Health insurance increase for tobacco users/ecig users

[Vaptor]

No point pretending you're using nicotine patches. That's just going along with their discriminatory demands. Otherwise next they will dictate you stop drinking alcohol, coffee and even what you eat. That is where it's heading. Beware.

 

[Vocalek]

Here is a well-researched report that folks can print and give to employers that are treating nicotine use as an excuse for withholding or overpricing insurance coverage.

http://heartland.org/sites/default/files/07-2012_final_r_street_-_heartland_paper.pdf

 

[rothenbj]

"Anyone testing positive for nicotine is a smoker, in their eyes (with some justification)."

Unless you're a snus or other smokeless tobacco user.

 

[Rocketpunk]

How many flippin' insurance salesmen smoke? I want to know that.

 

[Jim Bob]

IMO "the problem" with all of this is the insurance companies claim to be testing "for smokers" to raise their rates- even if you're on NRT and you are not smoking today (when the test is administered) then you are in fact a non-smoker, same for snuss use, vaping licking ash trays , eating fast food- you either smoke or you do not. Someone may have never smoked a day in their lives and start tomorrow, but to classify non-smokers as "smokers" - well "just because" they may start (or start back) is absurd in my view. I'm not trying to be argumentative, and I can clearly see your point; but given the fast recovery of the human body once smoking is ceased which many of us know from personal experience along with many of our doctors seeing the results, even if you correctly state 98% on NRT "are smokers on a break" they're still non-smokers at this point in time - in other words once is either pregnant or they're not.

It seems to me at least; the Real Issue Here NOW is that the insurance companies realize that smoking has been socially demonized by so many they see a very easy way to increase profits in quite unethical ways. What is stopping them from testing quarterly (or even more often?) IF they desire? (we know the tests exist to know when someone IS a smoker after all.).
It seems more wise to realize that if your company is paying for NRT and we know you will test positive for nicotine on NRT that you shouldn't be penalized as smoking when in fact you're not smoking at this time- what one "might do in the future" should never matter as you may not IF you're treated properly for your trying to live better. IMHO - YMMV

Perhaps I can make my point clearer. I'd like especially to point out the issue of fairness for the majority, and particularly those who have a greater expectation of fairness since they have not injured anyone in any way.

Example 1
Let's forget about vapers for the first part of this argument, and imagine a situation where vapers (and Snusers) did not exist.

In this test we'll use a Carbon Monoxide test machine.

Now, if a carbon monoxide tester is used, it identifies current smokers, and might be seen as the ideal test. However, it does not identify those on NRT. We know that about 98% of those on NRT will return to smoking. Therefore the insurance company's test for smokers has missed several of them since, at the time of test, they were on NRT and not smoking. Next month, or in six months, they will return to smoking - since 98% of NRT users are smokers taking a short break. Assuming that there are higher costs for smokers, and there has been an attempt to identify them in order to defray costs and avoid placing smoker's costs on non-smoking employees, is this fair to the insurance company? Is this fair to the non-smoking employees? Is it fair to the employer? No, no, and no. Others are paying the costs of smokers who were not identified.

So, this test is fair to the successful 2% on NRT. It is unfair to everybody else as many smokers are not identified.

We omitted the fact there are Snusers and vapers, for the sake of clarity.

Example 2
OK, now let's include the Snusers and vapers. The carbon monoxide tester is used again, and it picks up all the current smokers - but misses those temporarily on NRT, plus the exclusive vapers and Snusers (i.e. not the dual-users).

A best case scenario is that many (but not all) the Snusers will stay off smoking; and many (but not all) the vapers will stay off smoking. No research tells us what proportion of vapers at at any given time will stay free of smoking - but it's not all of them. Those figures are probably available for Snus, perhaps by derivative calculation from existing data.

So it is reasonable to assume that some vapers and Snusers will return to smoking, in addition to the 98% on NRT who will fail. There is evidence that in a worst case scenario (which may be the norm), 31% of ecig users will remain smoke-free at one year; this means a failure rate of 69%. So 69% of vapers may return to smoking. As this is only the 12-month figure, it will be worse at 20 months, the final test date.

So now we have a situation where even more smokers are not identified. The carbon monoxide tester was used but many smokers slipped though the gap. Is this fair to everyone else? No.

Example 3
For this test, we'll use a nicotine test. Everyone is included and it's a real-world scenario.

The nicotine test picks them all up: the smokers, NRT users, vapers and Snusers.

The smokers have to pay the higher insurance premium (or don't get employed). So do all the other nic-positive subjects. We know that almost all the NRT users are smokers on vacation, so it's by and large a fair situation for them - unfair to a tiny minority who are almost invisible. As for vapers and Snusers, it may be the case that 50% of them (or more) will return to smoking. So I'd have to say that, overall, to maintain a balance of fairness for everybody else involved, it's fair to hit them all with an increased insurance cost. It's unfair for a percentage of the vapers and Snusers but overall they are a tiny minority when compared to everyone else involved in the cost equation.

Example 4
As above, but NRT users, vapers and Snusers picked up by the nic test can self-identify as non-smokers. They are immediately tested on the CO machine. Those who fail are placed in the smoker category, those who pass are placed in the non-smoker category but are monitored over a two-year period, by use of a carbon monoxide tester applied randomly and without warning. If they continue to pass they stay as non-smokers.

The cost of this exception process is equal to or greater than savings made by having higher premiums for smokers. In addition it can't be used for employment purposes as the majority of elective non-smokers will eventually fail.

This testing and exemption process is pointless and unfair to the majority of the other employees and to the insurance company, since everyone pays increased costs attributable to people who say they are not smokers, but who are at most say 3% of the group.


Conclusion
It's all very unfair to vapers, Snusers and the tiny, almost invisible number who succeed with NRTs. Unfortunately these are a minuscule number compared to other employees, who benefit from the reduction in costs caused by smokers. The employers and the insurance companies are also protected from unjustifiable costs. Only a tiny number of people are affected currently, and why should everyone else bear their costs?

The situation might be different in twenty years time when more than 50% of smokers will be vapers or Snusers. That means half of the smoking population, which is say 20% of the gen pop. So it will negatively impact 10% of people at that time. Perhaps when 10% are negatively affected it will be acceptable to raise costs for everyone else. It doesn't seem fair when we are talking about 3% or whatever.


Yes I'm a vaper, but I can see both sides of the argument