I know someone who was recently disciplined at work for shouting an obscenity on the job.

Naturally, I asked him why he was dropping f-bombs at work. His answer: He had just found out how much his health-insurance premiums were going up this year.

I guess I can’t blame him.

Most of us with insurance have seen our costs going up for the last several years. It seems like everyone is complaining about the cost of health care these days.

At the same time, the country’s obesity rate is sky high, and disturbingly, it’s going up among children. Smoking refuses to go away. And a medical industry often driven by profits isn’t helping things, pushing up costs with marketing campaigns for high-priced drugs that don’t always seem like a medical necessity.

Does anybody see a connection?

Insurance costs go up when more people need more medical care, and the amount being collected from subscribers isn’t enough to pay for it all. So if people were healthier, they’d need less health care, and costs for the whole system wouldn’t be so out of control. Many health problems are out of our hands, of course &045; people don’t bring leukemia or Parkinson’s disease on themselves. And genetics and dumb luck play a big role in health. But at the same time, people greatly increase their risk of disease when they make unhealthy lifestyle choices.

How much does tobacco use cost all of us in health-care costs? People like to make smoking out to be a personal-freedom issue, but everybody’s personal freedom to smoke affects everybody else in more than one way. Aside from the medical problems that can be caused by second-hand smoke, the extra medical services needed by people who get sick from smoking means all of us pay more for health care. That’s right &045; the guy who lights up near you isn’t just contaminating the air you breathe; he could be picking your pocket, too. He’s probably not a bad guy, but he’s hooked, and it’s not easy to stop. That’s why we need to avoid shortsighted attempts to cut money for programs that discourage youth smoking.

Eating and exercise habits are also directly linked to health, and by extension, to health costs.

Most people don’t get enough exercise; it’s a bi-product of a changing culture where we have more leisure time, more cable channels and Internet sites to check out, and more work is done at a desk.

Then there’s food. Barbecuing is a religion in this country, and steak is a sacrament. We eat red meat like it’s going out of style, then wonder why our heart-disease rate is so high compared to other countries. And look at the constant struggle by junk food makers to cram more of it down our throats &045; and our willingness to swallow it. Everything is getting bigger these days. You can super-size your Extra Value Meal, and your kids can even get a &uot;Big Kid’s Meal.&uot; Snack chips are coming in bigger and bigger bags. Frozen dinners just can’t seem to get big enough. Remember when pop bottles were 16 ounces? That was only a few years ago. Now, 20 ounces is the norm, and you can also get a whopping half-liter of sugar-laden soda at your corner store. Do we really need all this?

To top it off, the drug companies are spending millions on advertising to get you to &uot;ask your doctor&uot; about the latest drug you may or may not need. The patients, of course, pay for all these ads through drug costs. I keep seeing one commercial featuring a woman cursed with the terrible medical problem of frequent urination, which of course is solved by whatever drug they invented for that. Is having to pee too often really a medical problem we need them to spend millions to research, cure and advertise about? Of course not, but they’re after profits, and I’m sure plenty of people are asking their doctor about the miracle anti-pee drug so they can spend less time in the john.

This isn’t meant to be a lecture, and by no means am I perfect, either. It’s just something that I’ve been thinking about, and I think it would be a good thing if others think about it more, too.

In our free society, all this is up to individual choice. People have the right to live their life as they want, eat as they want, and sell what they want. But as long as these same choices keep being made, the health care system won’t change much.

Dylan Belden is the Tribune’s managing editor. His column appears Sundays.