Light up, get fat — it’s the patriotic thing

In their private lives -- what today we would call "lifestyle choices" -- there's a tradition in America and particularly here in the West to let our neighbors alone, in hopes of being let alone, ourselves.

An imperfect tradition, but one in which we continue to make progress.

One of the great exceptions is in those areas where the "Big Brother" statists can argue (and do), "That particular lifestyle choice increases collective medical costs for all of us, so it has to be harshly discouraged" -- by taxes and restrictions at first, followed by prohibition if and when they can get away with it.

First they tried alcohol and drugs. Then tobacco. How about seat belts? Motorcycle helmets?

Proposals to limit restaurant portions and ingredients by law -- even to bar restaurants from serving fat people, outright -- were at first offered as absurd parodies, but are now at hand.

In fact, the notion that the majority, through the armed force of government, has a moral right to restrict our neighbors' behavior due to our "collective responsibility" to pay their medical bills, is simply dangerous and contrary to any principles of freedom.

But now comes word that the entire premise -- about collective medical costs -- is faulty in the first place. It turns out smokers and fat people and others who pursue "unhealthy" lifestyles don't run up bigger lifetime medical bills, at all.

In a paper published online last week in the Public Library of Science Medicine journal, Dutch researchers found that caring for thin and healthy people in adulthood actually costs more than the total lifetime costs of caring for either fat people or smokers -- countering the common perception that preventing obesity could save collectivist governments millions of dollars.

"It was a small surprise," admits Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."

Van Baal and colleagues relied on "cost of illness" data and disease prevalence in the Netherlands in 2003.

The researchers found that from age 20 to 56, obese people racked up the most health care costs. But because both the smokers and the obese people died sooner than those in the healthy group, it cost less to treat them in the long run. On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years.

Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.

The cost of care for obese people was $371,000 -- for smokers, about $326,000.

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

"This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," comments Patrick Basham, a professor of health politics at Johns Hopkins University, who was unconnected to the study.

Now, under the old and wise rule that people are responsible for saving and/or buying insurance to pay their own (and their families') medical bills, none of this matters a bit. Staying relatively slim and active and moderating or eliminating unhealthy habits are their own rewards, simply because you'll feel better.

But if you're a Nanny State collectivist, then the lesson of this study is clear: Stop exercising, bloat up on empty calories, take up the tobacco habit.

And convince everyone you know to do the same.

In fact, according to the heavy-handed policies you embraced back when you thought these bad habits cost the state money, you might even consider demanding that our politicians make obesity and tobacco use mandatory.