The great Health Care debate!

[trillionaire]

Date: 3/18/2009 3:39:42 PM
Author: tlh
I am very healthy - and I run A LOT. I often get sports related injuries. Not treating someone because they are obese would be the same as telling me I cannot be treated because of my personal choice or lifestyle. I CHOOSE to run. I CHOOSE to run a lot - this is a lifestyle choice.


Granted these sports injuries, aren't the same as $$ spent for BP medication, Type II Diabetes medication, Cholesteral Medication, Sleeping pills, or medication for depression - as exercise can help reverse the effects of all of these things - however, my exercise is what some could say, at an extreme level- but I run, swim, and lift weights because I enjoy it. But I often have to get PT due to issues and I am often seeing specialists...


Just a different side to the argument.

Can't tell you how many people I know that have had knee-surgery and ACL surgery due to sport injuries. They should all be insured/covered too. Thank god I didn't injury myself running the LA Marathon, LOL!!!

 

[tlh]

Date: 3/18/2009 3:44:29 PM
Author: trillionaire

Can''t tell you how many people I know that have had knee-surgery and ACL surgery due to sport injuries. They should all be insured/covered too. Thank god I didn''t injury myself running the LA Marathon, LOL!!!

Good point, my BFF had a knee replacement because of her tri''s - and before that would get cortisone shots like every 8 weeks. That can get $$$.

 

[vespergirl]

Date: 3/18/2009 3:12:42 PM
Author: iluvcarats

For the last time, I believe that we need change, but I do not think that modeling the Canadian system will work for us.

I don''t believe your suggestions will work either, but THIS just might.
But then again, I was routing for Ron Paul...

I agree with this - I want to mention that I was also a Ron Paul supporter, and would have voted for him if he had won the primary - he''s really more of a Libertarian (like me!) than a Republican.

 

[saltymuffin]

Everyone has a health "weaknesses". Everyone does "risky" things - that''s life. No one would have health care if you disqualified everyone who:

- overeats
- undereats
- doesn''t eat the right things
- doesn''t exercise enough
- exercises too much
- smokes
- drinks
- abuse drugs
- doesn''t wear a seat belt
- lives a stressful life
- doesn''t wash their hands enough
- doesn''t get enough sleep

That said - people do have to take responsibility for all of these things. They are all life choices. They may be addictive or though habbits to break, and they may require making tough choices, but they ARE within our control. Measures to assist people with all of the above, especially education and support, should not be excluded from a complete health plan.

 

[saltymuffin]

Date: 3/18/2009 3:12:42 PM
Author: iluvcarats

For the last time, I believe that we need change, but I do not think that modeling the Canadian system will work for us.

I agree with this too! Every country has to develop its own system, and there are a lot of models better to start with, and more suited to the US than the Canadian one.

 

[LtlFirecracker]

If I have time, I will try to do a lit search. It is an interesting. I am sure there are a ton of studies showing the short term cost savings of preventive care, which is probably what most people are thinking about when they say preventive services save money. A long term study would be much harder to do. But most of our money is spent in the last year of life. What would be interesting is how much of that money is spent on sick people with preventable diseases (i.e. small cell lung cancer) vs how much is spent on people who got diseases we can not yet prevent. I guess the question is, is one chronic/terminal disease more expensive to treat than another?

I read the ideas from Ron Paul, I like them. I think a lot of us have been trying to say things, he just puts it in a way that is clear and easy to understand, and some solutions, that on the surface look like reasonable ones. I think all the robo calls I got scared me away from him during the election.

 

[NewEnglandLady]

Date: 3/18/2009 3:12:42 PM
Author: iluvcarats

Date: 3/18/2009 1:54:10 PM

What is the difference between eyerolls

and passive aggression?
I guess together we are the pot and the kettle.
For the last time, I believe that we need change, but I do not think that modeling the Canadian system will work for us.

I don''t believe your suggestions will work either, but THIS just might.
But then again, I was routing for Ron Paul...

I''m glad you posted this, Iluvcarats, I was going to post a similar article written by Ron Paul earlier, but decided not to get involved in this one (healthcare is definitely not an area I''m well-versed in!).

I will admit that one of the things I think Congress did get right in 2003 was creating HSAs, which are tax free and can be rolled over to other accounts, so you don''t have to start over every year. I realize that this isn''t the best solution for low-income families who struggle with the cost of insurance, but I do think it''s a step in the right direction.

I know that both my doctor and my dentist do pro-bono clinics at least once a month because they feel morally obligated to give back to those in their communities who are not insured. I was recently talking with my dentist and he said that it''s harder and harder to do pro-bono work because his costs are rising so fast and insurance covers less and less. This goes in line with the HMO issue that Ron Paul cited. These managed care networks were creative as a cost-effective solution, yet the costs for HMOs have been sharply increasing over the past several years.

 

[beebrisk]

Date: 3/18/2009 2:50:27 PM
Author: zhuzhu
Oh I have seen plenty of sarcastic comments coming from you too, my dear Beebrisk.

Does that also mean you 'have no interest in intellectual debate'?

I never argued that it WAS "intellectual debate". You did. As soon as you start with the invectives, the call for "intellectual debate" is meaningless.

 

[beebrisk]

Date: 3/18/2009 3:17:11 PM
Author: zhuzhu

Date: 3/18/2009 2:09:08 PM

Author: vespergirl

Date: 3/18/2009 2:01:36 PM


Author: zhuzhu

Date: 3/18/2009 1:41:01 PM


Author: vespergirl




The reason that I posted the statistics on obesity and smoking is because a lot of the same people that are clamoring for free health care are not willing to take basic, common sense actions to protect their own health - like don''t be fat, ...... Of course those people also get some diseases that aren''t caused by their bad habits, but mostly we end up paying for their choices to be fat .....

Are you serious??? You really believe being fat is a choice?

For most people, yes, I do.



In 1962, research statistics showed that the percentage of obesity in America’s population was at 13%. By 1980 it has risen to 15% -- by 1994 to 23% -- and by the year 2000 the obesity progression in America had reached an unprecedented 31%.


http://www.americansportsdata.com/obesityresearch.asp



Did Americans somehow genetically evolve to become obese over the last 40 years? How else do you explain the tripling of the overweight and obese population except for lifestyle choices?

First of all, the heritability of the body mass index (BMI) is 82% in our study sample. This means 82% of body mass variability is explained by the genetic effects. Aside from the genetic predisposition, other risk factors for obesity include stress, central and peripheral actions of hormones, gene-environment interaction, depression, and social-economic status to just name a few.


And yes, even the “self-control” you and BB focus so much on, is under the influence of our genetic make-up (genes that regulate multiple neurotransmitter systems). Unless you want to start abort all the babies that carry risk alleles which predispose them to obesity and impulse control disorders, they deserve just as much respect and healthcare right as the rest of us.

No one ever said overweight people "don''t deserve" respect and health care. We simply said obesity is mostly avoidable and a result of bad choices. Don''t make people into heartless monsters by twisting words.

As for "pre disposition", it''s just that. It doesn''t mean you "are" going to end up a certain way and it doesn''t mean you can''t make concessions because you are pre-disposed to something. But you can, at the very least, try to avoid the "triggers". Predisposition does not render something inevitable.

 

[swimmer]

An interesting study just found that the more religious a person is, the more aggressive in nature they want their end of life treatment.

link

So, should atheists get a discount since their care will statistically will cost less?

 

[trillionaire]

Date: 3/18/2009 5:09:36 PM
Author: beebrisk

Date: 3/18/2009 2:50:27 PM

Author: zhuzhu

Oh I have seen plenty of sarcastic comments coming from you too, my dear Beebrisk.

Does that also mean you ''have no interest in intellectual debate''?

I never argued that it WAS ''intellectual debate''. You did. As soon as you start with the invectives, the call for ''intellectual debate'' is meaningless.

I think we can leave the subject of "intellectual debate" alone. Vesper was the one invoking it, and largely, it is not relevant to health care. Whether any of us thinks this thread is intellectual or not does not effect our ability to contribute in meaningful ways, so please, let''s do so.

 

[vespergirl]

Date: 3/18/2009 5:53:50 PM
Author: trillionaire

Date: 3/18/2009 5:09:36 PM
Author: beebrisk

Date: 3/18/2009 2:50:27 PM

Author: zhuzhu

Oh I have seen plenty of sarcastic comments coming from you too, my dear Beebrisk.

Does that also mean you ''have no interest in intellectual debate''?

I never argued that it WAS ''intellectual debate''. You did. As soon as you start with the invectives, the call for ''intellectual debate'' is meaningless.

I think we can leave the subject of ''intellectual debate'' alone. Vesper was the one invoking it, and largely, it is not relevant to health care. Whether any of us thinks this thread is intellectual or not does not effect our ability to contribute in meaningful ways, so please, let''s do so.

 

[trillionaire]

Date: 3/18/2009 6:11:01 PM

I think we can leave the subject of 'intellectual debate' alone. Vesper was the one invoking it, and largely, it is not relevant to health care.Whether any of us thinks this thread is intellectual or not does not effect our ability to contribute in meaningful ways, so please, let's do so.

 

[Libster]

Here is a link to the Medpac (Medicare Payment Advisory Comittee) website. Medpac provides reports to Congress regarding issues that effect the Medicare payment system in the United States. Medpac not only advises on payment issues but quality of care, access to care and other issues that affect Medicare.

You can search through the documents and may find them interesting/helpful/useful:
http://www.medpac.gov/documents.cfm

 

[beebrisk]

Date: 3/18/2009 6:11:01 PM
Author: vespergirl

Date: 3/18/2009 5:53:50 PM

Author: trillionaire

Date: 3/18/2009 5:09:36 PM

Author: beebrisk

Date: 3/18/2009 2:50:27 PM


Author: zhuzhu


Oh I have seen plenty of sarcastic comments coming from you too, my dear Beebrisk.

Does that also mean you ''have no interest in intellectual debate''?

I never argued that it WAS ''intellectual debate''. You did. As soon as you start with the invectives, the call for ''intellectual debate'' is meaningless.

I think we can leave the subject of ''intellectual debate'' alone. Vesper was the one invoking it, and largely, it is not relevant to health care. Whether any of us thinks this thread is intellectual or not does not effect our ability to contribute in meaningful ways, so please, let''s do so.

Vesper,

I know. Right??

 

[trillionaire]

Date: 3/18/2009 8:37:53 PM
Author: beebrisk

Vesper,


I know. Right??

Congratulations, you BOTH know how to quote out of context.

The rest of us are talking about health care. Feel free to join us...



http://www.mlive.com/opinion/ann-arbor/index.ssf/2009/03/letter_we_wanted_singlepayer_h.html

 

[coatimundi_org]

Date: 3/18/2009 1:41:01 PM
Author: vespergirl

Date: 3/18/2009 11:30:27 AM

Author: coatimundi

Date: 3/17/2009 1:56:38 PM

Author: vespergirl

Date: 3/17/2009 1:25:19 PM


Author: zhuzhu


What matters most is the future health of our population, and if we continue to turn away from those who are victims of the existing system, then very soon we will be the sickest nation and least productive one of all. Health is the single one most important investment of all. Let us give everybody the right to access care.

I agree with this, which is why my husband and I don't smoke, get 30 min. of cardio 5 days a week, and don't overeat. My son is also a healthy weight and is very active. I value my health, which is why I take care of it.



However, currently 62% of American adults are overweight or obese, and 34% of children are, which causes heart disease and diabetes, and 20% of Americans smoke cigarettes, which causes an array of cancers. The overweight and smokers are making themselves sick with preventable diseases, and their lazy attitudes towards their own health is costing everyone. Just getting access to free medical care isn't going to correct those behaviors.



Here is a 2002 study titled 'The Effects Of Obesity, Smoking, And Drinking On Medical Problems And Costs':


http://content.healthaffairs.org/cgi/reprint/21/2/245.pdf



Here is an excerpt:


Obesity has roughly the same association with chronic health conditions as does twenty years’ aging; this greatly exceeds the associations of smoking or problem drinking. Utilization effects mirrors the health effects. Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers. Nevertheless, the latter two groups have received more consistent attention in recent decades in clinical practice and public health policy.

Wow Vespergirl, your sense of entitlement (and immortality!) is astonishing.


You are aware that people that do 5 days of cardio a week, who don't smoke, and who eat healthily still get serious illnesses, but I suppose you just don't care, because your husband's job provides your family with good health insurance.


When I was a kid, my father taught me that not everyone has had the same advantages that I had starting out in life, and that is why it is important to share and be charitable. My mother is one of those people--she grew up begging for food, and she also instilled the same concept of charity in me.


In this thread, I am talking about Single Payer. Single Payer gives everyone the same access to healthcare. Perhaps, you Vesper feel that you deserve better, because your husband, as you so delicately put, 'makes money hand over fist.'

Date: 3/14/2009 8:03:51 PM

Author: vespergirl

My husband's company has been making money hand over fist for the past 10 years. They are an electrical contractor that handles large govt. contracts, and also private contracts. I think part of the reason that they do so well, in fact, is because they are not a union shop.

I'm sure the non union workers and gov't contracts help him out a great deal.


Put yourself in someone else's shoes--and not those of your immigrant parents fleeing a totalitarian regime. Put yourself in the shoes of, let's see, a family of four with an injured mother and a laid off father who lost all health benefits. Say one of the children is diagnosed with a serious illness like leukemia. Would you have a problem accepting assistance from the government? I seriously doubt it.


Or, don't. Just keep on posting your dubious statistics and whistle on your way to the doctor. I hope you don't have to wait too long in the waiting area--hope they have some good magazines this time.

I would like to point that I don't feel the need to personally attack individual posters for their views, but if you do, then perhaps you have some insecurity issues that you need to address. If I don't agree with someone, I engage in intellectual debate without resorting to personal attacks, but it seems that some posters here on PS are not mature enough (or don't have arguments strong enough) to be able to keep the conversation purely intellectual.


The reason that I posted the statistics on obesity and smoking is because a lot of the same people that are clamoring for free health care are not willing to take basic, common sense actions to protect their own health - like don't be fat, and don't smoke, which cause most of the health problems (and health care expenses) in the US today. Of course those people also get some diseases that aren't caused by their bad habits, but mostly we end up paying for their choices to be fat and to smoke (type II diabetes, heart disease, lung cancer).


And I'm not going to apologize for my husband being successful. He actually started out as an electrician who educated himself to work his way to the top. He works 14 hour days, and worked incredibly hard to earn his MBA, so I think that he deserves everything that he has earned. It's people like us who work hard, pay our mortgage and live within our means that are keeping the economy afloat right now. But I guess maybe you would have more respect for us if we were part of the irresponsible hordes who maxed out our credit cards and took out subprime mortgages causing the foreclosure debacle.

One person's intellectual discussion is another person's personal attack.

When personal examples are used to illustrate a point, those personal examples then become part of the discussion.

If some PS posters choose to use personal examples, and then react negatively when those same examples are utilized for the purpose of discussion, I suspect that's where the real insecurity lies.


We are talking about healthcare here right?

haha Well, we were...


What I'm hearing is that some people think they do everything right, and everybody else is wrong. That is hardly a defensible position, and in my personal opinion, reeks with a sense of entitlement.

You guys want to use personal information about me?

Here goes:

Age: 33
Height: 5'9"
Weight: 128 lbs.
Ethnicity: half Caucasian/half Asian
Housing: Home Owner--30 year fixed

Like to take long walks by the ocean--where I live. I enjoy badminton, zombieville USA (video game), and frozen pizza.

AND,

I have NEVER EVER voted for George W. Bush.

Knock yourself out.

 

[trillionaire]

Date: 3/18/2009 10:50:22 PM
Author: coatimundi
One person''s intellectual discussion is another person''s personal attack.


When personal examples are used to illustrate a point, those personal examples then become part of the discussion.


If some PS posters choose to use personal examples, and then react negatively when those same examples are utilized for the purpose of discussion, I suspect that''s where the real insecurity lies.



We are talking about healthcare here right?


What I''m hearing is that some people think they do everything right, and everybody else is wrong. That is hardly a defensible position, and in my personal opinion, reeks with a sense of entitlement.


You guys want to use personal information about me?


Here goes:


Age: 33

Height: 5''9''

Weight: 128 lbs.

Ethnicity: half Caucasian/half Asian

Housing: Home Owner--30 year fixed


Like to take long walks by the ocean--where I live. I enjoy badminton, zombieville USA (video game), and frozen pizza.


AND,


I have NEVER EVER voted for George W. Bush.


Knock yourself out.

Coati, I think I''d like to ask you out for Pizza and a walk on da beach!


Pretty please???

 

[coatimundi_org]

Date: 3/18/2009 10:53:08 PM
Author: trillionaire

Date: 3/18/2009 10:50:22 PM

Author: coatimundi

One person''s intellectual discussion is another person''s personal attack.



When personal examples are used to illustrate a point, those personal examples then become part of the discussion.



If some PS posters choose to use personal examples, and then react negatively when those same examples are utilized for the purpose of discussion, I suspect that''s where the real insecurity lies.




We are talking about healthcare here right?



What I''m hearing is that some people think they do everything right, and everybody else is wrong. That is hardly a defensible position, and in my personal opinion, reeks with a sense of entitlement.



You guys want to use personal information about me?



Here goes:



Age: 33


Height: 5''9''


Weight: 128 lbs.


Ethnicity: half Caucasian/half Asian


Housing: Home Owner--30 year fixed



Like to take long walks by the ocean--where I live. I enjoy badminton, zombieville USA (video game), and frozen pizza.



AND,



I have NEVER EVER voted for George W. Bush.



Knock yourself out.

Coati, I think I''d like to ask you out for Pizza and a walk on da beach!



Pretty please???

Go for it! I''m a cheap date.

Meet me over at my pad for beer and pizza. My treat. I''m charitable like that.

 

[ksinger]

Date: 3/18/2009 11:03:22 PM
Author: coatimundi

Date: 3/18/2009 10:53:08 PM
Author: trillionaire

Coati, I think I''d like to ask you out for Pizza and a walk on da beach!



Pretty please???

Go for it! I''m a cheap date.

Meet me over at my pad for beer and pizza. My treat. I''m charitable like that.

Trill, you ply her with lotsa beer....I''ll go paw through her pearl collection when she ain''t lookin''!!

I''ve got my eye on that lavender strand of hers!!

Seriously, this has been a great thread. I''ve learned bunches.

 

[coatimundi_org]

Date: 3/18/2009 11:06:05 PM
Author: ksinger

Date: 3/18/2009 11:03:22 PM

Author: coatimundi

Date: 3/18/2009 10:53:08 PM

Author: trillionaire

Coati, I think I''d like to ask you out for Pizza and a walk on da beach!




Pretty please???

Go for it! I''m a cheap date.

Meet me over at my pad for beer and pizza. My treat. I''m charitable like that.

Trill, you ply her with lotsa beer....I''ll go paw through her pearl collection when she ain''t lookin''!!

I''ve got my eye on that lavender strand of hers!!


Seriously, this has been a great thread. I''ve learned bunches.

Ooooo you bad, woman!

Let''s share our pearls--you''ve got some that I want too.

I''ve learned a bunch here too. Kudos to some great posters!

 

[trillionaire]

Anyone read this?

 

[beebrisk]

Date: 3/18/2009 9:12:52 PM
Author: trillionaire

Date: 3/18/2009 8:37:53 PM

Author: beebrisk


Vesper,



I know. Right??

Congratulations, you BOTH know how to quote out of context.

The rest of us are talking about health care. Feel free to join us...




http://www.mlive.com/opinion/ann-arbor/index.ssf/2009/03/letter_we_wanted_singlepayer_h.html

I think we can leave the subject of "intellectual debate" alone. Vesper was the one invoking it, and largely, it is not relevant to health care.

Largely, it is not relevant to health care. "Intellectual debate", that is.

Perhaps that's not what you "meant", but it IS what you said. I'd prefer to say that double talk largely is not relevant to health care..or anything.

Intellectual discussion requires honesty and the responsibility to take credit for what was said. Now I'm done with the discussion of the discussion.

 

[Jas12]

I don''t think the identical Canadian model is necessarily the best for the US to follow either--we have a different governing system and (some would argue) value system, smaller population etc. But something similar & tailored can work i am sure.

I am just wondering, those of you that strongly oppose a universal system do admit the current system is broken right? And if the answer is yes, why not let the government prove u wrong. What have u got to loose? Can it get much worse? How can you criticize something that hasn''t happened yet?

Vesper-- canada has MUCH less obesity (I think the WHO ranked canada 30 something and the US is in the top 10) and we certainly don''t walk more. Heck, we northerners barely leave the house from November to March and we have less access to fresh food due to climate. However, i think in general we have good preventative strategies in the form of government service, and in general we are less a "country of excess". When i go to the US i can''t get over the size of servings at restaurants and the variety of junk food in supermarkets. What is this a symptom of ? Everything is connected and hints at a need for change!


Obesity

 

[iluvcarats]

One of the biggest drains on our health care system is due to the effects of smoking, and the cost it takes to care for smokers during and at the end of their lives.

Cigarette smoking has been identified as the most important source of preventable morbidity and premature mortality.
Smoking is directly related to 90% of all lung cancer deaths.
Every year smoking takes 438,000 lives.
8.6 million Americans have at least one serious illness caused by smoking
Second hand smoke is responsible for 3400 lung cancer deaths.

Smoking is a choice.
One can argue that obesity can be genetically predisposed, that some can't exercise to keep fit because of health problems or injuries, or a whole plethora of other reasons that one can be predisposed to genetically.
But there is NOTHING in anyone's genes that makes them predisposed to smoking. No genetic code that forces one to reach for a cigarette and inhale poisonous carbon monoxide. One might get easily addicted, but there is nothing that makes one inhale a cigarette for the first time. Nothing.

It is a purely unhealthy choice for your body, and a selfish choice for others around you who have to breathe it in as well.
It causes house fires, forest fires, pollutes the air and often litters the ground.
It drains our country of huge financial resources.

Have you ever seen someone dying in the ICU of lung cancer? I have.
It is horrible to watch, hugely expensive, and 90% preventable.

If we do switch to a single payer system, I whole heartedly believe that smokers should contribute more.
I know that this is going to be met with outrage. I will be called intolerant, elitist, maybe even prejudiced.
So be it. If we want to talk about the responsibility to take care of the problem of health care in our country, this has to come first.
I am not denying health care to smokers, or saying that they have to stop. I am just suggesting that smokers should accept the responsibility that their actions have on the health of themselves and others around them, along with the huge drain their self induced habit has on our economy.
If not a single American smoked cigarettes, there would be a lot more money to help others who need care.
The diseases caused by smoking are preventable by simply not doing it. This should be where we begin.
We need to get rid of the tobacco lobbies, and get President Obama a patch!


SMOKING FACTS

 

[cara]

Sometimes costs savings and life savings work in opposite directions. Many preventive measures actually cost more money to implement than they save, its only when you factor in the saved life-years of people that you can call it ''cost effective'' to do the screening.

Smokers actually end up saving the system money by dying earlier. While they are alive, smokers cost more as they are more sickly, but lifetime studies show that smoking actually saves the health care system money in the long run. Non-smokers that live longer may have less costly ailments at younger ages, but when they are very old and at the end of their natural life, non-smokers can also have costly diseases that rack up big bills.

A government official from one of the former Eastern Block countries made this argument (smoking saves us money!) and was definitely pilloried in the press for it, but there you have it.

Here is a quotation from the abstract of a New England Journal of Medicine article The Health Care Costs of Smoking by J. Barendregt and others (1997): (While this was for a European country, I think similar analyses for the US have been done with similar results.)

ABSTRACT

Background Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs at advanced ages. We analyzed health care costs for smokers and nonsmokers and estimated the economic consequences of smoking cessation.

Results Health care costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers, but in a population in which no one smoked the costs would be 7 percent higher among men and 4 percent higher among women than the costs in the current mixed population of smokers and nonsmokers. If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period.

Conclusions If people stopped smoking, there would be a savings in health care costs, but only in the short term. Eventually, smoking cessation would lead to increased health care costs.

 

[iluvcarats]

Date: 3/19/2009 3:22:29 PM
Author: cara
Sometimes costs savings and life savings work in opposite directions. Many preventive measures actually cost more money to implement than they save, its only when you factor in the saved life-years of people that you can call it ''cost effective'' to do the screening.


Smokers actually end up saving the system money by dying earlier. While they are alive, smokers cost more as they are more sickly, but lifetime studies show that smoking actually saves the health care system money in the long run. Non-smokers that live longer may have less costly ailments at younger ages, but when they are very old and at the end of their natural life, non-smokers can also have costly diseases that rack up big bills.


A government official from one of the former Eastern Block countries made this argument (smoking saves us money!) and was definitely pilloried in the press for it, but there you have it.


Here is a quotation from the abstract of a New England Journal of Medicine article The Health Care Costs of Smoking by J. Barendregt and others (1997): (While this was for a European country, I think similar analyses for the US have been done with similar results.)


ABSTRACT


Background Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs at advanced ages. We analyzed health care costs for smokers and nonsmokers and estimated the economic consequences of smoking cessation.


Results Health care costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers, but in a population in which no one smoked the costs would be 7 percent higher among men and 4 percent higher among women than the costs in the current mixed population of smokers and nonsmokers. If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period.


Conclusions If people stopped smoking, there would be a savings in health care costs, but only in the short term. Eventually, smoking cessation would lead to increased health care costs.

This abstract is over a decade old.
Medical technology and research jumps leaps and bounds daily.
We are capable of prolonging life far longer than we could previously.
This is all projected costs for the population of the Netherlands.
Can you find me some intelligent data from this century for our country?

 

[cara]

Why don't you find some data to prove the point you want - that lifetime costs to a single-payer health system are higher for smokers than non-smokers? Be sure to find a recent article from a top journal on the topic using a US population.

Sometimes the perfect data doesn't exist and you use what is available. What exactly is it about the smokers in the US that would cause them to differentially live longer than non-smokers, relative to the Netherlands population? What modern treatment do you think would differentially increase the costs of treating smokers (but not proportionately increase the cost of treating non-smokers)?

Its fine to dismiss the finding out of hand as not being perfect data, but please either find a better, more appropriate study or articulate specific reasons rather than generalities why this particular result might be inaccurate.

My general point is that sometimes saving lives cost money. There are times when cost savings and life savings work in opposition. While it is fine from a public health viewpoint to discuss how to reduce obesity and smoking, and these are very worthy public health goals, allowing a debate about needed changes in our health care system to devolve into a blame game (oh, those smokers and obese people are to blame or I don't want single-payer because then I would be subsidizing smokers and obese people) is really a shame. We need to look at the big picture. Smoking and obesity are definitely health problems in our society, but we shouldn't allow those issues to dominate the debate since I don't think they are anywhere near the 'whole' problem. They are merely one small component.

 

[trillionaire]

I''m all for a ban on smoking.

 

[iluvcarats]

Date: 3/19/2009 4:09:35 PM
Author: cara
Why don''t you find some data to prove the point you want - that lifetime costs to a single-payer health system are higher for smokers than non-smokers? Be sure to find a recent article from a top journal on the topic using a US population.


Sometimes the perfect data doesn''t exist and you use what is available. What exactly is it about the smokers in the US that would cause them to differentially live longer than non-smokers, relative to the Netherlands population? What modern treatment do you think would differentially increase the costs of treating smokers (but not proportionately increase the cost of treating non-smokers)?


Its fine to dismiss the finding out of hand as not being perfect data, but please either find a better, more appropriate study or articulate specific reasons rather than generalities why this particular result might be inaccurate.


My general point is that sometimes saving lives cost money. There are times when cost savings and life savings work in opposition. While it is fine from a public health viewpoint to discuss how to reduce obesity and smoking, and these are very worthy public health goals, allowing a debate about needed changes in our health care system to devolve into a blame game (oh, those smokers and obese people are to blame or I don''t want single-payer because then I would be subsidizing smokers and obese people) is really a shame. We need to look at the big picture. Smoking and obesity are definitely health problems in our society, but we shouldn''t allow those issues to dominate the debate since I don''t think they are anywhere near the ''whole'' problem. They are merely one small component.

I thought that the article I posted with facts from the American Heart Association did prove my point.
We can keep people alive longer these days in all sorts of ways.
There are new innovative operations and cancer treatments that were not available 10 years ago.
I am saying it is speculative - it could happen, maybe, maybe not.
I am looking for actual facts, not projected statistics.
I wasn''t talking about obesity because as I said before, that is not always a choice.
Like I said before, the problems incurred by smoking are 100% preventable if you don''t do it.
You might still get lung cancer, heart disease, kidney cancer, breast cancer or many other diseases, but it won''t be because you chose to smoke.
So if you do choose to smoke cigarettes, you should be responsible for the choices that you make for your body.
Smoking is not a small problem at all. On the contrary, it is HUGE.