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Not pushing one way or the other, but it's important to consider the framing: Ignoring the second-hand smoke complexity for a moment, if everyone pays for every

Not pushing one way or the other, but it's important to consider the framing: Ignoring the second-hand smoke complexity for a moment, if everyone pays for every one else's health, then of course we should ban or tax cigarettes and/or anything that causes excess harm to a single person that others have to pay for (taxes help cover the externality). However, if each individual pays for the entirety of their own health-care costs, then it is far less obvious what actions should be taken. To put it another way, if I was in command of an army, I wouldn't allow smoking or various unhealthy or time-wasting activities. China wants a higher GDP: ban all the video games! This sort of social-engineering is _possibly_ for the best, and possibly for the worse, but I think it's a bit of an injustice to just state "well we all have to pay for each other's health so the policy should be ______". We don't necessarily have to all pay for each others health. Absolutes aside, a smoker should have higher insurance costs than a non-smoker. If we all had to pay for each others hobbies, for example, you'd bet there would be folks trying to get cloud-watching banned in favor of something productive like knitting. This sort of social planning rarely works out how one expects it to.

Clubber 5y ago
I would argue in the US, that sort of thing benefits corporate healthcare more than anything. Nobody wants other people telling them what to do. In other words, the more people say we're going to ban ______ because I don't want to pay for your risky lifestyle through my healthcare taxes, the less likely universal healthcare will ever be a thing in the US. If we really want universal healthcare, we should allow everyone to join, thus the universal part. But people like to preach to other people, so Que Será, Será.
Talanes 5y ago
> If we all had to pay for each others hobbies, for example, you'd bet there would be folks trying to get cloud-watching banned in favor of something productive like knitting. If I had to pay for other people's hobbies, surely I'd want the opposite? Why would I prefer to buy someone yarn rather than let them watch clouds for free?
wheels 5y ago
> Absolutes aside, a smoker should have higher insurance costs than a non-smoker. This is probably false. Smokers rack up less health care costs than nonsmokers because they die earlier. The study I'm linking doesn't consider the possibility of exiting paying into a healthcare system early, but even most smokers die after retirement: https://www.nejm.org/doi/full/10.1056/nejm199710093371506 https://www.nejm.org/doi/full/10.1056/nejm199710093371506
- erulabs 5y ago
  Hah that is interesting. I don't think it changes my point tho - maybe just makes smoking a bad example. However, I was using it as a proxy for "anything that increases your health-care costs".
- alasdair_ 5y ago
  Retired people provide a lot of useful labor, it’s just much of it is in the home and therefore both unpaid and invisible. Grandparents provide childcare for working children and they help take care of their spouses that would otherwise need in-home care. It’s a complicated calculation.
  - wheels 5y ago
    I think the argument that you're making is that smoking is a net-negative economically, which strikes me as plausible, if not obviously true. There you'd also need to go a step further and consider the economic contributions of the tobacco industry. You're right that it's very complicated (and macabre). But that's a broader question than whether or not their relative costs (vs. payments) into a healthcare system. The reason I brought up retirement is that most people in the west pay into health care systems until retirement, and only (or mostly) draw from it once retired.
TheOtherHobbes 5y ago
I find it it interesting that spending billions on promoting smoking somehow isn't considered social engineering, but trying to prevent it somehow is.
- erulabs 5y ago
  In spirit, I agree, but just in terms of economic language, the "social engineer" by definition has to raise funds non-voluntarily. You're 100% right, we're _all_ social engineers - but if you raise your funds voluntarily (ie: on the market), you're more accurately called a capitalist, at least in the language of econ.
devwastaken 5y ago
>However, if each individual pays for the entirety of their own health-care costs, then it is far less obvious what actions should be taken. This doesn't exist in the nature we find modern civilization in. You pay for others health, one way or another. We either pay for it sooner and reap the benefits of people being able to work, have families, money, or you pay for it with poverty, crime, "blood". You also pay for it with driven yet disadvantaged people not being able to rise to positions that use their abilities. Example: Students. Health is inherent to humans. To be human at all is to have health and medical requirements. Cloud services are not a requirement of your very existence.

Clubber 5y ago

I would argue in the US, that sort of thing benefits corporate healthcare more than anything. Nobody wants other people telling them what to do. In other words, the more people say we're going to ban ______ because I don't want to pay for your risky lifestyle through my healthcare taxes, the less likely universal healthcare will ever be a thing in the US. If we really want universal healthcare, we should allow everyone to join, thus the universal part. But people like to preach to other people, so Que Será, Será.

Talanes 5y ago

> If we all had to pay for each others hobbies, for example, you'd bet there would be folks trying to get cloud-watching banned in favor of something productive like knitting. If I had to pay for other people's hobbies, surely I'd want the opposite? Why would I prefer to buy someone yarn rather than let them watch clouds for free?

wheels 5y ago

> Absolutes aside, a smoker should have higher insurance costs than a non-smoker. This is probably false. Smokers rack up less health care costs than nonsmokers because they die earlier. The study I'm linking doesn't consider the possibility of exiting paying into a healthcare system early, but even most smokers die after retirement: https://www.nejm.org/doi/full/10.1056/nejm199710093371506 https://www.nejm.org/doi/full/10.1056/nejm199710093371506

erulabs 5y ago
Hah that is interesting. I don't think it changes my point tho - maybe just makes smoking a bad example. However, I was using it as a proxy for "anything that increases your health-care costs".
alasdair_ 5y ago
Retired people provide a lot of useful labor, it’s just much of it is in the home and therefore both unpaid and invisible. Grandparents provide childcare for working children and they help take care of their spouses that would otherwise need in-home care. It’s a complicated calculation.
- wheels 5y ago
  I think the argument that you're making is that smoking is a net-negative economically, which strikes me as plausible, if not obviously true. There you'd also need to go a step further and consider the economic contributions of the tobacco industry. You're right that it's very complicated (and macabre). But that's a broader question than whether or not their relative costs (vs. payments) into a healthcare system. The reason I brought up retirement is that most people in the west pay into health care systems until retirement, and only (or mostly) draw from it once retired.

TheOtherHobbes 5y ago

I find it it interesting that spending billions on promoting smoking somehow isn't considered social engineering, but trying to prevent it somehow is.

erulabs 5y ago
In spirit, I agree, but just in terms of economic language, the "social engineer" by definition has to raise funds non-voluntarily. You're 100% right, we're _all_ social engineers - but if you raise your funds voluntarily (ie: on the market), you're more accurately called a capitalist, at least in the language of econ.

devwastaken 5y ago

>However, if each individual pays for the entirety of their own health-care costs, then it is far less obvious what actions should be taken. This doesn't exist in the nature we find modern civilization in. You pay for others health, one way or another. We either pay for it sooner and reap the benefits of people being able to work, have families, money, or you pay for it with poverty, crime, "blood". You also pay for it with driven yet disadvantaged people not being able to rise to positions that use their abilities. Example: Students. Health is inherent to humans. To be human at all is to have health and medical requirements. Cloud services are not a requirement of your very existence.