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Tobacco use: Too expensive for U.S. health care

Post by Patrick O'Callahan on Feb. 17, 2011 at 7:52 pm |
February 17, 2011 4:33 pm

This editorial will appear in tomorrow’s print edition.

The Franciscan Health System – an empire of hospitals and medical clinics in Pierce and King counties – is about to take the big step from a no-smoking policy to a no-smoker policy.

To a nicotine addict seeking a job at, say, St. Joseph in Tacoma or St. Clare in Lakewood, it will be brutal. Although the rule won’t be applied retroactively to current employees, Franciscan will effectively be hanging out a “smokers need not apply” sign as of March 1.

Franciscan is far from alone. Some other large companies, such as Alaska Airlines, have had no-smoker policies in place for years. But health care organizations in particular have recently been moving to ban smoking – on or off the job – among their employees.

This is less a cause for celebration or criticism than it is a simple inevitability. Like many smokers themselves, America can no longer afford cigarettes.

The U.S. Centers of Disease Control has estimated that tobacco creates a $193 billion-a-year drag on the U.S. economy. It pegged the cost of treating nicotine-driven diseases at roughly $96 billion. Another $97 million resulted from lost productivity – absenteeism, impaired workplace performance, etc.

A country that squanders more on health care than any other nation on Earth – and prices millions of its citizens out of medical coverage in the bargain – cannot go on bearing such immense expenses for a uniquely disease-ridden and avoidable habit.

Franciscan’s chief operating officer, Dr. Cliff Robertson, says his company’s chief objective in barring tobacco use is to practice what it preaches – encouraging healthy communities. Its 8,100 employees in the South Sound constitute a large community.

There’s also the need to contain costs while continuing to provide high-quality health care. Every company that employs tobacco users carries a share of those tobacco-related medical and productivity costs – something between $3,000 and $4,000 on average per nicotine addict, per year, the CDC numbers suggest.

By trimming those costs within their own staffs, hospitals can make health care somewhat more affordable. They also make it more affordable by setting a healthy example that discourages smoking elsewhere. If there’s anything health care ought to be in this country, it’s more affordable.

The downside of policies like Franciscan’s is that they tend to hit the poor hardest. In this country, smoking is increasingly an addiction of the low income. Job applicants with limited education and skills are the most likely to be shut out of employment by nicotine bans.

That’s why we’re not celebrating. But the reality is that tobacco does far more harm than a private organization’s restrictions on tobacco do. Franciscan’s move is a form of tough love. It’s also the future.

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