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Thursday, November 20, 2014

Arguements for and against smoking cessation...

Had an interesting discussion, last week, while I was in Colorado, about the Affordable Care Act that was passed a couple of years ago in the USA... aka, ObamaCare. I was debating various subjects with a good friend while I was on a trip to Colorado. Healthcare in general came up... and since cancer is a subject that I have waxed eloquently (my grading on my comments), we were specifically discussing cancer and its impact on several of our friends... particularly the ones that are dead!

My friend is a libertarian and a very good business mind. Always searching for smaller government and lower costs in the economic cycles, he brought up that under ObamaCare we should be able to refuse care to smokers. It seems that there are tests we could do on patients that participate in the smoking habit. After-all, why should we, tax-payers have to pay for the care of people who made a choice to smoke... knowing full well that it would cause at a minimum a lower quality of life, and perhaps death. We decided to expand on the impact of not extending care to smokers.

First, cutting healthcare coverage would likely lead to many more people quitting the habit... through the tried and true method... "cold-turkey" or with the help of various support methods like nicotine patches, pills, support groups and so on... any costs would be picked up by ObamaCare. The benefit of this would be that over the next 20 years (a generation) it is likely the costs of diseases like cancer, heart disease, stroke and so on would go down... at least in the short term.

In the short term? Ya, the short term... it seems that if people ultimately live longer, the total healthcare costs would go up... here are the numbers from a study published in the New England Journal of Medicine, seventeen years ago... lifetime costs for smokers can be calculated as $72,700 among men and $94,700 among women, and lifetime costs among nonsmokers can be calculated as $83,400 and $111,000, respectively. This amounts to lifetime costs for nonsmokers that are higher by 15 percent among men and 18 percent among women. (entire study is here... http://www.nejm.org/doi/full/10.1056/NEJM199710093371506#t=articleDiscussion )

It is likely the ratios have stayed the same, but like all other healthcare costs, they will be wildly higher than those quoted in the article. So, in the short term, getting folks to stop is a good idea, but in the long term, that will reverse, because older people just 'cost more'.

It is amazing that most people want to live longer lives... and on average, if they live longer, healthier lives, they will cost the system more... maybe there is an argument that could be used that we should all smoke more to save the government money... that's like smaller government... my libertarian friend wouldn't fall for that one, but I sense that there might be some folks at FOX who might report that a discovery has been found to reduce costs at HHS.

So, what are we arguing about... should we quit just to cut costs? Well, if the legislative body of Congress is really there to get itself re-elected, of course cutting costs in the short term would likely help get individuals re-elected.

But then we have other implications of cessation programs... one is the impact on the farmers who grow tobacco. The government could likely cut costs by not having to pay subsidies to farmers to "not grow tobacco or to support the price of the killer tobacco". These are just ten of several hundred thousand farmers that received subsidies from Uncle Sam for their tobacco crops... this process goes on and one can suppose that these farmers and their families would all vote against the party that tries to end these subsidies. Who would vote for that, which could get them un-elected.

Recipients of Tobacco Subsidies from farms in United States totaled $1,519,000,000 in from 1995-2012.
RankRecipient
(* ownership information available)
LocationTobacco Subsidies
1995-2012
1Barnes Farming Corp ∗Spring Hope, NC 27882$2,265,492
2Worthington Farms Inc ∗Greenville, NC 27834$1,826,648
3Ham Farms Inc ∗Snow Hill, NC 28580$1,602,265
4Daniel H Lewis Farms Inc ∗Orrum, NC 28369$1,445,824
5Deas Bros Farms Inc ∗Jennings, FL 32053$1,325,463
6R Hart Hudson Farms Inc ∗South Hill, VA 23970$1,207,708
7Scott Farms Inc ∗Lucama, NC 27851$1,156,542
8Stuart Pierce Farms Inc ∗Ahoskie, NC 27910$1,153,762
9Roger H DupreeAngier, NC 27501$1,110,257
10Wayne Edwards Farms ∗Whitakers, NC 27891$1,104,368


More on smoking later...


 

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Blueknowser

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Grad. Saint Mary's University, 1975, got into the medical device business initially in sales, then various management positions up to president, all in Medical Devices. I prefer therapy products over diagnostic, but they are all fun, and in a way have defined my life. I have now evolved, with help from my 35 year partner Lynnda with whom I now share every hour. I am into staying healthy, photography, kayaking, bicycling, gardening and two books a week. I wish I had gotten to this stage earlier!