A national survey of about 1500 Americans finds that 60% believe smokers should pay higher insurance premiums, and 30% believe obese individuals should pay more. “When it comes to personal responsibility, consumers increasingly support making people pay more for unhealthy behavior,” write researchers from NORC at the University of Chicago in their Nov. 14 Health Affairs Web Exclusive.

Newspapers and media around the world picked up on this finding, from the Los Angeles Times to Le Matin and wire services in France, Spain, and China. But as important was another finding of the survey: Americans are unwilling to make people pay more for risks that are not perceived as their fault. An overwhelming 87 percent of Americans said that everyone should pay the same for health insurance regardless of health status or age. As Health Affairs Founding Editor John Iglehart said at the November 14 event at which the survey was released: “Whatever happened to community rating?”