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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)

grampdad
Posted on January 26, 2013 at 6:30pm
Sorry, but, an even greater expense is the costs to treat homosexuals…. http://www.wpaag.org/Homosexuals%20and%20Same%20Sex%20Marriage.htm
http://www.catholiceducation.org/articles/homosexuality/ho0075.html
http://www.earstohear.net/Separation/facts.html
http://www.frc.org/get.cfm?i=IS01B1

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Ohio50patriot
Posted on January 26, 2013 at 6:30pm
whats next from the wacky liberals? Kill the Jews? Work on a master race? Seems to me we have been down this road before. I want freedom not a government telling me what I can or cannot do. I do not want a government telling me I cant have health care because I am too fat or too old or too whatever. I work hard for my money and my health benifits that are included in my job. If you want to know what really runs up health care cost go to an emergency room and look at all the welfare recipiants going there with a government medical card and having their child examined because they have a cold or the sniffles. Tally up the cost of all the unisured mothers who gave birth on the taxpayers dime. I am not advocating abortion I am advocating responsibility.

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TIMEBOMB
Posted on January 26, 2013 at 6:23pm
Settle down my loyal subjects settle down no one’s dying yet,my lackeys have to come up with a workable plan to get rid of you grubby burdens. My pops told me it would come to this and I’d be able to fool the masses because they’re so stupid hell you voted for me twice. I’ll sell it as a cost cutting measure and you’re so gullible and ignorant you’ll buy it. Then I’ll move to other maladies like mental illness,that’ll be a bunch right there because most of you are nut jobs anyway. Then I’ll move to Christians and the grand daddy of em all the white male,of course I’ll have my pawns disarm you first then round you up and off to the ovens I’m going to skip trying to reeducate you it’s much too dangerous. The white male simply has to go because my racism and uber gayness compels me to orchestrate your demise. I forgot to mention I’m a Marxist and capitalism will die with you and the best part is you’ll go right along with it,you don’t want to be labeled a racist now do you? My media will eagerly label every white male a racist for criticizing your magnificent gay Marxist ruler. Okay pops get ready I’m sending you millions of souls to torment just like Hitler,Mao and Pol Pot did.

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Mudd
Posted on January 26, 2013 at 6:23pm
Sieg Hiel!

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civilwarcometh
Posted on January 26, 2013 at 6:21pm
Yeah it’s not like these people have jacked up certain treatment’s and drug’s or procedure’s over time to justify this huh? Man is not sneaky or a deceiver.

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Ballot_Box_Revolution
Posted on January 26, 2013 at 6:18pm
and now they can let them die since health is controlled by government….

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squirefld
Posted on January 26, 2013 at 6:16pm
And they laughed at Sarah Palin when she was the first to say that there were death panels in Obamacare. If there’s already this kind talk about smokers and over weight indivduial’s before Obamacare starts, what will happen to the 75 year old that needs a pace maker or the 65 year old that has to have chemo. We have a very evil cloud desending over the United Srares.

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dodgedart1966
Posted on January 26, 2013 at 6:13pm
I smoke. I have a little gut. Tell you what. Stop taking my taxes and I won’t ask for help when/if I get sick.
My mom’s 85 and still smokes a little. My Dad made it to 83, while smoking.
I’ll take my chances, just stop taxing me.

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ripley
Posted on January 26, 2013 at 6:11pm
And all the weed smokers who will end up with cancer.

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toomuchgovt
Posted on January 26, 2013 at 6:11pm
The money and the people that are employed by the government to get all these crackhead, needle freaks sober are you kidding? Haven’t you heard of drug court, rehabs? which brings in family court, criminal court and the department of social services. These are the darlings of the system. Yet another consequence of failed liberal social policies.

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barber2
Posted on January 26, 2013 at 6:05pm
So excited for the coming of the ” Affordable ( in a pig’s eye ) Health Act !” That’s when the kids in mom’s basement can be happy until they grow up at 25 and realize that the nation has been bankrupted by the radical Democrats who bamboozled them with their Bernie Madoff Economic policies just to win some votes !

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RANGER1965
Posted on January 26, 2013 at 6:05pm
If your health is on your own dime, or you pay for your own health insurance, then no one, NO ONE has a right to say anything about your habits whether they are good or bad.

If the tax payer is paying for your health care then they DO HAVE a right to ask things of you. But fair is fair. If we are going to condemn smokers and the obese for their poor choices, then we also condemn the liberal love affair with AIDS, Drug Addiction, Abortion, and Contraception. If it’s wrong to ask the public to support the poor choices of a smoker, then it’s just as wrong to ask the public to support a Drug Addict, or an Abortion.

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SolitudeBliss
Posted on January 26, 2013 at 6:04pm
Star Trek The Next Generation episode A Half Life: when reaching the age of 60 citizens of the visited planet were expected to throw a huge party with friends and family present for the “Resolution” which is when they would commit suicide so as not to be a burden to their families and society.

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- AmericanStrega
  Posted on January 26, 2013 at 6:23pm
  That was a good episode. Take a look at the movie “Logan’s Run”. It’s a really cheesy ’70′s movie, but is still a good watch.
  
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- normalmom
  Posted on January 26, 2013 at 7:06pm
  Yup, that does run put the concept out there doesn’t it?
  
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SolitudeBliss
Posted on January 26, 2013 at 6:01pm
Well, I’ve always said that smokers pay higher taxes for their cigarettes and die sooner thus not collecting SS so what the heck, smoke ‘em if you got ‘em. BTW- the way the country is going it might not be a bad habit to pick up.

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Oneoutofmany
Posted on January 26, 2013 at 6:00pm
As I understand it some states have late payment interest for medical claims. Now my understanding of this is that if an insurance company is late paying a claim for some reason (electronic data or mailing issues, strings of duplicate/corrected claim submissions, missing info, etc.) the penalty on the claim in can be well above the contracted rate. Like if a contract was for $8000 for a 3 day stay but billed charges were $250k, it looks like there are some instances in one state the insurance company would have to pay billed charges of $250k- a $242 difference. I think that the interest may go to the state in some instances and not to the doctor or hospital however am not 100% sure.

http://www.senate.state.tx.us/75r/senate/commit/c950/Downloads/PromptPay.pdf http://www.tdi.texas.gov/hprovider/ppsb418faq.html#toc28 http://www.theverdengroup.com/PromptPayByState_2010.pdf

I sometimes wonder if states that have late payment interest penalties like CA, Tx etc would be driving up everyone’s costs and premiums nationally significantly more than a few smokers or heavy people. It would be really interesting to see some stats of consumer costs of smokers in the insurance pool as vs cost of Calif/TX late payment interest for example.

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AmericaMustBeFree
Posted on January 26, 2013 at 5:59pm
How about instead we shoot the pigs who have poisoned our food and water.. and put countless chemicals in cigarettes to make people super addictive to them… Yeah that sounds like an awesome idea. Do you know that wheat is no longer the grain it was a 100 years ago.. they have posioned it and put it in almost everything…wheat today causes a myraid of health problems and one of them is weight gain.. how about Monsanto that has poisoned our food with their crappy seeds that have caused the bee population to die and without bee’s there is no pollination! This my friends one of the reasons for the food shortages that are coming. We have evil people who have helped us with our health problems.. lets blame them also and let them die by their own poison.. Idiots!

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Mil-Dot
Posted on January 26, 2013 at 5:53pm
Witness,
That’s right. Give basic life supporting drugs where necessary, they are cheap. I am talking about the exorbitant, super-expensive , extrordinary procedures ok? Don’t put words in my mouth you leech. I will defeat your arguments one after another. You will lose. Only a leech would spout off the crap that you advocate.

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fande3rls
Posted on January 26, 2013 at 5:51pm
Has any body seen on youtube the video,by George Benard Shaw , ,this is the same Idea. if they don’t obey the Collective just let the starve or gas them to death

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PJPaneczko
Posted on January 26, 2013 at 5:50pm
So it begins.

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bhelmet
Posted on January 26, 2013 at 5:46pm
If this comes to pass then I will truly tremble for my nation.

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Witness1974
Posted on January 26, 2013 at 5:45pm
“Let nature take it’s course unimpeded.”

What a great idea. You’ve stumbled upon the real cost savings: Kill all doctors, nurses, firemen, and police officers. Ban all life saving drugs: all antibiotics, drugs that control cardiac arrythmias, anti-cholesterol drugs . . . . Let’s all go back to “the state of nature where every man is at war with every other man and where life is solitary, poor, brutal, nasty, and short.” Now that’s livin’!

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progressiveslayer
Posted on January 26, 2013 at 5:45pm
It’s a slippery slope folks because there’s always somebody who thinks somebody else shouldn’t be around,obese,smokers,cancer patients. They could move to gays,lesbians and mentally handicapped like Hitler did because that’s what happens when you engage in eugenics. Look I don’t like paying for obese or smokers either but I know history and it always ends badly with these situations. The regime in power might not think it’s political opponents worthy of life and have them euthanized as well,you could go on and on the possibilities are endless.

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- progressiveslayer
  Posted on January 26, 2013 at 5:57pm
  https://www.youtube.com/watch?v=PVhE3Muh3co
  
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- AmericaMustBeFree
  Posted on January 27, 2013 at 2:00am
  And you don’t think they won’t. Here is what I said of Obamacare.. first they will let the elderly die, then the disabled and if you have a disease.. expect bottles of pain killers until you die.. or if you can’t handle that we can just put you to sleep! Lord help us!
  
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AmericanStrega
Posted on January 26, 2013 at 5:45pm
Mil-Dot
Posted on January 26, 2013 at 5:23pm
Tex,
Respectfully my patriot brother, is it really wise to spend hundreds of thousands of dollars to preserve the lives of those that will perish anyway? Is it really? Your opinion is as valid as mine. We are all entitled to that much. Freedom is utmost.

Mil-Dot:
If it’s you or one you love who is targeted for extermination will you still have the same opinion?

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- hatchetjob
  Posted on January 26, 2013 at 6:56pm
  I read on page1 that MIL-DOT’s family feels the same as he does on this.
  
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topazmarie
Posted on January 26, 2013 at 5:43pm
Health sinners forgot to include all elitists engaged in multiple sexual relationships. And, it’s about all of ‘em. Just think of all the STDs these freaks are harboring. That includes of course the Hollywood a..h….. who also try to tell us how to think. VILE

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TheBurningTruth
Posted on January 26, 2013 at 5:39pm
My thoughts exactly. In fact, the most expensive person of all is an illiterate ghetto mama whose family is 5th generation welfare and will never work. Well, unless you call “working” producing 5 or 6 kids from as many different men that will also have little to no prospect for being successful.

Truth is the Progressive Left is the most hateful and vicious group in existence. They define what THEY want to be right, and are happy to kill everyone else. This is the next step towards Eugenics as the Progressive Left under Margaret Sanger preached. It is also another step on the path toward either/both the Soviet Union and Nazi Germany of the 30s where the government acted to murder tens of millions of their own citizens.

I this case, they’ll use “obese” or “smoker” yet let bare-back-riding gays, crack whores and baby-factory mamas (with the obligatory Obama-phone) go.

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