The insurance company could reinvest its profits in commercial ventures that would enhance the public health sector, such as pharmaceutical companies. Although the issue of non-coverage of preexisting conditions was glossed over in the HIA, the emphasis on preventive health care and individual responsibility for health status had a financial justification. In the United states, for example, the Deputy secretary of Health and Human services Moley (1992) pointed out that, in 1991, one out of every six deaths and $65 billion in health care costs and lost productivity were related to cigarette smoking.