The cost of poor lifestyle choices on society

[HealthyMe2010]

http://www.ajc.com/health/cdc-add-2-per-1203158.html

"The CDC estimated excessive drinking cost society nearly $224 billion in 2006"

"Smoking has been estimated to cost society about $193 billion annually. An older study estimated the cost of not exercising to be around $150 billion."

No numbers for poor eating were given, but I bet it's higher than those listed.

I still can't understand why people are opposed to higher taxes or an outright ban on these drugs, or why people who put an effort to stay healthy, don't get compensated for saving billions of dollars.

What individuals do has a profound effect on the rest of us. Choosing to smoke or drink or live an unhealthy lifestyle, isn't a choice you make ONLY for yourself - we all suffer as a result

[dstewart]

http://www.ajc.com/health/cdc-add-2-per-1203158.html

"The CDC estimated excessive drinking cost society nearly $224 billion in 2006"
...
I still can't understand why people are opposed to higher taxes or an outright ban on these drugs, or why people who put an effort to stay healthy, don't get compensated for saving billions of dollars.

What individuals do has a profound effect on the rest of us. Choosing to smoke or drink or live an unhealthy lifestyle, isn't a choice you make ONLY for yourself - we all suffer as a result

I'll try to help you understand.

First, we all do things that "have a profound effect on the rest of us." Even things that aren't obviously unhealthy. But all of us do things that are unhealthy too. If it's not your diet or your smoking, it could be your skydiving or rock climbing or your lead foot on the gas pedal or your bicycle riding or your chronic inactivity or your use of multivitamins or.... How do you think you're going to balance, or even determine, all of those things, and work out a tax-and-credit system that actually calculates those things? It is sheer delusion to think that all those things can be determined, and the risks of each of them determined. And while you pick out quite obvious health hazards here--tobacco and alcohol-- the principle does not extend only to those two. The SAD diet kills far more than either tobacco or alcohol.

Second, why would the federal government, or the state government, or your local government, or worst, some combination of those, be the proper adjudicator and collector of costs (or creditor of credits)? The government has no special ability to make those decisions, nor any reason to. You talk about "the cost on society." The costs on society are not the costs on government. And when you run money through the government, it is not costless and it is not efficient. Not only does it cost a lot of money to just funnel the money through, but government, having no incentive structures to be efficient, cannot rationally price or compensate. This is not some abstract concern that you can fudge over; it is radical, and ineradicable, of governments: They cannot function efficiently because there is no economic structure--free prices, profits and losses, voluntary purchase--to enable government to either price or spend efficiently.

Third, government and society are not the same thing, and no, government is not the agent of society.

Fourth, we do not have a government monopoly health payment system. I know you want one, and many do. But we don't have one. But here are a couple of things implied by that: My family's costs are paid for by my family. What I pay is determined by the risks in our lifestyle or those of a group with whom we are voluntarily included and priced with--not with everyone in the country. And we get to adjust the price by purchasing what, if any, coverages we want. In a government monopoly system based on taxes, you can forget the idea that taxes will be applied individually to account for your healthy behavior--you'll be priced with the group, and that means that you will end up paying for the majority of the group and its unhealthy lifestyle choices.

Fifth, the majority of people who--just for example--drink alcohol don't impose any costs on others by doing it. I should not have to pay a tax on my very moderate alcohol consumption just because the guy down the street can't stop himself. And it's not possible, outside a maximum surveillance state, to base these taxes on individual conditions. But that would be the only fair thing to do. (The individual taxing, not the maximum surveillance state.)

Unless the government is paying for the health care of these unhealthy people, whose business is it to charge them or everyone taxes for smoking or drinking? If the government is paying for the health care of some (and of course it is with Medicare, Medicaid, the VA system, and Social Security disability, among myriad others) and taxes are charged on cigarettes, alcohol, high-fat foods (hey, does the avocado get taxed? It's fatty, but a plant food. How about coconut oil? There are a lot of people who say it's a positive health food; then there are those who say it's poison--who decides whether to tax it?), carbonated drinks (do sugar-sweetened sodas and chemical-sweetened sodas both get taxed? how about flavored sparkling water? how about stevia or xylitol sweetened?), sugary foods, fried foods, foods with saturated fats, and a practically endless list of potentially taxable foods or consumables or consumer goods associated with risky activities, is there any connection at all between the taxes and paying for the health care? There is not currently, and literally cannot be--it is not possible to make all risky consumptions and activities self-paying and without externalities.

How are you going to accommodate the differences in your tax on cigarettes for the real risks? Those whose diet includes a large amount of fruits and vegetables have a far lower risk of lung cancer from smoking than those who do not eat much plant food. Should they still pay a tax? Or the same tax? Why should they pay what those sedentary Atkins dieting smokers pay? Do you really think you can give them a tax credit for the veggies that will counter the tax on the tobacco?

We actually do have ways of making people pay as precisely as is practically possible for the damage that they do to themselves--or the good they do to themselves--through their actions and consumption. It's the medical bill, and insurance policies with prices based on actuarial models of risks. But once government gets involved, through taxation on selections of activities and products, and with paying, the connection is broken and can never be made rationally or efficiently.

[HealthyMe2010]

dstewart, you've made a simple problem into something very complicated.

If you are suggesting that avocado consumption is putting a burden on our police, courts, communities and health care system the same way alcohol is - just shoot me now.

If you can prove to me that coconuts and flavored water are causing rampant fatalities, like drinking and driving or smoking, I'll be the first to applaud you. The fact is, our OBVIOUSLY poor lifestyle choices (smoking, drinking,excessive gambling, drug use, overconsumption of junk food, etc) should be taxed or banned as it does create a very real problem for society (I'm not talking governments here).

Why you constantly defend these terrible drugs is completely beyond me. Do you think its OK to pay out trillions of dollars to fix the mess which these poor choices cause, while we have starving families and a broken education system we can't afford to fix? Yikes.

[dstewart]

dstewart, you've made a simple problem into something very complicated.

If you are suggesting that avocado consumption is putting a burden on our police, courts, communities and health care system the same way alcohol is - just shoot me now.

If you can prove to me that coconuts and flavored water are causing rampant fatalities, like drinking and driving or smoking, I'll be the first to applaud you. The fact is, our OBVIOUSLY poor lifestyle choices (smoking, drinking,excessive gambling, drug use, overconsumption of junk food, etc) should be taxed or banned as it does create a very real problem for society (I'm not talking governments here).

Why you constantly defend these terrible drugs is completely beyond me. Do you think its OK to pay out trillions of dollars to fix the mess which these poor choices cause, while we have starving families and a broken education system we can't afford to fix? Yikes.

No, I have not made something simple complicated. I've taken the principle you want to apply and shown that it is far more complicated than you think. You are of the belief that you can simply limit the application of the principle to two easy concretes, alcohol and smoking. But it is not just concretes, it is a principle that applies widely. You call some things obvious--but others can easily add to what you seem to think are the only obvious things, more concretes that are obvious to them, and are indeed implied by the principle. Look what you added between your first post and your reply: You added gambling, drug use, junk food, and of course, the nice, expansive, limitless "etc." It was no trouble, either, for me to reel off a list of other things that other people already believe are OBVIOUS tax targets--some of which are already being taxed in some states and other countries, any of which are proposed targets for taxes.

And yes, in fact, you are talking government here, because you are talking about taxing. I don't know of any other agent that taxes, and it is taxes you want imposed.

I have never defended alcohol or tobacco or anything that you say I defend. I say we should not tax or prohibit. Both my parents died from the effects of tobacco and a fat, meat-based diet. They both paid lots of taxes on their cigarette purchases. Neither cost the public anything. And their young deaths (first half of their sixties) meant that they collected Social Security for about two years. What were the costs they imposed on society or the government? Actually, the government made money off of them.

And this is all with taxes on the things you speak as if go untaxed. Haven't we solved the problem in your lesser-preferred way? Cigarette taxes make up the large majority of the price of cigarettes. Alcohol taxes make up a large part, if not the majority, of the costs of liquor. Yet you're not yet happy. Perhaps because it's not having the effects, either fiscal or incentive, that you would like it to have, or perhaps it's because your greater-preferred policy is prohibition.

But you do seem comfortable as a prohibitionist. Since you do explicitly say we should prohibit these things--alcohol and tobacco, and if you really follow through on your principle, gambling and junk food--do you really think that's costless? Even ignoring the costs to liberty, the social costs of prohibition of alcohol were immense. Spread prohibition over to food and . . . well, that'll make trillions look affordable with ease.

[HealthyMe2010]

dstewart, you've made a simple problem into something very complicated.

If you are suggesting that avocado consumption is putting a burden on our police, courts, communities and health care system the same way alcohol is - just shoot me now.

If you can prove to me that coconuts and flavored water are causing rampant fatalities, like drinking and driving or smoking, I'll be the first to applaud you. The fact is, our OBVIOUSLY poor lifestyle choices (smoking, drinking,excessive gambling, drug use, overconsumption of junk food, etc) should be taxed or banned as it does create a very real problem for society (I'm not talking governments here).

Why you constantly defend these terrible drugs is completely beyond me. Do you think its OK to pay out trillions of dollars to fix the mess which these poor choices cause, while we have starving families and a broken education system we can't afford to fix? Yikes.

No, I have not made something simple complicated. I've taken the principle you want to apply and shown that it is far more complicated than you think. You are of the belief that you can simply limit the application of the principle to two easy concretes, alcohol and smoking. But it is not just concretes, it is a principle that applies widely. You call some things obvious--but others can easily add to what you seem to think are the only obvious things, more concretes that are obvious to them, and are indeed implied by the principle. Look what you added between your first post and your reply: You added gambling, drug use, junk food, and of course, the nice, expansive, limitless "etc." It was no trouble, either, for me to reel off a list of other things that other people already believe are OBVIOUS tax targets--some of which are already being taxed in some states and other countries, any of which are proposed targets for taxes.

And yes, in fact, you are talking government here, because you are talking about taxing. I don't know of any other agent that taxes, and it is taxes you want imposed.

I have never defended alcohol or tobacco or anything that you say I defend. I say we should not tax or prohibit. Both my parents died from the effects of tobacco and a fat, meat-based diet. They both paid lots of taxes on their cigarette purchases. Neither cost the public anything. And their young deaths (first half of their sixties) meant that they collected Social Security for about two years. What were the costs they imposed on society or the government? Actually, the government made money off of them.

And this is all with taxes on the things you speak as if go untaxed. Haven't we solved the problem in your lesser-preferred way? Cigarette taxes make up the large majority of the price of cigarettes. Alcohol taxes make up a large part, if not the majority, of the costs of liquor. Yet you're not yet happy. Perhaps because it's not having the effects, either fiscal or incentive, that you would like it to have, or perhaps it's because your greater-preferred policy is prohibition.

But you do seem comfortable as a prohibitionist. Since you do explicitly say we should prohibit these things--alcohol and tobacco, and if you really follow through on your principle, gambling and junk food--do you really think that's costless? Even ignoring the costs to liberty, the social costs of prohibition of alcohol were immense. Spread prohibition over to food and . . . well, that'll make trillions look affordable with ease.

Ok, let's take a step back and rather than use the word "taxes", let's call it something else - I'm not here to play word games. If $226 billion is wasted because of excessive drinking, then "excess drinkers" should pay those costs. Call it a usage fee if you like or a "cleanup fee", if more appropriate, but my point is that those who create the excess costs to society should be the ones paying the majority of that bill. Personal responsibility = liberty and freedom, doesn't it?

Look at the seventh-day Adventists or even Buddhists. They make up tens of millions of people who choose to live without alcohol, cigarettes and animal products. They enjoy a much healthier and happy life than most of us AND they don't burden the "system". Why should they have to pay for other peoples bad CHOICES? We know that alcohol and tobacco aren't formulas for a better world - if prohibition causes that much of an uproar, perhaps we need to examine WHY people feel they need to poison themselves to be happy.

[AlwaysAgnes]

dstewart is right. I have a problem with banners. So shouldn't banners be banned? Society isn't worth living in if it doesn't value individual rights and liberty. No, don't try to live my life for me. Just shoot me. Go ahead. A bullet doesn't cost that much. Easy peasy, your problem solved.

[ETeSelle]

The fact is that all sorts of things are regulated in society--for VERY good reason. Prescription drugs (and illegal ones), for instance; guns; cars; even baby toys! Etc. etc. etc. Regulation is there for the good of EVERYONE.

Taxation is a different matter, of course. Personally, given that the U.S. is one of the least taxed of all the so-called "developed" nations, I'm not opposed to a "sin tax" on alcohol, sugary drinks, etc. But given the fact that Americans are pretty much #1 on the "sense of entitlement" and the "get your hands off my stuff" lists, we all KNOW that's never gonna happen. Heck, we're the only developed country w/out national health insurance--most people here care far more about themselves than they do about anyone else.

[AlwaysAgnes]

The fact is that all sorts of things are regulated in society--for VERY good reason. Prescription drugs (and illegal ones), for instance; guns; cars; even baby toys! Etc. etc. etc. Regulation is there for the good of EVERYONE.

Taxation is a different matter, of course. Personally, given that the U.S. is one of the least taxed of all the so-called "developed" nations, I'm not opposed to a "sin tax" on alcohol, sugary drinks, etc. But given the fact that Americans are pretty much #1 on the "sense of entitlement" and the "get your hands off my stuff" lists, we all KNOW that's never gonna happen. Heck, we're the only developed country w/out national health insurance--most people here care far more about themselves than they do about anyone else.

Everyone cares more about themselves, even those who think they have the right to tell others how to live their lives using government force to do so. That's morally wrong. If y'all want to live in an immoral society or a dictatorship, go for it. Just shoot me first, 'cause I'd rather be dead.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

Maybe there should be a sin tax on busybodies.

Are you sure you want to talk politics?

Over and out.

[HealthyMe2010]

dstewart is right. I have a problem with banners. So shouldn't banners be banned? Society isn't worth living in if it doesn't value individual rights and liberty. No, don't try to live my life for me. Just shoot me. Go ahead. A bullet doesn't cost that much. Easy peasy, your problem solved.

Prove to me that banners create the same amount of harm as smoking does, and I'll help with putting laws together to help ban them.

As for rights - have them all. I believe that every creature on this planet should have rights. But if your right to choose to smoke causes suffering to others, then something should be done about it, don't you think? The right to harm oneself and others isn't really expressing liberty, is it?

If a corporation is polluting drinking water for a poor village, shouldn't they pay for the compensation? Your actions, my actions, the actions of companies and governments impact EVERYONE. We have a duty to live in a way which creates as little harm to ourselves and others as possible.

Expanding in what EteSelle said, Americans want it all, yet they have high crime rates, high debt, high lifestyle related disease, high obesity, high unemployment rates, high poverty, instigate wars and more goodies. We have to stop being so selfish and acknowledged that "your life" impacts "my life" too. This world would be far better off if we lived for others, rather than for ourselves. It's called a "nonviolent lifestyle".

[rijman]

I agree with dstewarts point in his first post, what is healthy and what is unhealthy. I know a cyclist who is very fit. This friend cycled multiple days a week with rides up to 100 miles through mountains and he also ate much healthier than the norm including a lot of potatoes. He had two major cycling accidents, one was bike failure, that landed him in the hospital in serious condition. The most serious involved a lifeflight helicopter ride and apx 9 day stay in the hospital. This person was far healthier than the average American, BMI around 20, yet he engaged in a hazardous exercise that added significant costs to the healthcare system. A fit person who loses focus in a car and creates an accident can also drain monies from the healthcare system. It is a slippery slope when you try to tax unhealthy people. On the other hand, auto insurers charge different rates depending on risk and history, why couldn't health insurers do the same? Maybe there is the standard fee with healthy patient discounts. Those who cost the system the least pay the least. That seems fair to me.

[HealthyMe2010]

I agree with dstewarts point in his first post, what is healthy and what is unhealthy. I know a cyclist who is very fit. This friend cycled multiple days a week with rides up to 100 miles through mountains and he also ate much healthier than the norm including a lot of potatoes. He had two major cycling accidents, one was bike failure, that landed him in the hospital in serious condition. The most serious involved a lifeflight helicopter ride and apx 9 day stay in the hospital. This person was far healthier than the average American, BMI around 20, yet he engaged in a hazardous exercise that added significant costs to the healthcare system. A fit person who loses focus in a car and creates an accident can also drain monies from the healthcare system. It is a slippery slope when you try to tax unhealthy people. On the other hand, auto insurers charge different rates depending on risk and history, why couldn't health insurers do the same? Maybe there is the standard fee with healthy patient discounts. Those who cost the system the least pay the least. That seems fair to me.

I certainly understand your point about your cyclist friend. Let me ask you, was he wearing a helmet? The reason why I ask is because the healthcare costs related to bike injuries from cyclists who do NOT wear helmets is in the tens of millions, if not hundreds of millions of dollars. Should responsible cyclists or even non-cyclists be held responsible for paying those medical costs?

Let me put it in another perspective. When one is involved with a healthy lifestyle, their intention is to be healthy - there are very few risks associated with eating salads and going for an evening walk. However, when one chooses to take large risks by smoking, drinking or even skydiving for that matter, there has to be a level of understanding that the particular individual who's partaking in the risky behavior should be held accountable for the consequences of their actions. Many people choose NOT to take those risks in order to reduce or eliminate the burden which an accident or disease would put their family and community into. We can't avoid all risks, but to deliberately partake in something which involves a very high level of risk, should come with the understanding that you are responsible for the consequences.

People talk about rights and liberty, but we must be held accountable for our actions as well.

[HealthyMe2010]

Perhaps, in order to clarify our positions, I'd like to ask those who are opposed to increasing prices of these drugs (alcohol and tobacco) to let me know who should be responsible for paying for the damages they cause.

This might give me some understanding.

[rijman]

I certainly understand your point about your cyclist friend. Let me ask you, was he wearing a helmet? The reason why I ask is because the healthcare costs related to bike injuries from cyclists who do NOT wear helmets is in the tens of millions, if not hundreds of millions of dollars. Should responsible cyclists or even non-cyclists be held responsible for paying those medical costs?

Let me put it in another perspective. When one is involved with a healthy lifestyle, their intention is to be healthy - there are very few risks associated with eating salads and going for an evening walk. However, when one chooses to take large risks by smoking, drinking or even skydiving for that matter, there has to be a level of understanding that the particular individual who's partaking in the risky behavior should be held accountable for the consequences of their actions. Many people choose NOT to take those risks in order to reduce or eliminate the burden which an accident or disease would put their family and community into. We can't avoid all risks, but to deliberately partake in something which involves a very high level of risk, should come with the understanding that you are responsible for the consequences.

People talk about rights and liberty, but we must be held accountable for our actions as well.

Yes, my friend wore a helmet. He likely would have died in either accident without one according to his doctors.

An easier way to get to your benefit for healthy people I think is to bottomline it, just as the auto industry does. The auto insurance industry does not track and is unconcerned about their insured regarding who is healthy, alert, listens to music in the car, puts on makeup while driving, texting while driving, being an overly aggressive driver etc. The auto insurance industry cares about the bottom line, which of their insured costs them money. There are also risk factors built in such as teenage kids will pay more even if they are very good drivers. Health insurance could tweak their rates based on some initial factors, smoking, drinking, history, BMI, then discount based on who draws the least from the system.

[dstewart]

However, when one chooses to take large risks by smoking, drinking or even skydiving for that matter, there has to be a level of understanding that the particular individual who's partaking in the risky behavior should be held accountable for the consequences of their actions. Many people choose NOT to take those risks in order to reduce or eliminate the burden which an accident or disease would put their family and community into. ...
People talk about rights and liberty, but we must be held accountable for our actions as well.

We have a system for that: It could be called "paying your own way." Paying for your own medical care, paying for your own insurance. It's direct, completely ties risk to cost. (I'm not sure, but that might be what you call selfishness.)

What you propose instead is that we have a huge government to pay for the consequences of what we do, with a huge superstructure of taxation policy to make those who inflict damage on themselves pay the government enough to pay for what the government pays to treat those who have inflicted damage on themselves. What that does is replace direct responsibility that is inherently includes an efficient way of determining, allocating, measuring, and paying for risk, with indirect, socialized responsibility with no precision and no link between the degree of risk and the degree of cost.

There is no conflict between rights and liberty, and accountability---unless you create a conflict by collectivizing provision of services and payment.

[dstewart]

On the other hand, auto insurers charge different rates depending on risk and history, why couldn't health insurers do the same? Maybe there is the standard fee with healthy patient discounts. Those who cost the system the least pay the least. That seems fair to me.

Insurers do that, actually. Health insurers do that too. (One way of doing it is deciding not to insure for "preexisting conditions." Which only makes sense for insurers, as they know that the probability of having to pay costs for a person with a preexisting condition is 100% or very close to it. That is not a risk that can be managed, it is a known certainty that is a dead loss. The only proper insurance premium for that is a premium equal to the cost of treatment. And obviously, that kind of premium is unnecessary, as one can just pay the providers of treatment directly.)

However, health insurance is heavily regulated. (Contrary to what the left side of our political spectrum believes.) And part of the regulation is mandating coverages, controlling prices, and pretty much interfering in the actuarial determination of risk.

Aside from that, insurers do try to minimize costs by incentivizing healthy behavior, preventive medicine, and preventive consumption.

(This will probably spark a bunch of outraged posts from people claiming that insurers don't pay for care, or refuse to pay for care or rescind policies when someone actually needs treating. The reality is that since these are contracts, they are virtually always honored by the insurers. And when an insurer cancels a policy on someone when they need treatment, it is nearly always because the insured party bought the insurance policy without informing the insurer of a preexisting condition--that is, they acquired the policy fraudulently.)