Want to Save Health Care Costs? Then Subsidize Smoking


Now for a Big Gulp

I was provoked to bring up this topic one more time by a report in today's Washington Post that describes various ways in which the Obama administration is fiddling with health insurance as the age of Obamacare dawns. In particular, the Post reported:

…the law permits insurers to set their premiums for tobacco users 1.5 times higher than those for non-smokers.

It is well established that, on average, the amount spent on smokers' health care is less than that spent on people who watch their weight and regularly visit the gym. For example, back in 2008 the New York Times reported the results of a Dutch study in PLoS Medicine:

The [lifetime] cost of care for obese people was $371,000, and for smokers, about $326,000….Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.

Basically, the smokers and the fatties died much younger and saved both private and government insurers a lot of money.

OK. Higher premiums might be justified on the grounds that before the smokers and the hefties shuffle off this mortal coil, they may increase the costs of an individual health insurer in advance of enjoying the delights of Medicare. But for those folks who are forever insisting that the whole country adopt a single payer (government) plan because it will allegedly save money, the evidence suggests that they really might want to look into subsidizing cigarettes and carbs.