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There's been talk in the past of regulating health insurance costs by forcing people who make unhealthy lifestyle decisions to pay more.

Now, in at least one county, it's coming into effect. NorthEscambia.com reports that in order to save on health insurance costs, employees of the county in Escambia, Florida will not be hired at all if the smoke.

This move is, of course, more aggressive than simply charging more or higher health insurance premiums for smokers, but it's not surprising. Smokers cost the country roughly $92 billion dollars a year, and good portion of that is in health care costs.

And smoking isn't the only health culprit under examination. In California Governor Arnold Schwarzenegger has suggested that people who keep their weight, cholesterol, and blood pressure low should pay less than those who don't.

Opponents argue that such rules amount to discrimination, and that obesity and other health related problems aren't a simple matter of lifestyle decision-making.

But supporters argue that health insurance premiums are raised for all Americans by those who don't make healthy lifestyle decisions.

Either way, this argument adds a new dimension to the debate regarding health care in America, and how to best provide medical services to all.