Great picture from a NEJM article showing a continuing reduction in American tobacco consumption, a decline that accelerated during the Obama years. (Irony – Obama was a smoker during much of that time!)
My question – What would this look like if you added in all the people using e-cigarettes?
Cigarette smokers have rights. No one should be able to tell an adult that she can’t spend her hard earned money on cigarettes. But non-smokers have rights, too. Specifically, they shouldn’t have to pay to subsidize health care costs of people who choose to smoke. In fact, smokers hurt non-smokers by racking up health care expenses brought on by the hazards of their habit.
The folks behind Obamacare thought they’d figured out how to respect everyone’s rights, by giving healthcare insurance companies the ability to charge higher premiums – a surcharge – for smokers, up to 50% higher in some parts of the country. The idea is simple: smokers have the right to smoke, but not the right to pass on the increased cost of their health care to others.
The idea is also dead wrong. Higher insurance premiums price smokers out of insurance markets. When an uninsured smoker gets emergently sick, that means hospitals and clinicians don’t get reimbursed, which forces them to pass those costs on to people with insurance. When insurance companies price smokers out of their products, we all pay.
Fortunately, there’s a simple solution to the problem. To appreciate the solution, let me expand on the flaws in healthcare insurance surcharges.
(To read the rest of this article, please visit Forbes.)
The National Health Service in the United Kingdom has recently disseminated a wonderful graphic, helping people understand how likely they are to die from scary things, like war and airplane accidents, versus less terrifying but deadlier hazards, such as high blood pressure and high cholesterol: In behavioral economics, we talk about something called the “availability heuristic,” a fancy term meaning – when we try to guess how likely things are to happen, we use as a simple rule of thumb how easily instances of those occurrences come to mind. Things that come easily to mind, we assume, are more common. It’s easy to think of airplane accidents, because they’re covered in the news. Nothing newsworthy about a 90-year-old man dying from smoking related illness. This graphic is powerful, because it acts as a visual reminder of what we really ought to be scared about.
We’ve done a lot of things in the United States over the last few decades to curb tobacco consumption. We’ve warned people cigarettes will kill them, created persuasive ad campaigns to scare people away from cigarettes, and added a hefty tax to the product. As a result, cigarette use in United States is lower than it has been in decades. Which means one thing – to maintain profits, tobacco companies need to get people smoking elsewhere in the world. And their efforts seem to be coming to fruition, based on this picture from the Wall Street Journal, which I learned of through Conrad Hackett, twitter handle @conradhackett, from Pew research. Tobacco companies have a legal right to promote and sell their products in most countries. It’s just unfortunate their promotion and sales efforts are so successful.