should smokers and drinkers pay more for health care?

I'm not sure if this will pertain to any countries other than Canada since our health care systems obviously differ, but I thought it was an interesting topic.

flipping through the channels earlier today, there was a debate on one of our news stations asking people what they thought about this subject. some were saying yes, because they felt they were a drain on the health care system causing everyone to pay higher taxes for treatments to their "preventable" illnesses, while some of the experts were saying that it's not 100% possible to link lung cancer and other ailments generally related to someone who smokes or drinks. some people can smoke their whole lives and not get lung cancer, while others can develop it from something like pollution without ever smoking.

I don't know how they would even go about adjusting how much smokers/drinkers pay without turning our system into the sort of healthcare where everyone just pays for what they need.

so what are your thoughts?

Jam it back in, in the dark.

It's like car insurance or life insurance - you lead a risky lifestyle, you pay more. Makes sense to me.

There's nowhere I can't reach.

I'm not sure how drinking should affect payments; I mean, everyone drinks to some extent, no? If they did it by increments (ie: frequency of drinking) then maybe it would work.

Smoking should definitely play a factor, though. It's almost a no-brainer.

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

Certainly should make people pay more if they're going to engage in activities that will endanger their health. And these days the fact that smoking and drinking are both rather bad for your heath isn't exactly theory anymore. However with the drinking part, maybe if the person has a history of being a big drinker or alcoholic, one shouldn't be punished for taking a few shots at a party or something.

I am a dolphin, do you want me on your body?

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.

I was speaking idiomatically.

I know that you pay more for life insurance for smoking, I don't see why not for medical care, either. I smoke, so this would directly effect me, all the more reason why I'm trying to quit, I guess.

Drinking, though? That's really kind of hard, where do you draw the line, especially when you consider that somepeople can imbibe large quantities regularly without serious health problems like stomach cancer and liver failure. Besides, pretty much everyone I know has gone through phases with drinking, not like alcoholism, but when you're young the compulsion is to party. Then, you get older and it levels off. Certain types of alcohol, in moderation (red wines for example), can actually provide certain benefits to your health. The only case I could make for alcohol effecting premiums would be there's some documented case of abuse, i.e. DUI/alcohol related incident report(s).

Then again, why don't we just raise premiums for people who are not within healthy BMI standards. Being overweight has a lot of associated health issues. More than smoking, I'd wager, actually.

Or, here's another one, what about people with family histories of disorders like thyroid problems or other chronic health problems?

Pretty soon, everyone is paying ridiculous amounts of money for health coverage, as if it wasn't bad enough that already like 15% (or better, depending on which survey you look at) of people living in the U.S. can't afford/don't have medical insurance.

What kind of toxic man-thing is happening now?

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.

Originally Posted by Duo Maxwell

Then again, why don't we just raise premiums for people who are not within healthy BMI standards. Being overweight has a lot of associated health issues. More than smoking, I'd wager, actually.

Or, here's another one, what about people with family histories of disorders like thyroid problems or other chronic health problems?

Pretty soon, everyone is paying ridiculous amounts of money for health coverage, as if it wasn't bad enough that already like 15% (or better, depending on which survey you look at) of people living in the U.S. can't afford/don't have medical insurance.

At that point wouldn't it just be more cost effective for the State to not provide medical insurance for everyone? How could the State possible mandate that without making things much more inefficient?

FELIPE NO

Even as an apologist for smokers, I must say yes. Drinkers too.

But I feel that the rate at which one smokes/drinks should be taken into account. A heavy drinker or smoker is at more risk than someone who has a cigarette or two at a social event.

I have a question, how are smokers medically discerned from nonsmokers?

What, you don't want my bikini-clad body?

Originally Posted by Eleo

However, I do question how smokers are discerned from nonsmokers.

Determining who was a smoker could be seen as an invasion of privacy. That in itself will raise a lot of issues. At least I think it would here. No idea how well that would go over with countries like Canada. Canadians seem just as protective of their civil liberties, if not more so in some respects.

Jam it back in, in the dark.

There are two questions here.

Should drinkers pay more? No. Absolutely not. Alcohol has just as many positive effects as negative effects, and most (if not all) of those negative effects only happen if you drink too much. Oh, and "too much" varies from person to person. I really get sick of hearing some righteous people claiming drinking is bad for you; most medical studies say otherwise. After all, the worst things that can happen are organ failure (which generally only happens when you drink too much) and vehicular problems (causing by drinking and driving). So how this should go down is as follows . . . If someone ends up in the hospital due to alcohol-related issues, the premium should jump dramatically, as this is a sure sign that someone is getting dumb and drinking too much. As for those who drink and drive, I think the legal penalties for doing so should be bumped up a lot, like 10-20 years mandatory for the first offense; these people are dangerous.

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

There's nowhere I can't reach.

Originally Posted by PattyNBK

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

Actually the main cause of lung cancer is NOT smoking, smoking only increases the chance of getting cancer.
Cancer is mostly determined by chance and if your body already has some weak cells.

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

Originally Posted by PattyNBK

Should drinkers pay more? No. Absolutely not. Alcohol has just as many positive effects as negative effects, and most (if not all) of those negative effects only happen if you drink too much. Oh, and "too much" varies from person to person. I really get sick of hearing some righteous people claiming drinking is bad for you; most medical studies say otherwise. After all, the worst things that can happen are organ failure (which generally only happens when you drink too much) and vehicular problems (causing by drinking and driving). So how this should go down is as follows . . . If someone ends up in the hospital due to alcohol-related issues, the premium should jump dramatically, as this is a sure sign that someone is getting dumb and drinking too much. As for those who drink and drive, I think the legal penalties for doing so should be bumped up a lot, like 10-20 years mandatory for the first offense; these people are dangerous.

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

i like how smoking is OK and alcohol isn't just because one is deemed to be more socially acceptable than the other. sorry buddy, but one could also argue that smoking in very small quantities isn't fatal, and that its effects vary from person to person as well. you were also spouting complete crap when you said that medical studies say drinking is good for you. there isn't a single medical study on this earth that will conclude alcohol is ultimately good for you -- they all agree that its negatives far outweigh its positives. assuming that there are some small positive effects such as on the heart, you could achieve the same positive effects by doing other things such as a healthy lifestyle and eating habits. alcohol's positives pale in comparison to its negative effects, which completely nullify any good effects it (may) have. stop believing only what you want to believe because drinking is something you like to do and take a look at the entire picture.

I am a dolphin, do you want me on your body?

Originally Posted by Eleo

I have a question, how are smokers medically discerned from nonsmokers?

Eleo, they determine it with a saliva test, and it's really cool. My husband and I had to have it done a couple of years ago when we upped our life insurance. You have to hold a cotton swab between your cheek and gums for a couple of minutes. Some laboratory analyzes it and they can determine if you've smoked in the past five years. Pretty cool, huh?

To answer the question, though, I don't know much about socialized healthcare systems, but here in the US, I definitely think that smokers should pay more. Between that and the fact that their out-of-pocket expenses for copays, etc. will be higher by default simply because of not being as healthy, maybe more people will stop smoking.

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If you're going to commit drinkers and smokers to paying more on health insurance, you should do the same to black people because all they do is slit each other's throats over drugs and cash money.

(Seriously people - think about the generalization your making)

What kind of toxic man-thing is happening now?

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. You didn't emerge from between your mother's legs with a Big Mac in your left hand, a Coors Lite in your right, and a Marlboro hanging off your lips. You did, however, pop out with your family's predisposition for colon cancer and heart disease.

The top three underlying causes of death in the United States (in 2000) are Tobacco (18.1% of deaths), Obesity (16.6%), and Alcohol (3.5%). Underneath those are microbes, toxins, car crashes, firearms, sex, and drug use.

--

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

FELIPE NO

My thought exactly! What's to stop them from doing the same thing with the people who abuse themselves with fast food and other junk food, or any other harmful choices we all make? That said, seeing how out of control people are in regards to their health these days, doing so might just be needed...

What, you don't want my bikini-clad body?

Originally Posted by BlueMikey

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.

My thoughts exactly. I've thought about something like that, but I ended up finding to many questions. What about fat people? Should they pay more? People getting in car accidents? People getting hurt while doing sports, rockclimbing and so on? No matter how much I hate seeing the goverment using money on stabling people's stomach or cleaning drug users, I don't think there's a better way...

Jam it back in, in the dark.

Originally Posted by BlueMikey

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.

this is exactly why I'm really iffy about saying people who abuse substances should pay more for healthcare. once that line is crossed, other people will start to jump on this idea and it could very well escalate to the point where our healthcare system has been completely compromised from what it is today.

now I'll admit, I'm not 100% sure exactly how the healthcare system works in Canada, but I was always under the impression we paid a certain tax for it and our specific needs are paid for through job benefits. perhaps someone who knows more about it could explain it better, since I see the majority of people who have posted in this thread so far are from the states and you might be thinking about the topic more along the lines of how your own system works.

Quote:

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.

this is sort of what one of the "expert" guys were talking about. in studies, they haven't actually been able to verify that smoking WILL cause lung cancer, or that being an alcoholic WILL cause liver disease, only that it can, because not everyone who smokes or drinks excessively ends up with these types of complications. the increased chance is always there that you might, but then again there's always the chance that you'll get hit by a vehicle when you cross the road as a pedestrian. there's so many ways to spin the argument.

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.

There's nowhere I can't reach.

If your insurance company can justify it, and they can, then why would healthcare be any different? The 50/50 number sounds pretty misleading to me. I mean, if you look at how many sober drivers are on the road as opposed to drunk ones, having lets guess, less than 5% causing 50% of the accidents sounds pretty conclusive.

The experts arguing against this on the basis that smoking doesn't *always* cause cancer etc. are just talking out of their ass. The argument isn't that it *will* cause complications, only that it increases risk. They are arguing on their own terms in order to get around the debate.

Personally, I would have no problem with a higher rate impossed on smokers. They know it's a risky choice, and there are no redeaming features. It may even give them that last push to quit.

I don't support making this apply to other such choices, drinking included. I can't really justify it though.

Either way, if this does go through in some form, I could only be happy about it if it were setup in a way that discouraged other voluntary lifestyle choices from being added to the premium list.

Also, anyone trying to argue about non-voluntary things which increase risk like race, inherrited genetic conditions etc. are just trying to cloud the issue. This in no way would lead to such discrimination.

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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.

I am a dolphin, do you want me on your body?

Originally Posted by BlueMikey

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?

People make a choice to smoke or drink - more dangerous lifestyles, like the car situation.

Quote:

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.

I swear to God I remember reading in psych class that the same study was later found to be innacurate because it was not fixed to social class. That is, the people who lived next to power lines also worked many more hours and lived much less comfortably.

I was speaking idiomatically.

Originally Posted by BlueMikey

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.

No, it just make's it close to impossible to get.

Originally Posted by BlueMikey

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.)

Medicare and Social Security are practically the only government programs in good fiscal shape. Doesn't mean that will stay that way, but this issue seems like a rational to cut benefits prematurely.

What kind of toxic man-thing is happening now?

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.

FELIPE NO

It's just as dumb an idea to make people pay more money just because they put themselves at risk as it is for them to making such needless risks in the firstplace. If smokers and drinkers are going to have to pay more money for medicine and help, then you also have to consider these:

Outdoor workers who are exposed to the sun for the higher odds of getting skin cancer.

People who eat sugary foods that run the risk of getting diabetes.

Overweight people who have the greater risk of heart attacks and diabetes.

Sexual promiscuous individuals that don't protect themselves are more likely to get an STD.

Really, there's no way you're going to discourage every single person from being a dumb shit. When you need help, you need help. No one should be told to pay more for medicine just because they do something that' bad for their health.

Besides, smokers and alcoholics already invst an assload of money in their habbits as it is. Depending upon location, smoking's more expensive than gas and a lot of smokers go through their cigarettes or cigars faster than they can a whole tank of gas.

What, you don't want my bikini-clad body?

I think there should be more emphasis on preventive medicine, anyway.

Encouraging people to quit smoking and moderate their drinking, bettering their eating habits and more regular visits to the physicians office for check-ups. Then again, if you engage in any sort of rigorous physical activity like surfing, skateboarding and the like; you're putting your body at risk.

Most people only go to the doctor when there's something they feel is wrong. This isn't that healthy, because then the doctor can't take steps to alert someone if something could potentially be harmful.

I think modern healthcare is sort of fucked up, anyway. Prevention is the key, health is a process not a condition.

Jam it back in, in the dark.