Thursday, August 5, 2010

152. Don't confuse profits, morality

Community Health Partners (CHP) joins other Ohio employers, such as the Cleveland Clinic, Medical Mutual and Summa Health System, as the latest to implement a policy that will refuse employment to smokers.

CEO and CHP president Edwin Oley said in a statement, "In order for us to instill healthy habits in our patients, we must first lead by example."


Well, that is not entirely true and it is time to put an end to the charade. This is not about "healthy habits" or "leading by example."

The truth is that patients really could not care less whether their caretakers smoke or do not smoke. Patients want nurses and doctors who care-who take their time with them and clearly explain their medical situation. Just as importantly, they want doctors and nurses who are smart and experienced- those that patients would be willing to trust with their health.

So if the issue is not setting an example for patients, why has CHP chosen to implement this policy? Two reasons. The first reason is because they can, Ohio is one of 20 states that leave smokers unprotected from discrimination by employers. The second reason, and the much more important reason, is money--specifically in health insurance costs.

Undeniably, smoking is a dangerous addiction that causes significant harm to one's health. The numbers are staggering: Each year upwards of half a million people die prematurely from smoking, smoking is the primary cause in 30 percent of all cancer-related deaths, and smoking costs nearly 100 billion in employee productivity. Health insurance is more expensive; life insurance is nearly double. I've personally witnessed its destruction, and fearful of its addictive properties, I never smoked a single cigarette.

However, the question that most people have is why are only smokers targeted-if CHP is really trying to instill healthy habits, should not CHP also address other risk factors?

Obesity and other diet-related deaths, such as heart disease, strokes, cancer, and diabetes, are similar to smoking in terms of fatalities-killing 380,000-510,000 people each year. Wouldn't a hospital that did not have overweight employees create the same healthy example? Taking it a step further, of those within their healthy weight, the healthiest seem to be vegetarians and vegans-those that have shed the meat addiction.

In fact, the American Dietetic Association published the following statement in 2009: "The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates."

But let's not stop there. We all know that exercise is healthy for both the mind and body. Exercise helps combat obesity and chronic diseases. It can relieve stress and even improve your mood. So why doesn't CHP create some fitness criteria for new employees. After their screening for nicotine, why can't applicants change into their gym shorts and be asked to run two miles under sixteen minutes, do fifty push-ups and one-hundred sit-ups?

Let's also not forget the health benefits of vacations. The Researchers from the State University of New York at Oswego found that "men who take vacations every year reduce their overall risk of death by about 20 percent, and their risk of death from heart disease by as much as 30 percent." I wonder, is CHP increasing vacation time for employees to keep them healthy?

In general, I find slippery slope arguments to be somewhat lame, but I think these are fair questions. And there are more-what about drugs and alcohol, genetic predisposition, and mental health? Either way, I think CHP should stop following the shallow lead of other organizations and really commit to leading by example with their "healthy habits." I think CHP should be the first organization to hire only non-smoking vegans who are within their healthy weight and can pass a physical fitness test-- and give them several weeks of vacation each year. With such healthy habits, I don't even think they would need to provide health insurance for employees-and the charade can finally come to an end.

Of final note is the issue of employers controlling the legal activities of employees while they are on their free time. Certainly if all employers suddenly decided not to hire smokers--they would all be forced to quit smoking, or live in poverty. As a society, maybe it is time to abolish smoking, but I don't know if it should be the actions of organizations and corporations. However, that is another debate and another slippery slope.