I really don’t care if you supersize your next meal at your favorite fast food restaurant.  If you want to ride your motorcycle without a helmet, or drive your car with your seat belt unfastened, that’s fine with me, too.  And if you feel the need to light up a cigarette every now and then, it doesn’t affect me one way or another, so go ahead.

Of course, I’m an economist.  I’m not a dietician, traffic safety engineer, or – thank goodness -- your doctor.  Economists have this rather naïve idea that people are the best judge of what is good for themselves.  If you’re happier living a shorter life as a sedentary, chain-smoking, couch potato, we say, more power to you.

But the truth is, even as an economist, I can’t quite say this.  Because, in the world we live in, the way you lead your life does affect me, even if our paths never cross.  That makes me a stakeholder in the decisions you make, and so I really can’t keep quiet about it after all.

The connection we have, of course, is through the health care system.  We’ve grown up in an economy where very few of us actually pay for the health care services that we consume. Rather, there are third parties – the Federal government, a private insurer, or a hospital or local charitable organization – that help pick up the tab.  And when those organizations' coffers need to be refilled, all of us are asked to contribute, whether we benefited or not.

Those coffers have needed more and more filling lately.  Employer sponsored private insurance premiums have increased at a double digit rate for the last three years. Medicaid expenditures are the fastest growing obligation of cash-strapped states, with more than half of all nursing home residents’ bills paid by the program.  And the strain of paying for indigent care in urban hospitals has forced local governments to make some very unpleasant decisions.

In our system, if you are a smoker and I am not, we both pay the same premium to participate in the health care plan our employer sponsors.  But, other things being equal, you will consume more benefits.  That is why it is in my own self-interest to try to convince you to quit the habit and jump on the treadmill.

And it’s not just your co-workers who want you to quit.  Our employer has a stake in our lifestyle choices, too, and many have spent plenty on programs and facilities to promote health and wellness of employees.  The collective mechanism we use to raise money and pay for health care has turned us into a nation of busybodies.

But in reality the connection goes further than that.  Health care has become such a significant cost to businesses that differences in risk factors across cities and states can show up on the bottom line.  If one community is healthier than another, the companies who operate there have a competitive edge when they sell their products and services to the global marketplace.

And if you’re still with me, let’s take it one step further.  Healthier employees live longer and work longer than the rest of us.  That mean a higher payoff for any specialized training or education an employer might wish to make today in the expectation of future benefit.  More skills mean more money, both in profits to the company and wages to the employee.

I really don’t enjoy telling other people how to live.  But whether you live a healthy lifestyle or not, the better the rest of us live, the better off you will be.  And since they feel the same way about you, expect more, not less, scrutiny of how you take care of yourself.