What level of health insurance should be provided for preventable disease conditions, to provide a financial incentive for employees to change their behaviors and help prevent chronic disease and illness from occurring in the first place?
Would it be fair if obese employees with healthy lifestyles paid the same insurance premiums as other employees with healthy weights and lifestyles? Similarly, should well-treated but chronically ill employees with healthy lifestyles pay lower health insurance premiums than healthy employees who choose to smoke, who are overweight or obese, or medically non-adherent?
Everybody has habits that are not good for them. Why is it fair to single out smokers, the overweight and obese, and employees who fail to take their medications as prescribed?
Having an unusually high number of children is a lifestyle choice resulting in higher health care costs for employers. Would an employment policy that charged employee-parents just as much as smokers and obese employees be ethical? Why should the number of children involve the same ethical considerations as smokers or obese people?
Is it an ethical obligation for employers to subsidize any of the costs associated with child bearing or the health care of children generally? Is it ethical for employers to provide hidden subsidizes to families with an unusually high number of children through their disproportionate allocation of health care costs?