According to a newly released Dutch study (see AP report), you can do your part to reduce medical costs by smoking and getting fat. The study found that adult lifetime medical expenses for thin, healthy people run $417,000 on average, while medical expenses run $371,000 for obese people and $326,000 for smokers.
The main reason for these cost differences is that leaner healthier people live longer than obese people or smokers. In their old age, people that have had relatively healthy adult lives tend to get diseases that are far more expensive to treat than the diseases from which their less healthy counterparts die at a younger age. One researcher remarked, “Lung cancer is a cheap disease to treat because people don't survive very long.”
This study somewhat confirms what people have long known intuitively. I once saw a cartoon depicting a decrepit old man sitting on his doctor’s examination table. The doctor was saying to him, “You know all those years you added to your life through good, clean living? Well, you’re living them now.”
Of course, an accountant’s expense estimate says little about quality of life. A neighbor friend of mine found herself in her early 50s severely limited in what she could do as the result of over three decades of smoking. She is on oxygen and can barely walk more than a few feet at a time. She hates her addiction, yet it is so strong that she still smokes after years of trying various smoking cessation programs. She might save the medical system money, but no one would argue that the savings are worth her reduction in life quality.
Similarly, obesity reduces quality of life. So does being overly thin, for that matter.
As we collectivize medical care, whether this is done through government, private industry, or some combination of the two, we effectively give everyone that must pay into the system a say in our personal health. This can lead to a bean counter approach to medical care. From a pure accounting perspective, it is cheaper if you die earlier, even if you have lots of health problems before you die.
One of the benefits cited by proponents of Dutch-style euthanasia is that it saves money. It could be said that people that make life shortening health choices are taking a long-term self-imposed approach to money-saving euthanasia. They are slowly killing themselves, but by doing so they are saving the rest of us money.
Another result of collectivized medical care is that it allows people to impose compassion by coercion. They are so concerned about others’ quality of life that they are willing to use political power to create coercive disincentives to engage in unhealthy behavior. Sufficient political power toward such an end can only be generated for whatever the current cause celebre happens to be.
This means that manipulation of medical policies and priorities can be based more on whim and passion than on sound science. This is how New York City came to outlaw trans fats in restaurants. What will the next health crisis be that warrants oppressive government intrusion in our personal lives?
Collectivization of medical care inserts the concerns and emotions (and power structures) of a whole host of unrelated people into the relationship between the provider and the patient. This reduces availability and/or quality of products/services while simultaneously driving up costs. Of course, this is all done with the best of intentions.
Compassion is a wonderful thing. But we do not have the right to use coercion to enforce our version of compassion. That kind of approach is the opposite of virtue and leads to all kinds of undesirable unintended side effects, even if it makes us feel good.