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Experts Argue Caring for Smokers, the Obese May Be Too Costly: ‘Why Not Just Let These Health Sinners Die?’

Jan. 26, 2013 3:55pm Erica Ritz

AP: Do Penalties for Smokers, the Obese (Health Sinners) Make Sense?

A woman passes an advertisement outside a fast food outlet on January 7, 2013 in Bristol, England. (Photo: Getty Images)

(TheBlaze/AP) — Faced with the high cost of caring for smokers and overeaters, experts say society must grapple with a chilling question. The Associated Press summarizes: “Instead of trying to penalize them and change their ways, why not just let these health sinners die?”

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 another $1-per-pack cigarette tax, which was ultimately defeated.

“This is my life. I should be able to do what I want,” said Sebastian Lopez, a college student from Queens, speaking last September when the New York City Board of Health approved the soda size rules.

Critics also contend that tobacco- and calorie-control measures place a disproportionately heavy burden on poor people. That’s because they:

-Smoke more than the rich, and have higher obesity rates.

-Have less money so sales taxes hit them harder. One study last year found poor, nicotine-dependent smokers in New York – a state with very high cigarette taxes – spent as much as a quarter of their entire income on smokes.

-Are less likely to have a car to shop elsewhere if the corner bodega or convenience store stops stocking their vices.

Critics call these approaches unfair, and believe they have only a marginal effect. “Ultimately these things are weak tea,” said Dr. Scott Gottlieb, a physician and fellow at the right-of-center think tank, the American Enterprise Institute.

But Gottlieb’s view is contested, and the debate rages on in similarly unsettling directions. For instance, some studies suggest that because smokers and the obese often die younger, they may actually cost society less than those who tend to live longer and develop chronic conditions like Alzheimer’s disease.

So let’s return to the original question: Why provoke a backlash? If 1 in 5 U.S. adults smoke, and 1 in 3 are obese, why not just get off their backs and let them go on with their (probably shortened) lives, the Associated Press asks?

A smoker snuffs out a cigarette at the Capitol in Sacramento, Calif. , Friday June 22, 2012. (Photo: AP)

Because it’s not just about them, say some health economists, bioethicists and public health researchers.

“Your freedom is likely to be someone else’s harm,” said Daniel Callahan, senior research scholar at a bioethics think-tank, the Hastings Center.

Smoking has the most obvious impact. Studies have increasingly shown harm to nonsmokers who are unlucky enough to work or live around heavy smokers. And several studies have shown heart attacks and asthma attack rates fell in counties or cities that adopted big smoking bans.

But it can be harder to make the same argument about soda-size restrictions or other legislative attempts to discourage excessive calorie consumption.

“When you eat yourself to death, you’re pretty much just harming yourself,” S. Jay Olshansky, a professor at the University of Illinois-Chicago’s School of Public Health, said.

But that viewpoint doesn’t factor in the burden to everyone else of paying for the diabetes care, heart surgeries and other medical expenses incurred by obese people, John Cawley, a health economist at Cornell University, noted.

“If I’m obese, the health care costs are not totally borne by me. They’re borne by other people in my health insurance plan and – when I’m older – by Medicare,” Cawley said.

From an economist’s perspective, there would be less reason to grouse about unhealthy behaviors by smokers, the obese, motorcycle riders who eschew helmets and other “health sinners” if they agreed to pay the financial price for their choices.

That’s the rationale for a provision in the Affordable Care Act – “Obamacare” to its detractors – that starting next year allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

The new law doesn’t allow insurers to charge more for people who are overweight, however.

It’s tricky to play the insurance game with overweight people, because science is still sorting things out. While obesity is clearly linked with serious health problems and early death, the evidence is not as clear about people who are just overweight.

That said, public health officials shouldn’t shy away from tough anti-obesity efforts, said Callahan, the bioethicist. Callahan caused a public stir this week with a paper that called for a more aggressive public health campaign that tries to shame and stigmatize overeaters the way past public health campaigns have shamed and stigmatized smokers.

National obesity rates are essentially static, and public health campaigns that gently try to educate people about the benefits of exercise and healthy eating just aren’t working, Callahan argued. We need to get obese people to change their behavior. If they are angry or hurt by it, so be it, he said.

“Emotions are what really count in this world,” he said.

–

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Comments (409)

truthnstuff
Posted on January 26, 2013 at 5:37pm
Another great study by the wizards of smart. The government and Pravda herding us toward the slaughter house for our own good.

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oldironsides
Posted on January 26, 2013 at 5:35pm
never happen – only politically incorrect lifestyles will be punished. and how will they differentiate a smoker from a nicorette chewer ? and what about the pot smokers, can’t be good for the lungs the way they cough.

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jungle J
Posted on January 26, 2013 at 5:29pm
what about the rabid homosexual or the doper or the speeder or the drunk or the firefighter that doesn’t use his safety gear or the skier of the fitness fanatic or the slut of the or or or or … only the sane see you and they fear you and your progressive handlers

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Walkabout
Posted on January 26, 2013 at 5:28pm
Obesity & smoking is to some extent caused by the government & the ranchers.

If the the high poohbahs of government make all the choices for you and penalize you at an ever increasing rate for striving, then what does a person have left? Eating, smoking & sex.

You don’t even have sports anymore. the poohbahs are trying to get rid of football & NASCAR. They’ll get back around to proscribing the pother sports as well. a decade or so ago they were on jihad against soccer.

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toto
Posted on January 26, 2013 at 5:26pm
Freedom means making your own choices right or wrong AND paying for it. The problem with government is that if they (meaning all of us) pay, you will no longer have the freedom to make your own choices. How can people be so naive as to think Obamacare is going to be anything more than a boa constrictor wrapped around your life. For the elderly, that boa is going to be very hungry.

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- cish60
  Posted on January 27, 2013 at 2:40pm
  Wow, perfect analogy with the boa…thanks. Mind if I borrow that one for my in-laws, who are both elderly and believe it or not, FOR Obamacare?
  
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Lt_Scrounge
Posted on January 26, 2013 at 5:24pm
Here’s a thought. Since the Obamacare experts say that the Obese and smokers shouldn’t get healthcare coverage, they shouldn’t have to pay for it. Wanna bet how many people will be suddenly start eating more or light up to avoid the mess that is Obamacare?

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- toto
  Posted on January 26, 2013 at 5:28pm
  The problem is that these same people that are “poor” will get coverage paid for by the government since their income levels will entitle them.
  
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wisconsinlcm
Posted on January 26, 2013 at 5:20pm
History is repeating its self,If you follow history you will see that Obama is following in the foot steps of the nazis.They started out the same way with healthcare,healthcare stared to rule all expects of everyones life and death.Peoples basic rights were taken away then twenty million of their lifes.

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normalmom
Posted on January 26, 2013 at 5:16pm
One of the first things that needs to be done in the case of the “obese” is to reevaluate this supposed ideal weight. I personally couldn’t get to my supposed ideal weight without losing muscle tone and becoming a skeleton with skin. Yes some people these numbers fit but no where near everyone. Not every five foot woman could weigh 100 pounds and look healthy. There is more to peoples body mass and weight than how tall they are and what gender.

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zoro51
Posted on January 26, 2013 at 5:15pm
DAMNED BE THE CRITTICS to say let them die.. is like saying to a pregnant 10 yr old ABORT.. no reference to A life no reguard for a LIFE.. so be it may what they said be done to them.. and NO ONE CAFE ABOUT IT as they DO NOT CARE ABOUT YOU …

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Outlaw_Josey_Wales
Posted on January 26, 2013 at 5:13pm
Americans spend about $2 trillion a year on healthcare. $500 billion is spent because of smoking, obesity, bad diet and lack of exercise. If people would take better care of themselfs healthcare cost would be reduced by 25%.

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mensa141
Posted on January 26, 2013 at 5:11pm
Anti-smoking warlocks should take into account the years that non-smokers will suck on social security BEFORE you get so high and mighty. Same for obese people, particularly the obese who develop diabetes. Your last year or so of life is statistically the most expensive. Living longer just sucks up so much more social security and other societal costs. Leaving people to live their own lives may be a novel idea for you know-it-alls but it just may save of us a lot of money!

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- AmericanStrega
  Posted on January 26, 2013 at 5:15pm
  MENSA141:
  Ever see the movie “Logan’s Run”?
  
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- wisconsinlcm
  Posted on January 26, 2013 at 5:26pm
  This is just another way the communist left is trying to run our lifes,these jerks never give up.
  
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Wisdom7
Posted on January 26, 2013 at 5:11pm
“…calorie-control measures place a disproportionately heavy burden on poor people. That’s because they: -Smoke more than the rich, and have higher obesity rates.”

There is a lot to be said concerning this. Isn’t it amazing that we apparently have mapped the entire GENOME, but we can’t seem to cure a single thing these days? Isn’t it amazing that we all became guinea pigs to GMO foods without our consent? The FDA is even going to approve that salmon with an eel gene to be placed into the food supply (http://goo.gl/a61N4). Isn’t it funny that GMO foods have been found to cause cancer and serious illness (http://goo.gl/QO6qH). This isn’t conspiracy. This is fact. Corn and soybeans, the most genetically modified crops, are in almost “everything” you eat.

Look at the rates of disease on the rise. Around 7.5 million people have psoriasis, which has no cure and no known cause. According to the CDC, 25.8 million people have diabetes, which is continually on the rise. But hey, lets blame most of the cost of illness on smokers, which have drastically decreased. The CDC reported 20 percent decrease in people who smoke just since 2005 and some polls show an overall decrease of 68 percent.

The poor are always more obese, because they eat poor foods! Additionally, obesity isn’t something you can just blanket associate with all people because there are so many reasons for people being overweight. Stigmatizing obese people won’t help anything but increase rates of e

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- Wisdom7
  Posted on January 26, 2013 at 5:13pm
  Stigmatizating obese people won’t help anything but increase rates of eating disorders. For instance, you can gain more weight from eating once a day and chugging soda than eating six healthy meals a day and drinking water. Also the government still uses BMI as a measuring tool, which is inaccurate in determining bodyfat percentage. If all these people are lazy, then why are there overweight people who work in heavy manual labor jobs if all overweight people are lazy? Why are their skinny people who eat non-stop?
  
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barber2
Posted on January 26, 2013 at 5:07pm
Think that its ” detractors” should stop calling this mess ObamaCare and refer to it as the hidden BIG LIE disaster that it really is ! Remember that last Democrat Economic Bomb , the ” Affordable Housing Act ?! ” Well, this little beauty is the “Affordable ” Big Lie Bomb # 2 ! Wait ’til you see what this little beauty does to the economy and the court system. Our radical Democrats have a whole new vocabulary of meanings in their new Coded American English ! Each word exposes the Democrats for the liars they are : transparent; affordable; marriage; redistribution; social justice; change; ” we don’t have a spending problem,” we need to pass laws so we can read laws,” the ” rich don’t pay their fair share.” The list is much longer, but think you get the drift.

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Mil-Dot
Posted on January 26, 2013 at 5:05pm
“resource” not resourse”—-sorry

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Mil-Dot
Posted on January 26, 2013 at 5:01pm
I’m sorry about those that cannot hack it because they got some bad DNA, but I agree with the guy. Let nature take its course. This incessant sucking of resources (money) from the productive and disciplined must stop. Now, young children and teens, those that have not yet had a chance, yeah, take care of them. But spending gobs of money on evolutionary rejects and very old seniors is a waste of money big time. But, let us not forget the sole exception- if you are a politician, then every resourse in the country will be devoted to your well being. (sarc) Bottom line, let nature take its course unimpeded.

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BlackCrow
Posted on January 26, 2013 at 5:01pm
Hitler had the Jews, Michell Obama, fat people. Only this time I’m not giving up my gun!

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- barber2
  Posted on January 26, 2013 at 5:09pm
  And don’t forget Barack had ” rich people!” Won him an election stirring up that hate and resentment ! Scapegoats are so beneficial to a rabble-rouser !
  
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OlefromMN
Posted on January 26, 2013 at 5:00pm
@Restored One

It is just the herd culling itself according to the dopes (“experts”) that came up with this topic if they were intellectually honest. If a person is so irresponsible to be unarmed, why should society protect them right? Police (just as healthcare) do not come cheap.

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The-Monk
Posted on January 26, 2013 at 4:58pm
“Annual health care costs are roughly $96 billion for smokers and $147 billion for the obese…”

Health costs for being obese cost 1 1/2 times more than for smokers?

They must have left “menthol” smokers out of the study…. they get free health care anyways.

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doomytram
Posted on January 26, 2013 at 4:54pm
If Chris Farley were alive today, then he would need to die. The most important person in the world is the Skinny, Non-Smoking, Black lady with 5 kids and 4 baby daddy’s. The least important person on the world is the Fat, Old white guy, with a Smoking, heroin, and alcohol habit. Animal Farm is here Orwell.

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Restored One
Posted on January 26, 2013 at 4:52pm
“Instead of trying to penalize them and change their ways, why not just let these health sinners die?”

Couldn’t this statement also apply to the anti gun group. If you do not want a gun, let the unarmed die? Just sayin.

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zerorave
Posted on January 26, 2013 at 4:51pm
Why stop where are are now?
The movie Logans Run had it right- NO ONE OVER THE AGE OF 30
That should fix it and That’s where we are heading!
http://www.youtube.com/watch?v=LSUAAKFLoL0

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GotMullet
Posted on January 26, 2013 at 4:49pm
No… society’s malcontents and victims of their own aberrant lifestyle choices are protected. We should pay for them, and provide them free birth control (and condoms for protection, if they cannot reproduce naturally) and feed them with food stamps and pay for their healthcare…. People who produce and are self sustaining owe that to them.

Don’t you get it? “From each according to their ability, to those according to their need.”

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Metallicat
Posted on January 26, 2013 at 4:47pm
its not fair the way they target obese people. Ive known people who were perfectly “healthy”,until they were injured and became less mobile or had a child that put on pounds they couldnt lose afterwards.

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desert buckeye
Posted on January 26, 2013 at 4:43pm
And while we’re at it, we should allow the “stupid” to die as well. It’s my understanding that you can’t fix “it.” So, let’s stop subsidizing it.

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- barber2
  Posted on January 26, 2013 at 5:11pm
  DESERT: Think you have nailed the radical Democrats Plan B for economic recovery ! Plan A is soak the rich . Plan B : eliminate the ” troublesome” and the expensive ! ( probably in a hidden agenda notebook on the economic Czars’s desk )
  
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soybomb315_II
Posted on January 26, 2013 at 4:41pm
If it is the government who would be “caring” for these people…..Then yes, they should just let the people fend for themselves, or die

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