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The great Health Care debate!

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cara

Ideal_Rock
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I will say that the study I posted was an unusual way to slice the data. Most of the time, people just look at, say, annual expeditures on medical care for an age matched population rather than lifetime studies. Per year, smokers cost more. And there are costs to society from the smoker who dies early - lost wages and productivity, second hand smoke, etc. If you do a cost-effectiveness analysis and include those costs (such as lost wages) then smoking looks much more costly. But those are society-wide costs, not costs specifically to a health care provider for the medical care of the smoker alone.

Health care is one of those difficult things - we value human life, but at what cost? Dialysis is generally held up as the line - it costs approximately $100,000 per life year saved and is a standard expected treatment. But yet it is a difficult concept to discuss - are we willing as a society to decide whether or not to pursue treatment based on cost? Are we willing to value the life of a promising 20 yro more than an elderly person? Some screening procedures are rejected as too costly, even if they are less costly per life year saved than dialysis, so our current system is really quite dyslexic about this issue. And when it is your loved one on the line, would you really be happy with saying, oh well, this treatment is too costly at $150,000 per life year saved, I guess that''s it for Grandpa?
 

iluvcarats

Ideal_Rock
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Date: 3/19/2009 4:34:40 PM
Author: cara
I will say that the study I posted was an unusual way to slice the data. Most of the time, people just look at, say, annual expeditures on medical care for an age matched population rather than lifetime studies. Per year, smokers cost more. And there are costs to society from the smoker who dies early - lost wages and productivity, second hand smoke, etc. If you do a cost-effectiveness analysis and include those costs (such as lost wages) then smoking looks much more costly. But those are society-wide costs, not costs specifically to a health care provider for the medical care of the smoker alone.


Health care is one of those difficult things - we value human life, but at what cost? Dialysis is generally held up as the line - it costs approximately $100,000 per life year saved and is a standard expected treatment. But yet it is a difficult concept to discuss - are we willing as a society to decide whether or not to pursue treatment based on cost? Are we willing to value the life of a promising 20 yro more than an elderly person? Some screening procedures are rejected as too costly, even if they are less costly per life year saved than dialysis, so our current system is really quite dyslexic about this issue. And when it is your loved one on the line, would you really be happy with saying, oh well, this treatment is too costly at $150,000 per life year saved, I guess that''s it for Grandpa?

We actually had this discussion a few pages back.
I know it is long, but read the thread if you have the time.
If people didn''t smoke, there would be more money for "Grandpa" and everyone else.
Smoking is an unnecessary drain on the health care system, and all smoking related complications would cease to exist if people didn''t do it. ALL smoking related diseases can be prevented. What I am saying is that if people choose to do so, there should be some responsibility on their part.
 

cara

Ideal_Rock
Joined
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2,202
Date: 3/19/2009 4:26:45 PM
Author: iluvcarats

I thought that the article I posted with facts from the American Heart Association did prove my point.
We can keep people alive longer these days in all sorts of ways.
There are new innovative operations and cancer treatments that were not available 10 years ago.

I am saying it is speculative - it could happen, maybe, maybe not.
I am looking for actual facts, not projected statistics.
I wasn't talking about obesity because as I said before, that is not always a choice.
Like I said before, the problems incurred by smoking are 100% preventable if you don't do it.
You might still get lung cancer, heart disease, kidney cancer, breast cancer or many other diseases, but it won't be because you chose to smoke.
So if you do choose to smoke cigarettes, you should be responsible for the choices that you make for your body.
Smoking is not a small problem at all. On the contrary, it is HUGE.
Smoking itself is a huge problem, but stopping smoking alone is not the sufficient to solve our health care system problems. Nor is it feasible. I fully support public education, taxes, smoking bans in many places, etc., to reduce smoking but yet I don't think that that is the sole necessary step to making our health care system more functional. It is a small part of what is necessary to improve our overall health care system.

The article you cites lists strong 'lives and dollars' numbers on the costs of smoking - it does cost a staggering number of dollars annually to treat smoking related illnesses and smoking continues to take a staggering number of American lives each year. But your article does not have a comparable analysis to the study I posted, which estimated lifetime medical costs to a health care system for smokers and non-smokers.

Maybe you are right, and for the US population with modern treatments, lifetime medical costs for smokers are comparable or higher than for non-smokers, but my point is that cost-of-medical-care alone is not always the guiding light. Sometimes you have to spend money to save lives. Sometimes you might think you are saving 'the system' money when really you are delaying the expediture or increasing the overall expeditures if you manage to keep a person from dying of lung cancer but only to allow them to develop several chronic, expensive diseases that require gobs of money to keep them alive for an extra 20 years. It was a food-for-thought posting.

ETA: I have read the thread, but I didn't see the point I brought up discussed. Maybe I missed it.
 

iluvcarats

Ideal_Rock
Joined
Apr 17, 2008
Messages
2,816
Date: 3/19/2009 4:50:59 PM
Author: cara
Date: 3/19/2009 4:26:45 PM

Author: iluvcarats


I thought that the article I posted with facts from the American Heart Association did prove my point.

We can keep people alive longer these days in all sorts of ways.

There are new innovative operations and cancer treatments that were not available 10 years ago.


I am saying it is speculative - it could happen, maybe, maybe not.

I am looking for actual facts, not projected statistics.

I wasn't talking about obesity because as I said before, that is not always a choice.

Like I said before, the problems incurred by smoking are 100% preventable if you don't do it.

You might still get lung cancer, heart disease, kidney cancer, breast cancer or many other diseases, but it won't be because you chose to smoke.

So if you do choose to smoke cigarettes, you should be responsible for the choices that you make for your body.

Smoking is not a small problem at all. On the contrary, it is HUGE.

Smoking itself is a huge problem, but stopping smoking alone is not the sufficient to solve our health care system problems. Nor is it feasible. I fully support public education, taxes, smoking bans in many places, etc., to reduce smoking but yet I don't think that that is the sole necessary step to making our health care system more functional. It is a small part of what is necessary to improve our overall health care system.


The article you cites lists strong 'lives and dollars' numbers on the costs of smoking - it does cost a staggering number of dollars annually to treat smoking related illnesses and smoking continues to take a staggering number of American lives each year. But your article does not have a comparable analysis to the study I posted, which estimated lifetime medical costs to a health care system for smokers and non-smokers.


Maybe you are right, and for the US population with modern treatments, lifetime medical costs for smokers are comparable or higher than for non-smokers, but my point is that cost-of-medical-care alone is not always the guiding light. Sometimes you have to spend money to save lives. Sometimes you might think you are saving 'the system' money when really you are delaying the expediture or increasing the overall expeditures if you manage to keep a person from dying of lung cancer but only to allow them to develop several chronic, expensive diseases that require gobs of money to keep them alive for an extra 20 years. It was a food-for-thought posting.
Cara,
I appreciate what you are saying, but by no means do I think that smoking is the ONLY problem.
But it is a large one. We will always be fighting the good fight against diseases, it is just that smoking related diseases are completely unnecessary. We could be using more money and resources on other diseases that aren't preventable.
Smoking is a large reason as to why our health care system is hemorrhaging money, and since these are diseases that are actually within our control to prevent, it seems like a good place to stop the bleeding first.
 

Porridge

Ideal_Rock
Joined
Oct 27, 2008
Messages
3,267
Good point iluvcarats. In Ireland we tax smokers so much that it is now almost impossible for, say, the average student to afford to be a heavy smoker. Advertising is banned, 10 packs are banned and a pack of 20 costs €10 ($13.66). That''s €70 a week for an average smoker! Smoking is not allowed anywhere where people are working, including pubs and restaurants. I for one am a fan of all this. People argue the point that where do you stop - tax people who create unnecessary stress for themselves? Top sporters for potential bodily harm?? No, of course not, some things are just part of life, and we don''t want to end up like scared robots. But how about the real unnecessaries - crisps, candy, chips, other fast foods? I don''t mean make it unaffordable, but more expensive than healthy food would be smart.
I think we can all agree that smoking is completely unnecessary and a great place to start.

In the same vein, I believe a backbencher tried to propose an obesity tax in the UK a number of years ago, but it was shot down for the "where do you stop" reasons. Also argued was the point that not everyone is on a level playing field with regards to how they were raised. But it was introduced in Alabama a short time ago, by the insurance companies covering state employees. Anyone know how that''s faring out?
 

iluvcarats

Ideal_Rock
Joined
Apr 17, 2008
Messages
2,816
Date: 3/19/2009 6:39:14 PM
Author: Porridge
Good point iluvcarats. In Ireland we tax smokers so much that it is now almost impossible for, say, the average student to afford to be a heavy smoker. Advertising is banned, 10 packs are banned and a pack of 20 costs €10 ($13.66). That''s €70 a week for an average smoker! Smoking is not allowed anywhere where people are working, including pubs and restaurants. I for one am a fan of all this. People argue the point that where do you stop - tax people who create unnecessary stress for themselves? Top sporters for potential bodily harm?? No, of course not, some things are just part of life, and we don''t want to end up like scared robots. But how about the real unnecessaries - crisps, candy, chips, other fast foods? I don''t mean make it unaffordable, but more expensive than healthy food would be smart.

I think we can all agree that smoking is completely unnecessary and a great place to start.


In the same vein, I believe a backbencher tried to propose an obesity tax in the UK a number of years ago, but it was shot down for the ''where do you stop'' reasons. Also argued was the point that not everyone is on a level playing field with regards to how they were raised. But it was introduced in Alabama a short time ago, by the insurance companies covering state employees. Anyone know how that''s faring out?

Thanks Porridge.
The governor of NY (my state) just proposed an obesity tax on all sugar drinks.
The lobbies here are so strong, and it was shelved.
I am sure stores like Wal-Mart who sell a lot of these products looked very unfavorably on this tax.
I agree that making healthy food affordable and junk food expensive is a good idea. Unfortunately it is the opposite
38.gif
 

beebrisk

Brilliant_Rock
Joined
Dec 18, 2005
Messages
1,000
Date: 3/19/2009 6:51:41 PM
Author: iluvcarats
Date: 3/19/2009 6:39:14 PM

Author: Porridge

Good point iluvcarats. In Ireland we tax smokers so much that it is now almost impossible for, say, the average student to afford to be a heavy smoker. Advertising is banned, 10 packs are banned and a pack of 20 costs €10 ($13.66). That''s €70 a week for an average smoker! Smoking is not allowed anywhere where people are working, including pubs and restaurants. I for one am a fan of all this. People argue the point that where do you stop - tax people who create unnecessary stress for themselves? Top sporters for potential bodily harm?? No, of course not, some things are just part of life, and we don''t want to end up like scared robots. But how about the real unnecessaries - crisps, candy, chips, other fast foods? I don''t mean make it unaffordable, but more expensive than healthy food would be smart.


I think we can all agree that smoking is completely unnecessary and a great place to start.



In the same vein, I believe a backbencher tried to propose an obesity tax in the UK a number of years ago, but it was shot down for the ''where do you stop'' reasons. Also argued was the point that not everyone is on a level playing field with regards to how they were raised. But it was introduced in Alabama a short time ago, by the insurance companies covering state employees. Anyone know how that''s faring out?


Thanks Porridge.

The governor of NY (my state) just proposed an obesity tax on all sugar drinks.

The lobbies here are so strong, and it was shelved.

I am sure stores like Wal-Mart who sell a lot of these products looked very unfavorably on this tax.

I agree that making healthy food affordable and junk food expensive is a good idea. Unfortunately it is the opposite
38.gif


It also got shelved because there are some wise people who want government to "govern" and not act as social engineers.

"Making healthy food affordable and junk food expensive" is NOT the job of our legislators. It''s up to YOU not to buy what isn''t good for you or at least buy it in moderation.

And I''m not sure your statement about the cost of junk vs. healthy food is factual. I find lots of stuff with high sugar and fat contents to be way higher. A single banana is cheaper than a candy bar. By the portion, plain oatmeal is cheaper than Frosted Flakes. Lean chicken breast sure is less expensive than even a small steak and water (as opposed to soda) is free.
 

iluvcarats

Ideal_Rock
Joined
Apr 17, 2008
Messages
2,816
Date: 3/19/2009 7:11:41 PM
Author: beebrisk
Date: 3/19/2009 6:51:41 PM

Author: iluvcarats

Date: 3/19/2009 6:39:14 PM


Author: Porridge


Good point iluvcarats. In Ireland we tax smokers so much that it is now almost impossible for, say, the average student to afford to be a heavy smoker. Advertising is banned, 10 packs are banned and a pack of 20 costs €10 ($13.66). That''s €70 a week for an average smoker! Smoking is not allowed anywhere where people are working, including pubs and restaurants. I for one am a fan of all this. People argue the point that where do you stop - tax people who create unnecessary stress for themselves? Top sporters for potential bodily harm?? No, of course not, some things are just part of life, and we don''t want to end up like scared robots. But how about the real unnecessaries - crisps, candy, chips, other fast foods? I don''t mean make it unaffordable, but more expensive than healthy food would be smart.



I think we can all agree that smoking is completely unnecessary and a great place to start.




In the same vein, I believe a backbencher tried to propose an obesity tax in the UK a number of years ago, but it was shot down for the ''where do you stop'' reasons. Also argued was the point that not everyone is on a level playing field with regards to how they were raised. But it was introduced in Alabama a short time ago, by the insurance companies covering state employees. Anyone know how that''s faring out?



Thanks Porridge.


The governor of NY (my state) just proposed an obesity tax on all sugar drinks.


The lobbies here are so strong, and it was shelved.


I am sure stores like Wal-Mart who sell a lot of these products looked very unfavorably on this tax.


I agree that making healthy food affordable and junk food expensive is a good idea. Unfortunately it is the opposite
38.gif



It also got shelved because there are some wise people who want government to ''govern'' and not act as social engineers.


''Making healthy food affordable and junk food expensive'' is NOT the job of our legislators. It''s up to YOU not to buy what isn''t good for you or at least buy it in moderation.


And I''m not sure your statement about the cost of junk vs. healthy food is factual. I find lots of stuff with high sugar and fat contents to be way higher. A single banana is cheaper than a candy bar. By the portion, plain oatmeal is cheaper than Frosted Flakes. Lean chicken breast sure is less expensive than even a small steak and water (as opposed to soda) is free.
BB
I don''t think that an obesity tax here in NY is a good idea. I pay enough tax thank you very much!
28.gif

I was just giving porridge an example.
You must live in a different part of NY than I do, because I get a water bill every month.
My grocery bills are also huge, and I buy only healthy food, but then again we don''t have Costco here.
I am not sure that my statement is factual either though.
It just seems like a bag of Doritoes and a big Slurpie cost a lot less than grilled salmon and a salad.
 

trillionaire

Ideal_Rock
Joined
Apr 18, 2008
Messages
3,881
Date: 3/19/2009 7:11:41 PM
Author: beebrisk



Date: 3/19/2009 6:51:41 PM
Author: iluvcarats



Date: 3/19/2009 6:39:14 PM

Author: Porridge

Good point iluvcarats. In Ireland we tax smokers so much that it is now almost impossible for, say, the average student to afford to be a heavy smoker. Advertising is banned, 10 packs are banned and a pack of 20 costs €10 ($13.66). That's €70 a week for an average smoker! Smoking is not allowed anywhere where people are working, including pubs and restaurants. I for one am a fan of all this. People argue the point that where do you stop - tax people who create unnecessary stress for themselves? Top sporters for potential bodily harm?? No, of course not, some things are just part of life, and we don't want to end up like scared robots. But how about the real unnecessaries - crisps, candy, chips, other fast foods? I don't mean make it unaffordable, but more expensive than healthy food would be smart.


I think we can all agree that smoking is completely unnecessary and a great place to start.



In the same vein, I believe a backbencher tried to propose an obesity tax in the UK a number of years ago, but it was shot down for the 'where do you stop' reasons. Also argued was the point that not everyone is on a level playing field with regards to how they were raised. But it was introduced in Alabama a short time ago, by the insurance companies covering state employees. Anyone know how that's faring out?


Thanks Porridge.

The governor of NY (my state) just proposed an obesity tax on all sugar drinks.

The lobbies here are so strong, and it was shelved.

I am sure stores like Wal-Mart who sell a lot of these products looked very unfavorably on this tax.

I agree that making healthy food affordable and junk food expensive is a good idea. Unfortunately it is the opposite
38.gif


It also got shelved because there are some wise people who want government to 'govern' and not act as social engineers.

'Making healthy food affordable and junk food expensive' is NOT the job of our legislators. It's up to YOU not to buy what isn't good for you or at least buy it in moderation.

And I'm not sure your statement about the cost of junk vs. healthy food is factual. I find lots of stuff with high sugar and fat contents to be way higher. A single banana is cheaper than a candy bar. By the portion, plain oatmeal is cheaper than Frosted Flakes. Lean chicken breast sure is less expensive than even a small steak and water (as opposed to soda) is free.
pound for pound, most veggies and fruits are FAR cheaper than meat. (with the exception maybe of whole chickens, which I can get for .59-99/lb). Rice and beans are pretty cheap, even canned veggies and fruit are moderately priced. My roomie and I have been eating vegetarian lately to try to save money, but we never feel full or satisfied. I cook at least a lb of beans per week, but we haven't figured out how to keep from feeling like we are starving half the time...

However, I can go to the grocery store and get a frozen dinner for $1-2. I can get a 1-1.5lb hungry man meal for $2 on sale.
23.gif
There is a lot of cheap food that is not great for you. The dollar menus at all of the fast food places are just one example. Burger + fries = $2

fresh food, however. does not last as long, ie does not have a good shelf life, so it's easy for it to go to waste if you don't use it quickly (I am VERY guilty of this!)

ETA: Taxing unhealthy food is not much different than taxing cigarettes or alcohol at a higher rate, IMO. If you want it, you pay for it. it would just have more of a financial implication across retailers than cigs or alcohol... not that I want gov't micro managing my life, I'm just saying that I don't see that as very different.
 

LtlFirecracker

Ideal_Rock
Joined
Feb 29, 2008
Messages
4,837
So yesterday I was watching the news, and I found out San Francisco had "universal heath care." Does anyone know about that? Does anyone live there? And if you do are you willing to tell us your experiences with that?
 
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