Ummm... Amy, we guys have a campaign for prostate cancer awareness...

...but nobody's sure where to wear the ribbon!

-----

"The extra cost would reduce smoking through economic reasons..."

No. Again, be consistent. If a lack of cheap, safe drugs is the reason for the immense ilegal drug trade, a lack of cheap, quality tobacco, a drug, will result in illegal tobacco trade. There is a reason the Federal agency is named The Bureau of Alcohol, Tobacco, Firearms and Explosives.

Of course, if this man is right, then the expense of illegal drugs reduces their use. How is that bad? Note that violations of the 4th Amendment by police accompany, but are not caused by the presence of drugs.

As for smoking, add this to your repertoire of questions regarding national health care:

Would this be the same level of government responsibility shown by the states, who subsidized tobacco while their own health departments were telling them how it kills people?

You should wonder how the states were not a defendant in the tobacco "settlement".

Cigarettes are over $7 a pack in some states. Smoking is not dropping at any significant rate.

But get Obamacare, and you too can spend the rest of your life with a broken ankle unless you quit smoking.

"The extra cost would reduce smoking through economic reasons..."

I don't agree with this silliness, either, but I posted it because of his contention that much of lung cancer is self-caused.

I don't smoke and never have, but at some point we are still a free people.

Dr Dave goes as far as I am willing to go. People who make risky decisions do not have the right to force me to pay for the consequences. Beyond that, we are free to do as we wish with our lives.

I started smoking as a young kid who wanted to look cool. When I realized it wasn't as cool as it seemed, I had a very rough time quitting. Most people don't start smoking in hopes of losing their lung or getting heart disease. When I was younger, we could smoke everywhere. Standing in the line at motor vehicle? Light up. Work? Forget cigarette breaks, we just lit up at our desk. An after dinner smoke? No problem, the waiter would bring a light. None of that is possible anymore and that's a good thing. I just don't know that taxing cigs any higher is a good thing. A pack here in NY is $8. I don't expect non-smokers to pity the smokers, but isn't that enough already? I don't see a tax being raised on beer to prevent all the drunks from smashing into other people let alone developing alcohol related diseases. And considering the massive cuts our county has seen, I'm wondering where all these cig tax dollars have been going since the last increase.

My dad has been smoking for 60+ years. He had to quit for a little while earlier this year, and I thought he quit for good, but no, he's smoking again. Not as much as he was, though, but still. He's 77, has been smoking since he was 15, and does NOT have lung cancer, amazingly enough. He's got acute emphasema(sp?), and that's it. On the other hand, I knew a woman who never smoked, came from a family of non-smokers, and she died of lung cancer. Go figure.

And not for nothing, but I think 70-year-old men should get GREEN ribbons, especially if they served in the military! o.O

"People who make risky decisions do not have the right to force me to pay for the consequences."

Excuse me, but what's a "risky decision"?

Something someone else does? Merely living in California?
Do you deny medical treatment to a guy with an otherwise spotless driving record because he was 10MPH over the speed limit when he crashed? 15MPH?

If you don't decide this, someone else will do it for you. I'm pretty sure you won't like the result.

Pay your own way just this much and you decide what risk to take.

Every claim made by Dr. Dave is a lie.

Not smoking will not cure lung cancer. You can't be cured of lung cancer by quitting smoking and the fact that you don't smoke won't cure you if you contract it.

Mortality from all cancers would not be reduced by 50% by not smoking. This is simply false.

And 90-95% of lung cancers are not known to be caused by smoking. About 15% of cases are among non-smokers. The ACS's own numbers are in the 80% range, and that's for an association w/ smoking. So again, he's just making shit up.

And his claim that investing in lung cancer drug research is worthless because it will only ever prolong life by 4 months at most is another lie.

There are a few very expensive end-of-life cancer drugs that fit this description (e.g. http://online.wsj.com/article/SB124630681515869963.html), but they're not representative of all cancer drugs in use or under development. And Dr. Dave has no way of predicting what new drug research may yield.

At this point I'm going to go out on a limb and bet that Dr. Dave isn't a medical doctor.

One last point. It's absurd to claim that a $4 a pack cigarette tax will simultaneously reduce smoking and also fully finance insurance for the uninsured. It's not enough even if there's no decrease in smoking. Again he's just lying.

I'm not defending smoking here. I'm just really sick of being lied to regarding public health issues.

"People sometimes make bad driving decisions, but billions of people drive without getting into terrible accidents that cost others for their medical care."

So starts a reply that doesn't answer the question: Who decides? It engages a fallacy, instead.

And wait just a minute. In 2008, through October, 31110 people died (dunno how many are hurt) in car crashes, and this is down because of gas prices. This is good, how?
What were these people doing? Do they get medical care withheld?

Hey, if a cigarette tax will save cancer deaths, a gas tax will save people from crashes!

We can simply price our way to perfect health and complete safety!

Here's an article, with video, explaining some details about motorcycle helmet fitting. There's a chunk in there about a Grand Prix rider crashing at big speed (170+) and not even being knocked out; you can watch his head hit the racetrack a few times. His $2000 custom leathers, $600 helmet, $300 boots and physical conditioning program put Shinya Nakano back to work in a couple of hours.

How does that fix an idiot pulling out in front of a kid on a dirt bike or a mom on a scooter? You notice the loud Ninja or Harley, but that's not everybody.

Hmm. Have you ever heard what kills car drivers most often? Head and spinal injuries. You should be wearing a helmet. You should have your car regulated by GPS to the speed limit. You should have controls in the car which prohibit you from doing other things, like eating, talking on a phone, etc.

All of these things are possible when you let someone else decide.

Again: if you pay, you get to decide. If you don't, then the clerk will.

Chances are, the clerk will look at bicycle stats and ban them. Get ready.

People need to drive. Nobody needs to smoke (save for the odd schizophrenic self-medicating, as I recently learned).

Amy: No, I don't want to force you to wear a helmet -- I'd just like you to pick up the cost of riding a bike without one.

I don't have stats handy to back this up, but something to think about: On average, the medical costs associated with a motorcycle accident victim who is wearing a helmet are greater than the costs of those who are not wearing a helmet. Why? Because it doesn't cost as much to store a dead body as it does to keep someone alive/fix their mangled body.

And I read in the LA Times today that a church in South Central has received a $500k grant to teach African-Americans about nutrition.
I believe deeply in government, good government, but there are times....still, the phony "libertarians" piss me off. I wonder how Amy "Bozo Hair-do" Alkon will pay her health insurance from age 55 to 65? I mean, it's going run a grand easy per month, and that is if everything is clear. And by age 60, we are talking $2k--every month.
I suspect Ms. Bozo Hairdo (Or should I call that a "hair don't") will be crying for federal help. Hey, I want all the subsidies I can get, and the lowest taxation also. And no military service.
And, I want a $500k grant to teach some people about nutrition....

If they were allowed to, health insurance companies would undoubtedly alter their coverage to account for people who engage in cost-increasing behaviors like smoking and riding a motorcycle without a helmet. And they should be allowed to, and we should be free to choose to engage in behaviors that other people consider risky. And, finally, the system should not penalize you because of the risky behaviors that I choose to engage in.

"And most people don't see(k) out the most deadly car they can find, then buy it."

Buyers don't look for the worst, they look for the best if they look at all. For years, the worst was the Chevy S-10 Blazer, but there was no shortage of buyers because the damned things worked well. There is also a blanket ban on towing U-Haul trailers with Ford Explorers (ditto of the Blazer) here in the Southeast because of a trailering accident; other vehicles in the class, like the Blazer, Isuzu Amigo, Pathfinder, etc., have no such ban. The medium sport-utes are nice, but they don't take kindly to idiot driving.

Nice Poe, i-hole. Snore.

"People need to drive."

No, not as much as they do. Fatalities are down precisely because leisure driving is down.

Think a minute about "knowledge workers". The bulk of them only commute because of a power structure that cannot imagine being in control unless they can command personal attendance. I can do more than 80% of my work with industrial design impacts from my house, but I have to drive 26 miles to work because my bosses say so.

Smokers are already funding insurance -- new tobacco tax rates became effective April 1, 2009. The cigarette taxes went up 158%. Loose tobacco for roll-your-own went up 2,159%.

That was on top of the state and local sin taxes and the amount smokers were already being charged to fund the tobacco settlement with the states -- that the states have already raided.

And you still want to throw more on top?

How about this -- if you are over BMI -- you get taxed.

How about taxing the hell out of sugar and HFCS?

Obesity causes diabetes and other heart conditions as well. It is just as preventable as cancer from smoking. Lose weight, eat better. You are paying as much for that risk as you are for smoking. But where is the sin tax for being fat?

I would like to see the non-smokers get back the health insurance dollars being used on smokers through a $4/pack health insurance tax.

This is completely preposterous.

Everyone dies. On average, roughly 50% of a persons life cycle medical costs come in the last six months of life (excluding death by various forms of violence to the body), no matter what disease is the culprit at the end.

Agreed, smoking is stupid.

But eliminating smoking will not change the cost of health care one iota.

It will, however, make Social Security insolvency worse.

(Sometime ago, some non-smoking economists calculated that the smoking induced cost to health care, under the most generous assumptions, was no more than twenty-five cents a pack.)

But eliminating smoking will not change the cost of health care one iota.

Yes it would. The cost to everyone else will go up as well since the smokers are no longer funding SCHIP. ;-)

Jim P.

Yes it would.

I have to admit, you got me there.

Amy, I'll make a deal with you. You give up your Ritalin and I'll agree to another $4 a pack tax on my cigarettes.

The real truth is that you, alone, are more of a drain on the healthcare system than I will ever be and I smoke 4 1/2 pack a day.

Wanna bet? Add up how much you pay your HMO vs how much use take from it. Me? I haven't seen a doctor in 7 years.

Will I get lung cancer? Probably. But I'll die before I ever get to Medicare.

Meanwhile, we'll all be paying for your Ritalin when you're 80.

Do you have any idea what lung cancer costs? Any idea?

The same as most other diseases that kill you, and less than the rest.

And the cost to your friends is the same, either way, and it happens at about the same time.

For those who are already smoking in their twenties, and continue until they die, the average lifespan 81 years for women, and 72 years for men.

For never smokers, 88 and 80.

Yes, smoking takes some years off of life. Yes, it is a stupid habit (speaking as a never smoker).

But the notions that smokers cost more, or that smoking causes conspicuously early death are wrong.

You'll all be paying for my Ritalin? Please.

Well, yes, we all do. Insurance is pooled risk, after all.

Damned foolishness.

Lets say we go with the "only pay for your own mistakes" type model. Sounds great in theory.

But then we get into the whole deal about calculating odds, diet regimens, and all sorts of other crap. The end result will be a close watching beaurocracy that is intrusive as anything else we presently bitch about.

Like waffles for breakfast, and you put syrup on it? Well, you didn't use low fat syrup and whole grain waffles, and you use butter too, well then no insurance for you. True that is a bit of an "extreme" possibility, but tell me something run by committee that is not carried to a logical absurdity?

Insurance SHOULD offer discounts for preventive self care, it SHOULD offer programs that cover preventive tests & other coverage.

But the further you carry these arguments for self paying, the further we go into intrusiveness into one another's private lives and personal pleasures.

I like to smoke, but I don't do it much. I smoke a cigar or three between 1 & 3 times per month. I also exercise rigorously. I bicycle everywhere, no less than 12 miles per day not counting intensive physical training 5 times per week as part of my job, nor my off duty exercise done on my own time, from swimming to lifting.

I also happen to enjoy waffles with lots of butter & syrup.

I don't cook (kitchens are my kryptonite) so I either order out, cook a tombstone pizza, or eat microwave meals. I'm sure y'all are aware those are not the healthiest of meals.

My point here is that our lives are not cut and dry good or bad ways to live, and any number of factors great or small can impact our health that have little to do with our actual habits.

So how do we measure our costs? How do we do that fairly?

There are limits to just how well we can do this.

I favor methods that encourage healthy behavior, I even favor penalizing people who grossly abuse their bodies and expect me to pay for it. But there is a different between the guy who goes to McDonalds to supersize 5 meals per day and then lays around the house, and the person more like myself, who simply indulges a bit here and there and is otherwise in ridiculously good shape. Should I be penalized in the same way?

And what role should family history play into all this? Should the person whose had both parents and both grandparents and two uncles die of cancer be charged the same as somebody whom has no family history of serious illness?

Its a complicated at best.

Amy - neither have the food nazis.

They'd rather have you use low-fat salad dressing where the oil has been replaced with anti-freeze and corn syrup because they believe (sans evidence (HA!)) that fat is a Bad Thing.

Amy, My 2 sons have ADD and are on medication. The insurance company makes me go monthly for check ups or I cannot refill. It obviously is a way to get money for the doctor, the insurance, and the pharmacy. It used to be every 3 months. Do you think though that twice a year is enough. Obviously you take care of yourself, but do you think that even on a low dosage, you should monitor a little more often. Then again, I'm not a doctor. I'm not telling you what to do, just curious.

When your cynicism needs to be expressed, you can go here to find a term to describe that vexing medical condition!

'Toon.

"The insurance company makes me go monthly for check ups or I cannot refill."

Hmm. Can you trust that system to get the diagnosis itself right?

They were diagnosed years ago before the insurance regulations changed. I have no doubt that my two sons have ADD and I cannot deny the positive things that the meds have done though I did fight putting them on anything. What I think is wrong is that the doctor even admits that its a waste to see them monthly, but his hands are tied because of the insurance.

I know many people who suffered accidents because of the absence of helmet.It is better to use a helmet while riding bikes.