should smokers and drinkers pay more for health care?

I do support that sort of thing, I like the car insurance example, where if I drive a car that is more likely to be stolen or crash or if I am a driver more likely to crash, then I pay more.

We need to be careful though with healthcare, especially like in a state-run system in Canada or through the US's Medicare. If insurance can discriminate (not a negative connotation of that word here) against someone who smokes because they are more likely to get lung cancer, why couldn't they also require a blood test when you sign up and make you pay more if you have a recessive gene that makes you more likely to, say, die of a stroke, regardless of your lifestyle?

You could argue that thems the breaks and that's just what happens in a free market, but it's just not humane. And it's not a far leap.

In a more parallel example, why stop at smoking or drinking? I read a report once (hell, there is a report for everything) that said if you live near high voltage power lines then your risk of cancer goes up. Should people who live near power poles pay more? There is a town in Arizona that has an abnormally high frequency of childhood leukemia...so if parents have a child, should their employer group health plan rates go up compared to someone in another town? Do cell phone users pay more since there are some reports (and many reports that refute this) that say cell phones cause brain tumors? These are all choices people can make, where they live, what products they use, which, depending on who you ask, can impact health. Not as much as smoking, but they can.

It's a fine line to straddle.

Jam it back in, in the dark.

Originally Posted by Watts

For America, the good people that smoke and drink in more then what can be considered moderation saves our medicare and social security programs money. Since those people tend to die much sooner. Last time I checked, medicare doesn't cover huge operations like liver, kidney, or lung transplants. But that's a far cry from a socialized medicine system where public health is in the realms of public responsibility.

Medicare does cover major organ transplants. It is harder to get one of the organs with a large waiting list if your reason for needing them is because you were a smoker, but it doesn't disqualify you.

It costs a hell of a lot more to provide the services it takes to attempt to save someone from dying of lung cancer than it does old age.

Plus, your Medicare and Social Security money doesn't just disappear if you die earlier, it just gets transferred to your spouse.

(Medicare is also moving to start covering smoking cessation programs.)

Originally Posted by ElectricSheep

This entire debate could be generalized to the question, "Should lifestyle choices influence the cost of privatized (or government) healthcare?". Smoking is a lifestyle choice. Drinking is a lifestyle choice. Poor diet is a lifestyle choice. Physical inactivity is a lifestyle choice. This contrasts with genetic deficiencies which are not lifestyle choices.

Spare the slippery slope bullshit. You know well enough that's far beyond the scope of this thread.

But, as I said, there are other lifestyle decisions people make that affect their health, like the choice of a place to live (although Medicare does not make that distinction). The worst small particle air pollution in the US is in Los Angeles, so should all those people pay a 5% premium because they live in LA? And you ignore other lifestyle decisions like owning microwaves and cell phones.

Plus, although fat people usually overstate the effect, there are genetic dispositions to being overweight. Sure, smoking, it is easy to define that as a choice, but most things we have a choice in.

Am I going to have to start submitting my grocery receipts to show that I'm eating what they want or I have to pay more? It is well-known that it is incredibly hard for the poorer people of the country to eat healthy -- crap food is a hell of a lot cheaper...so...I guess we kick these people when they are down, as poverty generally leads to worse health. So we make them pay more insurance or pay more on food.

Originally Posted by ava lilly

there's also a study he mentioned on drinking and driving related car accidents, which is probably what the biggest problem with drinking is, and that apparently found that it was only a about 50/50 chance of the accident being caused by an alcoholic. you may rarely ever drink, but if you have a few glasses of wine or something and then drive your friend to the airport, you're just as likely to cause an accident as anyone else who has been drinking, regardless of how often you drink. your car insurance should certainly go up because of it, but your healthcare? I dunno.

The one thing I would mention about this issue (to the experts and anyone else who brought it up) is that (in the US, at least) any injuries sustained by drunk driving accidents are not usually covered by medical insurance companies and would have to be covered by a combination of automobile insurance and lawsuits.

There's nowhere I can't reach.

True about the transplants, but it's not a Medicare restriction. Medicare doesn't do as many transplants simply because there aren't as many old people who need transplants, when you're 80, you just go on hospice.

This thing is sticky, and I don't like it. I don't appreciate it.

We are rapidly approaching the day where having genes that makes one more prone to disease is preventable. And, at that point, it largely becomes a monetary issue: can the parents afford gene therapy for their yet unborn child who is apparently more prone to breast cancer?

I don't necessarily think this sort of determination will come to play anytime soon, but the insurance companies will do anything to make a buck.

How ya doing, buddy?