Obtaining health care under the Affordable Care Act (ACA) could cost smokers as much as 50% more than non-smokers (with all other factors being equal). Is this fair? Many say it is more than fair. Consider the fact that smoking kills 443,000 Americans each year at an annual cost to the nation of $193 billion in medical care and lost productivity. Smokers are much more likely to get sick, miss work due to illness, and incur costly medical treatment.

We have an incredible amount of statistics and probabilities related to illness, hospitalization, and the associated costs that justify the ACA smoker rates. But in charging smokers more for their healthcare, have we just jumped on a very slippery slope? What if the government decided that ice cream eaters who indulge in a bowl of Chocolate Cherry Nut Fiesta each night should be charged more for insurance?

What if every time you bought a half-gallon (or a 5-quart tub) of ice cream your purchase was entered into a database and your ice cream consumption was counted?

• Would you be upset if your insurance rates increased due to "overconsumption of unhealthy substances?"

• What sort of statistics or probabilities would you need to see to convince you that this "unhealthy substance bump" in insurance rates was justified?

Do insurance companies have any business making rate determinations based on statistics that accurately describe personal choices?