Charge smokers more

By Staff Reports

Smokers raise the overall cost of health care for state employees. It's only fair to require state workers who smoke to pay more for their health insurance.

South Carolina soon will join seven other states in charging public employees who smoke -- or whose insured dependents smoke -- more each month for insurance coverage. Each employee who falls into that category will have to pay $25 a month extra for health insurance than nonsmokers.

The charge is per policy, not the number of smokers in the family. The new rules will take effect in January 2010, giving smokers ample time to quit if they choose.

The change was heavily promoted by Gov. Mark Sanford. He said that smoking should remain a choice for state workers but that nonsmokers should not have to bear the higher costs resulting from tobacco-related conditions.

We agree. The evidence that smoking is the No. 1 preventable cause of illness in the world is conclusive. Smoking is a factor in a wide range of life-threatening illnesses, including heart disease, a variety of cancers and lung diseases. And not smoking is the most effective way to reduce the risk of contracting those diseases.

The State Budget and Control Board estimates that tobacco-related health-care claims amount to about 7 percent -- or $75 million -- of state health insurance claims. That is $75 million nonsmokers shouldn't be obligated to pay.

Granted, this new policy will be hard to enforce in some respects. After all, it relies largely on the honor system.

State employees will be asked to sign a document saying they don't smoke, and so far, no penalties have been put in place for lying. But other states with similar policies levy fines on smokers who lie and order past surcharges paid, and South Carolina is likely to do the same.

This policy not only will require smokers to bear the financial burden of their habit, it also could have the beneficial result of prompting many smokers to quit. And the state will help out if they do, enrolling them in smoking cessation programs.

Some might ask about other groups that have "self-inflicted" health problems, such as those who are obese. At least one other state, Alabama, is considering a surcharge for obese workers similar to the one for smokers, and that might be the trend. Sanford said he is open to the idea, and that workers who exercise and maintain good health habits should be rewarded.

While it is evident that a sedentary lifestyle and obesity can contribute to poor health, we think the focus for now should be on smokers. The dangers of smoking are clear cut.

Smoking -- as long as others aren't inflicted with secondhand smoke -- should remain a choice for adults. But that choice should entail picking up the tab for health-care costs resulting from smoking.

That's only fair to the state workers who don't smoke.