Smoking and mirrors

The AP is reporting on a study showing that preventative medicine for obesity and smoking actually results in higher healthcare costs. For example, smoking will increase your life expectancy by about 8%, but will increase your healthcare costs by 25%. This is the result of the disproportionate amount of money spent to keep people alive at the end of their lives. Studies have shown that one third of the lifetime cost of healthcare is incurred over the age of 85 (for those living that long). From the report:

Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.

The cost of care for obese people was $371,000, and for smokers, about $326,000.

The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.

“This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars,” said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas, and changing science.

What’s especially interesting and relevent about this is that both Obama and Clinton insist that much of the tremendous cost of their healthcare proposals will be paid for by better preventative healthcare, especially for obesity. It’s pretty much a given that whatever they claim the cost will be, you can pretty much double that. Anyone who doesn’t believe me can look at Massachusetts’ universal coverage initiative (or anything else the government does, for that matter). But with this new study, maybe even that is an underestimate.

Instead of trying to placate us by “lowering” health care costs by simply shifting them onto our tax costs (plus overhead) it would be nice if one candidate would come out for actually lowering the cost of healthcare in a meaningful way. Tort reform and more intelligent allocation of research funding would do a lot. There’s also the radical notion that maybe we could make some sacrifices and just say ‘no’ to some of the incredibly expensive yet only marginally more effective medical technology that we’re always paying for. A good example is 3D ultrasound. Do we really need to pay billions of dollars as a nation just to make really creepy renderings of babies? Especially when its those babies who are going to inherit the debt—and precedent—for the frivolity.

It seem to me the main problem being addressed by these proposals is that there are a lot of people who can’t afford healthcare. Why not just buy them healthcare as part of our existing welfare infrastructure? Why the need for yet another beaurocracy? We should agree to more government only with reluctance, not relish.

3 responses to “Smoking and mirrors”

  1. Jonathan,

    Nice post. I had heard about this study, but hadn’t read anything about it yet.

    One thing I think we should do in this country is to de-couple health insurance from employment. Because of th current system, most consumers aren’t aware of the true cost of their health care and don’t bother shopping for the best value.

    Also, being able to buy across state lines for a plan that suits me (instead of one loaded with a lot of crap I don’t want) would be a large boon, too,

  2. Alain: I can’t argue with that, and agree that people should be better aware of what healthcare costs them. But shouldn’t our employers be just as worried about the cost of healthcare and have incentive to shop around just as much?

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