Bad health Condition: Obamacare

I just saw an article reminding me that Obamacare authorizes a surcharge / penalty for up to 50% of the insurance premium for smokers.  When companies began doing this in 2011, the New York Times was unhappy: They rolled out an attack focusing on Walmart.  They were aghast, calling it “a shift toward penalizing employees with unhealthy lifestyles rather than rewarding good habits”:

When Wal-Mart Stores, the nation’s largest employer, recently sought the higher payments from some smokers, its decision was considered unusual, according to benefits experts. The amount, reaching $2,000 more than for nonsmokers, was much higher than surcharges of a few hundred dollars a year imposed by other employers on their smoking workers.

And the only way for Wal-Mart employees to avoid the surcharges was to attest that their doctor said it would be medically inadvisable or impossible to quit smoking. Other employers accept enrollment in tobacco cessation programs as an automatic waiver for surcharges.

“This is another example of where it’s not trying to create healthier options for people,” said Dan Schlademan, director of Making Change at Walmart, a union-backed campaign that is sharply critical of the company’s benefits. “It looks a lot more like cost-shifting.”

Yes, evil Walmart.  But when this article was written, Obamacare had already passed, and was already much worse: As of January, a 60-year-old smoker will be paying more than $5,000 per year more than a non-smoker.  This is, according to the Obama administration, because smokers cost so much more in medical interventions.

That struck me as odd, because I do medical cost research on a regular basis. That question is not at all “settled science,” and it took only seconds to turn up this research:

Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

In sensitivity analyses the effects of epidemiologic parameters and cost definitions were assessed. Until age 56 y, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs.Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions.

In other words, non-smoking, non-obese “healthy living” people had the highest medical care costs, because they lived longer. Obese people were less expensive, and smokers were the least costly in health care expenditures.

This was based on data from the Netherlands, but the general principles have applicability here.

But at least the Obama administration gets to apply a regressive health care tax on poor people — the ones most likely to be smokers and/or obese. This is the same sort of “regressive tax” punishment that the Obama-inflicted high energy costs do to poor people. The fact that assertions are made based upon poor science, or completely contrary to research, is hardly surprising from this administration. Here’s an encapsulation of their approach to behavior modification:

National obesity rates are essentially static, and public health campaigns that gently try to educate people about the benefits of exercise and healthy eating just aren’t working, Callahan argued. We need to get obese people to change their behavior. If they are angry or hurt by it, so be it, he said.

Notice that they would never take this approach with welfare — which has placed tens of millions of people in generations of poverty and crime.  It is sad — and it is expensive. When will the New York Times rage against the administration for yet another attack on the poor?

===|==============/ Keith DeHavelle

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