Do penalties for smokers and the obese make sense?

[jsr]

http://hosted.ap.org/dynamic/stories/U/US_MED_HEALTH_COSTS_REALITY_CHECK?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-01-26-18-21-22

Jan 26, 2013 6:21 PM EST
Do penalties for smokers and the obese make sense?
By MIKE STOBBE

NEW YORK (AP) -- Faced with the high cost of caring for smokers and overeaters, experts say society must grapple with a blunt question: Instead of trying to penalize them and change their ways, why not just let these health sinners die prematurely from their unhealthy habits?

Annual health care costs are roughly $96 billion for smokers and $147 billion for the obese, the government says. These costs accompany sometimes heroic attempts to prolong lives, including surgery, chemotherapy and other measures.

But despite these rescue attempts, smokers tend to die 10 years earlier on average, and the obese die five to 12 years prematurely, according to various researchers' estimates.

And attempts to curb smoking and unhealthy eating frequently lead to backlash: Witness the current legal tussle over New York City's first-of-its-kind limits on the size of sugary beverages and the vicious fight last year in California over a ballot proposal to add a $1-per-pack cigarette tax, which was ultimately defeated.

[actslikeacarrot]

1. i dont like the way we are going...

...with these conversations. Its almost like we are trying to put a price on human life. Thank you op for the thought provoking article.

[Still Sensible]

2. No. You could make a longer list easily

how about moderate to heavy drinkers?
how about people who drive fast?
how about people who have dangerous hobbies?
how about people that are less sanitary in their hygiene?

Let's piss off a lot of people and add folks that keep guns in their home.

All of these things are likely to lead to higher health costs over time or from injury as well. If we brainstorm we can come up with many more that would make just as much sense.

[Sivafae]

3. What about people who have gained weight due to taking medications that make you fat?

The problem with that logic is the ingrained belief that someone is overweight due to their own behaviours. If you are taking Depokote, that simply isn't the case.

Or what if the reason you are obese has to do with a medical problem to begin with?
Or what if you have an injury or condition that prevents you from getting exercise?

The other problem with this logic is that the medical profession simply will not take due responsibility for the fact that they may themselves may be the reason someone is overweight.

They will give you medicine, not tell you that weight gain is a side effect and how to counteract it, then JUST tell you to loose weight after the medicine has reeked havoc with your weight.

It's ludicrous really.

[raccoon]

11. SSRI's cause weight gain too. nt

[KT2000]

4. should a smoker be denied

medical care if they are hurt in an accident? Should an obese person be denied medical care if they are exposed to something like 9/11 pollution?
We have lost our souls here in the US.
I am afraid the free market crowd is still in charge.

[flvegan]

5. Let me know when nutrition is taught. n/t

[union_maid]

6. How about when people live to be very old

but have dementia or are in some other way unable to take care of themselves. That's really expensive. How about we just realize that we don't really know all the things that contribute to ill health and while encouraging healthy habits is great, we probably shouldn't demonize those who fall short of perfection.

[DogPawsBiscuitsNGrav]

7. The insurance companies win again. It's mandatory we pay them and they can charge what they want

to whomever they want. Same as car insurance. If you have bad credit because Wallstreet and the bankers destroyed the economy, you pay more. I would think that credit ruined people would be less of a risk since they'd be driving less with less money to spend on car maintenance and gas. There are never any safety nets for the people written into these laws to keep the insurance companies from robbing us blind for any reason they want.

Today it's 4000 more per year for smokers. Tomorrow its 5000 more for the obese. And lets not forget those with bad credit, the mandatory auto insurance sure didn't forget them.

So much for single pay, fair and affordable.

[JVS]

8. It makes sense for insurance companies, but if your goal is universal health care instead of...

profit it does not make sense to take groups that are already under-served by the medical system and make it more difficult for them to access healthcare.

For insurance companies the best system would be for all unhealthy people to be denied treatment while everyone is forced to pay for coverage. This is why they are a terrible vehicle to achieve universal coverage.

Also, there is a lot of talk about how expensive unhealthy people are to the system. I never hear anyone mention that people who die at 60 save the social security system a ton of money compared to people who make it into their late 90s.

[Egalitarian Thug]

9. Only from the short-sighted, doomed to fail perspective that dominates America today and

for the last 30 - 40 years or so.

Here's the thing. Just like every other non-botanical creature on earth, we are animals. We like to pretend that we are better than the other animals, but all the evidence is clear, we are just like them. We are ruled by uncontrollable and often unperceived impulses that regularly drive us to to take the worst actions, make the worst decisions, and behave in utterly irrational ways. We have several characteristics that seem to make us different or special, but in the end, we act no better (and often much worse) than any other animal.

One example; We have the capacity to understand that uncontrolled breeding will absolutely without fail lead to the devastation of our environment and ultimately our own demise, yet we breed like rabbits and then weep at the sight of starving children.

Smokers are addicts, I don't think there is any rational debate that this is so, but we like to pretend that it is a choice and therefore assign the blame to those that partake. The Obese eat too much and move too little, yet we claim that this too is beyond our control. Has anyone ever seen an obese person that lives in a famine stricken area? The very idea is ridiculous, but here in America obesity is due to genetics, a virus, a bad childhood, whatever we can make up to lay the cause on somebody/thing else. In fact, we have an entire industry devoted to nothing other than excusing our own lack of will that takes in more than enough money to end all hunger on earth.

And by this same lack of honest, objective consideration, we have a significant faction that fervently believes that denying help to those that need it will somehow, despite all evidence to the contrary, make those people give up the cigarette and put down the fork and just get better.

[eridani]

10. From a strictly financial standpoint, the healthy and clean-living should be paying penalties

http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html

Preventing obesity and smoking can save lives, but it does not save money, according to a new report.

It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.

"It was a small surprise," said Pieter van Baal, an economist at the National Institute for Public Health and the Environment in the Netherlands, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."

In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers.

[SoCalDem]

12. If one assumes that these habits/conditions shorten life

it seems to me that the "savings" from their non-collection of long-term "benefits" more than makes up for whatever care they may need to cushion the blow of a shortened life..

From a dollar and cents approach, isn't it cheaper to pay some medical expenses for a rather acute and probably short "final illness" of a 60-70 yr old, than to pay "benefits" to "maintain" a "normal" person who may live to be 90+??

Just think of all the lovely uncollected SS/Medicare/pensions..

These Darwinian "experts" may be worrying unnecessarily, since as people get pushed out of jobs they need in order to keep health insurance, and they face the years from 50 to 65 without care, the Boomer generation will probably start dropping like flies after the first hard frost...

It's odd isn't it, how all the other 1st world countries seem to manage offering health care to ALL their citizens without having to make them resent the care someone else gets?

With all our high-fallutin' new drugs and million-dollar machinery that every clinic seems to have to have, the use of these is always available and ready for the wealthy, and the rest of us seem to always have to prove our worthiness..