A.G. Sulzberger reports in the New York Times about a new practice by some employers: refusing to hire smokers:
More hospitals and medical businesses in many states are adopting strict policies that make smoking a reason to turn away job applicants, saying they want to increase worker productivity, reduce health care costs and encourage healthier living.
The policies reflect a frustration that softer efforts — like banning smoking on company grounds, offering cessation programs and increasing health care premiums for smokers — have not been powerful-enough incentives to quit.
The new rules essentially treat cigarettes like an illegal narcotic. Applications now explicitly warn of “tobacco-free hiring,” job seekers must submit to urine tests for nicotine and new employees caught smoking face termination.
I have to side with Boston University School of Public Health’s Dr. Michael Siegel, who points out, “Unemployment is also bad for health.” Smokers denied jobs based on their tobacco use are likely to feel hopeless and unlikely to have the employer-sponsored health insurance that might provide them with quitting help – hardly a recipe for successful smoking cessation. Still, this is a rational response by employers who sponsor their workers’ health insurance and see costs increase when their employees use lots of healthcare. It just doesn’t sound like something that’ll be good for the population’s overall health.
If the Affordable Care Act’s ultimate impact is that most under-65 people get their insurance through health insurance exchanges rather than employers, then employers can base their hiring decisions on candidates’ abilities rather than their anticipated healthcare costs. And if insurers expect their plan members to keep the same insurance for longer than they keep their jobs, they might be more motivated to offer counseling, patches, and other assistance to help smokers quit.