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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)

Guy_From_Michigan
Posted on January 26, 2013 at 10:20pm
I am getting so tired of the ^%&^% Liberals telling everyone what to do and how to live.
They are ok with all of us paying our taxes (And yes I pay lots of taxes and have paid taxes since I was 16) to pay for people that make babies but forget they they need to be supported. Thats their right to like like they want to and we pay the bills.
I AM FAT, I HAVE ALWAYS BEEN FAT. I’m 54 and pay my own Blue Cross, Its expensive because we have to take care of druggies, drunks, AIDS, Food Stamps, and now student loans we are about to be paying for spoiled kids.
I pay my Social Security and with me being FAT I will die early and not be able to collect as much as a skinny person. So how about FAT people like me getting a “Deal” on our Social Security?
So I am now the problem, I don’t think so. I have been paying in for years, supporting everyone else so when its my time to get something from the system its Kiss off, just go die because you are not what some brain deal Liberal thinks I should be.

You little girlie men could not last a week in my shoes, I work 12 to 16 hours a day, Self employed and I employee 15 people and I did not need the government to give me money to hire someone.

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- cosmic dogma
  Posted on January 26, 2013 at 10:24pm
  Ditto, and much respect! Thank you for your hard work.
  
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- DAGNY
  Posted on January 26, 2013 at 11:38pm
  And actually, healthcare would be so outrageous if the government didn’t dictate to insurance providers what protocol they must follow for patients.
  
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Wichita1
Posted on January 26, 2013 at 10:15pm
Who did not see this coming? The people groups added to the list will continue to grow. The death panel will select those whom are worthy of the TAX PAYER FUNDED National Health Care.

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Proud Southerner
Posted on January 26, 2013 at 10:09pm
They might be on to something here. When a non communist administration takes over we can just say that people that are unemployed and are on welfare programs are more unhealthy than the rest of the population and let them die away. Eventually we can make this thing work.

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ILUVPORK
Posted on January 26, 2013 at 9:49pm
In the last 4 years I have been inspired to get healthy.Michelle and her athletic arms have inspired me to work out. I get up and march while watching tv ,knee lifts ,using light weights and jogging in the living room.Each day I take a vitamin and log everything I eat to not go over 1300 calories.Ihave lost some good weight but still strugging to get to my desired weight.I am motivated by the news of the politicians and their think tanks to get in shape.So I can run as fast as I can to hide when they come for me.Once captured I will be in shape to push the dollies full of dead americans into the ovens at the death camps. I will be there to be gods witness of the evil that has desended upon this country once the last body is fried they will throw me in too. But for all my working out and calorie counting and trying to prove I am worthy to live by making items to sell and having skills it still will not be good enough because I am not one of them ,in the clique not weathly ,healthy ,young and wise.Sarah Palin was right and the left skewered her,”Death Panels”.Then they set the bar higher and higher it will never end you will never please the government elites.But Presidents come and go just like the ancient roman rulers,Pain and suffering will forever plague the living our only hope is the after our lives are over god will be standing there with welcome arms and a loving heart.And say to us the worst is over you went through he// now your real life will begin.Live ,love,enjoy

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- hatchetjob
  Posted on January 27, 2013 at 2:35pm
  Good comment, ILUVPORK, very good.
  
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From Virginia
Posted on January 26, 2013 at 9:30pm
I don’t believe second hand smoke harms non-smokers. I have a small bird that was supposed to live 5 years. I was warned not to smoke in the same HOUSE as him. I’ve smoked – heavily – around him for 17 years and he shows no signs of croaking.

Seriously, I made a decision in my 30′s to get a bird and I’m in my 50′s now. sigh……

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merchantsailor
Posted on January 26, 2013 at 9:17pm
You take that whole article and replace obese with Jew and you have 1930′s Germany or Soviet Union, when “Pappa Joe starved 3,000,000 + people to death for what or who they are. Remember these clowns always come up with a way to mass murder the indigenous population for their idea of UTOPIA!!! So this guys UTOPIA is males and females that weigh any where from 100 to 150 pounds, stand more than 5’4″, light brown skin, wavy ****, no baldness, no smoking except the occasional doobie on Saturday night, bicycle riding electric car driving, in touch with themselves, solar suckers. just sayin…………..

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usmc1063
Posted on January 26, 2013 at 9:13pm
How nice just kill everyone who doesn’t conform to your ideals. The communist have been doing that for years at the tune of 100 million people. The Nazi’s did the same thing before and during the second worlds war. Might just be time to re-educate the educator’s who believe that crap. Wake up America and remember a liberal progressive mind is a terrible thing to use.

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Wolf73b
Posted on January 26, 2013 at 9:12pm
This is crazy. We were assured by the liberal leadership and their compliant media arm that the idea of death panels was insane. So, this kind of thinking must obviously be a mistake.

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RaydocX
Posted on January 26, 2013 at 9:02pm
when the dollar goes up in smoke and there are food lines, the obese will fare better longer than the grimly svelte.

but the self congratulating members of the non-obese might want to reconsider patting themselves on the back for the (inevitable) applications of death panels or whatever euphemism the OCare bureaucrats come up with to determine cost benefit analysis… after the obese and smokers are written off the roles at age XX, there STILL won’t be sufficient funds in the failing power that is America with it 50+% tax rates and the stifling economic and enviornmental controls… more cuts will be necessary…

undereducated? check… overeducated? check (can’t have too many too smart who might oppose the ruling class)

in fact, when they get to overuse of smart metered energy, the skeletal will have to watch out… you keep your homes much warmer in the winter than those of us with some natural insulation…

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blazingaway
Posted on January 26, 2013 at 8:56pm
I’m all for it … if you’re too stupid to care for your own health it is because you WANT TO BE that stupid and remain that stupid and sooner or later, perhaps if you see enough people suffering from all of their stupid choices to eat themselves into an early, miserable, painful grave then you might stop doing the same thing. I’m sick and tired of society paying for these damn lazy, stupid, emotional dumb asses

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- RaydocX
  Posted on January 26, 2013 at 9:04pm
  that only applies if you are talking about a universally accepted definition of health…
  while lung cancer and emphysema afflict primarily smokers, it isn’t JUST smokers, and thousands of smokers die of old age with never a problem… there is an underlying genetic bias.
  
  and once you start down the slippery slope of ‘you can’t have this because of XX’ your name is on a loterry ball with some characteristic that will cull you from the register, too… only the elites will be protected, befitting their exalted enlightenment.
  
  Report this comment
- cosmic dogma
  Posted on January 26, 2013 at 10:32pm
  Why is it OK for society to pay for vast numbers of illegitimate children to be born and pay for vast numbers of freeloaders to lay around smoking doobies while fat responsible people work hard paying taxes to support them? Seems pretty unfair to me. No -health- care -for – non- tax -payers!!!!!! Sounds reasonable to me.
  
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Granny58
Posted on January 26, 2013 at 8:51pm
everybody does something they shouldn’t…why single out these examples? it’s just more attempt at control.

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susan126
Posted on January 26, 2013 at 8:31pm
Then we also should let all the drunk drivers that are injured in accidents die too. It’s their choice to drink. How much does it cost to save their lives?

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TheGrtDcptn
Posted on January 26, 2013 at 8:23pm
Get rid of all repeat offenders sitting in prison…I don’t care what the crime was…ADIOS…!!

Just another waste of MONEY…That IS what this is all about…RIGHT…?!?!

pffttt…

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- RaydocX
  Posted on January 26, 2013 at 9:09pm
  a la Stephen Coonts ‘Under Siege’ wherein Americans by mob rule take over after disaster…
  
  funny, that’s one of those ‘why i own firearms’ eventualities…
  the filmmaker of the Tom Cruise alien fantasy ‘War of the World’ said he was trying to depict the sort of disaster Europeans faced with WWII as having hit here, since we have never faced such displacement.
  
  he was right, including the great depression. but if the dollar is brought down and superinflation takes over, a virtual certainty at the rate we are building debt vs. our tax collection, we will face such harsh realities, and only those who are prepared– in a host of ways– will have a prayer of weathering the storm. And don’t expect Government to help… they’ll be too busy looking for their own golden parachutes. but until that time, they will happily classify and parse the population in ways they claim to be racist and prejudicial if done by John Q Public.
  
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hugo65hsv
Posted on January 26, 2013 at 8:09pm
We’ve heard enough from experts.. They can go where the sun don’t shine as far as I’m concerned…

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- wowjustwow
  Posted on January 26, 2013 at 8:15pm
  You don’t need experts, I agree. Just read ingredient lists and check the chemical names online. Then you’ll know that often what you’re eating isn’t food anymore. Many diseases come down to choice. I judge nobody. Everyone gets the choice and the consequences.
  
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- Stelex
  Posted on January 26, 2013 at 8:22pm
  “I judge nobody” really …..did you read your last few post idiot. You cant fix stupid can you……60,000 sperm and your the one that got thru. Sick joke if you ask me.
  
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- wowjustwow
  Posted on January 26, 2013 at 8:34pm
  No, Stelex, you can’t fix stupid, which is why I am so glad I’m not “broke” like you. I am sure that all of the information I’ve laid out irritates you because you get frustrated that somebody may find value in what I have to say and skip over your usual misanthropic, boring rants with trite phrases like “ya can’t fix stupid–doyyyy!”
  
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- Stelex
  Posted on January 26, 2013 at 9:15pm
  Wow……so you read my stuff. Glad to see your following. Keep it up you may learn something. Ya just can’t fix stupid ya fool
  
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ICEDRAGONNITE
Posted on January 26, 2013 at 8:09pm
DEATH panels.

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wowjustwow
Posted on January 26, 2013 at 8:07pm
Big business can tamper with food all they want, but they can’t make you eat it. Most people would be shocked at what they are eating — it’s a slow-killing chemical cocktail. Once you know, it’s up to you to cut the stuff out because nobody is stopping the food giants. This isn’t propaganda; it’s fact. I’m not talking about “fast food” chains. I’m talking about boxed stuff in supermarkets. It will make you obese and sick. If you choose to eat it anyway, it will take you out and make the slow death a painful one. But, it is a choice that each of us has to make everyday for ourselves and our kids and then just live with the consequences – good or bad.

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Keep Your Skepticals On
Posted on January 26, 2013 at 7:53pm
“If I’m obese, the health care costs are not totally borne by me.”

“If I am ______, the _______ costs are not totally borne by me.” is more like it. Fill in the blank with anything, anyone does that you do not like and it’s true.

But more importantly, fill it in with something you do like, and it’s true.

“If I am free, the costs of freedom are not totally borne by me.” This is why independence is so important and interdependence is so dangerous. ThatGuycare is not about rationing healthcare, it’s about rationing freedom.

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- Keep Your Skepticals On
  Posted on January 26, 2013 at 8:20pm
  Also: Isn’t it true that it costs much, much more to care for a “healthy” person for the one reason that they do live so much longer? I seem to remember several statistics that showed those 10-12 years that “health sinners” tend to lose are far, far more costly due to ailments, assisted living, diseases & cancers associated with aging than all the treatments provided for smoking/obesity.
  
  I’m not in any way arguing old age costs too much (but I’m sure that is next after “they” control smoking/obesity) but if we’re going to look at the costs of freedom, let’s be honest about it. It is very likely that if honestly look at the burden of smoker/obese on society purely in dollars, they are reducing costs. Anyone have those statistics?
  
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- wowjustwow
  Posted on January 26, 2013 at 8:30pm
  No this is false because a healthy person who lives longer isn’t sick. Healthy people don’t get, for example, type 2 diabetes. It’s caused by diet and is cured by diet (fact, not opinion). Healthy people rarely get other chronic diseases (ibs, crohns, gout, etc.) because again, they are caused by type of food intake. To live long and not need healthcare would be great for all of us. It’s when people have chronic illnesses that it really becomes expensive.
  
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Acena
Posted on January 26, 2013 at 7:53pm
So people with ; AIDS,chronic alcoholism ,anorexia ,bulimia ,diabetes,heart diseases,black lung,lung cancer,COPD,throat/mouth and jaw cancer,several mental illnesses ,birth addictions and defects,hepatitis C and drug addictions should be left to die because they are self induced illnesses .

Organ transplants and premature births are way too costly .

And birth defects that create lifetime dependents – Cystic ,MD,sickle cell,cerebral palsy,autism,mental illness,spinal bifida and mental retardation are obviously economic fodder.

Fire up those gas chambers Hitler!

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South Philly Boy
Posted on January 26, 2013 at 7:52pm
And the CORRUPT NEWS MEDIA busted Sarah Palin CHOPS

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- Stelex
  Posted on January 26, 2013 at 8:04pm
  Ain’t it a riot, when you listen to the libs, Death Panels sound plesent.
  
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- wowjustwow
  Posted on January 26, 2013 at 8:11pm
  Sarah Palin is a moron; no more – no less. A pretty moron. She’s probably okay with that at the end of the day. Why aren’t all of you?
  
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- Stelex
  Posted on January 26, 2013 at 8:19pm
  Wow…..your chronic masterbation is making you blind, that will also cost us all. Obviously your ignorance has cost us dearly and the fact your just a fool will no doubt cost us more in the long run. By the way do something about that smell, good god man.
  
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- wowjustwow
  Posted on January 26, 2013 at 9:02pm
  Stelex…first of all I’m not a man…I’m a woman. Everything else you said isn’t worth addressing…you are really pretty boring.
  
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- Stelex
  Posted on January 26, 2013 at 9:17pm
  I stand corrected…….Good God Woman. All else stands.
  
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- Stelex
  Posted on January 26, 2013 at 9:20pm
  Are you a single woman???? Ha…….thats a stupid question ……. sorry. Are you attractive…….ha thats a stupid question. Go cozy up with Beckel and lets chat again tomorrow. Gnight.
  
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- wowjustwow
  Posted on January 27, 2013 at 1:59am
  No, Stelex…I’m married and I’m fit and I have a good-looking husband. Sorry.
  
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mikenleeds
Posted on January 26, 2013 at 7:51pm
am not as hard as some of you guys but i d agree if you are a fat cow,smoker,drug attic they should have to pay alot more for their share of the insurance , am a very healthy 47 year old due to control and hard work

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- Stelex
  Posted on January 26, 2013 at 8:00pm
  Your also arrogant and ignorant. I’m happy for you being fit. Thats your choice I pay for my insurance and I say F U that I should have to pay more, how the hell do you know if you won’t have a long lingering disease later in life that costs me ……….morons like you who play into the narrative are killing this country. We used to be a “Live and let live” country, now we are a “Live like me or die” country. Hope your proud of what you promote. JAGOV
  
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- wowjustwow
  Posted on January 26, 2013 at 8:13pm
  Hey…aren’t the red states the most obese? Why, yes, they are. They are costing this country in healthcare.
  
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- Stelex
  Posted on January 26, 2013 at 8:15pm
  Hey, I live in a Blue state DB. Grow a set and start thinking for yourselves and stop with the progressive propaganda. Jagov.
  
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- wowjustwow
  Posted on January 26, 2013 at 9:09pm
  Stelex, my “set” is proverbial as I’m not a man and wouldn’t want to grow actual balls.
  
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- Stelex
  Posted on January 26, 2013 at 9:24pm
  Today’s medicine can do anything……If they can give a convicted killer in MA a ******, you can get a set of balls. Don’t give up.
  
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- Stelex
  Posted on January 26, 2013 at 9:29pm
  Blaze……we’re all grown ups here…….the word V…..a…..g…….i…..n….a….should not be blocked. Grow up
  
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carolsue1ok
Posted on January 26, 2013 at 7:48pm
girls and women who get pregnant out of wedlock should not get heath care because they could have avoided being pregnant and we should not have to pay for their sins.

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- wowjustwow
  Posted on January 26, 2013 at 9:11pm
  Sounds good…let the guy who impregnated them share the expense.
  
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Stelex
Posted on January 26, 2013 at 7:48pm
I smoke, I own guns, I’m a big guy, slightly over weight but by Gov standard probably obese. In what way shape or form should I feel secure in my own country anymore. How should I feel being the target of Government condemnation. The most powerful entity in the land hates me. Along with at least 47% of my neighbors and or “Fellow” Americans.
I’m an individual being told to be part of a collective. I hear collective I think of the borg. I am not 4 of 9 or any other #. I am a soveriegn individual and I loath big Government. Time for my kind to either get a lobby or take action. I’m not going to submit to tyranny or progressivism. So come try to kill me or we will find a way to take back this country. Just saw Red Dawn again last night, the good one. watch it and get pumped up. Its coming

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- Granny58
  Posted on January 26, 2013 at 8:56pm
  we really need arrows on this site so we can agree without having to type. Arrow up!
  
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- Stelex
  Posted on January 26, 2013 at 9:27pm
  Thanks Granny……we’ll get it back.
  
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jeffersonian1776
Posted on January 26, 2013 at 7:47pm
I bet you that all those tiny little “green” cars that all these save the planet commies are driving around in and demand that we be forced to do the same, have a much shorter lifespan on average too. Obviously, due to the fact that they are more likely to die in a crash than someone like myself in my big planet destroyer SUV, they live shorter lives on average, that’s just the way it is.
Why the hell should I be coerced or outright forced to save the planet along the rest of the duped society? I don’t want to save the planet, am I not free to live my own life, the way I choose to live–taking my one hour showers, driving my big V8 engine where ever I choose to, avoiding things such as high-speed rail and those stupid curly lightbulbs that you need two of to put out the same amount of light as the Tom Edison bulbs, leaving my tv on all night cause I can’t sleep without it, and setting my thermostat at 72° in winter and 64° in summer just cause I damn well can, and also flying my own airplane (a small exec.) when I could be flying coach with hundreds of others, just because if Nancy Pelosi can do it then so can I too, and going on yearly hunting trips to shoot polar bears just because I rather enjoy it.
Why ride your bike to work when you can ride in SUV luxury?

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- DeniseJ
  Posted on January 28, 2013 at 4:38am
  Not to mention the approved lightbulbs are full of Mercury, a poison. Hey, I have a flash: why not get rid of Obamacare and let us take our chances with pay as we go medicine as in the OLD days. And the original 15 million uninsured could be taken care of with an appropriate, voluntary contribution on our tax returns. Oh, I forgot – Obamacare is REALLY about control, forced support of abortion, subsidizing health-hazardous gay and promiscuous behavior, and giving the far left their desired ability to PLAY GOD, cull the herd of non leftist supporters……….
  
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Totally Domestic
Posted on January 26, 2013 at 7:45pm
Uh oh, do you think BO will give his BFF Krispy Kream Cristy a waver?????

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RougeFastFingers
Posted on January 26, 2013 at 7:44pm
‘Experts’ these days seem to be quite cavalier about people’s lives.

Fat people are the most helpless of all in society, shunned, insulted, belitted dailey and caught quite often in a situation they are not emotionaly able to cope with.

Instead of the constant insults and uncaring, how about some compassion for these people? It is disgusting the way people seem to feel its acceptable to hurt and belittle them.

My brother suffered from being obese his entire life, he endured years of insults, pain, and lack of friends because nobody wanted to be around the fat guy, no girl would kiss him let alone make love to him and perfect strangers felt it their right to hurt his feeling for daring to show himself in public. Think of your own lives, how would you feel if you never were kissed or loved?

Fat people are the only approved minority that society feels it can mock, simply because these people are weaker in mind and body. Those that do make me sick, and these ‘experts’ can go F*** themselves raw.

Imbeciles

As John Galt states, they have more compassion for a useless crackhead then they do for a fat man.

The true measure of a society is how it treats the weakest amoung it, it appears these ‘experts’ lean towards the nazi side of the spectrum.

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- Stelex
  Posted on January 26, 2013 at 7:49pm
  There are no “Experts” only accademics ……….psuedo science all the way.
  
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- wowjustwow
  Posted on January 26, 2013 at 8:24pm
  You don’t need experts…read the ingredients and check out what they are online. It’s easy to avoid these things that cause people to be obese once you have the knowledge. You don’t have to end the way your brother did — wish he knew these things because it could have been different for him. The sad part is that most people don’t realize that they are slowly dying from chemical overload. There is a reason why lots of food has a long shelf life…food should break down — we all know that from when we were kids. It’s not the same these days. Avoid the bad stuff with knowledge. Be your own expert. You WILL feel better.
  
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