Novel way to curb Smoking Public Health Cost

It has happened for nearly all illegal drugs, so I'm sure some of it will happen with tobacco too.

The fact the tobacco grows well in numerous areas here means some people will grow their own. Even though much marijuana was once was smuggled in here, personal and black market marijuana cultivation never came anywhere close to eradication. Even wild natural growth was not stamped out, though its THC concentration may not be what the black market wants.

While I don't know anyone who admits (to me) to be in that position, I've heard that it is surprisingly common.

Those graphs do seem almost identical.

When comparing tax levels, don't forget to include additional government revenue from our 1998 Tobacco Master Settlement Agreement, so far approaching roughly $200 Billion. This money does not appear as federal or state taxes, but is rolled into and hidden in the pre-tax wholesale prices.

The states were supposed to use it to discourage smoking and offset their tobacco-related health costs, but unfortunately most of it was squandered on everything but. "Free money" quickly gets spent. Even worse, some states even securitized their annual payment stream to get a big windfall up front.

 

Yes, I know it's easy to grow and stuff. But is it worth it? I mean, it seems to me (from a very limited understanding) that tobacco relaxes you a bit. But it doesn't do that as effectively as marijuana, and it doesn't give you the highs of other drugs. So would it be worth the bother of trafficking or illegal growing or whatever? I have no idea.

It is almost spooky.

I understand it varies from state to state. But where you live, what does a packet of 20 or 25 cigarettes cost? Here it's about A$40-50, I think - so about US$27-33, or starting at a little under two hours at minimum wage.

 

The price per pack is high enough in some states that there is an underground market of cigarettes brought in from states with lower prices.

 

For U.S. taxation purposes, a pack is 20 cigarettes. I believe that is also an almost universal retail pack size here (apart from singles), though apparently many other countries have larger sizes available. People wanting more, buy a carton of 10 packs.

I thought a typical price in my state (WA) was about $10 per pack. This map agrees:
https://worldpopulationreview.com/state-rankings/cigarette-prices-by-state
showing $10.14 for my state, and a range in other states from just over $6 to just under $12, an average of $8 and a median just slightly less.

These pages show significantly lower prices:
Cigarette Prices by State in 2022 | Balancing Everything
Map of State Cigarette Taxes & Price Per Pack

 

I see your point its complicated for sure but as far as Group Insurance if you smoke you policy monthly payment should be substantially more than someone who gives a shit about his health. I retired last year from a Corp job a guy who still worked there in my dept was a super heavy smoker same age as me died about 5 months ago.

 

Thanks. That is interesting.

So your cigarettes are between 1/5 and 2/5 of the price of our cigarettes, but your smoking rates are extremely similar, and have fallen at a similar sort of speed.

I thought our policies on pricing, branding and advertising were working really well. But perhaps they are not. This is really filling me with doubt.

 

I retired well before Medicare age, and without a retirement medical package due to those pesky recessions that cause mass layoffs before workers qualify for such. So I've been paying my own individual medical insurance ever since, but at least am not far from Medicare age now. This gets very expensive as one gets close to Medicare age.

Looking at the rate sheet for plans from my health provider (it is Open Enrollment now), smokers pay 20% more than nonsmokers. For any given plan, the only other pricing variables are age and county of residence.

I don't know if employer or other group plans are priced by smoking status, but some employers certainly do give discounts or other benefits to employees who follow certain healthier habits.

Because he has ceased drawing benefits, your employer and Social Security saved a ton of money on his pensions. And Medicare saved a ton on his senior-age health costs.

But these savings are too controversial and non-PC to be included in most studies about overall societal costs of smoking.

 

I was able to work till 66 so luckily did not have to get after market insurance which is very expensive.

We are on Medicare Advantage United Health Care PPO Choice. Its very good has covered all my existing doctors. Even covers free gym which is great as I go everyday trying to get back into shape.

Did not know about the smoker's 20% health providers are charging as we don't smoke. Should be more. There's a ton of late in life care with liefetime smokers. Very debilitating.

 

That 20% smoker's premium (which starts at age 21, younger smokers are not penalized) may be specific to my state and health plan. I wouldn't be at all surprised to find different surcharges elsewhere.

Over a lifetime, I'm not sure that smokers are more medically expensive than non-smokers. Even non-smokers get extremely expensive later in life. My non-smoker dad is a prime example, going to the doctor every month for many years now, with several ER visits and hospitalizations in the past couple years.

Smokers might just run into those costs earlier, shortening their life and compressing those same health expenses into fewer years. This most certainly impacts employers, who have to pay for a bunch of employee medical costs that are delayed to retirement Medicare years for non-smokers. Medicare might come out even, or even ahead. I just don't know for sure.

Pensions and Social Security should benefit from smokers, as they pay in the same amounts but draw benefits for a very significantly shorter period. But we have no path for transferring those savings to health coverage. In fact, pension systems are already fairly stressed.

 

We just have a healthcare system instead. It's loads easier and cheaper.

 

Is it faster too?

Past news articles here have described a two-way flow across the U.S.-Canada border to take advantage of some of the advantages of each. U.S. patients getting prescription drugs much cheaper in or from Canada, or sometimes even getting some drugs that are prescription-only in the U.S., over-the-counter as nonprescription in Canada. Canadians willing to pay higher U.S. prices coming here to get treatment quicker, skipping longer waiting lines at home. Canadian health agencies even sending some patients here for certain specialty treatments, for lack of approval or capacity or equipment at home. E.g. a few years back, there was news about how many BC mothers-to-be with various special conditions or complications were being sent to deliver in Seattle, paid by their own health system. It seems that also gives the newborns dual citizenship.

Though the actual rate at which Canadians get care in the U.S. seems to be a strong function of the political views of the reporting entity.

Other past articles have described medical tourism, people traveling overseas (outside North America) for various treatments. Americans do it save money, Canadians do it for quicker treatment.

Canadian sunbirds are advised to get some form of health or travel insurance, to cover the high costs of any medical treatment during their long winter residence here. And apparently there are a significant number of senior Canadians who qualify for the U.S. Medicare system, through marriage or work history or green cards.

 

Don't know if it still is true, but I've heard Canada described as a country the size of the US with the population of New York. It just might be easier for their system and patients to hop the border. And it isn't like regions and care in US don't have long wait times, or require long travel.

 

Actually, the reverse migration, USA to Canada, is true due to drug prices.

Bob Wilson

 

As for Canada's population, make that equal to the population of California, or twice the population of New York State.

Though the vast majority of Canada's population is compressed into a fairly narrow band along the U.S. border.

 

If the logistics mean it is cheaper and easier for Canadians to cross the border for some care, more power to them. I suspect the US providers wouldn't support a stop being put to it.

 

When I was last in Buffalo NY 25 years ago was told every medical facility had a cash plan for Canadian customers.

 

when we were in northern vermont many decades ago, we were talking to a canadian couple who said that many canadians came here for treatment that had a long wait time in canada.

i have also been reading a lot of horror stories about u/k wait times through covid, and our local wait times have greatly increased from pre to 'post' covid due to the retirement of many health care workers and salary competition

 

I don't think it is ever cheaper for them. They would do it only for other reasons.

 

It's usually about the same, although the lack of paperwork in Australia can make things marginally faster.

I've heard of waiting lists in Canada and they're getting bad in the UK. I don't know what the situation is in Canada, but in Britain it all seems to be part of a deliberate plan to make people less enamoured of the National Health Service so people will be less likely to oppose a sale to American insurance companies in future. But here the only real waiting lists are for psychiatry and psychology, because after Covid demand has shot up in a way they just weren't prepared for.

If you live in Europe, Australasia or Asia, there are tiers of travel insurance. The cheapest is for domestic travel only. The next cheapest, if you're European, is for travel within Europe. Then sometimes there's a deal that covers certain other countries - ones with affordable healthcare or with reciprocal healthcare rights with your home country, or developed countries where risks of hospitalisation, flight cancellation, crime and other insurancey things, are lower. Then there's a "Worldwide excluding USA" cover. And finally, the most expensive by far - usually two or three times dearer than "Worldwide excluding USA" - is "Worldwide including USA".

 

Yep. Our healthcare system is a disgrace. Based on $$$$ not healthcare.