New health debate: Should society let smokers, obese die?
NEW YORK — With the high cost of caring for smokers and overeaters, experts say society must grapple with a blunt question: Instead of trying to penalize them and change their ways, why not just let these health sinners die?
Annual health care costs are roughly $96 billion for smokers and $147 billion for the obese, the government says. These costs accompany sometimes heroic attempts to prolong lives, including surgery, chemotherapy and other measures.
But despite these rescue attempts, smokers tend to die 10 years earlier on average, and the obese die five to 12 years prematurely, according to various researchers' estimates.
And attempts to curb smoking and unhealthy eating frequently lead to backlash: Witness the current legal tussle over New York City's first-of-its-kind limits on the size of sugary beverages and the vicious fight last year in California over a ballot proposal to add a $1-per-pack cigarette tax, which was ultimately defeated.
“This is my life. I should be able to do what I want,” said Sebastian Lopez, a college student from Queens, speaking last September when the New York City Board of Health approved the soda size rules.
Critics also contend that tobacco- and calorie-control measures place a disproportionately heavy burden on poor people.
Critics call these approaches unfair, and believe they have only a marginal effect. “Ultimately these things are weak tea,” said Dr. Scott Gottlieb, a physician and fellow at the right-of-center think tank, the American Enterprise Institute.
Gottlieb's view is debatable. There are plenty of public health researchers who can show smoking control measures have brought down smoking rates and who will argue that smoking taxes are not regressive so long as money is earmarked for programs that help poor people quit smoking.
And debate they will. There always seems to be a fight whenever this kind of public health legislation comes up. And it's a fight that can go in all sorts of directions. For example, some studies even suggest that because smokers and obese people die sooner, they may actually cost society less than healthy people who live much longer and develop chronic conditions like Alzheimer's disease.
So let's return to the original question: Why provoke a backlash? If one in five U.S. adults smoke, and one in three are obese, why not just get off their backs and let them go on with their (probably shortened) lives?
Because it's not just about them, say some health economists, bioethicists and public health researchers.
“Your freedom is likely to be someone else's harm,” said Daniel Callahan, senior research scholar at a bioethics think-tank, the Hastings Center.
Smoking has an obvious impact in the form of secondhand smoke.
But there's a burden to everyone else of paying for the diabetes care, heart surgeries and other medical expenses incurred by obese people, noted John Cawley, a health economist at Cornell University.
“If I'm obese, the health care costs are not totally borne by me. They're borne by other people in my health insurance plan and — when I'm older — by Medicare,” Cawley said.
Higher health care premiums for smokers are allowed under a health care law being put into effect, but there is no such provision for the obese.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Surge in small drones making airline pilots nervous
- Boston airport’s ‘naked man’ remains behind bars
- Fissures begin to emerge among Dems
- Many older people silently harbor gene mutation that could start them on the path to blood cancer
- In Ferguson, demonstrations over black youth’s slaying by police officer peter out
- House ethics panel defers campaign finance investigation of New York Rep. Grimm
- Test vaccine to fight Ebola promising
- Liberal Supreme Court Justice Ginsburg has stent placed in heart artery
- National Guard reinforcements contain damage in Ferguson
- Fewer adults smoking, U.S. survey finds
- Obama’s immigration actions neglect business pleas