It's no secret that healthcare costs are on the rise. If current trends continue, the US will be spending $4.3 trillion on it annually.

“Eat your greens, or you won’t get any dessert.” It’s a refrain heard at dinner tables up and down the country on a nightly basis. Now a version of that bargain is also creeping into approaches to employee health. Wellness programs aim to limit costs resulting from the chronic illnesses that account for the lion’s share of healthcare expenditure and many companies are promoting ideas around exercise, healthy diet and smoking cessation in an effort to stop their people falling ill in the first place. Bringing these people on board can require some persuasion.

On the face of it, a push to wellness seems entirely admirable. Who could argue against the idea that it’s better to prevent serious illness rather than try to cure it? If people are in good health, their general quality of life is likely to be better, they’ll live longer and they’ll enjoy themselves more as they do so. But staying healthy requires consistent effort both inside and outside of working hours, so employer sponsored wellness programs can serve to further blur the line between personal and professional lives. Smoking is a good example. As lighting up has become less and less socially acceptable, so companies have stepped up their efforts to stamp it out among their populations. At first, this took the form of simply banning smoking on company property, but it has now progressed to the point where certain organizations simply refuse to hire smokers.

Cigarettes are an entirely legal product, taxed and controlled by the government. But now people face being denied employment as a consequence of what they do, quite legally, in their own homes and on their own time. In a nation like ours, which places such a high value on personal liberty, such intrusion seems particularly alien. In this country we ceaselessly defend our right to carry guns, items specifically designed to have a catastrophic impact on health, and suggestions of banks being nationalized or medicine being socialized are routinely met with howls of protest.

But by rejecting a healthcare system overseen by government for one driven by the free market, we are ensuring that outside agencies have more and more say in our private lives. It is a simple matter of economics. If your employer is paying for your healthcare, they will pursue every opportunity to drive down costs. If that means being a non-smoker is a prerequisite of employment or enrollment in the company health plan, then you will just have to accept it. And it might not stop there. If smoking is in the crosshairs, why not drinking alcohol, or eating fatty foods? How long until people have to take a cholesterol test before a job offer is extended?

Perhaps I’m being paranoid. Perhaps business only has our best interests at heart and we all stand to benefit. My main concern is that if a zero-tolerance approach to wellness is adopted, we will effectively disenfranchise anyone who doesn’t conform to its standards. Hopefully companies will continue to work with their employees to help them change unhealthy behaviors rather than simply refusing to deal with them. We’re constantly being told to eat more vegetables. This is a situation that calls for more carrot and less stick.