Who should pay for you to stop smoking?

There’s an effort underway by the American Lung Association to require group health insurance plans to pay for comprehensive smoking-cessation programs — meaning counseling combined with coverage for prescription and over-the-counter treatments. In its recent State of Tobacco 2009 Report, the association points to states like Pennsylvania as weak on insurance mandates for smoking-cessation programs.

Without access to a comprehensive program, only 5 percent of smokers will succeed at quitting, says the association.

I’ve never smoked, so I can’t speak to the difficulty in quitting. I have no doubt it’s hard. But I don’t want to pay for other people to quit their bad habits. If smoking-cessation is a mandatory health insurance benefit, everyone with a group plan in that state will end up paying higher premiums in order to support the claim expenses.

It seems legislators would love to put the burden of everyone’s bad habits on health insurance companies: “Hey, let’s require health insurers to pay for stop-smoking programs, and weight-loss programs, and drug addiction rehab!” But why should health insurance companies — and everyone in group health plans — have to pay for people to clean up their bad habits?

And where does it end? Should health plan members shoulder the burden of paying for sex rehab, like the 45-day-plus program that Tiger Woods is in?

If health insurance companies do a cost-benefit analysis and decide on their own that it’s cheaper to pay for smoking-cessation programs than to pay for treatment of smoking-related illness, then that’s their call.

But health insurance shouldn’t be a conduit for forcing Americans to make healthy choices. It seems to me we’ve lost sight of the fundamental purpose of health insurance — to help us when we get sick or injured.