Should smokers be taxed to cover the health expenses that may have to be covered

[Jo]

by the state?

Should they be taxed specifically to cover over programs such as SCHIP?

[Beka]

I think it's a really grey area, so many lifestyle choices can have effects on our health causing high medical expenses that i believe it would become difficult to decide who can be blamed for their medical state and who can't. if we high light smoking we have to high light obesity, if we hight light obesity we have to high light malnutrition, sports related injury, car related injury- the list is endless.

One reason i would say there is actually less need to tax smokers in the UK to pay for medical expenses incurred is the fact they are already one of the most heavily taxed groups in our country. The average carton of 20 cigarettes costs around $13 here- so a huge ammount of tax goes into the government from smokers, we have a "free" health system however i have yet to see improvements in it proportionate to the tax hikes on cigarettes each annual budget.

No one in my house smokes so this isn't from a smokers point of view, this is from the point of view that sees so many other people take needless risks in life and they don't recieve the condemnation smokers do. We allowed people to become drawn into a tobacco industry that is intent on keeping them hooked and so we (as a nation) should be obliged to help those people not demonise them.

In England we are now seeing the introduction of many anti-smoking laws (no smoking in public indoor places, immediately outside of them and the rise in age to buy cigarettes from 16 to 18) but we are also seeing a huge drive from the government to assist those wishing to give up. We're also seeing huge awareness campaigns like never before. To me that is a solution- not taxing existing smokers who are already in the state of needing medical help but placing funding to attempt to prevent another generation being suckered into it.

I also feel we should not highlight smokers as a problem group when the majority of them have worked and paid taxes, paid into insurance funds to have health care when they need it.

[gr8mommy]

I'd rather see subsidies for tobacco farmers end.

[Erika]

Exactly the same as Beka.Over here, smoking has been banned in all workplaces and public places since 2004. On top of that, a pack of cigarettes cost about $10. The tax that smokers paid on their cigarettes more than made up for the amount of health care costs they would incur.

[Lori]

I don't think somebody's poor choices abdicates a civilized society of its responsibility to make sure the basic needs of all citizens are met, and I consider health care a basic need. So I do think smokers should be covered the same as everybody else.

[Danielle]

Exactly the same as Beka.Over here, smoking has been banned in all workplaces and public places since 2004. On top of that, a pack of cigarettes cost about $10. The tax that smokers paid on their cigarettes more than made up for the amount of health care costs they would incur.

It's very similar here and I agree that the cigarette tax should more than cover the additional healthcare costs.

[ArmyDad]

The problem I have taxing smokers for high profile programs are: what happens when you say X amount of smokers will bring in y amount of taxes. Well if the smokers quit because of the high prices and x becomes smaller where does the extra money come from?

[Kristi]

No I don't think that is fair. Like someone else mentioned there are alot of things that affect your health that are choices. Would they start taxing people with poor eating habits who end up with medical problems because of it? And heavy drinkers? I think it is unfair to tax someone for a bad habit.

[BigDave]

It is complete and utter absurdity. Why should I have to pay an extra tax to fund another persons health care. Why not tax the super obese an extra tax for the food and gasoline they consume? Have a scale at the pump and check out line. If you are over a certain weight for your height, guess what here is an extra tax to help other people. Or why don't we put higher taxes on people who use public transportation.

This is just another lane to a nanny style government. We already have that here in MN. We get taxed out the WAZOO for everything. The gvmt is in our lives everywhere. there was even a law that came up that required CO2 detectors in every house, new or old. REQUIRED! FU.

I feel the same way about taxing smokes. F and U.

[Jeri]

I think we should have nationalized health care, and that everyone should be taxed to pay for it. I'm not in favor of singling our certain groups as high risk and charging them more because of it.

[gr8mommy]

I think we should have nationalized health care, and that everyone should be taxed to pay for it. I'm not in favor of singling our certain groups as high risk and charging them more because of it.


I shudder to think of the mess that the government would make of any type of national healthcare system.

I also disagree about singling out high risk behaviors---if I don't smoke, don't drink, eat well, exercise regularly, and get a checkup every year, why should I pay the same amount as someone who smokes like a chimney, drinks like a fish, sits around stuffing their face with junk food, and hasn't seen a doctor in years?

I do think it hypocritical to tax smokers when we're paying farmers to grow tobacco, and giving incentives for cigarette manufacturers to keep making them.

[ArmyDad]

I shudder to think of the mess that the government would make of any type of national healthcare system.

My feeling exactly, It would be a mess and it is my firm belief that we would end paying more for a national healthcare system with taxes then we do now out of the paychecks. The military who has its own doctors are going broke with healthcare, and what 10-15% at the most of the population is entitled to the healthcare. Retirees get screwed with the system now wait times are 9-12 months just to go see an eye doctor. It is a good Idea on paper but I think once the reality hits. watch out

[giana]

Chris
You KNOW it works very well in many European countries so dont say it does not work in reality please

[Kate]

Chris
You KNOW it works very well in many European countries so dont say it does not work in reality please

It works well in Australia, too.

[gr8mommy]

Yes, it works so well overseas that millions of people come here every year as 'tourist patients'. There was a huge article last year about how our hospitals in NJ are going broke because people with means fly in from overseas, know they'll be treated both well and quickly, then fly back home, often not paying the bill because it simply isn't cost effective for our hospitals to litigate internationally.

I'll look to see if the article still exists online.

[Danielle]

Yes, it works so well overseas that millions of people come here every year as 'tourist patients'. There was a huge article last year about how our hospitals in NJ are going broke because people with means fly in from overseas, know they'll be treated both well and quickly, then fly back home, often not paying the bill because it simply isn't cost effective for our hospitals to litigate internationally.




Okay, we're wayyy OT but I have to add...

I'm sure this is true, and I know for a fact that some rich Canadians will go to the US to pay for procedures so they do not have to wait their turn here in Canada. Wait times are sometimes excessive but personally, that's a price I'm willing to pay to have heathcare available to everyone and to never have a loved one denied care because they cannot afford it.

IMO, if the US is willing to accept these overseas and cross-border patients, that's a flaw in the US system not in the system of any other country. If the US denied access to these patients, Canada and other countries would have to face the reality that there need to be some changes in the healthcare system with regards to wait times. At present, wait times are being falsely reduced by this border hopping and that makes it look like the government is actually doing something productive to reduce our wait times.

[Jo]

Danielle-do they prioritize the wait list for people? My concern with a system like yours is that waiting for treatment could cost someone their life. When we went to Johns Hopkins with Rai, the wait time for a hemispherectomy was 11 months. They were down a surgeon because Dr. Carson had cancer at the time. Rai would have died if we had waited.

[Danielle]

Absolutely Jo. I know people that have gotten an MRI or CT scan on the same day they visited their physician because something life-threatening was suspected. However, wait times for MRIs for a bad knee for example can take a few months. Honestly, I don't know anyone who has waited an excessive amount of time for any procedure but I've heard stories of it happening. In my personal experience and from what I've seen from others around me, the wait times are not life threateningly long.

The best example of cross-border surgery I an think of is a co-worker of mine who went to Michigan for bariatric surgery (gastric bypass). She could have waited and had it done here in 6 months but she opted to pay to have it done in Michigan the next month. Was her condition life-threatening? Maybe in the long term it was as she was about 350lbs but I strongly doubt she would have been harmed at all by waiting 6 months.

[gr8mommy]

Okay, we're wayyy OT but I have to add...

I'm sure this is true, and I know for a fact that some rich Canadians will go to the US to pay for procedures so they do not have to wait their turn here in Canada. Wait times are sometimes excessive but personally, that's a price I'm willing to pay to have heathcare available to everyone and to never have a loved one denied care because they cannot afford it.

IMO, if the US is willing to accept these overseas and cross-border patients, that's a flaw in the US system not in the system of any other country. If the US denied access to these patients, Canada and other countries would have to face the reality that there need to be some changes in the healthcare system with regards to wait times. At present, wait times are being falsely reduced by this border hopping and that makes it look like the government is actually doing something productive to reduce our wait times.


Unfortunately, it is illegal for US hospitals--emergency rooms in particular---to deny care to anyone. Period. They aren't permitted to ask for insurance, they don't have to ask for any form of proof of citizenship, nothing. So, someone flies here from god-knows-where, takes a taxi to a hospital ER, and gets treated. Is that a flaw in the US system? Perhaps. Except that whenever any body tried to rectify it, cries of discrimination (race, age, economic class, you name it) abound.

[Danielle]

Well then how do they bill people Denise? I guess I was under the impression that you had to have insurance or a legal US address so they could bill you. Then again, how would they prove the address is yours without ID. I see the issue there, especially with the harder to serve (ie: homeless) population. We actually have the same issue here. But... what kind of world would we have if we denied the poorest of us even basic heathcare? There are no easy answers.

[gr8mommy]

No, there aren't. But national healthcare is, in my opinion, not one of them.

[Danielle]

Do you have an issue with an effectively run national healtcare system or do you just not trust the government to run it properly? Do you think the current US system is effective?

[gr8mommy]

Both. I don't think the government should be in the healthcare business. Even the limited programs now are in jeopardy because politicians, most with no background in medical care, are all looking out for themselves and their reelections rather than the people that need assistance. I think the best solution is to keep most health care/insurance private, but make insurance companies limited profit enterprises so they have no incentive to cut costs---read, benefits to patients--- in order to give shareholders their dividends. They wouldn't have shareholders anymore.

I do think that, by and large, the current US system is effective. 85% or so people are covered under insurance plans, so we're talking about 15% of folks who can't (or don't, or won't) provide insurance coverage for themselves. I do think there should be need based programs for those who need help. I think they should be stringently managed.

[Jo]

Both. I don't think the government should be in the healthcare business. Even the limited programs now are in jeopardy because politicians, most with no background in medical care, are all looking out for themselves and their reelections rather than the people that need assistance. I think the best solution is to keep most health care/insurance private, but make insurance companies limited profit enterprises so they have no incentive to cut costs---read, benefits to patients--- in order to give shareholders their dividends. They wouldn't have shareholders anymore.

I do think that, by and large, the current US system is effective. 85% or so people are covered under insurance plans, so we're talking about 15% of folks who can't (or don't, or won't) provide insurance coverage for themselves. I do think there should be need based programs for those who need help. I think they should be stringently managed.

I agree and disagree with you. I don't trust the government to run a nationalized health care program effectively. I really don't my taxes spent on the whims of politicians who are making decisions based on whatever issue is currently being drummed up. I also wouldn't like non medical personal deciding coverages any more than I like it now by insurance companies. I also agree with changing the structure of insurance companies. I think it was United Healthcare that paid out a huge bonus to the CEO at the same time they were cutting benefits and raising premiums.

I don't wholly agree that our current system is effective. Yes, there are people who won't work or pay for insurance. But the expense in general of having a private policy is becoming financially out of reach for most people. If a company does not provide benefits, the cost to the individual is insane. I know families who earn decent money but the husband is a contracted employee and so they don't have benefits through the companies. The cost of an individual plan other than catastrophe insurance is a budget breaker.

I do think we also need an a la carte system. We pay $1400 a month for COBRA in Minnesota which is more than $400 more than we paid for essentially the same plan under COBRA in Virginia. That is because Minnesota has so many more mandated coverages, including wigs for cancer patients. I would rather the state mandate that these coverages are offered but let us, the consumer chose which ones we want to pay into. Dave just got the big V. Why should we have to pay for maternity benefits? I would rather have the option of dropping that expense and perhaps adding it back once the girls reach puberty. I would rather be covered just in case something happens then.

I think consumers need to have more power and opportunity to decide what they want to pay for individually. It would lower premiums and perhaps put more insurance policies within financial reach.

[gr8mommy]

I do agree that consumers need to have more power. I also think that we, as consumers, need to really rethink HOW we use our healthcare benefits, and how we take care of ourselves. Many people don't take advantage of all the benefits (particularly for things like yearly physicals, immunization boosters for adults, etc.) yet screech when things that could have been caught earlier or avoided become real (and expensive) problems. That wouldn't change with a national system.

[Danielle]

Many people don't take advantage of all the benefits (particularly for things like yearly physicals, immunization boosters for adults, etc.) yet screech when things that could have been caught earlier or avoided become real (and expensive) problems. That wouldn't change with a national system.

Very true... except for the expensive part, that would be different with national healthcare (at least on the part of the individual).

[Polly]

I'd rather see subsidies for tobacco farmers end.

ITA, Denise. With the exception of the farmers who do not sell tobacco for cigarette production. Virginia has many programs for this: http://www.tobaccofreekids.org/research/factsheets/pdf/0107.pdf

Although, I must add that I also would tie funding for these programs to a guarantee of crop rotation. Tobacco exhausts the soil and shoud be rotated with organic methods, like planting peanuts, instead of biotech chemicals that temporarily enrich the soil but run-off. These are killing the Chesapeake Bay...but I digress.

Fine. I'm all for across the board luxury tax. That includes alcohol, too.

Polly