When people use tobacco insurance companies charge them higher premiums. So smoking and chewing must be unhealthy, right?

Right. More smokers means more lung cancer, heart disease and other illnesses. According to the CDC, about 443,000 Americans die from smoking-related illnesses each year.

Then why are seven of the largest life and health insurance companies in the United States, Canada and the UK invested to the tune of $4.4 billion in tobacco companies?

Having grown fat off individuals' health care premiums, particularly smokers', giant insurers like Prudential, Mass Mutual and Sun Life are investing some of those billions in tobacco companies.

J. Wesley Boyd, MD, PhD, and colleagues at the Cambridge Health Alliance at Harvard shared a list of the insurers and the size of their investments in tobacco companies as of March of this year. In a correspondence piece to the New England Journal of Medicine published June 4 they wrote:

"Although investing in tobacco while selling life or health insurance may seem self-defeating, insurance firms have figured out ways to profit from both. Insurers exclude smokers from coverage or, more commonly, charge them higher premiums. Insurers profit -- and smokers lose twice over.

"These facts should discomfit Canadian and British readers as their countries consider further privatization of health insurance," wrote Boyd. "For those of us in the United States, these data are a reminder of the true priority of the insurance industry, which is making money, not ensuring health and wellbeing."

A rational person might hope that this knowledge would cause some discomfiture in Washington, DC, where Congress is presumably wrestling over how to best reform the health care system so that it serves people, not profits, and wrests some control over health care delivery away from insurance companies. But so far, those in charge of crafting the plan are listening only to industry.