There's a piece in today's WaPo's health section about the growing number of employers moving to penalize workers for indulging in unhealthful behaviors--most notably smoking--even outside of the workplace, on the argument that such employees wreak disproportionate havoc on companies' health insurance premiums. The article features people whining about the Big Brotherish aspect of this intrusion into their private domain, including some guy from Buzzard Bay, Mass., who sued an ex-employer for firing him after he tested positive for nicotine. 

This is one of those cases where the violation-of-individual-rights argument strikes me as only moderately compelling. In general, I think adults should be allowed to behave as stupidly as they want--as long as they don't expect the rest of us to bear the burden of that the stupidity. Health insurance is the fastest rising cost of doing business in this country, and, especially for small employers, one or two seriously ill workers can jack up the rates for an entire office faster than you can say "we're dropping your coverage." So while I do think canning an employee for what amounts to human weakness is too harsh, I see no problem with some of the other measures being taken, such as companies' asking smokers to defray the costs of their habit by upping their insurance contributions. 

Sure, some smokers will feel persecuted because they're ponying up more for their vice than the fat guy in the next cubicle who gorges on pork rinds all day. But, fair or not, smoking is a more straightforward risk factor to attach estimated costs to and assign blame for and--perhaps most importantly from employers perspectives--keep track of than someone's eating or exercise or sexual habits. (Excepting, of course, all those wacky generation YouTube staffers who like to post pics of themselves having sex on the web. But that's a different issue.)

In a perfect world, could employers come up with a more comprehensive, more precise way to assess risks and distribute costs among employees? Absolutely. Then again, in a perfect world, we wouldn't have to rely on our employers for health care coverage.  

 --Michelle Cottle