Yep, yep, yep.On the other hand, if we’re not going to provide universal healthcare, then the poorest among us being one of the likeliest groups to do something that will also make them the sickest among us, creates a drag on all of us. These are after all also the groups who are the least likely to be insured, or are underinsured. That puts strain on medical services, increases costs, and so on.
Not coming down either way here, just pointing out that the impact of a person’s decision to smoke is not *solely* limited to their own body.
But let me reframe this. Say there is a company with a highly addictive product and that company hooks people on their product. They make a ton of money selling a highly addictive product. This product, as it turns out, has a huge societal cost and it causes disease in enough people that use the product that it is obvious the product is causing the disease. What is that company's responsibility to their consumers? If they make a ton of money off of tobacco and shield their profits so they don't have to pay as many taxes--which then leads to lower tax revenue for which to fun Medicaid/Medicare.
We've already decided that Opioids are highly addictive and we are suing companies in order to fund relief efforts in places that were worst hit by the opioid epidemic. We have already determined in court that tobacco is also a highly addictive substance that causes disease. They've already paid out millions over it, and are now doing the same crap they did here, but in places with lower regulations.
While I think it is a personal choice to smoke, I also think that much of what we think of as personal choice is us being highly manipulated by our advertising environment. I think that these companies use behavioral science to trick us into buying more, reap the benefits of the profits and then tax shelter their way out of paying much of anything for taxes. In fact, I think these guys are more of a drag on society than any sick, poor smoker because at least the sick, poor smoker pays taxes. And the reason these folks aren't insured....well, that also has a lot to do with these same people because they don't want to have to offer health insurance to "low skilled" workers.
See the same thing happens here.For the record having grown up in the U.K. I’m enormously in favour of universal healthcare free at the point of access. But smokers and drinkers pay huge amounts in alcohol and cigarette tax and duties to help fund it.
Here in LA, a pack of cigarettes is about $8, and about $4 of that is taxes. These taxes go mainly to fund schools, but public municipalities use tobacco tax revenue for a lot of things. Smokers actually pay a lot more taxes. It makes sense to put it into a fund to help pay for their healthcare later, that wouldn't be bad. But instead, they fund a lot of other social services. Why is it that these people are seen as awful drags on society when our school system relies on their revenue? Wait, are these people really dregs on society at all given that they fund local systems?
When we talk about tobacco, it's easy to start labeling users as one thing or another, but we never label the companies they work for that don't give them health care, we don't label the extra tax dollars they pay above and beyond non-smokers, and we don't label the manipulative advertising of companies designed to get people addicted. I hate when the war on smoking becomes the war on smokers, but that's exactly what happens.