The article certainly draws conclusions that the research doesn't. [0]
It seems to be that the obese and smokers do cost a lot more on the healthcare system - however they also die earlier, and so the net cost ends up being less.
> Nevertheless, these findings suggest that although effective obesity prevention reduces the costs of obesity-related diseases, this reduction is offset by the increased costs of diseases unrelated to obesity that occur during the extra years of life gained by slimming down.
However, it doesn't seem like government funding into prevention or research were also tallied into the costs of the illnesses, which are not inconsiderable.
He brings up some interesting points, but he closes his article writing, "Those who die young save health care systems money, not cost."
Yes... if everyone died, including the smokers, governments would effectively cut healthcare costs to 0. Thats not how public health systems work though.
Usually, there's a medically expensive period before death and the burden may even begin in the productive years. Smoking probably causes higher incidence and severity of common diseases like influenza, additionally resulting in loss of labour, income and associated taxes.
It might be true that it tobacco reduces the overall health care burden because it causes people to die earlier, but it's not relevant. Setting your car on fire might also have the side-effect of lowering the operating cost of that car.
Of course it's relevant to how much governments spend. You can't simply ignore the consequences you dislike.
That doesn't mean it's a good reason not to discourage smoking, but that's because we shouldn't hinge that decision on the financial considerations in the first place.
I think there are a lot of reasons to scoff at the "but death saves money" argument. Most of those reasons have to do with the difficulty of accounting for the value of a life fully lived.
E.g., if a highly educated worker dies ten years before retirement, how much productive labor did the society that educated that person lose out on?
What about the non-paid labor that the elderly/retired often take on? "Free" child care for the grand kids, much higher rates of volunteering in churches/schools/etc., and so on.
Suffice it to say that this is not exactly a trivial computation...
I wouldn't say it's trivial, but it does probably save money overall. Highly educated workers are rare overall, and they smoke at much lower rates, so they barely count to the average. The elderly get an income enough to live off plus usually quite a lot of expensive healthcare for many other conditions - and I'm glad they do! But not for financial reasons.
Mostly in countries that have a national healthcare system, as the government has to pay directly for the harm caused by corporations to its population's health. This applies to the coal and oil/car industries, too.
However, one could argue that even countries such as the U.S., which have a private healthcare system are negatively impacted by harmful industries like these, because the citizens pay for healthcare when they could be paying for something else. But the effect is not as direct, and it may not be as big either, as the government can still profit from taxes in the private healthcare industry and so on.
Especially in USA...your last year can cost millions of dollars, paid or unpaid. Cancer treatment is expensive.
That's without calculating asthma, missed days of work, productivity loss due to feeling sick etc etc.
Now in third world countries cigarettes might actually save money, maybe. It kills quite a few before getting pensions, and healthcare is limited so you have to accept that your days are over.
This fact check gives estimates between 3 and 6 billion a year in direct health costs and possibly 14 billion in wider costs including e.g. missed work days due to illness and responding to more fires.
I think these estimates from the CDC are pretty conservative. In the US, EVERY YEAR:
"Smoking-related illness in the United States costs more than $300 billion each year. Nearly $170 billion for direct medical care for adults
More than $156 billion in lost productivity, including $5.6 billion in lost productivity due to secondhand smoke exposure"
A major way (the only way?) to curb tobacco usage is to simply increase taxes on tobacco usage, but politicians/bureaucracy prefers the short-term tobacco tax revenue.
Thanks for the link. CDC's reference 11 seems particularly relevant[1], although the $170 billion measure is not totally attributable to the government: from Table 3, more like $108.4 bil between Medicare ($45.0 bil), Medicaid ($39.6 bil), and other federal programs ($23.8 bil; e.g. Tricare, VA health benefits, etc.). The paper's data set and method of extrapolating portions of healthcare expenditures attributable to smoking does raise an eyebrow at first glance, but I've admittedly not dived deep enough.
EDIT:
> A major way (the only way?) to curb tobacco usage is to simply increase taxes on tobacco usage...
If by curb you mean reducing the number of new adopters proportional to overall population, I agree and would support such a measure. As a former smoker and current smokeless tobacco user myself, I'd say those of us who fell for the trap are fucked six ways from Sunday; as much as I'd like to quit, my mind and body are way too dependent on nicotine to function effectively on a day-to-day basis. I'd need roughly 3 months of leave and a lot of mindless distractions to drop the habit. A significant increase in per-unit cost for no apparent reason (like 2-3x overnight) would probably work too...like a proverbial slap to the face that would incite just enough outrage on the merits to serve as an effective distraction, hopefully for long enough to allow physiological dependencies to permanently fade.
