Wednesday, February 06, 2008

Help Your Country - Die Young

A group of Dutch scientists has estimated the charges on health systems caused by obesity and smoking:

The outcome was that longlivety eventually turns out to be more expensive than living unhealthy and dying young:
"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

The results were obtained not through data analysis but by modeling three hypothetical groups: Obese non-smokers (BMI > 30), non-obese smokers, and non-obese non-smokers. These were then evaluated with regard to their respective statistical probability for certain illnesses from the age of 20 until the time when the model predicted their death. It turns out, though the highest yearly costs were incurred by the smokers in their older ages they were in total less costly since they died early, whereas the expenses for the non-obese non-smokers in their late years added up and the total lifetime health spending was larger. The researchers estimated the average cost for health treatments for the smokers to 220,000 EUR, for the obese non-smokers to 250,000 EUR and for the the non-obese non-smokers to 281,000 EUR.

If you were looking for a reason to get rid of these New Years resolutions, here it is. I am feeling bad already. It's about time I start being a good citizen, hand me the cigarettes.


  1. The only point that I see in this analysis is that end-of-life expenses are pretty much the same no matter how you live.

    One immediate flaw in this analysis is that the productivity and economic contribution of the healthy non-obese non-smoker is not taken into account; I'll bet that that more than compensates for the end-of-life expense differences.

    All the non-economic costs, such as , e.g., as simple as kids not having their grandparents, are also not taken into account.

    These analysts are like the landscapologists and Boltzmann brainists - completely missing reality in their mathematical models.

  2. A person's longevity is more "expensive" to the rest of us only if they fail to contribute value during that time - maybe we should be asking, what can the elderly contribute. There is so much (mentoring, "picking up the pieces" for recycling, etc.) they could be doing, and many are.

    One thing though - the comparison of work-hours versus consumption hours cannot in principle be solved by any tricks involving manipulation of the exchange medium (i.e. money, with interest etc.) for trading value. That is a fallacy of not understanding how utility is created versus how it is distributed.


  3. Hi Neil, Hi Arun:

    I completely agree with you. It's another example that shows how inappropriate a one-dimensional measure like 'money' can be. The analysis they do is of some interest, but I hope people don't abuse it. A while ago I heard a very depressing interview with a Dr. med from a large hospital (in Germany) who was talking about rehab therapy for elderly patients, where the people would stay in the hospital some days longer. He said his experience has been very good, the patients like it, feel better, recover faster after being sent home, the whole family profits, etc. Then he said these arguments however didn't convince anybody to support their program, the only argument that worked was: in total the cost is less.

    Dear Arun:

    Hasn't somebody yet invented the virtual grandfather? Arguing with people's economic productivity is a slippery road. You could go on and argue we should put them all on drugs so they don't need so much sleep, and maybe Valium for the public service guys, cocaine for the scientist, and marijuana for the teachers. Hopefully they work full power for some decades and then drop dead unexpectedly, as to contribute maximally to our economy with a minimum of expenses.



  4. Even if a person does not contribute enough to the countries GDP in their old age, you should still attach an intrinsic value to peoples long life. Ask yourself how much extra tax you would be willing to pay if you knew it would give you ten extra years of healthy life. If they dont include that figure in the equation then they cant draw any conclusions.

  5. I remember during the Great Tobacco Company Lawsuit era that it was noted that smokers didn't really impose a lot of extra costs on the govt, on account of their lower life expectancies.

    Somehow, the tobacco companies never actually made use of that argument, for some reason.


  6. Arun, is there actually any evidence that smokers/obese people are less productive, or is that just something you feel should be true to give some justification for equating "healthier" with "morally superior"?

    Also the numbers tip even more in favor of us unhealthy ones if you factor in the pension system as well. ;)

    In related news:

  7. Hi Bee,

    This is off topic, except that it's another study overturning common wisdom: "Optimal boarding method for airline passengers." The comments say: "This study was motivated by an experience that occurred while traveling to a conference." Cute analysis of something we've probably all wondered about.

    Best, Kris

  8. Getting back to the topic, we could also have Aldous Huxley's Brave New World. Everyone stays youthful and in perfect health until fifty. Then you drop dead. Certainly more cost effective. (Unfortunately, I'd be dead now.)

  9. Hi Bee,

    “The researchers estimated the average cost for health treatments for the smokers to 220,000 EUR, for the obese non-smokers to 250,000 EUR and for the non-obese non-smokers to 281,000 EUR.”

    It is curious to note how some scientists and others look for distinctions between our species and others that are not simply quantitative or qualitative yet rather ones that appear to be unique. In nature you can find others with what could be considered intellect, language (verbal and other), complex behavior (organization), process (like farming), emotion etc. All of these many consider things that distinguish our species from others even though they have been shown to exist elsewhere. The one thing that is different in this regard is that our species is the only one that attempts to extend life beyond what is useful in terms of the individual or the collective. I have often wondered since this appears to run counter to nature in general if this should be judged to help or be a detriment. This article lends another viewpoint from which I might consider this.



  10. The report was an eye opener for me in several ways.

    1. That programs would/could be implemented within governments that would help reduce effects on one's economic cost to the healthcare systems.

    2.That such a study could induce one to think that by assuming a preferred bad habit, it wouldn't matter in the end.

    3. That the effect of psychological processes within regard to the categories chosen never were included.

    It might have been better to look at countries whose life span and ages would show, cultural respective lifestyles, and how they contributed to longevity and cost to systems?

  11. I can't remember who said it, but it was some long ago movie star:

    "Live fast, die young, and leave a good looking corpse."

    Well, I guess if you're obese that last part wouldn't apply. ;-)

  12. You'll love this one :-)

    Ex-Chancellor under Investigation for Violating Smoking Ban

    Former German Chancellor Helmut Schmidt's famous fondness for tobacco has got him into trouble. The former leader lit up at a theater in Hamburg -- after the city introduced a smoking ban. Now an anti-smoking group has reported them to the police.

  13. The consequences of smoking may seem very far off to many young people, but long-term health problems due to the hazards of smoking arise with nicotine and the other toxins in cigarettes affecting a person's body quickly and also affects even the young smokers.
    SmokingHarms - quit smoking methods, Smoking Harms Pregnancy


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