Smokers, drinkers and the obese are often scapegoated for costing taxpayers a fortune in health care bills, but new research suggests these groups actually cost the government significantly less than their healthier peers.
The London-based think-tank the Institute of Economic Affairs (IEA) challenges the conventional wisdom healthier lifestyles lead to lower costs for the government and brings into serious question one of the central policy planks of the public health movement – ever higher sin taxes.
Many health economists and public health officials support higher taxes on cigarettes, alcohol, fatty foods and sugary drinks on the grounds people who get sick because of these products have their medical care paid for by others who made healthier choices.
This is especially true in the United Kingdom, which has a socialized health care system funded through general taxation. According to the IEA report, over the next 50 years, the U.K. will spend an additional five percent of its GDP on health care, old age care and pensions – equivalent to more than $134 billion.
Lifestyle choices are often blamed for the rising cost of medical care, but the report’s Christopher Snowdon points out that “this ignores the costs associated with living a healthy lifestyle for longer such as nursing home and welfare.”
Life expectancy in the U.K. is projected to rise to 87 by the end of the next decade – an increase of six years. People living into their late 80s and early 90s are also for the most part not working, with the working age population shouldering the burden for their needs.
These costs are significant, with the needs of an 85-year-old costing five times more than someone in their 60s and ten times more than someone in their 40s.
In short, more people are living longer with chronic and non-fatal diseases that require costly and extensive medical care. Counterintuitively, while the healthy are costing the government a fortune, the same cannot be said for those who indulge in unhealthy lifestyles.
Snowdon argues, “In the UK, there is little evidence to suggest the obese and drinkers cost more over the course of their lifetime. Smokers’ costs are significantly less than non-smokers.”
Since these groups have a substantially shorter life expectancy, they don’t draw on as much public support in terms of social security and health care. Long-time smokers typically have a life expectancy 10 years shorter than non-smokers.
But, Snowdon adds, if obesity only cuts someone’s life expectancy by one year, the taxpayer will likely come up short.
“Absurd claims have recently been made about obesity bankrupting the NHS. The economic evidence is quite clear that it is the aging population, not obesity, drinking or smoking that is the real threat to public finances,” said Snowdon.
“Instead of using those who lead unhealthy lifestyles as scapegoats, we must accept that healthier living merely postpones the costs of disability and disease, and paves the way for higher costs further down the line.”
The report says that longer lifespans may be socially desirable, but the costs rising life expectancy and healthy lifestyles should be recognized as falling on the taxpayer and non-healthy lifestyles shouldn’t be singled out for blame.
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