by Drew J Jones
Thu Jan 25th, 2007 at 06:20:21 AM EST
Yesterday Mark Thoma's Economist's Voice included a diary on NHS doctors and trusts debating whether to treat smokers -- a question that I find absolutely horrifying, not because I'm a smoker, but because of the absolutely disgusting degree to which smokers have become targets in this day and age. The argument is fairly straightforward: Smoking increases costs. Smokers are more likely to suffer complications, such as failure of tissue to heal quickly and infection. Thus, argue proponents, finite resources should be concentrated on those who are least likely to suffer such complications.
It is, as one of the opponents points out, the accepted norm to preach discrimination against smokers in western societies. Smokers in Nottingham fork over £5.40 for a twenty-pack of Marlboros -- fully three times the cost of the same pack in Atlanta. (And, yes, you can pay less if you want to smoke the stale European garbage, but even that will run you £4.25.) In San Francisco, last I heard, smokers were banned from lighting up in the streets. Across America and Europe, smoking is being banned from bars and restaurants. And now, finally, we have discrimination in the world of medicine.
But, as is always the case, no such discrimination exists against (say) the morbidly obese, who enjoy greater influence due to their larger numbers -- and who, I'll bet, cost society far more than smokers could ever dream. Presumably these are not life or death surgeries, but, if we are to begin discriminating based upon cost considerations, then socialized medicine in Britain has rendered itself no more a moral beacon than its privatized counterpart in America. And it is made worse by the fact that smokers in Britain are already paying taxes for the NHS, in addition to the insane "sin taxes" they pay at the supermarket. It is, in other words, organized theft.
As I have pointed out in the past, I am, while leaning to the supportive side, very suspicious of universal medicine because of the political football I knew our habits would inevitably become. (My habit has long become one, of course, but putting medicine in the political arena would, without question in America, open the door to full-scale totalitarianism, as far as habits are concerned.) I despise, knowing that I am more intelligent than most of them could ever dream, politicians who pretend to know what is best for me, and who pretend to know what is, or is not, harming society to one degree or another. As a fairly militant cultural libertarian, I'm of the opinion that we all have our bad habits (smoking, poor eating, drugs, booze, dangerous sexual behavior, etc), and that our habits should be off limits to our potential tyranny of the majority. I don't begrudge people these choices, and I expect the same treatment.
Now the argument will, of course, be made that smokers chose to adopt their destructive habit, and this is unquestionably true. Most, if not all, destructive habits are a matter of choice. But allow me to ask: Are smokers going to be given a corresponding discount in their tax rates? The fact remains that smokers pay for the NHS just as nonsmokers do, and even more at a given income because of the previously-mentioned sin taxes, as well as the taxes they pay, in America, for programs like Social Security and Medicare that they are less likely to receive back upon retirement given their lower life expectancies.
And this is to say nothing of my bet that the tax revenue generated by cigarettes in England likely exceeds -- and by an obscene amount -- the difference in cost associated with treating smokers as opposed to nonsmokers.
It's easy to hate on smokers -- to blame them for the problems of society associated with higher medical costs while ignoring the ever-growing number of Jabba-the-Hutt-like beings that make up our populations. (And, by the way, I don't see any discussion of all the expensive drugs advertised on American television dealing with illnesses associated with obesity. I wonder how that impacts our public spending and insurance premiums....) The smokers have paid amounts exceeding their fair share without bitching, yet still the social engineers want more. This obsession with controlling one's fellow human beings is despicable, and it is dangerous. Nonsmokers have been given everything they wanted on a silver platter: Smokeless bars, smokeless streets, high taxes, and on and on. They spent years whining and got their way, so now, please, leave us the hell alone.
Or, if they're truly going to insist on denying treatment, then give us back our fucking tax money.