8 ms·
Smokers don't use $1m more per person in healthcare costs than non-smokers. That doesn't pass the smell test. For comparison, total US healthcare spending is ap
by dmurray 7y ago
Smokers don't use $1m more per person in healthcare costs than non-smokers. That doesn't pass the smell test. For comparison, total US healthcare spending is approx $3t/year, or $10k/person-year, or $750k/person-lifetime.
I don't know what the real number is. There are plenty of studies showing it's negative, mostly funded by tobacco companies. That might not quite be true, but it's not far off: a non-smoker who lives to 90 has similar levels of health issues in his last 5 years as a smoker who dies at 65.
Reducing smoking would be a huge public good, but the benefit mostly accrues to the smoker, not to the state. We don't need to pretend it's otherwise for these campaigns to make sense.
- trianglem 7y ago>$750,000 per person You’re making GP’s point. If you filter for just tobacco users from the general population it could very well be above a million per tobacco user.
- Retric 7y agoSanity check. From 1990 to 2000 ~1/4 of US adult population smoked. Suggesting that smoking adds 750,000 * ~50,000,000 people / (75 years lifespan) ~500 Billion per year to US heath care costs is wildly off base. It turns out smokers do cost more while alive, but die sooner which mostly erases the difference in medical costs. There are estimates for lost productivity amounting to 150 Billion per year in the US, but again these ignore the fact Nicotine is a stimulant.
- trianglem 7y agoNot all of them die early. Plus there are a variety of high priced treatments that they use along the way.
- cm2012 7y agoAnd some have almost no healthy issues. But the average is overall cheaper costs, which is what we're discussing.
- MiroF 7y agoThe number is closer to $200 billion according to the CDC. Still crazy high and of the same order of magnitude, so hardly "wildly off base"
- Retric 7y agoThe CDC lists $170 billion in direct medical costs. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/tobacco.htm https://www.cdc.gov/chronicdisease/resources/publications/fa... Clearly the living have higher medical costs than the dead so some indirect savings exist. Thus, net costs are below that 170B and thus wildly off of a 500B net healthcare cost.
- jachee 7y agoThat is still the same order of magnitude. $5T would be "wildly off"... And you must concede that even "only" a $170B reduction in medical costs could change the entire market.
- Retric 7y agoAs I said it’s not a difference in net costs of 170B. It may cost 20$ to eat out at lunch, but the alternative is not skipping eating. So the net cost for eating out is the delta between my options. Random study: Results Smoking was associated with a greater mean annual healthcare cost of €1600 per living individual during follow-up. However, due to a shorter lifespan of 8.6 years, smokers’ mean total healthcare costs during the entire study period were actually €4700 lower than for non-smokers. For the same reason, each smoker missed 7.3 years (€126 850) of pension. https://bmjopen.bmj.com/content/2/6/e001678 https://bmjopen.bmj.com/content/2/6/e001678.
- MiroF 7y agoSo I can't count the $ in lost productivity from these people dying early, but you can count their deaths as savings on healthcare?
- 7y ago
- taneq 7y agoBut we’re converting smokers to non-smokers, not executing them out of hand, so you’re only saving $250k. Of course, allowing smokers to buy their own vapes seems like a trivial cost to save $250k/person (and, you know, their lives).
- ethbro 7y agoWhich also doesn't include the economic output of their still being fit enough to work (and still living).
- martinald 7y agoNo, I'm not saying that. I'm saying that even if 10k people in the US avoided 1million in catastrophic care due to tobacco (and believe me, there are many more than 10k cases per year - some cancer treatments cost $200k+ just in pharmaceuticals), that's $10bn in savings. Considering how most vape products seem to be made on a shoestring in some factory in China, I think CDC and the FDA should be throwing enormous amounts of money into building high quality, super effective vape products.
- bagacrap 7y agoHave you heard of a juul?
- big_chungus 7y agoWhat you're not considering is the demand induced by a "safer" product. Look at the recent vaping epidemic among teen-age youth. How do you know continuing to improve vape technology won't continue to drive up demand to the point where the cost burden is spread more thinly across more people? E.g. instead of fewer people having very expensive cancer care, vaping could still cause some damage and incur costs across more people.
- allovernow 7y agoThis is bullshit think of the children scaremongering. Even among teens smoking rates are dropping. Adults are responsible enough to make the choice for health reasons. And there's still zero indication that vaping is harmful, so at the very least it's not as bad as smoking since it's been around for a decade at least now and nothing obvious has come up. And nicotine has this weird reputation as being dangerous, but beyond addictiveness it has not be shown to be harmful, even potentially neuroprotective. Not to mention scaremongers tend to ignore that it is a stimulant, and can help with anxiety. Schizos are known to self medicate with it, for example. >https://time.com/5727662/smoking-vaping-rates-2018/ https://time.com/5727662/smoking-vaping-rates-2018/
- MiroF 7y agoNicotine use and addiction among teens is higher than it has been in decades. The rates are staggering. Agreed that is a completely different problem than smoking, but still worth discussing since it is so addictive.
- anfilt 7y agoHow does anyone pay 10,000 a year on health care, unless you saying everyone is having major operations or procedures a year or expensive tests. I certainly don't.
- war1025 7y agoInsurance premiums
- anfilt 7y agoI don't pay anywhere near that much.
- tbyehl 7y agoAnd how much is your employer kicking in?
- anfilt 7y agoNone.
- lotsofpulp 7y agoYour claim was how does “anyone” pay $10k for insurance. It doesn’t matter what you pay. The answer is older people in high cost of living places. https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates_2020.pdf https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra... And insurance is just insurance. out of pocket maximum is usually $10k+, so if you do need care, add that to premiums.
- anfilt 7y agoI did put a qualifier on that statement though, I said "unless". I doubt the average person is having constant surgeries, procedures, expensive tests or expensive medications every year. Like I could see something happening in a year, but not every year.