Wednesday, November 01, 2006

Personal Responsibility

Should non-smokers have to pay for the medical bills of smokers in a publicly-funded healthcare system, or should the smokers have to cough up the dough?


Anonymous Anonymous said...

I think it makes sense for smokers to have to pay for it. Smoking tabacco is outlandishly unhealthy. If someone wants to smoke then I'm all for it, but I don't expect to have to pay for it. Unless of course they are willing to cover my losses as I learn how to juggle expensive China.

02 November, 2006 00:14  
Blogger Mookie said...

I agree. A friend mentioned that they already have to pay taxes on every pack of cigarette they buy, which would be the most effective way to pay for the health costs. Another friend told me (and I have yet to verify this, but it makes some sense) that every $5 pack if cigarettes costs society $7, so even with taxes and such, it is still a net loss to society. Also, tobacco farming is hideous. Tobacco depletes almost all the nutrients in the soil. I used to be a smoker, and every once in a while will enjoy a tobacco product (hookah), but to be a full-blown pack-a-day smoker is far too damaging and costly.

The smoking friend mentioned earlier suggested that they would not like to pay for someone riding a motorcycle, because one of their relatives died in a motorcycle accident. The relative had some kids and was divorced, so now they have to find a new caretaker. My friend thinks it was irresponsible for their dead relative to ride around on a motorcycle, least of all without a helmet, because of who and what was relying on them . I made the same case with cigarettes, and suggested that it is not fair for people to have to lose a friend or relative to tobacco use. If one doesn't quit smoking for their own health, they can at least think of who else may benefit by having them be healthy and long-lived.

02 November, 2006 08:02  
Blogger Drunken Tune said...

If the Amish pay the Social Security tax today, nonsmokers should pay for smokers in a publicly funded healthcare system. No group should be exempt from the pool, even if they have a good reason for exemption.

Everyone's got a good reason not to pay for someone else: there’s their religious faith, their personal beliefs, their life choices, or who they are. They might really be better than the other person, morally, intellectually, or physically for all we know!

Should I pay taxes if I think taxes are wrong, and I don’t really affect the system? Hell no, I say! Should I pay less healtcare taxes if I don't smoke, or am not fat, or don't have cancer? I'd like to say yes; yet, even if the reason is valid, I should have to pay. We've all got excellent reasons for not doing things. I know I do, and both of you do too.

At least, that's what I think. I could be wrong.

02 November, 2006 22:46  
Blogger Mookie said...

"even if they have a good reason for exemption"

I'm not saying they are exempt, I'm just asking if they should pay their fair share. If they don't have to, they have less of a reason to be responsible for their actions, which means the ones that try to care for themselves are rewarded with higher medical costs. Smokers will have little incentive to alter their destructive (and costly) habits; and non-smokers will see little need to support an unfair allocation of resources. If we are to have publicly-funded healthcare, everyone has to pull their own weight.

It was suggested to me that packs of cigarettes should be made $20 a pop. Comes out to about $1 a cig. Think of the profit! And how people will really SAVOUR each puff! That's appreciation!

02 November, 2006 23:34  
Anonymous Anonymous said...

Unfortunately, the "Slippery Slope" arguments apply here as well as they do anywhere. Exemption from coverage by government fiat is a dangerous precedent.

The biggest problem with private health insurance is that lawyers and MBAs have more control over what is covered than doctors, which means the people best equipped to make medically sound decisions are subordinate to those equipped to make financially sound decisions.

If the state starts deciding coverage, they are going to exhibit the same shortcoming - most politicians do not have medical credentials.

Worse, coverage could be set based on lobbyists' agendas. For example, MADD would probably like to deny coverage to alcoholics injured in car accidents (I'm sure someone could come up with an argument that suggested the injured person's alcoholism was a contributing factor in the accident, irrespective of the person's inebriation).
The religious right could campaign for reduction in funding of counseling for homosexual teens, but might allow for funding for psychological coercion of homosexuals to adopt "straight" behaviour.

You really want the politcal mob in this country deciding your medical coverage on a case-by-case basis? Better to just assign blanket coverage to everyone and rely on statistics to even things out, rather than create loopholes and variable coverage to open the system to arbitrary exclusions through political maneuvers.

03 November, 2006 09:00  
Blogger Mookie said...


Please read the original post and previous comments before posting.

"I'm not saying they are exempt, I'm just asking if they should pay their fair share."

I don't think it's fair that I should pay so people can smoke consequence-free. The slippery slope argument goes both ways. If smokers get coverage at my expense, then so do grotesquely obese people (non-thyroid), so do people that get diabetes from eating too much sugar, so do alcoholics, etc. I don't care if people want to do these things to themselves, I just don't want to pay for the extra costs. Most of these things can be resolved by taxing unhealthy products, which puts the blame where it ought to go: on the consumer.

Blanket coverage, yes, but not blanket costs. If I do everything right health-wise, and the gluttonous slob does everything wrong, but we both pay the same, I get less for what I paid, and the slob gets more. This is not FAIR.


I'm left as can be, but I can't stand this mentality that suggests that people don't have to be responsible for their actions. This is one of the few "conservative" arguments that has any viability, especially in this situation.

Indiscriminate Nanny Healthcare:
"You don't have to pay attention to what you do to your body, someone else will pay and take care of you!"

Gluttonous slob:
"Good, I was a afraid I would have to alter my behaviour, but now I know I can do whatever I want and not have to face the consequences - everyone else (especially the responsible ones) gets to do that for me."

03 November, 2006 09:23  
Anonymous Anonymous said...

Hmm, I think Drunken Tune makes a good point. I run every week, lift weights, and don't really eat much sweets or greasy food. Should I be able to apply for a discount on my medical costs? With perhaps only a slight exaggeration, my lifestyle compared to the average person may be similar to the difference between an average person and a smoker. If they start making exceptions, there are plenty of other legitimate exceptions that they would need to make. Also, what if the person smokes a pack/month, rather than 2 packs/day?

In principle, I guess I do agree that people who take care of themselves better shouldn't have to pay as much. But at the same time, the cost for providing medical care for all, regardless of condition, is rather inexpensive when you consider how much wealth our country has. Perhaps it's worth more trouble to differentiate than not to. Part of the strategy for those who don't want any sort of public healthcare system rely on us being divided by our differences. To make progress we may need to remain united.

03 November, 2006 11:10  
Blogger Mookie said...

I think it's vacuous. People should be rewarded for being responsible. I think consumers need to pay attention to what it is they are buying and putting into their bodies. Indiscriminate healthcare removes the responsibility from the consumer and puts it on the (perhaps more responsible) tax-payer. Paying taxes on luxury items that make people sick seems like a fair equalizer. The consumer ends up paying for the damage they do to their own bodies, but there is no need to meddle with the healthcare system to differentiate, nor for responsible people to complain. I can have my home-made-from-scratch organic carrot cake and eat it, too.

03 November, 2006 11:20  
Blogger Sylvana said...

Just a thought from someone who has paid into health plans through various companies for years. It is extremely frustrating to those of us who very rarely need a doctor, and who never need high maintenance to know that co-workers who have blatantly abused themselves with cigarettes, excess food, etc., use thousands of dollars in benefits. I have had my premiums increase when a few employees racked up the costs. Believe me, it is not pleasant to see a big chunk of my paycheck disappear. What I would like to see in company-sponsored health plans would be a rebate system, where at the end of each year, I would get a little check. There would be no "punishment" for those who racked up costs. Back many years ago, there was a sort of sliding scale, based on some sort of demographics/statistics, ie, a single man/woman in their 20s paid $10 a month, and it went up based on age/marital status, etc. I think those days are gone. I am sure it is because the system needs more funds to cover the rising health-care costs and the many new health problems related to obesity and general ill-health due to the deplorable diets of most Americans. I don't think we will see sliding scale payments anymore, but rebates would be nice. When small companies provide health care, one person with extensive cancer treatment due to cigarette abuse can be so costly as to force the company to reevaluate the health plan. The more people in a company who have costly treatments, the higher the costs will be to everyone else. The insurance companies are, after all, a profit-based enterprise. And since this country does not have universal health care, the working class relies on company health plans. So there is a bit of resentment when a smoker receives expensive treatment. The same goes for treatments related to obesity.
As much as we care for our fellow man, we still wish things could be "fair" for all and that everyone would be considerate of the community as a whole.

05 April, 2007 21:00  

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