Wednesday, March 08, 2006
Kentucky putting the squeeze on smokers
In Kentucky, tobacco has long been an important cash crop. It still brings in hundreds of millions of dollars a year. But tobacco has also brought the Bluegrass State something less glorious -- Kentucky has the highest smoking rate in the United States. Nearly 28 percent of Kentuckians smoke regularly, more than any other state.

Considering the state's heritage, we found it interesting when Kentucky decided to start charging state employees who smoke more money for health insurance than it charges nonsmokers. The man who led the effort to add the surcharge is Gov. Ernie Fletcher, who also happens to be a doctor.

Gov. Fletcher feels that insurance surcharges along with a wellness program will lower Kentucky's smoking rate. In addition, he thinks it is fair for smokers to pay more than nonsmokers because they cost the state so much more for medical care.

But there are a lot of angry smokers in Bluegrass Country. Here's one common complaint -- Why doesn't the state ask other people in high risk categories to pay more?

One state employee we talked to says she smokes two packs a day, but hasn't had any major medical problems, so why should she pay more?

We asked the governor what he thought about that argument. He says right now smokers are indeed the only group paying more, but he wouldn't rule out expanding the surcharge to other higher risk categories. Kentucky is one of five states that ask smokers to pay a surcharge, but it got our attention because of its number one ranking in a category it doesn't want to lead.
Posted By Gary Tuchman, CNN Correspondent: 6:56 PM ET
Since obesity & obese-related illness (e.g. diabetes) is killing more Americans than lung cancer, I think anyone 20% over their ideal weight should be forced to pay more.
Posted By Anonymous Frankie, Dublin, CA : 7:44 PM ET
I am glad Kentucky is finally cracking down on smokers. Having not only been borne in Kentucky, my father died from cancer directly linked to smoking when I was just a kid. Prior to his diagnosis, he was a healthy individual with no major medical problems. Once he found out that he was covered in cancerous tumours, his medical bills soared to almost a quarter million dollars... this was in just SIX months. He died at the end of that time.

This caused unneeded grief for my family and myself. I was 14 at the time and it put a lasting impression of what smoking really does... I just wish it hadn't come so late to so many people.

Smokers should have to pay for harming themselves and I agree with Ernie 110% on charging more for "higher-risk" lifestyles that the individuals have chosen.

Somewhat related, on a recent trip to Singapore I stayed with a friend's family who had just purchased a new car. Singapore has been trying to cut back on people always driving and not using public transportation, so a normal economy car costs around $125,000 USD. Needless to say, not many people drive. Something similar should be done with tobacco and smoking... and Kentucky needs to move on from being so reliant on that as a cash crop.
Posted By Anonymous Chadwick Horn, San Francisco CA : 7:47 PM ET
The complaint of these smokers is something I have always agreed with:

You can't punish smokers for simply leading unhealthy lifestyles if you aren't going to throw all other unhealthy habit practitioners into the mix. Shouldn't people who eat McDonald's Big Macs three or more times per week be required to pay higher premiums like these smokers in Kentucky are required to?
Posted By Anonymous Levon, Redondo Beach, California : 7:53 PM ET
Maybe state and federal agencies should stop paying tobacco farmers to grow tobacco. Why are these farmers subsidized. This blood money, allotted by our representatives, gets funneled back into their pockets by lobbyists. I live in a state (South Carolina) with the lowest cigarette tax (0.06 cents). South Carolina also lags behind many third world nations in educational funding. Priorities. Make smokers pay their share. Stop paying farmers to grow tobacco. Stop our government representatives' financial gains at the expense of tobacco addicts.
Posted By Anonymous Skip, Sumter SC : 7:53 PM ET
As a nurse in a large hospital, I can go down the list of patient on a daily basis and see that the majority of illnesses are due complications of smoking and drinking alcohol. If it were not for those two things, my job would not be in such high demand.
Posted By Anonymous Darlene, Dallas, Texas : 7:53 PM ET
I am personally tired of this whole subject of charging smokers more for health coverage; it's a slippery slope we shouldn't go down. Next thing you know, employers will be charging more for health insurance for anyone with anything other than a perfect lifestyle. For the record, I'm a smoker and in more than 15 years of employment post college, I've used my health insurance maybe 3 times. In addition, not to be morbid, but in terms of overall-lifetime health & retirement costs, studies have shown smokers actually SAVE money - they die earlier (much less in pension & retirements) and tend to have more serious illnesses that result in quicker deaths (shorter terminal hospital stays). From a purely monetary perspective, it would make sense to encourage people to smoke!
Posted By Anonymous Carey, Charlotte, NC : 7:58 PM ET
I take a sick delight in the fact that smokers are angry at the added cost placed on them. Did they not already realize that they're paying a lot of money for the cigarettes in the first place? Does it not occur to anyone that it's already free to not smoke? With the cost of cigarettes being what they are, I think it's amazing that anyone can afford to take up the habit!

I think that it's not only reasonable, it's responsible to charge smokers more than non-smokers. Smoking is directly linked to a variety of serious diseases that are not cheap to treat. One can't claim ignorance of such health risks - there's a warning label on the box. Add in the impact of second hand smoke, smoking related fires, etc. and it's a wonder that this wasn't done sooner.

My biggest question is this - given everything we know about the negative medical effects of smoking, and add on top of that the cost, the bad breath, the stained teeth, the 'inconvenience' of addiction - why does anyone in our day and age, in this country where everyone and their mother knows all of this, why does anyone smoke? It makes no sense to me.
Posted By Anonymous Brian Westover, Rexburg, Idaho : 7:58 PM ET
There are so many sad factors to this I wouldn't even know where to start. So anyone who smokes now they will have to pay double or triple what it was a year or two ago! This is a sad factor, the government trying to force people to quit, now they are attacking our heathcare and taking away the very rights that we have as consumers. We as consumers have the right to pick and choice what we want and what we do not want. If history serves me correctly, wasn't the same thing that they did during the Prohibition era. The government made it illegal for us to drink, guess that is our big brother. Now they are trying to take away something else, give me a break!

Yes, I am a smoker, but I don't go around forcing my habit onto other people. When I am in resturants or public places, I always ask the people around me if they mind me smoking 9 times out 10 they don't mind or they ask me to sit a little bit further away. Thats just being respectful and being a responisble smoker as well as not pushing my habits onto others, now why can't the government do the same?
Posted By Anonymous L Smith, McHenry, Illinois : 8:02 PM ET
After living in other states (Texas and California) my husband and I located to Kentucky three years ago. We were surprised to see so many people smoking and not have the manners not to smoke around non-smokers. I say, hat's off to Gov. Fletcher! I look forward to seeing this and other stop smoking moves spread statewide.
Posted By Anonymous Anna, Russell Springs, KY : 8:04 PM ET
Can't agree more with Gov. Fletcher. My brother was in great shape for many years while he puffed away. Then, six months after the bad news, he was no longer the same man, in body or in soul. His insurer spent a lot of money trying to keep him alive, a lot more then his employer had paid in over the years. While the where-do-you-draw-the-line arguement holds much merit, in my opinion, the other potentially arguable behaviors ( over eating, extreme sports, etc.) don't kill the way tocacco does. So, no I don't think insurers can charge more if someone is out of shape, nor do I think they should be able to offer incentives for people who work out. As far as I'm concerned, this is just about tobacco, a very dangerous drug that needs to be prohibited from advertising. Smokers should be given the cold shoulder for their own benefit.
Posted By Anonymous Paul Mayer, Montrose California : 8:10 PM ET
I've been a smoker for quite a while, having even quit for seven years then pick up the habit again. Why don't they charge the obese as well. Discrimination? Absolutely. A doctor was asked to apologize to a woman he was was obese because she was offended. She may be offended but she is still fat. There are a plethora of diseases that the obese suffer from that are more costly then those of the smoker. I don't know who this governor is but most probably he is obese
Posted By Anonymous Connie Louise, Esmont, VA : 8:18 PM ET
Unlike heart disease and cancer, smoking is a choice. I don't think it's unreasonable for insurance companies to require a higher premium from those who choose to smoke. What is unreasonable is asking non-smokers to help foot the bill for treating emphysema and other smoking related medical conditions.
Posted By Anonymous Justin Hamaker, Lakeport, CA : 8:19 PM ET
I don't agree with our Governor about much, but he's right on this one. Smokers have higher life insurance rates, why not health insurance also? Regardless of the two-pack-a-day woman's comment, smokers as a group have more incidents of illness, and should pay more for health insurance. I wonder though whether this will decrease non-smokers' premiums.
Posted By Anonymous Rob, Frankfort, KY : 8:25 PM ET
I think there are a lot of people out there who are addicted to many things, smokers included. You have people addicted to alcohol, food, drugs, smoking, just to name a few vices. Insurance companies who are promoting this trend of charging more for people who have certain vices are missing the boat. What they need to do is initiate preventative programs and help people pay for services that in the long run, can prevent people from getting addicted in the first place or help them kick any number of habits. Why not give smokers a discount for keeping off of cigarettes for a year or more with a doctor's annual visit required to verify it? Why not give someone struggling with obesity a 25% discount off their monthly payment to a gym for sticking with it for a certain amount of time or attaining goals? It's common sense that rewards work more than punishment. I'm a SAHM of three children and I know that much.
Posted By Anonymous Michele, Dundalk, Maryland : 8:29 PM ET
I find it interesting that obesity is not being added to increased health care costs. Obesity is becoming a national crisis, yet the focus is still on smoking. Obesity is on a fast tract to becoming the leading cause of death in the United States. The general public is quick to criticize a smoker "Smoking is bad for you" but you don't hear anyone telling an obese person "Maybe you should not have supersized that meal in front of you".
Posted By Anonymous Steven, Los Alamos NM : 8:31 PM ET
Great idea. Lets not forget about fat in food...lets put a tax on them. And cars, cars kill...TAX them. Too much calcium can lead to kidney stones, right? Lets tax milk. Oh, and TV...sitting around watching the tele can make you fat...and that can lead to heart problems. Tax, tax, tax...that's the answer!!!!!
Posted By Anonymous Mike, San Diego, CA : 8:34 PM ET
As a non-smoker I find this to be an interesting approach, but given the reduction in anticipated lifespan for smokers, I wonder if smoker's overall lifetime healthcare costs are in fact greater than a non-smoker, given that the non-smoker might live an additional 10 to 15 years.

Moreover, a smoker's reduced lifespan will certainly save in other areas such as Social Security benefits.

Will overweight people be next to pay a surcharge? How about diabetics? Or (insert your malady here)?

Perhaps cost comparisons such as these have been made, but I haven't seen any.
Posted By Anonymous Bryan Steckler, Marion, Indiana : 8:34 PM ET
So, a 25-year-old who smokes, but is in oterwise perfect health and exercises regularly and eats healthy has to pay extra for health insurance but a guy that weighs 400 pounds and eats cheeseburgers for breakfast, lunch and dinner and then washes it down with a bottle of bourbon does not? That makes perfcet sense to me.
Posted By Anonymous Jeff Heiliger - West Lafayette, IN : 8:35 PM ET
It's also noteworthy that Lousville and Lexington, Kentucky's two largest cities, have both recently enacted city-wide smoking bans.
Posted By Anonymous Daniel Wiginton, Lawrenceburg, KY : 8:35 PM ET
Hi Gary, As a OR Nurse for 40 years I have seen first hand the damage to the physical body created by smoking. I have told any one who would listen that people will not stop smoking until they have to pay their own smoking related medical bills. It may not seem fair but it is not fair that non-smokers have to pay higher premiums to cover diseases that could be prevented. It makes sense to me for all smokers to be penalized in this way, but carry it further and expect them to pay all health care costs related to smoking. Obviously, I have never smoked so I do not see this from a smokers perspective.
Posted By Anonymous Judy Stage Brooklyn, Michigan : 8:36 PM ET
In a free enterprise economy it will become commonplace for risk factors to drive insurance costs. Physician's who promote wellness should be compensated and patients who strive for wellness should have reduced charges. Only then will we harness our health care costs.
Posted By Anonymous Barbara Clifford Winston Salem, NC : 8:40 PM ET
The woman who says she doesn't have any major medical problems must obviously not be thinking about the future because she will some kind of cancer that will cost the insurance company tens of thousands of dollars. Come on people smoking a cigarette is like sucking on a car tail pipe eventually your body will suffer damage and you will need health insurance.
Posted By Anonymous Tristen, Morehead KY : 8:42 PM ET
Ok, yeah - beware the slippery slope on this one. Diabetics - they are high risk. Sports car? That screams risk. What do you do on your time off? Is it risky? I cannot argue against increasing rates for smokers - but how far will the segragation go?
Posted By Anonymous Roger Dallas Tx : 8:43 PM ET
Before I say anything, I am not a smoker, never have been, and I find smoking in my presence to be highly offensive.

But I do not agree people who smoke should have to pay more for their health insurance. We are reading more and more about how obesity is causing serious health concerns in the United States. Will overweight people also have to pay more for health insurance? Where will it end?

Just about anything a person does in life is going to increase their health risks. People who smoke shouldn't be singled out.
Posted By Anonymous Joseph Kowalski, North Huntingdon, PA : 8:44 PM ET
How about the whisky in Kentucky, you make the whisky there to. start charging them drinkers to.
Posted By Anonymous Hughes Phillips Ingleside Tx. : 8:45 PM ET
Well, let me chime in here with my two cents. First off, Governor Ernie Fletcher is a joke. He is a one term governor and he won't be re-elected. He has done next to nothing for Kentuckians since he took office. Most state employess will not vote for him a second time. I can't wait until he is out of office. But I digress. Back to the smoking issue we have in this state. It does seem that everyone in this state smokes or uses some form of tobacco product. I don't know we have the highest rate of smokers than any of the other southern states that continue to rate below us in terms of education and quality of living. My grandfather died of lung cancer in 1984, and he had lived in Kentucky all his life. He grew tobacco most of his life too. I don't know if most people in the state smoke because of the number of people in the state who also grow tobacco. I don't know if we have sort of tobacco culture in this state that says since we grow a lot of tobacco, we also have to smoke it. Here in Lexington, smoking has been banned in public places. Louisville has also tried to ban smoking in public places. It also seems like more and more young women in this state has taken up smoking. I don't understand this. You see a lot of beautiful young ladies on the college campus with a cigarete in their mouths. God forbid the quit smoking, they might actually gain a pound! For shame. I really don't know what the anser to curbing smoking in Kentucky is. I don't think it is neccessarily because we have a bunch of ignorant rednecks in this state who don't understand that tobacco will kill you if you smoke long enough. We have some people like my uncle who is a farmer who would never think of smoking or chewing tobacco, yet they will damn sure grow the stuff and let other people die from it. We have plenty of anti-smoking education in this state. Maybe a lot of it is because these young people have parents who smoke, so they take up smoking as well. I think the problem is probably worse in the southern and and eastern parts of the state where the poverty level is higher than it is here in the central or northern areas in the major cities like Lexington or Louisville. I don't think this is a problem that is going away anytime soon, and more and more Kentuckians will have to pay higher health insurance costs because of the amount of smokers we have in this state. Just say no Kentucky.
Posted By Anonymous Michael Brown Lexington, KY. : 8:54 PM ET
Kentucky's reputation as a smoking state is well earned given the amount of farm tobacco acreage and the low tax charged per pack of cigarettes, among other reasons. Louisville has taken a step in dealing with the problem by passing anti-smoking laws as well as LOexington. However, there is a lot to do. It will be years before tobacco farmers can convert crops into cash crops other than those currently produced.
Posted By Anonymous Ed Cole - Louisville, Kentucky : 8:55 PM ET
Smokers should pay more based on its thier choice to smoke. Many medical ailments such as asthma are based on issues that cannot be controled. For that matter overweight Americans should pay more also. It would keep my rates and co-pays lower... :)
Posted By Anonymous Ralph, Manchester NH : 9:02 PM ET
First of all, the main difference between smokers and people in other high risk categories is that smoking is a choice! Smokers are voluntarily putting themselves into higher risk categories and it's costing society a lot of money, so it doesn't seem unreasonable for society to push some of that extra cost back to them. Second of all, other insurances work in much the same way - a 17 year old driver will have much higher premiums than a 30 year old driver, even if the teenager is cautious and responsible, has never been in an accident, etc. It's a probability argument - regardless of whether an individual teenager has a good track record, being of a certain age places them in a higher risk group, and the insurance game is set up so that everyone has to pay for the overall statistics of their "group". I don't see how the smoking issue is much different - it seems that smokers who argue they should be exempted from the extra charge because they have never had a health problem in the past are ignorant of the fact that health reports show that regardless of their current health, they are in fact more likely to have health problems in the future (insurance works on probabilities!) Gov. Fletcher is a smart man, because he's going to help people to see that getting out of this "high risk" group is actually much easier than getting out of the "teenager" car insurance bracket - you don't have to wait several years to come of age and experience reduced rates, you can quit right now! Not only will you save money on your insurance, but think of all the money you'll save on cigarettes. I hope this surcharge will encourage some smokers out there to commit themselves to putting their health first by quitting - smoking is really one of the most pointless vices in society anyway (you get nothing out of your habit but an empty wallet, black lungs, and bad breath)
Posted By Anonymous Theresa, Albany, CA : 9:02 PM ET
In addition to these insurance surcharges smoking has been banned in indoor public places in all of Lexington, the second largest city in Kentucky, for two years now. This attitude towards smoking in Kentucky is much needed, considering the obesity rate in the state. I am from Lexington Kentucky, but now living in California as of 5 months ago, where the lack of obese people and smokers gathered out front of bars or on bar patios was a welcome culture shock. I would very much like to see Kentuckians living as healthy as Californians, and believe the insurance surcharge is a step towards that.
Posted By Anonymous Annie Glyer, San Mateo, CA : 9:05 PM ET
I live in Kentucky AND I smoke AND I DID NOT put Governor Fletcher in office. It is unbelievable to me how this state can help the tobacco companies put our farmers out of business. This is part of our heritage and is also our right to smoke. Now some of these farmers are turning to growing grapes for wine to earn a living. It's hard to have a winery in most areas of this state where these farms are because they are in "dry" counties. What are these people supposed to do??? Rely on FarmAid Concerts?????
Posted By Anonymous Beth Richardson, Fort Mitchell, Kentucky : 9:07 PM ET
I have seen many people constantly draining the medical system that are obsessed with ailments when they have nothing wrong at all. Their medical file is so thick and I, a smoker, may see the doctor once over two years and have a very thin medical file. They are using up appointments that the ill have to wait wekks and sometimes months to get in.
Posted By Anonymous Dorothy Hopson Courtice ON Canada : 9:08 PM ET
This is all well and good but ONLY until the fat people are charged a surcharge as well; not to mention the drug abusers, gay men and women (AIDS), alchoholics and people taking psychiatric drugs that alter their mental state. Only the "normal" should have a "normal" premium but heaven only knows, Dana Reeves was "normal" and she died from lung cancer. So did a marathon runner I know (at the age of 33). Stop picking on the smokers. We're all going to die from SOMETHING anyway and in that respect I'd say we're all normal.
Posted By Anonymous Lisa Jacobson, Culver City, CA : 9:08 PM ET
I suppose the added health insurance cost could be seen as just another sin tax, like taxes on alcohol. It's probably reasonable to add gluttony to the list of sins to tax as well. The squeeze has been placed on smokers for years now, beginning with workplace smoking bans. Here in Lexington you can't smoke in the restaurants or in the stands at UK football games. As a non-smoker, I'm glad, but smokers by and large don't appreciate government trying to save them from themselves. Maybe the reason non-smokers are so hard on smokers in Kentucky is because the smoke has been so thick for years.
Posted By Anonymous Joyce West, Lexington, Ky. : 9:15 PM ET
Adding a surcharge to Commonwealth employee's health insurance premiums who smoke sounds like a good idea, as long as the surcharge is also added to people who overindulge in eating and drinking alcoholic beverages. Being a Commonwealth employee myself, I notice more employees who are overweight than who smoke, which may be more of a health problem.
Posted By Anonymous Mark, Highland Heights, KY : 9:16 PM ET
While we charging smokers more, why don't we charge people who have children involved in sports, more? After all, putting little Johnny out there to play soccer and football is purely voluntary. Sports injury clinics are popping up all over the country. It's a huge money making business. Check out any emergency room on the weekends. They're full of kids waiting to be stitched up and have their broken bones set. Do you really think it will stop with the smokers? No. Obesity and alcohol are next. How about women of child bearing age? Why should I pay for the high costs of OB's? After all, I don't plan on having any children. Companies will use every excuse in the book to charge anyone and everyone more for their health insurance. Next thing you know, they'll be pricking your finger, taking your blood and charging you based on your genetics. It's coming, but sadly most won't see it until it hits THEM right, smack dab in the pocketbook.
Posted By Anonymous Debbie - Cincinnati, Ohio : 9:39 PM ET
The surcharge is $15/month; hasn't had an effect on anyone at my state workplace.
Posted By Anonymous Larry Totten, Jamestown KY : 9:49 PM ET
make it as hard as possible for smokers. it's not a choice it's an addiction. Obesity, alcoholism, any other thing you want to use to distract from the subject is just that, a distraction. Tobacco Kills. period. May as well pay for your own care as it goes downhill.
Posted By Anonymous dave, austin, texas : 10:38 PM ET
OK I don't smoke. I don't think this surcharge is fair. If smokers are going to be charged so should people that are overweight, people taht are thin but don't exercise, and people that drink more than 3 drinks a week. All of these are choices as well. And ultimately this surcharge is not going to bring the cost of healthcare down anyway. The rising cost of healthcare is way more complicated than people that smoke.
Posted By Anonymous Frances Moore, Seattle WA : 10:39 PM ET
Amazing how one guy is so worried about the KY farmers who would be hurt economically because of the government's initiatives. I'll bet this same guy wouldn't feel any sympathy for an Afghan farmer who grows poppy !
Posted By Anonymous Marc W. New York, NY : 10:41 PM ET
Ooooh no! Slippery slope! Ha! I think this is a great idea. I'm tired of subsidizing stupid people's insurance.
Posted By Anonymous Brian, Shawnee, KS : 10:42 PM ET
I live in NC -- another big (and probably the biggest in my opinion) of the tobacco states. So, I must agree with an earlier comment that we need to stop subsidizing farmers who plant tobacco and instead use it to plant healthier alternatives -- like apples (another cash crop near me). I'm personally allergic to cigarretes (and pipes) and I have to agree with this legislation to a point; I feel that it should be phased in a way to encourage people to stop smoking and act as a reward over time to reduce back to a normal rate after someone has stopped smoking. Say, the premium is cut in half after 10 years of not smoking. I also know that people can quit smoking; I've helped four friends and several co-workers quit by giving them encouragement and I've seen their health get better as a result of quitting. As for other "high-risk" factors, I reluctantly say yes to those as well. I weigh 95 lbs more than my suggested weight for my height and yet I'm healthy and have a lot of muscle mass. So, in that regard I think if other groups are going to be included then there should more influence from personal factors regarding insurance premiums.
Posted By Anonymous Mark -- Waynesville, NC : 10:55 PM ET
There is ample precedence for higher insurance rates for higher risks. I drove a sports car for years; I paid higher car insurance rates for it. I was diagnosed with diabetes last year; my insurance premiums went up 20% this year. I moved into a flood plain; my home insurance increased. My brother pays higher home insurance rates because he lives more than 10 miles from a fire department. Unhealthy people with unhealthy habits should pay more than those who are healthy. By the way, Ms Louise in Esmont Va (9th post) Gov. Fletcher is actually quite thin.
Posted By Anonymous Scott French, Louisville, KY : 11:05 PM ET
As a Physician and soon to be a third year law student-I am contemplating if there is any "cause of action" against people who


Expose other people to a "substantial risk" of lung cancer

If one exists then the second part of the analysis

1. Who can you sue?
2. Any infringements on an indivudual's fundamental constitutional rights?
3. What is the "scope" of the cause of action.

Wishing all the creative lawyers best of luck

Francis F Joseph MD
Posted By Anonymous Francis F Joseph CHicago IL : 11:07 PM ET
I don't smoke anymore but aren't smokers already paying more...its called a cigarette tax. Where is all that money going??

I think we need to consider taxing our elected officials...for all the stupid things they do!
Posted By Anonymous Larry Apfelbaum, Bloomington, Illinois : 11:11 PM ET
Of course smoking is a choice, so is over eating, alcohlism, drug addiction, driving too fast, not wearing a seat belt, not exercising, playing sports, oh and let's not forget being a reporter in Iraq. All of these can be dangerous to your health. Why not put restirctions on all of them? How about a government enforced healthy lifestyle? They can tell us what to eat, how much to eat, how to spend our leisure time, dictate an exercise regime, monitor everything we do that could be considered risky.

We all hear how we need to exercise more, but wait, that can lead to health problems if you don't do the right exercise the right way with the right equipment.

Anderson is doing a story on the dangers of cheerleading... time to raise their health insurance... afterall cheerleading's a choice. Being on top of a human period can't be good for your health. (And according to the story it's not!) Why am I paying for their choice? Since cheerleading starts so young I'm paying for their medical treatment that can go on for 50 or 60 years!

Sure everything's a choice..just make sure you make the right one.
Posted By Anonymous Lee-Ann, Sudbury, ON, CANADA : 11:21 PM ET
Smoking, unlike obesity, is an easily controlable risk. Furthermore, smoking not only directly harms the smoker, but also anyone directly near them and anyone who breaths the air. Obesity has many causes, of which over eating is only one. And obesity doesn't affect anyone else. Not only should smokers be charged more for insurance, they should be taxed like any company that emits pollution into the environment. Sure one cigarette isn't much, but the billions smoked each year add up. And anyone defending smoking, if it's so good why not put cigarettes in your kids Christmas stocking? We all know smoking isn't good and results in death. Smokers, like anyone else, just don't like being told what to do.
Posted By Anonymous Larry, Oakton, VA : 11:30 PM ET
My comment is about the "farmer's should stop growing tobacco" theme.

I moved to a rural county in KY 10 years ago. Never having smoked, I didn't understand the tobacco issue AT ALL until I got here. Now I understand that the profits that farmers make from their little tobacco allotments allow them to break even farming everything else.

In many cases, farmers LOSE MONEY bringing produce to market. Often the ONLY WAY they stay afloat is with tobacco money. We are already losing American farms at an alarming rate, and until we can successfully transfer the money-making ability of tobacco to another crop, farmers won't growing tobacco. They can't afford to stop.

It's important for everyone to realize the complexity of this issue.
Posted By Anonymous Marla Scottsville, KY : 11:50 PM ET
Healthcare cost money. Smokers need more healthcare due to their choices. I would not want to pay for someone elses choice to smoke. Smoking is a luxury and should be treated that way. You smoke , you pay.
Posted By Anonymous Erik , Detroit , MI : 11:51 PM ET
Kentucky is one of five states that ask smokers to pay a surcharge, but it got our attention because of its number one ranking in a category it doesn't want to lead.

Hmm, one would think it would be be proud to have such a distinction. Afterall, we all know tobacco is not a real health risk. How could it be if the business of it is allowed to exist? You can't say it is dangerous and please buy our product all in the same puff. The bottom line is tobacco is not only dangerous, but it is a leading cause of preventable death for the smoker and those around them.
Posted By Anonymous Teri Thomas Toledo, OH : 11:56 PM ET
Smoking is a choice. Your show aired some comments of what were obviously non-smokers. Let's use an anology:

Okay, so non-smokers shouldn't have to pay for smokinf related illnesses since it's a smokers "choice." Well then, people who drive SUV's BY CHOICE, with a high roll-over tendency should not expect those who do not choose to drive the dangerous gas guzzling monstrosities to pay for injuries sustanied when the SUV rolls over nor should non-SUV driving persons be subject to paying higher furl cocts because the markets "assume" we all "need" to horde oil for our SUV's. It's all relative. Some say people who smokers deserve to die. I counter that SUV drivers deserve the same.
Posted By Anonymous Kat, Phoeniz Arizona : 12:03 AM ET
Obesity has been debunked as a leading cause of death by the CDC, after their initial claims. The number CDC reported - 400,000 annually - has been revised to only 25,814 in 2004. This would make it the around number twelve in terms of causes of death. It lags behind suicide, the flu, accidents, and Alzheimer's, among other things.

I'm all for people paying for health insurance based on risk, particularly when it stimulates them to manage it themselves. But we stick to the facts when it comes to qualifying those risks.
Posted By Anonymous Patrick, San Diego, California : 12:03 AM ET
Those who whine and cry over tobacco surcharges on Health Insurance fail to realize that all other types of insurance providers are allowed to set rates based on many factors, including lifestyle choices. These include higher life insurance rates for smokers, overweight people, and drug and alchohol users; higher auto insurance rates for those who speed (and get caught) and primary residence location; even higher homeowner & other policy rates based factors like personal credit scores.

Those who choose to smoke, like those who choose not to pay bills on time, speed, drink, use drugs, not watch weight, etc, get stuck with higher bills because of their behavior, so why should smokers be any different? Or do smokers feel that it's their right to stick non smokers with the bills that their decisions lead to? I'm sure non-smokers would be among those to complain & moan if suddenly credit scores couldn't be used to set home owner's rates, and those of us who pay bills on time saw our rates go up because of that.

State governments which provide funding to the companies that serve their employees are well within their rights to demand that the high risk population pay for it's voluntary behavior, same as they do on their life insurance policies available to employees.
Posted By Anonymous Alan Rosenthal, Troy, MI : 12:06 AM ET
My parents started me smoking over fifty years ago. Yes, I do have health problems, like emphazema, caused by working in a garment factory and being exposed to other cancer-causing elements.
Most of my health problems are inherited from my great-grand parents being too closely related. This happened too much and now their descendats are paying the price. So many birth disabilities.
Yes, most of us do choose our lifestyles, be it smoking, drinking, drunk drivers, drugs, and that list is long.
Smoking and second-hand smoke may cause respitory troubles, but it seems no one here has given much throught to the pollutants released daily from factories and, of course there is the big issue of vehicle exhaust. How about higher health insurance premiums for all factory workers, everyone who owns and drives a car, anyone involved in sports, construction workers, police, firemen, doctors, nurses, everyone who works in a known high risk job?? Even news reporters are in high risk, proved by those two recently hurt in Iraq. And lets not forget the reporters hurt and even killed by those they have investigated, school teachers, the list goes on and on. In all fairness, who doesn't work in a potentially high risk job???
Why not do an across-the-board increase for everyone? That way, the insurance companies can get richer. Anyone notice how hard it is to get money out of the insurance companies?
Posted By Anonymous Blackrose Grwd SC : 12:07 AM ET
I am very upset at the comment made by one of your viewers who wrote the comment about emphysema ONLY being a smoker's disease! I do have COPD/ emphysema, BUT it is from a liver deficiency called Alpha 1 Antitrypsin and NOT from smoking. This is a RARELY tested deficiency that many people are unaware they even have it until their late 30s or early 40s, as I found out at the age of 40. It is ignorance *stigma* like this that causes people with lung problems to not get the funding needed to help our illnesses! Don't think all lung diseases are from just smoking. Maybe this is one reason why many younger Americans die over "those funding dollars" that the viewer was so upset that is being spent on lung problems. I hope this viewer doesn't find out that they too have this deficiency and wonder why the funding isn't there. I come from a non-smoking family, so there is no 2nd hand smoke their either. Good topic for you to do a study on I think :) Thanks for letting me vent!
Posted By Anonymous Donna Wells, Frankfort Indiana : 12:22 AM ET
Unlike heart disease and cancer, smoking is a choice. I don't think it's unreasonable for insurance companies to require a higher premium from those who choose to smoke. What is unreasonable is asking non-smokers to help foot the bill for treating emphysema and other smoking related medical conditions.

Posted By Justin Hamaker, Lakeport, CA : 8:19 PM
This is the comment that I was referring to....
Posted By Anonymous Donna Wells, Frankfort, IN : 12:27 AM ET
Three cheers for Governor Fletcher. It's refreshing that he has the guts to stand up to the people polluting the air around us and increasing our health care costs. Don't try to talk about smoker's rights around still have the right to smoke but don't do it anywhere near me. As far as the increased insurance rates go, there are such things as consequences for the choices you make. I believe smoking should be banned inside all buildings statewide. Smoking sections inside buildings are a's like having a peeing section in a pool.
Posted By Anonymous Paul Seibert, Ft. Mitchell, Ky. : 12:30 AM ET
I seem to recall years ago that a certain percentage of people vehemently opposed the seat belt laws. They whined that the government was taking away their freedom etc. I wonder how many of the whiners are still alive today due to the very laws they fought. The U.S. needs a similar movement against smoking to save the smokers from themselves for very similar reasons to the seat belt laws - to reduce health care costs and needless personal injury and sickness. The wise must lead the ignorant much like a parent to a kicking screaming child. There is no wisdom in smoking or allowing it to continue.
Posted By Anonymous Alan, Baltimore, MD : 12:47 AM ET
I have to admit that its almost a guilty pleasure to see, in the middle of winter, people huddled in the alleys smoking their $8 per pack cigarettes (per new Chicago ordinances). I think the emotion is called shadenfreude.
If it isn't obvious which side of the issue I'm on already, I'd like to give a lot of credit to Gov. Fletcher. This is a move that might have electoral ramifications but its an important step that has plenty of precedent. Teenage driver carry more expensive car insurance, so do those that tend to get into accidents. There are plenty of other places where i would like to see my tax dollars spent than footing the bill when someone voluntarily elects to die a horrible, painful death.
At this point it is not a matter of ignorance or some sort of implicit struggle with big brother curtailing smokers' liberties. At this point it is a matter of common sense. Nothing more. Smokers are right, the government and society at large is picking on you. But its not because of any serious animosity, its because, by continuing to partake in an activity that they KNOW is going to kill them, they are demonstrating a complacency that signals to us that we CAN pick on them.
Posted By Anonymous Dan, Chicago, Illinois : 12:51 AM ET
Smokers need to pay morefor health insurance. Hopefully, smokers will tire of paying higher costs for health insurance, and quit smoking.

Naturally, once a smoker stops smoking, then he or she will pay a lower rate for health insurance.

Smokers, stop smoking and lower the cost of your health insurance.
Posted By Anonymous Marc, El cajon, california : 12:54 AM ET
I haven't seen anyone point out the elephant in the living room yet.

Childbirthing and related costs are astronomical, and having children is most certainly as much of a choice as smoking or any other lifestyle choice.

I'd prefer a type of "cafeteria" insurance plan where I could pick and choose -- if I'm a smoker but I will not be having children I'd like a rate based on that. I'd prefer as well, not to pay for the lifestyle choices of others.
Posted By Anonymous B. Regina Reno Nevada : 1:10 AM ET
I think that smoker should be taxed and have added medical cost. They are the reason that non-smokers have lung cancer. They just don't care what they are doing to non-smokers. I also think that all restraunts should be smoke free this way a non-smoker can enjoy their meal without having to breathe in someones poison. If a smoker told me that they were dying because they smoked I'd say so I do not feel sorry for you you have done this to yourself.
I'm not looking forward to moving back to the states because of smokers.
I think that all smokers should be put on a island to live and the states can live smoke free this way they can smoke their until they die also this island will not have any medical care to save your life if you have lung cancer this way you all can breathe in each other poison. Plus smokers don't realize it but they really do stink.
Posted By Anonymous Rhonda Himle Okinawa ,Japan : 1:19 AM ET
Last time I checked smoking cigarettes was legal so charging them more is riduclous. I'm totally against smoking cigarettes but this is just a political move by the Republican governor looking for another term. Since his last one has been marred in controversey!
Posted By Anonymous Gregory Dowell, Louisville, KY : 1:24 AM ET
I'm not a smoker, but I may be a tad overweight. I think this policy is perfectly valid. As the one blogger said, the auto insurence has been doing it this way forever. I say, when you are placed on a health insurence plan, you should be required to take a physical. Make it like a drug test where its done at a random time on a random day. Blood tests could show weather that person is obese because of genetics, or thyroid problem or simply because he chowed down on a half dozen krispy kremes for breakfast. Smokers, drinkers, people who take drugs, charge them all extra. Maybe this would be incentive for people to GET healthier. Can do this once a year or something, like when your auto insurence goes down cause you havent gotten a ticket. If loosing 5 lbs would drop my medical insurence, I probably would make the extra effort.
Posted By Anonymous Kyle, Hattiesburg MS : 1:26 AM ET
Instead of adding to the cost of medical insurance for any group or individual I think it would have been much more important and appropriate if our state leader (a doctor) had worked toward finding a way to make insurance afforadable to all working kentuckians who cannot afford it due to it's already inflated cost rather than just costing some of his fellow Kentuckians more out of their pocketbooks.
Posted By Anonymous Robert Hunt Canada, Ky : 1:46 AM ET
This is nothing new. Some (I don't know how many) insurance companies have been doing this for a long time. My insurance will charge me more if I declare that I am a smoker (I'm not). I don't see a problem with this since, statistically, it is more likely that smoking may end up costing the insurance companies more. However, I also agree with everyone who talks about those who live on junk food, alcohol, or other equally health-damaging diets...
Posted By Anonymous Luis, Tucson AZ : 2:00 AM ET
As a former smoker, I sympathize with those who still smoke.

The reality is that smoking increases one's risk for cancer, heart disease, stroke, and the list goes on and on. Pointing a finger at other high-risk groups does not change the fact that most smokers eventually will require expensive health care before they die.

I suffered quite a bit to quit smoking. I prefer not to pay for those who choose to continue with this deadly habit.
Posted By Anonymous DM, Memphis, TN : 2:00 AM ET
As a smoker and state employee, I truly don't object to paying more for health insurance. However, obese individuals should be paying three times the cost for health insurance. I see my physician regularly, once a year. I have never been diagnosed with hypertension, my joints are in fine shape, no cardiac problems, I don't have sleep apnea and I take no prescription medication. Ask any morbidly obese individual how many times they have visited their doctor in the past year and how many pills they take every day, you will see who spends more on health care, the obese. I agree that health problems from smoking are self inflicted, I could quit. Obesity is self inflicted, too. They could shove their plate FAR away, better yet, break their plate. I appologize to non-smokers that I happen to offend. Now I expect and appology from all obese people because I find this health problem totally offensive. Perhaps some day we will all take responsibility for our own actions and become the perfect person some of you think you are.
Posted By Anonymous Lisa Lexington, KY : 9:54 AM ET
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