Tag Archives: healthcare

Smoking Bans Will Cause Healthcare Costs To Rise Even More

NPR has an article highlighting two studies which show that indoor smoking bans have a big effect on people’s health:

  • The first study focused on a Minnesota county that banned workplace smoking and found that heart attacks dropped by a third within a year and a half of the ban
  • The second one was a meta-study which concluded that smoking bans were likely the reason for a drop in heart attacks and strokes by a sixth and of lung diseases by a quarter.

Photo by RawMotion

As we saw before, heart attack, cancer, lung disease and stroke are the top four causes of death in America, and together are responsible for 57% of fatalities. Smoking is a factor in all of them. Politicians and anti-smoking advocates are quick to point out not only the public health benefits of smoking bans, but also the financial savings due to all the health care that’s not being provided anymore. (The same holds true for food taxes and bans, like Hungary’s junk food tax.) At first blush, that makes sense, because if people aren’t having heart attacks and strokes, they won’t need as much care. And in the short-term, that may be true. But what is often forgotten is that everyone grows old, and aging is far worse for your health than smoking: over their entire lifetime, a smoker’s healthcare is estimated to cost about 326,000$, but because the non-smoker will live longer, their bill will run 417,000$ — 28% more.

Therefore, it’s crucially important for everyone to realize that in this age of health and budget consciousness, the two goals of living longer and spending less on healthcare are very much at odds with one another. Without any improvement to the health status of the population, healthcare costs are predicted to increase even beyond the currently oppressive levels. Almost half of our government expenses are currently used by two agencies specializing in geriatric care: Social Security Administration and Department of Health and Human Services, which includes Medicare. With half of the states in the union having already enacted comprehensive smoking bans, those agencies’ budgets will only need to go up, and eventually, most of the government’s function will be simply to care for the elderly.

See also:

From The Archives of Internal Medicine and Circulation, via NPR

How To Celebrate Universal Healthcare

a Text From Last Night

 

In economics, this is known as the Peltzman Effect. In psychology, it’s called risk compensation.

 

From Texts From Last Night

Scoundrel Doctors Driving Up Healthcare Costs

Just like some doctors are noble and work at free clinics, some doctors are greedy and get into the business to buy mansions and join country clubs. And what better way to make money than to follow in the steps of the great Andrew Carnegie and create a vertically integrated business? Then, instead of making no money when you send Ethel to get an MRI, you can send Ethel to your very own MRI machine and not only bill the insurance company for seeing the patient, but also for administering the MRI! Brilliant!

And then, what if every now and then, you erred on the side of caution and maybe sent a couple of patients to get MRIs when they probably didn’t need them, but hey — it’s better to be safe than sorry. After all, the insurance company or Medicare will pay from their crazy money hoards. Right before they raise all our premiums and taxes.

Jay Karnes in an MRI on House, M.D.

 

That story is what a new study is toeing around; it found that the doctors who had a stake in the MRI machines were about twice as likely to needlessly send patients to get MRIs. In other words, 42% of the MRIs they ordered turned out to be negative, but only 23% of the ones ordered by doctors who had no financial interest in the MRI machine.

If the patients were driving the requests for unnecessary MRIs, via demands that they’d rather be safe than sorry, both the doctors that own MRIs and the ones that don’t should have roughly the same number of negative results. So clearly, what’s going on is that much like some banks, some doctors are just padding their own wallets at everyone else’s expense. Oh, and this has been going on for over 20 years.

From NPR

Not Living In A Nanny State Is Now A Radical Idea

On Monday, eight Republican presidential candidates showed up for a Tea Party debate in Tampa, and Ron Paul The Libertarian was among them. Everyone’s favorite CNN anchor, Wolf Blitzer, moderated the event and asked Ron Paul the following question:

“A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it.

“Who’s going to pay if he goes into a coma, for example? Who pays for that?”

Ron Paul’s answer was along the lines that freedom is all about making your own choices and taking the risks (and rewards) associated with them. But since his choice was to not pay for insurance, do we let him die? His answer was that it’s not the government’s job to take care of him, and pointed out that when he started practicing medicine in the ’60s, before Medicaid, people in the hypothetical guy’s position would get taken care of by family or charitable organizations like churches. Which is a very important distinction that’s been lost recently: government is a subset of society, not society itself. In other words, when Blitzer asked the question

But Congressman, are you saying that society should just let him die?

what’s important to note is that it is not the same question as “should the government let him die?” The government is not the one and only institution in the country. As a society, of course we should not let him die, but as Ron Paul pointed out, that doesn’t automatically mean it’s the government’s job to help him. Other institutions, like charities and churches, have a specific mandate to help those in need and rolling their function into the government’s purview should not be a foregone conclusion.

Naturally, a lot of people in the authoritarian left are up in arms about Ron Paul’s answer, because to them the nanny state is the ideal solution. And to their credit, it does seem like an attractive one: instead of paying taxes AND health insurance, why not just pay taxes and have the government handle everything? It’s a lot less of a headache for everyone, plus no one falls through the cracks. Of course, there are a couple of problems with this line of thinking:

  • The same logic is easily extended to other services. Besides healthcare, we all need food and shelter, so instead of paying rent and groceries, why not just pay more taxes and get those things for free? Imagine having a guaranteed house and being able to walk into a grocery store and walking out with whatever you need without ever pulling out your wallet. If we all paid 80% in taxes and got all the essentials paid for by the government, we wouldn’t have to worry about anything, and still have walking-around money. Except, who decides how good of a house you get, or if you can get Nutella at the grocery store, or how often you can see a doctor? Your mom the government, not you. And how hard will you work, knowing that you won’t get a better house, food or health plan because you’re working harder? The reason America won World War II and the Cold War was because of our fantastic economy, and nothing else.
  • Over the past 50 or so years, Western governments have generally been good. They more or less do what’s right for the people without crushing too many freedoms. So we tend to live in that bubble and forget that this is an exception, not just with respect to other present-day governments (China, Iran, North Korea, Cuba, Venezuela, Saudi Arabia), but to human history (the Roman Empire, the feudal system, the Soviet sphere, Nazi Germany, etc). And without the proper safeguards in place, there is absolutely nothing to keep good government from turning evil.

Take a look a Venezuela: Chavez turned it into a nanny state by nationalizing the country’s profitable oil industry and using that money to pay for all kinds of social programs. Then he basically installed himself as dictator. Would it have been as easy for him to take power, were it not for the fact that the entire population depended on him for everything from healthcare to food subsidies?

Historically, Americans have depended on their government for very little besides national defense. But since the Great Depression and the idea of a safety net that arose from it, that has been changing a great deal. We now depend on the federal government for retirement, food subsidies, student loans, mortgages, highways, and for a large and growing number, even healthcare via Medicare, Medicaid, and the VA. And the more and more services that get added to the government’s menu, the harder it will be to slap away the hand that feeds us.

The policy of the American government is to leave their citizens free, neither restraining nor aiding them in their pursuits. (Thomas Jefferson)

We’ve come a long way from Thomas Jefferson. Below, is the video of the exchange between Blitzer and Ron Paul, who will not be the next president, if for no other reason than he does not look presidential.

From NPR

Hungary Introduces Misguided Fat Tax

At the beginning of the month, a new law went into effect in Hungary which adds a 10 Forint tax (about 5 cents) to junk food, “products with high sugar, salt, and/or caffeine”. The stated reason for this tax is their appalling 18.8% obesity rate (which is still lower than the lowest American state), so the extra millions this tax will generate will go to the state health care system, because according to their Prime Minister, “those who live unhealthily have to contribute more”.

 

Hungarian dobos torte, from the Café Gerbeaud in Budapest

 

All of which would be well and good, if not for the fact that healthcare for fat people is cheaper. The biggest healthcare costs are associated with old age, when regardless of how healthy you are, you’re on all kinds of pills and in and out of the hospital more than the movie theater. And while fat people do cost more in healthcare up to old age, the fact is they die at a younger age than healthy people. The result is that over their lifetime, healthy people cost about 420k$ while obese people only cost 370k$. So what the Hungarian government is doing via this tax is exactly the opposite of what they want: they’re adding more costs to their healthcare system by creating an incentive to be fit.

Now, is it bad to be healthy and fit? Of course not. It’s just their reasoning that’s backwards. If they were actually being altruistic and said “we don’t want our population being fat because… ewww. And we’re willing to pay higher healthcare costs for it”, that would make perfect sense. But taxing fat people because they cost the healthcare system more is like putting an air travel tax on housewives instead of business men.

Hungarian Parliament Building on the Danube

 

To be fair to Hungary, it’s not the only country that taxes junk food — it’s just the newest, and their law is the most comprehensive. But Denmark, Finland, Switzerland, Austria and other countries tax things like soda and candy and ban trans fats.

And on a different note, this kind of story is a big part of why many Americans are against a national healthcare system: once the government is responsible for the costs of healthcare, it can also pass laws to lower those costs. At least half of Americans don’t like their government also doubling as their nanny and telling them they can’t eat Pringles because trans fats have (erroneously) been banned to keep their health costs down.

A government big enough to give you everything you want is a government big enough to take from you everything you have. (Gerald Ford)

Not that the lack of a healthcare system is much of a deterrent — New York City, Philadelphia and other places in the US already ban trans fats. And the federal government has been wrongly banning things for a century; for example, absinthe was banned from 1912 to 2007 because it caused epilepsy or hallucinations or madness, depending on who you asked, when in reality it does none of those things, or anything particularly bad.

From Spiegel Online, via Reddit and Neatorama