Does a healthy public save or cost taxpayer money?

You always hear that obesity or smoking puts a strain on the medical system and costs taxpayers. Is this true? Even if those unhealthy folks pay into Social Security and Medicare for years and then die before collecting the benefits?

The average age of death is ~75. If someone dies (as an indirect result of poor diet, smoking, drug use, etc) at age 65, then in some ways their lifestyle has saved taxpayer money. For example:

  1. if they have retired then they are not adding much to the economy anyways – their death causes no loss of tax revenue
  2. fewer medical bills, less general stress on medical system down the line
  3. no more social security or other benefits are paid

On the other hand, if unhealthy people are kept alive longer due to medical intervention, then they are not only a burden on the medical system early on, but also later on as well. However they do often die, which lessens the burden on the medical system.

Healthy people, on the other hand, who are more likely to grow old, have a longer time over which to put stress on the medical system, and eventually in the end, they will get near death and put a lot of stress on it eventually anyways.

So: In general, does a healthy public save or cost taxpayer money?

(This could go in GD; it will probably be debated. However I think it is a factual question they may have an clear answer)

Lots of smokers are very sick, and suffer from a greater or lesser degree of disability, for a fair spread of time before they die. It’s not as if smokers typically live active, healthy lives and then conveniently keel over one morning at around the age of 66.

There was just an episode of This American Life on this topic. Ah, yes, it’s Act III of this episode (not audio yet). They conclude that smoking actually saves society money from people dying early. The rest of the story is pretty comical. I recommend it.

OTOH healthy-living people don’t have an inexpensive last period of life either. The counterpart of ‘dying from consequences of unhealthy lifestyle, age 55-65’ is probably ‘dying from dementia, age 90-100’.

Are these smokers just dropping dead early, or are they seeking prolonged medical treatment?

Lung cancer kills people fairly quickly and there isn’t a lot of treatment for it so it is cost saving. The cardiovascular problems and emphysema are probably more expensive to deal with. It is controversial whether the smoking increases or decreases health care costs.

When you consider savings in pensions and social security, I don’t there there is any question that smoking saves society money. Here is how the federal government deals with the larger economic picture: "The goal of the U.S. health care system is ‘prolonging disability-free life,’ states the 2004 Surgeon General’s report on the health consequences of smoking. ‘Thus any negative economic impacts from gains in longevity with smoking reduction should not be emphasized in public health decisions.’

weh? Cancer is MUCH more likely to kill an older person than “dementia.” You should also be more specific regarding to what aspect of “dementia” you are referring.

From Alzheimer’s is 10th on the list. Cancer is 2nd.


I should stop checking the dope and start listening to my podcasts! I’m falling behind!