should smokers and drinkers pay more for health care?

I'm not sure if this will pertain to any countries other than Canada since our health care systems obviously differ, but I thought it was an interesting topic.

flipping through the channels earlier today, there was a debate on one of our news stations asking people what they thought about this subject. some were saying yes, because they felt they were a drain on the health care system causing everyone to pay higher taxes for treatments to their "preventable" illnesses, while some of the experts were saying that it's not 100% possible to link lung cancer and other ailments generally related to someone who smokes or drinks. some people can smoke their whole lives and not get lung cancer, while others can develop it from something like pollution without ever smoking.

I don't know how they would even go about adjusting how much smokers/drinkers pay without turning our system into the sort of healthcare where everyone just pays for what they need.

so what are your thoughts?

It's like car insurance or life insurance - you lead a risky lifestyle, you pay more. Makes sense to me.

I'm not sure how drinking should affect payments; I mean, everyone drinks to some extent, no? If they did it by increments (ie: frequency of drinking) then maybe it would work.

Smoking should definitely play a factor, though. It's almost a no-brainer.

Certainly should make people pay more if they're going to engage in activities that will endanger their health. And these days the fact that smoking and drinking are both rather bad for your heath isn't exactly theory anymore. However with the drinking part, maybe if the person has a history of being a big drinker or alcoholic, one shouldn't be punished for taking a few shots at a party or something.

I do support that sort of thing, I like the car insurance example, where if I drive a car that is more likely to be stolen or crash or if I am a driver more likely to crash, then I pay more.

We need to be careful though with healthcare, especially like in a state-run system in Canada or through the US's Medicare. If insurance can discriminate (not a negative connotation of that word here) against someone who smokes because they are more likely to get lung cancer, why couldn't they also require a blood test when you sign up and make you pay more if you have a recessive gene that makes you more likely to, say, die of a stroke, regardless of your lifestyle?

You could argue that thems the breaks and that's just what happens in a free market, but it's just not humane. And it's not a far leap.

In a more parallel example, why stop at smoking or drinking? I read a report once (hell, there is a report for everything) that said if you live near high voltage power lines then your risk of cancer goes up. Should people who live near power poles pay more? There is a town in Arizona that has an abnormally high frequency of childhood leukemia...so if parents have a child, should their employer group health plan rates go up compared to someone in another town? Do cell phone users pay more since there are some reports (and many reports that refute this) that say cell phones cause brain tumors? These are all choices people can make, where they live, what products they use, which, depending on who you ask, can impact health. Not as much as smoking, but they can.

It's a fine line to straddle.

I know that you pay more for life insurance for smoking, I don't see why not for medical care, either. I smoke, so this would directly effect me, all the more reason why I'm trying to quit, I guess.

Drinking, though? That's really kind of hard, where do you draw the line, especially when you consider that somepeople can imbibe large quantities regularly without serious health problems like stomach cancer and liver failure. Besides, pretty much everyone I know has gone through phases with drinking, not like alcoholism, but when you're young the compulsion is to party. Then, you get older and it levels off. Certain types of alcohol, in moderation (red wines for example), can actually provide certain benefits to your health. The only case I could make for alcohol effecting premiums would be there's some documented case of abuse, i.e. DUI/alcohol related incident report(s).

Then again, why don't we just raise premiums for people who are not within healthy BMI standards. Being overweight has a lot of associated health issues. More than smoking, I'd wager, actually.

Or, here's another one, what about people with family histories of disorders like thyroid problems or other chronic health problems?

Pretty soon, everyone is paying ridiculous amounts of money for health coverage, as if it wasn't bad enough that already like 15% (or better, depending on which survey you look at) of people living in the U.S. can't afford/don't have medical insurance.

For America, the good people that smoke and drink in more then what can be considered moderation saves our medicare and social security programs money. Since those people tend to die much sooner. Last time I checked, medicare doesn't cover huge operations like liver, kidney, or lung transplants. But that's a far cry from a socialized medicine system where public health is in the realms of public responsibility.

Originally Posted by Duo Maxwell

Then again, why don't we just raise premiums for people who are not within healthy BMI standards. Being overweight has a lot of associated health issues. More than smoking, I'd wager, actually.

Or, here's another one, what about people with family histories of disorders like thyroid problems or other chronic health problems?

Pretty soon, everyone is paying ridiculous amounts of money for health coverage, as if it wasn't bad enough that already like 15% (or better, depending on which survey you look at) of people living in the U.S. can't afford/don't have medical insurance.

At that point wouldn't it just be more cost effective for the State to not provide medical insurance for everyone? How could the State possible mandate that without making things much more inefficient?

Even as an apologist for smokers, I must say yes. Drinkers too.

But I feel that the rate at which one smokes/drinks should be taken into account. A heavy drinker or smoker is at more risk than someone who has a cigarette or two at a social event.

I have a question, how are smokers medically discerned from nonsmokers?

Originally Posted by Eleo

However, I do question how smokers are discerned from nonsmokers.

Determining who was a smoker could be seen as an invasion of privacy. That in itself will raise a lot of issues. At least I think it would here. No idea how well that would go over with countries like Canada. Canadians seem just as protective of their civil liberties, if not more so in some respects.

There are two questions here.

Should drinkers pay more? No. Absolutely not. Alcohol has just as many positive effects as negative effects, and most (if not all) of those negative effects only happen if you drink too much. Oh, and "too much" varies from person to person. I really get sick of hearing some righteous people claiming drinking is bad for you; most medical studies say otherwise. After all, the worst things that can happen are organ failure (which generally only happens when you drink too much) and vehicular problems (causing by drinking and driving). So how this should go down is as follows . . . If someone ends up in the hospital due to alcohol-related issues, the premium should jump dramatically, as this is a sure sign that someone is getting dumb and drinking too much. As for those who drink and drive, I think the legal penalties for doing so should be bumped up a lot, like 10-20 years mandatory for the first offense; these people are dangerous.

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

Originally Posted by PattyNBK

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

Actually the main cause of lung cancer is NOT smoking, smoking only increases the chance of getting cancer.
Cancer is mostly determined by chance and if your body already has some weak cells.

Originally Posted by PattyNBK

Should drinkers pay more? No. Absolutely not. Alcohol has just as many positive effects as negative effects, and most (if not all) of those negative effects only happen if you drink too much. Oh, and "too much" varies from person to person. I really get sick of hearing some righteous people claiming drinking is bad for you; most medical studies say otherwise. After all, the worst things that can happen are organ failure (which generally only happens when you drink too much) and vehicular problems (causing by drinking and driving). So how this should go down is as follows . . . If someone ends up in the hospital due to alcohol-related issues, the premium should jump dramatically, as this is a sure sign that someone is getting dumb and drinking too much. As for those who drink and drive, I think the legal penalties for doing so should be bumped up a lot, like 10-20 years mandatory for the first offense; these people are dangerous.

Should smokers pay more? Yes. They are doing something that is dangerous by its very nature and has very little (if any) positive value (and those are actually just side effects, not actual uses). They endanger themselves and endanger others (second-hand smoke is sometimes worse than first-hand smoke, depending on if the smoker smokes with filters or not), and are far more likely to get numerous diseases than the average person. There is no doubt that lung cancer and smoking are linked; smoking is the top cause of lung cancer! Sure, it's not guaranteed, but then the same could be said for having sex with someone who has AIDS in that it's a gamble; you might get lucky, but chances are greater that you're gonna get something nasty. Bottom line, people shouldn't have to pay for others' stupidity. Oh, and if people lie about smoking and get caught, their insurance should be rendered null and void.

i like how smoking is OK and alcohol isn't just because one is deemed to be more socially acceptable than the other. sorry buddy, but one could also argue that smoking in very small quantities isn't fatal, and that its effects vary from person to person as well. you were also spouting complete crap when you said that medical studies say drinking is good for you. there isn't a single medical study on this earth that will conclude alcohol is ultimately good for you -- they all agree that its negatives far outweigh its positives. assuming that there are some small positive effects such as on the heart, you could achieve the same positive effects by doing other things such as a healthy lifestyle and eating habits. alcohol's positives pale in comparison to its negative effects, which completely nullify any good effects it (may) have. stop believing only what you want to believe because drinking is something you like to do and take a look at the entire picture.

Originally Posted by Eleo

I have a question, how are smokers medically discerned from nonsmokers?

Eleo, they determine it with a saliva test, and it's really cool. My husband and I had to have it done a couple of years ago when we upped our life insurance. You have to hold a cotton swab between your cheek and gums for a couple of minutes. Some laboratory analyzes it and they can determine if you've smoked in the past five years. Pretty cool, huh?

To answer the question, though, I don't know much about socialized healthcare systems, but here in the US, I definitely think that smokers should pay more. Between that and the fact that their out-of-pocket expenses for copays, etc. will be higher by default simply because of not being as healthy, maybe more people will stop smoking.

If you're going to commit drinkers and smokers to paying more on health insurance, you should do the same to black people because all they do is slit each other's throats over drugs and cash money.

(Seriously people - think about the generalization your making)

This entire debate could be generalized to the question, "Should lifestyle choices influence the cost of privatized (or government) healthcare?". Smoking is a lifestyle choice. Drinking is a lifestyle choice. Poor diet is a lifestyle choice. Physical inactivity is a lifestyle choice. This contrasts with genetic deficiencies which are not lifestyle choices. You didn't emerge from between your mother's legs with a Big Mac in your left hand, a Coors Lite in your right, and a Marlboro hanging off your lips. You did, however, pop out with your family's predisposition for colon cancer and heart disease.

The top three underlying causes of death in the United States (in 2000) are Tobacco (18.1% of deaths), Obesity (16.6%), and Alcohol (3.5%). Underneath those are microbes, toxins, car crashes, firearms, sex, and drug use.

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Spare the slippery slope bullshit. You know well enough that's far beyond the scope of this thread.

My thought exactly! What's to stop them from doing the same thing with the people who abuse themselves with fast food and other junk food, or any other harmful choices we all make? That said, seeing how out of control people are in regards to their health these days, doing so might just be needed...

Originally Posted by BlueMikey

I do support that sort of thing, I like the car insurance example, where if I drive a car that is more likely to be stolen or crash or if I am a driver more likely to crash, then I pay more.

We need to be careful though with healthcare, especially like in a state-run system in Canada or through the US's Medicare. If insurance can discriminate (not a negative connotation of that word here) against someone who smokes because they are more likely to get lung cancer, why couldn't they also require a blood test when you sign up and make you pay more if you have a recessive gene that makes you more likely to, say, die of a stroke, regardless of your lifestyle?

You could argue that thems the breaks and that's just what happens in a free market, but it's just not humane. And it's not a far leap.

In a more parallel example, why stop at smoking or drinking? I read a report once (hell, there is a report for everything) that said if you live near high voltage power lines then your risk of cancer goes up. Should people who live near power poles pay more? There is a town in Arizona that has an abnormally high frequency of childhood leukemia...so if parents have a child, should their employer group health plan rates go up compared to someone in another town? Do cell phone users pay more since there are some reports (and many reports that refute this) that say cell phones cause brain tumors? These are all choices people can make, where they live, what products they use, which, depending on who you ask, can impact health. Not as much as smoking, but they can.

It's a fine line to straddle.

My thoughts exactly. I've thought about something like that, but I ended up finding to many questions. What about fat people? Should they pay more? People getting in car accidents? People getting hurt while doing sports, rockclimbing and so on? No matter how much I hate seeing the goverment using money on stabling people's stomach or cleaning drug users, I don't think there's a better way...

Originally Posted by BlueMikey

We need to be careful though with healthcare, especially like in a state-run system in Canada or through the US's Medicare. If insurance can discriminate (not a negative connotation of that word here) against someone who smokes because they are more likely to get lung cancer, why couldn't they also require a blood test when you sign up and make you pay more if you have a recessive gene that makes you more likely to, say, die of a stroke, regardless of your lifestyle?

You could argue that thems the breaks and that's just what happens in a free market, but it's just not humane. And it's not a far leap.

this is exactly why I'm really iffy about saying people who abuse substances should pay more for healthcare. once that line is crossed, other people will start to jump on this idea and it could very well escalate to the point where our healthcare system has been completely compromised from what it is today.

now I'll admit, I'm not 100% sure exactly how the healthcare system works in Canada, but I was always under the impression we paid a certain tax for it and our specific needs are paid for through job benefits. perhaps someone who knows more about it could explain it better, since I see the majority of people who have posted in this thread so far are from the states and you might be thinking about the topic more along the lines of how your own system works.

Quote:

In a more parallel example, why stop at smoking or drinking? I read a report once (hell, there is a report for everything) that said if you live near high voltage power lines then your risk of cancer goes up. Should people who live near power poles pay more? There is a town in Arizona that has an abnormally high frequency of childhood leukemia...so if parents have a child, should their employer group health plan rates go up compared to someone in another town? Do cell phone users pay more since there are some reports (and many reports that refute this) that say cell phones cause brain tumors? These are all choices people can make, where they live, what products they use, which, depending on who you ask, can impact health. Not as much as smoking, but they can.

It's a fine line to straddle.