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?

ANSWER

Nationalization of health insurance scheme forms part of the first step government or organizations should take to attract employees in living healthy lifestyles. By providing a robust preventable insurance scheme to employees, ensure workers take advantage and get vaccinated against some of the preventable diseases. Increasing the amount of insurance cover for preventable conditions encourages employees to live healthily and avoid contracting some of the chronic illness like heart attack and stroke. The responsibility of caring for the body lies with the individual. Thus, fairly to say, a person who is health conscious should not pay same premiums as another health unconscious individual. In the case of an obese person with a healthy lifestyle, he/she should pay the same amount of premiums with people having healthy weights and lifestyles. The reason is that they are all minding their body care, and thus, should receive equal insurance premium treatment. On the other hand, treatment of chronic conditions is a bit expensive; thus, patients with chronic illness have to pay extra premiums for insurance. Also, individual exposing themselves to the possibility of getting chronic illness by smoking should remit extra premiums to the medical insurance. Even though each person has a habit that is not good for the body, some people recklessly expose themselves to infections like avoiding taking medications; thus, it is just and fair to treat them unequally with others, when it comes to medical insurance premiums and cover. Insurance is calculated on the risk exposure levels of an individual. The more children a person has, the higher the medical costs. In the same case, the frequent times a person smokes or eat unhealthily, the higher the chances of health problems. Thus, it is ethically right to charge insurance premiums depending on the lifestyle choice of an individual either to have many children or continue drinking alcohol or smoke.  Ethically, it is right for employers to provide employees with an insurance scheme that covers children but to a certain number of children. The company insurance scheme should treat all workers equally. Therefore, the firm should provide medical schemes indiscriminately by only limiting the number of dependants on the cover to certain acceptable limits (Runciman, Merry & Walton, 2017).

Reference

Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right (1st Ed.). London: CRC Press.