A new Dutch study reports that smokers and the obese actually cost less over their lifetimes than healthy people. This somewhat discredits the commonly bandied-about assertion that active, healthy people reduce a nation’s medical costs because they stay out of the hospital.
Before you get too excited – the study is a far cry from a free ticket to start in on a smoking and eating binge-bender. The reason that smokers or obese people spend less on health care is that they die off quicker. Although a smoker or an obese person has significantly higher health costs per year, their lives are shortened enough that their total expenditures are less.
"It was a small surprise," Pieter van Baal, an economist at the National Institute for Public Health and the Environment in the Netherlands, told the International Herald Tribune. "But it also makes sense. If you live longer, then you cost the health system more."
From the International Herald Tribune:
On average, healthy people lived 84 years. Smokers lived about 77 years and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than the healthy people.
Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on. The cost of care for obese people was $371,000, and for smokers, about $326,000.
The study focused only on health care costs associated with obesity and smoking; it did not address other behind-the-scenes costs such as lost economic productivity due to related illnesses.
If we really are to have a national health care program in the US, and expense is the primary concern, we should keep encouraging cars, building highways, and pushing cigarettes and fast food to keep the population dying off young.
This study very much reminds me of an NPR piece from 2006 entitled Ride a Bike, Ruin the Environment. The premise is similar – because people increase their lifespan by bicycling (10.6 days per every year of cycling, according to a University of Pennsylvania study), they’re around to do more environmental impact.
Although bicycling accidents happen, as we pointed out in a previous article, it’s more dangerous to NOT ride a bike. In a nutshell: the health benefits of cycling dramatically outweigh the danger of bike accidents.
(Professor Karl T.) Ulrich acknowledges the paradoxical nature of his argument. "As a society, we value longevity more than long-term environmental impact," he writes. "If we did not, we might provide incentives for risky behaviors such as smoking, drug abuse and driving without seat belts."
That might be an enticing idea for the beleaguered tobacco industry. "Smoke Marlboros and Save the Environment."