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Arizona Governor Proposes Flab Tax

Soulskill posted more than 3 years ago | from the to-be-spent-on-pork dept.

Medicine 978

Hugh Pickens writes "The WSJ reports that Arizona governor Jan Brewer has proposed levying a $50 fee on some enrollees in the state's cash-starved Medicaid program, including obese people who don't follow a doctor-supervised slimming regimen and smokers. Brewer says the proposal is a way to reward good behavior and raise awareness that certain conditions, including obesity, raise costs throughout the system. 'If you want to smoke, go for it,' says Monica Coury, spokeswoman for Arizona's Medicaid program. 'But understand you're going to have to contribute something for the cost of the care of your smoking.' Coury says Arizona officials hadn't yet finalized how they would determine whether a person was obese or had sufficiently followed a wellness plan, but that measures such as body-mass index could provide some guidance. Estimates for the costs of obesity in America range from about $150 billion to $270 billion a year. According to the latest CDC statistics, from 2009, 25.5% of Arizonans are obese, about 1.7 million people."

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Tax junk food (4, Insightful)

Anonymous Coward | more than 3 years ago | (#35717948)

Just tax junk food like is done with cigarettes, alcohol, etc. Use the tax revenues to compensate the extra medical costs.

Nope, nope, and a scoop of nope on top. (1)

Anonymous Coward | more than 3 years ago | (#35717978)

That won't work. People can still get fat on "legit" foods quite easily.
I really don't think I need to say any more on that.

The junk food approach has been dead for a long time now.
Please quit spreading it.
Over-consumption is the only thing you can target effectively.

Re:Tax junk food (1)

Joce640k (829181) | more than 3 years ago | (#35718142)

Junk food is the cart, not the horse.

Re:Tax junk food (3, Insightful)

somersault (912633) | more than 3 years ago | (#35718218)

Junk is a very subjective term. I think all "low fat" food is junk.

Revenge of the smokers (1, Funny)

symbolset (646467) | more than 3 years ago | (#35718328)

We told you this was a slippery slope. Enjoy your slide into bacon-free health.

First, is there a problem? (4, Informative)

Moraelin (679338) | more than 3 years ago | (#35718342)

Working on either solutions or explanations before knowing if there is an actual problem, is called Tooth Fairy Science. You know, the kind where you figure the market value and profits/losses per tooth type, before even knowing if there is a Tooth Fairy.

In this case, last I've seen a study based on data from an actual health insurance company, it turned out that smokers and the obese actually cost LESS. Summary, for example, here: http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html [nytimes.com]

I don't just mean on the total with pensions and all. Even just the healthcare taken separately, actually cost less. Why? Because they die earlier and need less medicine in the long run.

The problem is that you don't need the most care when you're 30. You need the most care when you're 70, and the latter is for decades if you prolong it.

The fat smokers need expensive chemotherapy or surgery for maybe a year, then die. That is, if they don't just keel over and die of a heart attack. If not the first time around, the second will get them. And that's that. While the guy who was fit and lean and never had any vices, if he lives to 100, will likely be on expensive anti-Alzheimer medication for two decades. Plus various other trips to the doctor as their body is barely functioning and getting worse by the year. The guys who died a horrible death in their 50's just saved you all those costs.

So, really, the smokers and obese actually subsidize healthcare for everyone else just by biting the dust earlier. And that's in addition to paying for a pension they won't get as much of, or at all. And subsidizing the government via tobacco taxes.

So, really, WTF? You'd think someone would at least say, "hey, thanks fatty" ;) The notion that, OMG, let's tax them some more 'cause they cost us money, is provably false, and fucking stupid too.

But it keeps happening because it's two overlapping groups of people who already feel bad and guilty about it, and have been amply proven to be easy to guilt trip some more into paying even more.

Where's my reward? (1)

yeshuawatso (1774190) | more than 3 years ago | (#35717954)

"Brewer says the proposal is a way to reward good behavior and raise awareness that certain conditions, including obesity, raise costs throughout the system."

Where's the reward? If you're on Medicaid and already fit, then the reward of the $50 is not a reward at all since you never received the punishment to begin with. Negative reinforcement only works if you're taking away something negative to begin with. Want to give me a reward, how about you tax the fatties more for FICA and give me a break since I won't be using as many services as Mr. BigMac-a-day who can't keep his hands out of anything deep fried and covered in Mayo.

aren't taxes paying for the increased cost? (0)

Anonymous Coward | more than 3 years ago | (#35717986)

i was under the impression that a lifetime smoker pays way more on average in taxes (on tobacco) than the extra cost of keeping him alive. at least this is the case in Hungary where i live.

Re:aren't taxes paying for the increased cost? (1)

clickety6 (141178) | more than 3 years ago | (#35718024)

"In 2007, the US Centers for Disease Control and Prevention estimated that the heath care costs associated with smoking were $10.28 per pack. (Lexington Herald Leader Nov 25, 2007). " Actual tax on a pack of cigarettes is closer to $1 per pack.

Re:aren't taxes paying for the increased cost? (1)

Nursie (632944) | more than 3 years ago | (#35718062)

Interesting. Over here in Australia a pack of smokes costs almost 20 dollars, so it's probably covered.

Re:aren't taxes paying for the increased cost? (0)

Anonymous Coward | more than 3 years ago | (#35718116)

You have got to be shitting me.

Re:aren't taxes paying for the increased cost? (1)

Nursie (632944) | more than 3 years ago | (#35718166)

Nah it's crazy but true.

Your pack is 25 cigarettes (I have no idea why, everywhere else in the world does 20), so that's something. But when I stopped last year a pack of 25 Marlboro gold/light/whatever you want to call them was heading north of 18 AUD in a lot of places. You could find them for 17 in a few places. I'm not sure if that tax has gone up again since then but it's going to go up again pretty soon I think.

I don't know how anyone could afford to be a heavy smoker here.

They also passed the law saying cigarettes are not allowed to be on display, so they're all in closed cupboards or drawers under the counter. And they must all be "fire safe" now, which is apparently even worse for the smoker and certainly tasted bad (for a given value of bad, I came to realise towards the time I was quitting that they all tasted bad)

I have no idea what impact all this has on the smoking rate here, but you can't say they aren't tackling the problem head-on.

Re:aren't taxes paying for the increased cost? (1)

IB4Student (1885914) | more than 3 years ago | (#35718122)

A pack is like $4 or so at Walgreens.

Re:aren't taxes paying for the increased cost? (1)

Inda (580031) | more than 3 years ago | (#35718050)

I've seen reports that state £2b is spent by the NHS on smokers each year in the UK, and £10b is generate by taxing smokers.

I see no one is mentioning drinking. I beleive it causes more ill health among the population.

Fact checking is down to the reader :)

Re:aren't taxes paying for the increased cost? (2)

Inda (580031) | more than 3 years ago | (#35718076)

(stupid /. HTML)

I've seen reports that state £2b is spent by the NHS on smokers each year in the UK, and £10b is generate by taxing smokers.

I see no one is mentioning drinking. I beleive it causes more ill health among the population.

Fact checking is down to the reader :)

Re:Where's my reward? (1)

xnpu (963139) | more than 3 years ago | (#35718000)

Indeed. I'm all for making the willingly unhealthy pay for their own care, but it doesn't seem like those who are healthy or pursue a healthy lifestyle to their best abilities are in any way relieved here. If money is not somehow earmarked, it's just going to end up in the wrong pockets at no benefit to us.

Re:Where's my reward? (1)

yeshuawatso (1774190) | more than 3 years ago | (#35718060)

If we pay less FICA for Medicaid we will benefit. Fatties are the ones whom would pay more. We get more take home pay, they get future health care cost paid for being unwilling to eat a salad every now and then.

Re:Where's my reward? (0)

Anonymous Coward | more than 3 years ago | (#35718348)

Be careful here. The term "fatties" can easily be re-defined to include just about anybody who isn't in absolutely perfect condition. That's the problem with this "I don't want to even think I'm paying for something someone else will use" mentality. I'm pretty sure you have a habit or two that somebody somewhere won't like. By adopting this kind of attitude, you're giving people an excuse to pour on more regulations of your personal behavior and choices. This isn't a left-right thing either as some allege here. Please note that it's the Republicans in this case. It'll be the Democrats next time. They seem to have no problem with regulations that annoy actual people, but when it comes to regulating things that would make a real difference, like making corporate-produced food less harmful, that neither of them wants any part of.

Re:Where's my reward? (2)

lanner (107308) | more than 3 years ago | (#35718070)

Ding ding ding! We have a winner.

Even if the funds were earmarked, they would still use them for something else. Arizona republicans think the law only applies to them other guys. They have already raided several funds that had specific uses. They don't care.

Photo unit snaps GOP party chief speeding 109 mph
http://findarticles.com/p/news-articles/arizona-capitol-times/mi_8079/is_20090508/arizona-dps-photo-unit-snaps/ai_n51711437/ [findarticles.com]

Arizona: Judge Throws Out Political Arrest Based on Photo Ticket
http://www.thenewspaper.com/news/28/2801.asp [thenewspaper.com]

Republican hu? Yea, you're free to go. I like how that last article puts it up to being a "political arrest" over the fact that he had committed a felony.

Re:Where's my reward? (3, Informative)

DamienRBlack (1165691) | more than 3 years ago | (#35718164)

Obesity does have strong correlations to health problem, but your insensitive stereotypes are rude and unfounded. Making such demeaning caricatures out of heavier individuals is simply not helping the issues. Yes, many people would reap many health benefits from losing weight, but almost as many underweight people would reap similar benefits from gaining weight.

It is always important to remember that the #1 health risk to the obese is not heart problems or diabetes, it is misdiagnosis. So many people and even doctor assume that if you're heavy, all your health problems are caused by that, and so they often miss obvious symptoms of other real, life threatening conditions. It is also important to remember that an unstable weight correlates to health problems even more strongly than obesity. Many heavier individuals are pressured by peers and doctors to lose weight, and they often attempt to do so with unhealthy means, such as various eating disorders. This often leads to fluctuating weight and other problems. If you have to choose between fluctuating weight and obesity, obesity is statistically much safer.

Not to beat a dead horse, but another thing to keep in mind is that correlation is not causation. Many instances in the statistics of obesity can be shown to involve the correlation of "I am sick, and it is making me heavy". When these cases are weeded out, the correlations become much weaker, and it becomes even more obvious that the underweight or inactive are at just as much risk as the obese.

In conclusion, you can decide, if you wish, that obesity is not a responsible way to live. I would accuse you of insensitivity but nothing more. But ridiculing and stereotyping the obese as moronic imbeciles that are out of control and grossly irresponsible is crossing the line. I wouldn't call you quite as bad as a racist, but you would be quickly approaching it. The fact of the matter is that very few of the people who are obese would live up to any of those demeaning stereotypes, and probably just as many (per capita) "normal" individuals would live up to them if you simply looked. But you aren't looking, because you are singling out the obese and deciding to throw your vile at them, when they simply don't deserve it anymore than anyone else.

Re:Where's my reward? (1)

mmcuh (1088773) | more than 3 years ago | (#35718304)

Yes, many people would reap many health benefits from losing weight, but almost as many underweight people would reap similar benefits from gaining weight.

Are you saying that there are almost as many unhealthily underweight individuals as unhealthily overweight ones? Are you talking about Arizona, USA, the developed world or the whole planet? Because for any of those options, except possibly the last one, I find that extremely hard to believe.

Re:Where's my reward? (1)

somersault (912633) | more than 3 years ago | (#35718334)

The fact of the matter is that very few of the people who are obese would live up to any of those demeaning stereotypes

Yeah, I'm sure the vast majority of them are all eating well (what I consider eating well is not the same as what Ancel Keys [stop-trans-fat.com] considers eating well btw, he was a complete fucking idiot who caused way more people to get fat and sick than otherwise), getting regular exercise and high quality sleep. Gimme a break.

I see many, many fat people walking around, but I don't see many skeletons. And the ones that are anything like skeletons in this area are clearly junkies. I agree that fat is beneficial (dietary fat especially, though you don't need a lot of stored body fat - a man can live for a month on water with just 10% body fat), and you need to be getting enough protein and other nutrients to keep your body in good repair, but it's BS to act like underweight is anywhere near as bad for you as overweight. Even just simple things like the extra strain on your joints if you have poor walking technique (as most people do - if you're not moving silently, you're transferring shock loads into your knees/hips/back) are pretty horrible.

Re:Where's my reward? (0)

Anonymous Coward | more than 3 years ago | (#35718336)

Yes, many people would reap many health benefits from losing weight, but almost as many underweight people would reap similar benefits from gaining weight.

That's an excellent point... IN SOMALIA!!!!

Start a survey of every Walmart in the US, see how many underweight people you can spot.

Re:Where's my reward? (0)

Anonymous Coward | more than 3 years ago | (#35718186)

If government say's reward, hey mean "na, not a real reward that would cost us somethiing, we mean, we gonna punish you slightly less".

Re:Where's my reward? (1)

somersault (912633) | more than 3 years ago | (#35718270)

I'll give you the deep fried bit, but if you had your burger in a wholemeal bun then you could have one slathered in mayo every single meal and not get fat. If you don't believe me, look at the Atkins and low GI type diets. I know these things are true, because I've experienced it myself, and a couple of my friends are also on this type of diet. Even the one with a really poor metabolism is losing weight.

When you add in easily digested food like fries and sugary drinks, that's when you start getting energy much faster than your body can burn it, which is when you start getting fatter. You can eat the same amount of calories in low GI carbs and you won't get as fat, or as tired. Again, speaking from direct experience. I eat high GI food right after exercise because that's when my body is in overdrive and needs energy stores replenished, but any other time is just a waste.

Re:Where's my reward? (0)

Anonymous Coward | more than 3 years ago | (#35718316)

And what about the people like my wife who is obese due to biological factors, and probably eats less (but pays more... big macs are cheap, while organic veggies, fresh fish, and lean meats are more expensive) and exercises more than most people?

BMI is fucking useless (0)

Anonymous Coward | more than 3 years ago | (#35717980)

I have a body mass index of 30 (obese). My body fat percentage is 12%. My waist to height ratio places me well within the athletic range. . .

Re:BMI is fucking useless (1)

ciderbrew (1860166) | more than 3 years ago | (#35718012)

Fat bastard :)

Re:BMI is fucking useless (1)

ilovejesusontoast (1276736) | more than 3 years ago | (#35718054)

BMI is only accurate for the general population (young to middle aged adults). It isn't meant to be necessarily accurate for an individual.

Waist to Hip ratio is a better measure.

Re:BMI is fucking useless (1)

Chrisq (894406) | more than 3 years ago | (#35718150)

BMI is only accurate for the general population (young to middle aged adults). It isn't meant to be necessarily accurate for an individual.

Waist to Hip ratio is a better measure.

Except if you have a fat arse

Re:BMI is fucking useless (1)

AmonTheMetalhead (1277044) | more than 3 years ago | (#35718274)

And manboobs

Re:BMI is fucking useless (1)

Chrisq (894406) | more than 3 years ago | (#35718318)

Except if you have a fat arse

And manboobs

I wonder if CowboyNeal is reading this!

Re:BMI is fucking useless (3, Informative)

meerling (1487879) | more than 3 years ago | (#35718110)

Yep, all those simplistic charts and tables that politicians and pencil pushers can comprehend are about as accurate in determining health as eviscerated chicken guts are for predicting hurricanes.

Way back when I used to be in the military. Their chart added the same amount of pounds for every extra inch above the base height. Virtually everyone on the planet 6' or taller was obese by that chart. (The idiots that made it apparently assumed an increase in height didn't have an increase in the other 2 dimensions. Something that can only be achieved if you are taffy and not an actual human.)
Just before I got out, they switched over to a different voodoo formula that used your neck diameter and height to make the calculation. Many tall thin people were labeled obese by that, yet ironically, the short fat guy that wobbled when he walked got listed as acceptable weight because his neck was so fat we all called him 'no-neck'.

There are scientific ways that can accurately determine if you are overweight or not (excluding the obvious extreme cases), but those methods will never be used by those idiots wanting to punish fat people. Those jerks just want something fast and easy with which to vilify one segment of the populace, and rack up cash quick.

Re:BMI is fucking useless (1)

Joce640k (829181) | more than 3 years ago | (#35718206)

Yep, the BMI curve only fits people in the middle of the height range - if you're tall it'll say you're obese and if you're short it won't. It's been 150-odd years now so you'd think doctors would have figured this out, but .... noooo.

Here's a whole bunch of random people's BMIs plotted on a chart [wikipedia.org] . If you squint your eyes you can clearly see the dots form a curve, not a straight line.

Clue: Humans are three dimensional, the power term in the equation should therefore be a 3, not a 2.

(...and that would only fix the 'height' problem, it still wouldn't take into account the muscularity of a person). /rant

Right, smokers should pay extra (4, Insightful)

Nursie (632944) | more than 3 years ago | (#35717982)

Which they do, through tobacco taxes.

I never understand why they required to pay extra again by some people. Either the tobacco tax is a premier example of taxation without representation, or smokers have already paid in. Probably more than they'll ever get out in terms of medical care.

And that's if they even cost the medical system more. They tend to die off...

Re:Right, smokers should pay extra (1)

dreamchaser (49529) | more than 3 years ago | (#35718002)

It only would apply to smokers who expect taxpayers to foot the bill for their healthcare. Your argument doesn't make sense in that context.

Re:Right, smokers should pay extra (0)

Anonymous Coward | more than 3 years ago | (#35718028)

Smokers are also taxpayers, and they pay a hefty fee on on cigarettes, thus footing their own healthcare bill. Charging them again is double-dipping, but nobody will care because nobody likes smokers, who are in turn, used to paying extra.

Re:Right, smokers should pay extra (4, Interesting)

Nursie (632944) | more than 3 years ago | (#35718042)

"It only would apply to smokers who expect taxpayers to foot the bill for their healthcare. Your argument doesn't make sense in that context."

Eh?

But smokers who expect the taxpayer to foot the bill have been paying a lot of extra tax, that's the argument.

In countries like the UK the estimated extra burden on taxpayer funded services is around half the tobacco tax revenue. And STILL people say that smokers ought to be denied care or be made to pay for their care. It doesn't make sense to me.

I don't smoke (any more) but it's hard for me to see this as anything other than taxation as moral punishment, and denial of services paid for by that taxation as further moral punishment.

Re:Right, smokers should pay extra (0)

Anonymous Coward | more than 3 years ago | (#35718354)

But smokers who expect the taxpayer to foot the bill have been paying a lot of extra tax, that's the argument.

They have paid no more than the smokers who don't expect the taxpayers to foot the bill. That's the difference between this and regular tax.

Re:Right, smokers should pay extra (4, Insightful)

xnpu (963139) | more than 3 years ago | (#35718030)

The issue is that this money just disappears in a big black hole. If it were properly tracked, accounted and appropriated towards medical care, we would at least know what we're talking about. Now we have no clue, making these kind of discussions much less useful.

Re:Right, smokers should pay extra (0)

Anonymous Coward | more than 3 years ago | (#35718056)

Its healthy people that should be charged more, they end up costing more money in the long term.Smokers, Fat People, and Drinkers have the decency to die earlier before they become a financial burden on the state, aside from the Taxes they pay, they don't spend years in retirement being economically inactive and taking out of the system as opposed to putting in. They work , then they die pretty quickly afterward on the whole
I as a smoker,and drinker, but quite slim am awaiting societies gratitude for my sacrifice

Re:Right, smokers should pay extra (1, Insightful)

perrin (891) | more than 3 years ago | (#35718072)

Dying from smoking tends to be very expensive. It is not like dying from a car accident or bungee jumping, where you either die or cost a fortunate in medical expenses due to long rehabilitation, but you die and it costs a fortunate to keep you hospitalised while you cough your lungs out or wither away to chemo/radiation therapy. I was in a lung ward for two weeks and saw enough of that stuff to be permanently immunized to the idea of taking up smoking for whatever reason.

Selling smoke to people under 18 + N years should be illegal, where N is increased every year. There is no excuse to keep that substance legal, except that it is sometimes too hard to stop for some people already hooked on it.

Re:Right, smokers should pay extra (1)

Joce640k (829181) | more than 3 years ago | (#35718230)

Yep, 18 year-olds generally haven't got a clue about anything much so they don't see the bad side of smoking.

Conversely, very few people start smoking in their mid-20s (or later). Smoking seems to me like a good place for the law to protect people from their own stupidity/ignorance.

Re:Right, smokers should pay extra (0)

Anonymous Coward | more than 3 years ago | (#35718326)

At least in Spain nowdays the kids start smoking at around 12. Which is a lot worse because it means someone bought the cigs for them.

Re:Right, smokers should pay extra (1)

AmonTheMetalhead (1277044) | more than 3 years ago | (#35718292)

And it also doesn't help that euthanasia is illegal over there. I know that if/when i get cancer, and it's terminal, that I'll off myself, I'm not planning on rotting away hooked on machines

Re:Right, smokers should pay extra (1)

Kjella (173770) | more than 3 years ago | (#35718310)

Dying from smoking tends to be very expensive. It is not like dying from a car accident or bungee jumping, where you either die or cost a fortunate in medical expenses due to long rehabilitation, but you die and it costs a fortunate to keep you hospitalised while you cough your lungs out or wither away to chemo/radiation therapy. I was in a lung ward for two weeks and saw enough of that stuff to be permanently immunized to the idea of taking up smoking for whatever reason.

The thing about deaths is that everyone has one, it's only a matter of when and how. The health freak that is in and out of hospital from 80 to 90 as his health finally fails may not be cheaper than the smoker that was in and out of hospital from 60 to 70 before kicking the bucket.

Re:Right, smokers should pay extra (0)

Anonymous Coward | more than 3 years ago | (#35718160)

Either the tobacco tax is a premier example of taxation without representation,

Whoa, whoa. I agree that the tobacco tax already should cover this, but do you have ANY idea what "taxation without representation" means? It refers to a situation where someone is considered enough of a citizen and a member of society to be required to pay taxes, but not enough to be represented by the government, e.g. not having the right to vote etc. It has absolutely NOTHING to do with whether someone who's already paying tobacco tax should be able to be required to pay a premium for health insurance coverage again.

Re:Right, smokers should pay extra (1)

Nursie (632944) | more than 3 years ago | (#35718188)

I understand the origins of the term "taxation without representation". I borrowed it, perhaps improperly, to describe a tax that's taken without recompense or service in return.

Tobacco tax, especially in the situation where smokers will then be charged more than non-smokers for health care, would seem to be in that category.

Re:Right, smokers should pay extra (1)

geekmux (1040042) | more than 3 years ago | (#35718222)

Which they do, through tobacco taxes.

I never understand why they required to pay extra again by some people. Either the tobacco tax is a premier example of taxation without representation, or smokers have already paid in. Probably more than they'll ever get out in terms of medical care.

And the surcharges we all pay on concert tickets? How about the extra tax we pay in certain states for the "convenience" of buying fast food? The point is higher taxes on products in high demand isn't something new or unique to the tobacco industry. And remember, much like my other examples, it's a luxury tax. People choose to smoke, and can live without tobacco. It's rather hard to compare that to the expense of having medical insurance for yourself and your family, which isn't so much an "optional" expense.

And that's if they even cost the medical system more. They tend to die off...

Die off? I wouldn't count on it. I believe the last statistic I read on this stated that the average person spends more in the last 6 months of their life on medical expenses than they ever did leading up to that point. There's a damn good reason cancer hasn't been cured yet (or a cure has not been made public). Treating cancer is FAR more profitable than curing it ever will be.

Re:Right, smokers should pay extra (2, Insightful)

Nursie (632944) | more than 3 years ago | (#35718258)

It's not a luxury tax, it's a sin tax. And when said sin tax outweighs (as it does in some countries, no idea about the US), the tax burden from the activity, I think it's pretty damned rich to demand even more from those people who have been paying it.

S'all I'm saying.

People do choose to smoke, and can live without tobacco. Charging them extra for state healthcare when that habit has benefited the state more than enough to offset their costs, it's just wrong. And if the state is genuinely out of pocket on smokers, then the tax should be bumped up to cover it, IMHO.

Re:Right, smokers should pay extra (1)

RobotRunAmok (595286) | more than 3 years ago | (#35718240)

I never understand why they required to pay extra again by some people.

You mean, the Nanny-state hipsters?

It's a psychological tic. Used to be called "sanctimoniousness" before religion became out of fashion. Now, absent any strong central religious authority through which to channel it, it expresses itself as sin taxes, including (especially) "carbon credits," which are the New Church's version of medieval indulgences.

Re:Right, smokers should pay extra (1)

Bert64 (520050) | more than 3 years ago | (#35718244)

Or perhaps the revenue from tobacco taxes is outweighed by the cost of tobacco related health problems.

Smokers do die off, but the dying process (ie the time from when they start being unhealthy and requiring medical help to their death) is often longer.

Re:Right, smokers should pay extra (1)

mirix (1649853) | more than 3 years ago | (#35718286)

Not to mention that if a smoker dies at 60, the state saves 20 years of pension...

Most everyone dies of cancer and heart disease anyhow, smoking just makes it happen earlier, so that cash is spent either way. They also get to skip out on the decade or two of hip replacements and so on.

Re:Right, smokers should pay extra (1)

Tom (822) | more than 3 years ago | (#35718294)

Tobacco taxes don't pay for health insurance coverage.

What tobacco taxes are are three things:
One, they pay for the externalized costs that smokers inflict on the rest of society. All those remains don't clean themselves up, for example, and if you've ever been to a train or bus station when the cleaning people have been on strike for two days, you have a rough idea of the unbelievable volume that accumulates. I never realized just how many used cigarettes get disposed there.
Then there's the whole laws and regulations, someone has to pay for the lawyers and law-makers. I'm quite happy knowing that at least the anti-smoking laws pay for themselves via tobacco taxes.

Two, a high tobacco tax is one way in which society can regulate undesired behaviour. Every free market fanatic should be glowing over this "market solution" - you adjust the price and thus adjust demand. Basically, we as a society don't want smoking. I can outline in any length you want why smoking is a negative for society as a whole, or you can Google it. For this argument, simply assume that it is and see taxation as a way to regulate it because higher costs mean people smoke less.

Three, that last isn't really true and everyone knows it. Smoking is an addiction and smokers would rather go hungry than smoke less, that's just how addictions work. Granted there are light and more severe cases, so that's a general statement and there is some effect of tax raises to tobacco consumption, but it is far from 1:1. That, however, means that tobacco taxes are one of those taxes that the state can levy without driving tax income down. Raise the tax on X and people consume less X so your tax income may actually fall, oops. But a few taxes are in what is called inelastic markets, where demand is not driven by price so much as by other factors - need or addiction. Bread and other basic food isn't subject to price/demand rules simply because people have to eat. Petrol is much the same, it has a large inelastic part because people have to drive to work. And smoking and other addictions are like that as well. People simply don't smoke less because it gets more expensive, they will save the money elsewhere.

Re:Right, smokers should pay extra (1)

Bacon Bits (926911) | more than 3 years ago | (#35718322)

I never understand why they required to pay extra again by some people.

Simple: Everybody agrees to raise taxes on demographics they do not belong to. Everybody wants the services of government, but nobody wants to pay for them.

What "extra medical costs" ? (1)

sofayam (582239) | more than 3 years ago | (#35717988)

Smokers die earlier and collect fewer pension payments. Aren't fatties just as big a saving on the long run?

Re:What "extra medical costs" ? (0)

Anonymous Coward | more than 3 years ago | (#35718086)

Smokers tends to die of cancer. It's slow, painful death, and costly death. Chemotherapy isn't cheap, palliative care costs arm and leg to.

BTW. pensions are not medical costs.

Re:What "extra medical costs" ? (0)

Anonymous Coward | more than 3 years ago | (#35718104)

http://en.wikipedia.org/wiki/Tobacco_smoking#Economic 2nd paragraph. Actually says that Philip Morris preformed a study that showed that it is actually cheaper to let people die young. Of course this was an older study before so many wonderful and expensive (But life saving just ask my mother, who had and is now lung cancer free. She stopped smoking about fifteen years before getting the cancer.) Drugs and therapies. So I don't think it is any longer more economically viable since curing the cancer wasn't cheap but on the other hand my mom's retirement won't be cheap for your company or social society.(Not saying she doesn't deserve it.)

Re:What "extra medical costs" ? (1)

Chrisq (894406) | more than 3 years ago | (#35718172)

http://en.wikipedia.org/wiki/Tobacco_smoking#Economic 2nd paragraph. Actually says that Philip Morris preformed a study that showed that it is actually cheaper to let people die young. Of course this was an older study before so many wonderful and expensive (But life saving just ask my mother, who had and is now lung cancer free. She stopped smoking about fifteen years before getting the cancer.) Drugs and therapies. So I don't think it is any longer more economically viable since curing the cancer wasn't cheap but on the other hand my mom's retirement won't be cheap for your company or social society.(Not saying she doesn't deserve it.)

Hmm, is this the same Philip Morris that hid the dangers of smoking for decades [encognitive.com] and covered up the additional fire risk of a new 'safer' cigarette [no-smoking.org] . Forgive me if I take it with a pinch of salt.

Re:What "extra medical costs" ? (2)

proverbialcow (177020) | more than 3 years ago | (#35718140)

Medicaid != Retirement distribution, so while it may save the Federal retirement trust in the long run, it doesn't do anything for the Medicaid program administered by the state of Arizona. Also, I think you're not taking into account the people whose weight problems don't kill them immediately. Chronic heart disease, diabetes, operators waiting to take their call so they can bill Medicaid for Hoverounds...

Why not... (0)

jprupp (697660) | more than 3 years ago | (#35717990)

...let the fucking market deal with this?

Re:Why not... (0)

Anonymous Coward | more than 3 years ago | (#35718134)

Because ultimately, the market solution for providing healthcare is for everybody to pay precisely the amount that their own care costs. That's not a good thing. It could only be fair if we all had perfect control over our own health and there was no such thing as luck.

Re:Why not... (1)

proverbialcow (177020) | more than 3 years ago | (#35718148)

Because Medicaid exists outside the bounds in which the market operates.

Smokers die younger (1)

rich_hudds (1360617) | more than 3 years ago | (#35717996)

Smokers die younger which saves far more money in the long term

Re:Smokers die younger (1)

geekmux (1040042) | more than 3 years ago | (#35718252)

Smokers die younger which saves far more money in the long term

Yes, and there's a multi-billion dollar industry out there prolonging that death as much as possible in the form of cancer treatments. THAT is ultimately the point here, so let's just stop this tired old argument that smokers die young, because they certainly don't die cheap.

Fighting each other not Med Companies (1)

Anonymous Coward | more than 3 years ago | (#35718004)

There are thousands of reasons to be fat. Doing things and eating well are comparatively expensive.

The system is getting ready to make a scape goat of the unpopular fat people. Already self conscious and worried for their health now they will have to pay more.

Meanwhile, the medical insurance companies will make billions from the most expensive medical coverage on the planet that is driving those that are covered into bankruptcy. Those that aren't covered are abandoned to die in one of the richest countries in the world.

Yea its your fault if you're overweight...... We'll solve everything by kicking the little guy while he's down, not by fixing the system that supports and is owned by the very rich.

Re:Fighting each other not Med Companies (1)

AmonTheMetalhead (1277044) | more than 3 years ago | (#35718314)

Those that aren't covered are abandoned to die in one of the richest countries in the world.

I never understood why you people tolerate that situation.

While we're at it. (1)

Seumas (6865) | more than 3 years ago | (#35718008)

Can the government give me some gold stars on the chart on the back of the classroom door every time I do something nice or choose not to do something bad? Maybe you want to reward me for praying or choosing not to play violent videogames? Maybe give me two gold stars every time I go a month without a sick day? Yay!

Is it me... (0)

Shadowruni (929010) | more than 3 years ago | (#35718010)

Is it me or does the governor of AZ wake up and say, "What civil liberties can I shit on today? Oh! I know! I'll start enforcing medical programs just like Big Brother did in 1984. Winston seemed to like it so much!"

Re:Is it me... (1)

proverbialcow (177020) | more than 3 years ago | (#35718162)

This is nothing. You should see our county sheriff.

Will they tax stupidity, too? (1, Troll)

wavedeform (561378) | more than 3 years ago | (#35718014)

It seems like Arizona could solve most of their budget woes by taxing stupidity.

Republican Death Panels (0)

lanner (107308) | more than 3 years ago | (#35718016)

Arizona resident here. Downtown Phoenix, no less, about eight blocks from the capitol.

I don't know WTF this has to do with news for nerds, but I'll bite.

Looks like we are becoming the new Floriduh here. Some of the bad attention is well deserved. Some of it not.

Maybe if they had not given that huge tax break to University of Phoenix, they would not have to do stuff like this;

http://www.bizjournals.com/phoenix/news/2011/04/04/Arizona-Legislature-OKs-tax-break.html [bizjournals.com]

Also, I would be negligent if I didn't point out that republicans here went and made their own FUD true: Death panels!

http://www.azcentral.com/arizonarepublic/news/articles/2010/12/09/20101209Montini1209.html [azcentral.com]

http://www.azcentral.com/arizonarepublic/local/articles/2011/02/25/20110225montini0225.html [azcentral.com]

Re:Republican Death Panels (1)

DNS-and-BIND (461968) | more than 3 years ago | (#35718052)

Now this is strange. I have heard, multiple times right here on Slashdot, that there is no difference between (D) and (R). Now, someone says there is? Can someone clarify this for me? I get confused when someone reads a story and posts a bunch of off-topic links attacking the "other" party.

Re:Republican Death Panels (1)

asylumx (881307) | more than 3 years ago | (#35718236)

D and R are indeed different, but not drastically different. However, the GP is actually pointing out that the Rs are not as fiscally responsible as they want you to believe they are (throwing tax cuts around when almost every state already faces a deficit) and also that they are guilty of exactly what they've accused the Ds of doing in recent history.

Taxing cigarettes (0)

Anonymous Coward | more than 3 years ago | (#35718018)

If you want to smoke, go for it but understand you're going to have to contribute something for the cost of the care of your smoking.

What an idiot and an asshole. Cigarettes are already taxed relentlessly. It seems that nowadays smokers are the ones whose rights can be and will be trampled on with impunity.

Big Government? (0)

Anonymous Coward | more than 3 years ago | (#35718032)

I'm not going to comment on weather it's right or wrong but how is this not the most terrifying of the Noecons kryptonite, big government?

Re:Big Government? (1)

Anonymous Coward | more than 3 years ago | (#35718192)

"Jan Brewer has proposed levying a $50 fee on some enrollees in the state's cash-starved Medicaid program, including obese people who don't follow a doctor-supervised slimming regimen and smokers. Brewer says the proposal is a way to reward good behavior and raise awareness that certain conditions, including obesity, raise costs throughout the system."

Rule of thumb: It isn't "big government" if it involves nickle-and-diming poor people or enforcement of 'morality'. The actual size and intrusiveness of the state apparatus required are largely irrelevant. This is why, for example, the the war on drugs is not a big government program; but Head Start is.

I'm kinda split on stuff like this (4, Interesting)

Sycraft-fu (314770) | more than 3 years ago | (#35718036)

On the one hand I do appreciate that people who take more risks need to bear more burden for the costs of those risks. We see that in other kinds of insurance all the time. The amount a life insurance policy costs varies with the kind of work you do, the amount a car insurance policy costs varies with your driving record and so on. It makes sense to look in to things like this for health insurance as well. If you want to live a more risky lifestyle, ok, but then you need to be willing to contribute more to your likely higher costs. Basic actuary science and all that.

On the other hand I worry about two things:

1) How do you define some of the things like obese? That one is really problematic because the value for it keeps sliding down, what used to be normal is now overweight and so on, and because it generally uses a very bad measure (BMI is extremely stupid). So I worry that this will end up with a system that pushes skinny past the point of reason, that people who are perfectly healthy will be told "You have to pay more because you are too fat," and that people who are underweight (which is far more serious medically) will be left alone.

2) Where does it end? You do have to keep an eye on the whole slippery slope thing when it comes to health insurance. You don't want to start up with a system of "Everything wrong with you costs more." Otherwise you'll end up with a system more or less where the people who can afford it won't need it because they have nothing wrong or likely to be wrong and the people who need it won't be able to afford it because it'll be so expensive. Insurance works when you spread the risk over a lot of people. Now you can limit it to only things people have control over, like what they eat or what drugs they do and so on, but you do run the risk of the government dictating what kind of lifestyle you are allowed to lead.

I also have to wonder about the particular choices. There are an awful lot of things that people do voluntarily that increase their health risks. Why is obesity such a target? I understand that a lot of people are heavy, but you need to run the costs of that against the costs of other choices people make. A lot of people drink heavily too (as much as 10%), and that causes some serious health issues, yet does not seem to get discussed.

I'm not 100% opposed to an idea like this, despite being overweight myself. I just think it needs to be very carefully examined and limited beforehand.

As an example of a problem take using BMI for weight. When I was 18 I worked as a surveyor's assistant for the summer before university. It was physical labour outside for 8-9 hours a day, 5 days a week. Of course being 18, my metabolism was high. I weighed about 185 then, which according to the current BMI scales is "borderline overweight". Still within the normal range, but right at the top. Maintaining that would be essentially impossible as I aged, and you'd have a hard time finding anyone who would argue that I wasn't in good shape, however it was only barely good enough, despite having age on my side.

It is real easy to just start categorizing things without thinking it through and where there's money involved, the pressure becomes all the greater. If more money can be mode with more people being "overweight" then there is an incentive to lower what qualifies, even if there's no medical reason.

How about an idiot governor tax? (2)

ThorGod (456163) | more than 3 years ago | (#35718040)

How about an idiot governor tax?

For all the idiot governors out there. Can't tax their IQ, so we'll have to find something better to tax.

Its a PORK BARREL (1)

Stumbles (602007) | more than 3 years ago | (#35718044)

Jan must not be a fattie. So whats next? Tax people because their paraplegics or handicapped in some way. Just think of the billions that could be saved if these type people started paying a "Your physically handicapped" tax. But I would like to see a POLITICIAN tax of %50 of their income (all inclusive) and the tax should be called; I have my head up my ass tax.

Re:Its a PORK BARREL (0)

andy1307 (656570) | more than 3 years ago | (#35718114)

people started paying a "Your physically handicapped" tax.

A bad-grammar tax would raise a lot more revenue.

Insane (1)

b4upoo (166390) | more than 3 years ago | (#35718058)

There are numerous ways that people harm themselves. How about fines for people who fail to exercise? Or fines for those that work too much or work at desk jobs which encourages diseases? How about fines for people who eat bacon? Or how about fines for people with serial, sexual partners who tend to be the ones who get AIDS? How about fines for sky divers or motorcyclists as they tend to sustain injuries in those activities?
                    The list of things that do harm is endless. Should we tax those things? And isn't getting old a great expense to society? Should we fine people for every day they live after the age of 50?

Great, make up your mind! (1)

ciderbrew (1860166) | more than 3 years ago | (#35718080)

In one story you read we are heading for a pensions crisis as we will all live too long and in the next story we are all to fat and will die too young. Make up your mind!

The thing I take from all the fat stories in the press is I know for a fact that we can expand world population by another few billion people. There are enough calories for everyone in the system. Some people just need to learn how to share. Also Canada will not survive a war to protect its fresh water; but that is for another post.

smokers cost *less* (1)

30F06950 (248885) | more than 3 years ago | (#35718084)

I've seen it mentioned somewhere, though I have no reference to hand so this may be complete BS, that smokers cost health systems (when retirement is included) *less* on average because although they have more heath problems that results in them dying younger and therefore having substantially less cost during old age.

which if true leads to the slightly paradoxical idea that smokers should pay *less* rather than *more* for their healthcare.

Re:smokers cost *less* (0)

Anonymous Coward | more than 3 years ago | (#35718226)

I would genuinely be interested in seeing that research, but no matter how interesting it is starting a comment with:

I've seen it mentioned somewhere, though I have no reference to hand so this may be complete BS

is a great way to give people the impression that your comment is maybe better ignored in favour of more certain statements...

How bout a tax on active people? (1)

mykos (1627575) | more than 3 years ago | (#35718106)

Their joint problems and accidents are going to cost medicaid just as much.

Re:How bout a tax on active people? (0)

Anonymous Coward | more than 3 years ago | (#35718228)

There aren't enough of them in America to make such a tax financially relevant. The administration costs of said tax would likely be more than the capital collected.

Fatties however.. dime a dozen.

I guess CowboyNeal won't be going to Arizona (1)

Chrisq (894406) | more than 3 years ago | (#35718144)

I guess CowboyNeal won't be going to Arizona any time soon.

Hmm... (1)

fuzzyfuzzyfungus (1223518) | more than 3 years ago | (#35718158)

I'm guessing that she isn't gunning for the title of "small government Republican" here?

per kg! (0)

Anonymous Coward | more than 3 years ago | (#35718170)

medicare should be paid on "per kg basis"!

So the food one eats to get flabby... (0)

Anonymous Coward | more than 3 years ago | (#35718174)

...becomes an expense related to the tax, and is thereby tax deductible?

tax big pants (1)

malloryweis (1786850) | more than 3 years ago | (#35718196)

BMI does correlate with cardiovascular risk, and is useful when applied on a population basis, but less so to some individuals who are muscular. From experience most people who use the "BMI isn't useful, look at weightlifters/bodybuiilders" comment, are far from having a muscular physique. Ways around this: DEXA scanning for body morphometry (http://en.wikipedia.org/wiki/Body_fat_percentage), is an accurate way of determining body fat composition, but is time consuming and would add cost. A better predictor of cardiovasulcar risk (and other manifestations of the metaboic syndrome such as diabetes) is waist circumference. Rather than taxing healthcare or unhealthy foods (which are fine in moderation), why not heavily tax big pants (>37 inch waist is the cut off for risk in a male).

Re:tax big pants (1)

ciderbrew (1860166) | more than 3 years ago | (#35718224)

That is a good idea. If I were to be taxed that way I think I would make an effort. Do I get money back for being grossly under weight?

... only certain childless adults ... (1)

PolygamousRanchKid (1290638) | more than 3 years ago | (#35718198)

From TFA:

Ms. Brewer's surcharge would apply only to only certain childless adults:Those who are obese or chronically ill, and those who smoke.

So it's OK to be fat and smoke, if you have children. Ms. Brewer is thinking of the children!

Also:

They would need to work with a primary-care physician to develop a plan to help them lose weight and otherwise improve their health. Patients who don't meet specified goals would be required to pay the $50, under terms of the proposal.

So already overworked physicians will be tasked with yet more paper work, for filing out exemptions forms. Who is going to process all this? The state will need a Department of Fat, Smoking and Do-You-Have-Children. Any savings from the surcharge will be burned up in the processing bureaucracy.

Oh, I'm skinny, don't smoke and I don't live in Arizona.

Illegal? (1)

proverbialcow (177020) | more than 3 years ago | (#35718216)

It just occurred to me: this is in violation of the Americans with Disabilities Act. It's a fine on being obese and smoking, but it only applies to the obese and/or smokers who are sick and thus drawing Medicaid support. That would be interesting to see in court.

About damned time (1)

Shivetya (243324) | more than 3 years ago | (#35718234)

In an age where far too many people are clamoring for "other guy" to pay for services they want it is good to see someone saying, well if your going to ask others to take care of you here are some ground rules. If you want someone to pay for it then they will, however there are some requirements you must meet as well. Frankly, asking people to adhere to weight control programs, take smoking cessation courses, and in general live a healthy life, is not too much to ask. We have far too many people who have no issue asking someone else to pick up the tab. What makes many of them worse is that far too many continue on with similar bad habits. Not only are they not financially self responsible they treat their bodies the same way. They simply act as if someone else will fix it. They will just pop into the doctors office for their cough, their bad knees and ankles, and demand treatment. When the doctor helps them and then tells them what they need to do to prevent it far too many will tell the doctor to mind his own business.

In my work, where the majority of people are middle and upper middle class, it is common to find those who bitch about their contribution to their medical plans. Hell we have some complain that they company doesn't contribute more to their retirement. Yet you rarely find the case with these people where they aren't under a permanent cell phone contract of some sort usually on the order of $100 or more; have an expensive car or worse a lease payment, and then top it off with all sorts of other expenses. When did we become a society where self gratification took precedence over responsibility to self and others? I know people in their fifties who are not saving for retirement or are making a piddling attempt all the while burning money on frivolous stuff.

When the government starts to reach resistance in its borrowing it will be cutting programs right and left. It behooves everyone to save for their future because you cannot guarantee that all the things promised you by politicians will be three when you need them. You must also accept that unless Washington takes steps to correct its spending (we have more debt spending than some G7 countries have total spending) that you will have far less to spend on anything.

So get your health in line. If it takes a kick in the pants to get people to do that, or should I say I kick in the wallet, then its a good thing. Grow the hell up. Its your body, you are in the best position to take care of it. It is just sad some people require prodding if not penalties just to do what is right for themselves.

 

for it (1)

Tom (822) | more than 3 years ago | (#35718254)

count me as "in favor".

Health insurance covers risks we are subject to and have little control over. However, just like car insurance premiums depend on the type of car you drive simply because some car types are statistically more likely to crash or get broken into, so do certain life choices affect your health costs.

I don't mind helping shoulder the burden for someone who's had bad luck and serious health troubles. That's what an insurance system is for, and that guy with the bad luck could be me.
I do mind paying for someone's self-inflicted lung cancer. That guy could not be me.

I am overweight. (1)

AbRASiON (589899) | more than 3 years ago | (#35718264)

Tax them - as long as it's clearly defined heavily obese, not a problem with me. These people need to learn (as do I) - they should have some self control.

That being said, it needs to be measured properly and the revenue NOT relied on.
Victoria Australia introduced more expensive speeding fines and permenant fixed cameras, they generated revenue which the government began to rely on, once relied on, suddenly people were tired of the fines and slowing down, the government were 'losing money' so they changed the definition of speeding (1.864 miles an hour over the limit is fine worthy)

I would hate them to suddenly define anyone with a BMI over 30 for example as obese, - as the BMI system is heavily flawed as is peoples definitions of overweight when you understand what ectomorph, mesomorph and endormorph actually means.

Outliers, much? (1)

unkiereamus (1061340) | more than 3 years ago | (#35718272)

I, for on, would like to point out one of the inherent weaknesses with the whole BMI thing. Namely, I'm 6'8", in order to qualify as a "healthy" weight, I'd have to weigh in at 227 lbs. Having actually weighed that much in the past, anyone looking at me could tell you that I'm decidedly underweight at that point....The system just doesn't handle the extremes all that well.

Would I then be penalized in AZ for maintaining a healthy weight, because I would be "obese" by the numbers?

I'd like to think that of course I wouldn't, people would recognize the unfairness in the situation, but then, these are politicians, and I've seen enough of them in action to know the truth.

How far? (1)

yogurtforthesoul (1032362) | more than 3 years ago | (#35718344)

What about taxing politicians for anxiety and mental issues as they tend to cause them (via attack ads, talks, false information, revocation or imposing of various laws, wars, etc...), i.e. perhaps even as far as heart attacks and of course PTSD, as their bills squabble over ever piece of minutiae that they have a personal issue with... What about bad drivers? The clergy down the street that rile up citizenry depending on your religion or lack of? What about people that hold a fireworks show; should they cover a "scare" charge for children? Politicians that are dismissive and get rid of collective bargaining, cancel school funds, close liquor stores, live in a "Governor Mansion" and claim they're struggling, or start wars that they never need fight themselves? What about politicians that steal, arguably, money that could be used for the workforce, but are instead used for lobbying fees?

How far should this be taken? If there is one profession that deserves a "medical" tax it's politicians and anyone that has any dealings with them whether that be clergy or lobbyists. They constantly hold society hostage to their causes and yet this is considered fine. If the Wisconsin or Bush era dealings taught us anything is that they are petty and laws like what they suggest here are exactly that, petty. They enact more harm that a Big Mac ever could.

They are responsible for a fair share of hurt and pain both mentally and physically and I'm hard pressed to find a reason to tax fatty rather than them. As they have created the majority of our mess. Why not find ways to help first and punish later? If politicians contributed money from their lobbying endeavors (hahahaha) I'm willing to bet that Medicare/Medicaid/Social Security might be standing on firmer ground.

Fat people equalize themselves as they will die due to issues related to their weight at an earlier age; to me it seems tax payer wise to be equal. This is just another divisive issue to bring up that goes nowhere, but makes people think that something useful has been done and gets that politician re-elected by being in the limelight (in fact it does almost nothing other than make sure fat people die without insurance or support). If you grow old and healthy you'll use a lot yourself even though you're healthy, but eventually you will get sick and die making many of these costs equalize. You use a lot unless you die in your sleep or have a heart attack without any help (or die of anything where help is not available). But, if this happens when you're 100 then you use a fair amount no matter what.

There will be exceptions, but these "point the finger" and "blame games" are simplistic war drum machinations... (I didn't look for grammar, a little too tired; so overlook any spelling, word misuse, issues...)
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