many of the most effective measures to help the 90% or more of smokers who want to quit to do so. They opposed restrictions on smoking on airplanes and in offices, bans on smoking in private residences to protect children or neighbors, and the smoker surcharge which Banzhaf helped develop in the 1980s – along with the National Association of Insurance Commissioners [NAIC], the state officials in charge of protecting the public by regulating insurance.
JOHN F. BANZHAF III, B.S.E.E., J.D., Sc.D.
Professor of Public Interest Law
George Washington University Law School,
FAMRI Dr. William Cahan Distinguished Professor,
Fellow, World Technology Network,
Founder, Action on Smoking and Health (ASH)
2000 H Street, NW
Washington, DC 20052, USA
(202) 994-7229 // (703) 527-8418
GWU Law School
202 994-7229 / 703 527-8418