Obtaining health care under the Affordable Care Act (ACA) could cost smokers as much as 50% more than non-smokers (with all other factors being equal). Is this fair? Many say it is more than fair. Consider the fact that smoking kills 443,000 Americans each year at an annual cost to the nation of $193 billion in medical care and lost productivity. Smokers are much more likely to get sick, miss work due to illness, and incur costly medical treatment.

We have an incredible amount of statistics and probabilities related to illness, hospitalization, and the associated costs that justify the ACA smoker rates. But in charging smokers more for their healthcare, have we just jumped on a very slippery slope? What if the government decided that ice cream eaters who indulge in a bowl of Chocolate Cherry Nut Fiesta each night should be charged more for insurance? What if every time you bought a half-gallon (or a 5-quart tub) of ice cream your purchase was entered into a database and your ice cream consumption was counted?

• Would you be upset if your insurance rates increased due to overconsumption of unhealthy substances?
• What sort of statistics or probabilities would you need to see to convince you that this unhealthy substance bump in insurance rates was justified?

Do insurance companies have any business making rate determinations based on statistics that accurately describe personal choices?

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Example:Personally, I would be upset if my insurance rates increased due to unhealthy eating. However, this is already starting to be a consideration for some insurance companies. My dad works for a very small cabinet shop and is required to have his weight and blood pressure checked quarterly, among other things. The company has a healthcare professional who comes onsite and conducts these tests. There are thresholds documented for each category and insurance prices do increase if you exceed their limits. Once you fall below the threshold, your insurance price will be reduced. Due to the fact that over-consumption or unhealthy eating often lead to an increase in weight, he is already experiencing a situation in which his insurance rates are affected. This is somewhat similar to the implementation of soda taxes in different areas of the country. I dont feel like I should pay extra simply to consume a soda rather than a glass of orange juice. In this situation, Im not sure that any amount of statistics or probabilities would convince me that insurance rates should be increased for unhealthy habits. If you look at other health issues that are genetic, such as cancer, this is a medical condition that will be burdensome to the healthcare system and quite expensive. We wouldnt raise their insurance rates for cancer, so why should we do so for eating habits? If I were to look at probability though, I would want to see at least a 75% chance of developing a specific disease due to unhealthy eating habits before I approved of an insurance rate increase. Let's be honest. It seems like nowadays, almost anything can kill you, and sometimes they even revise those statements a few years later to say they were wrong. An example of changing recommendations can be seen when looking at BMI. "The report on nearly three million people found that those who's BMI ranked them as overweight had LESS risk of dying than people of normal weight" (Belluck, 2013, para. 3). What happens if we had increased insurance rates for those people who are categorized as overweight only to find out that they are actually at less risk of dying? Would the insurance companies refund money to those individuals? References Belluck, P. (2013). Study suggests lower mortality risk fro people deemed to be overweight. Retrieved fromhttp://www.nytimes.com/2013/01/02/health/study-suggests-lower-death-risk-for-the-overweight.html