Taxpayers need to know how heavy a toll they'll be paying for weight-loss drugs | Hacker News Reader

Taxpayers need to know how heavy a toll they'll be paying for weight-loss drugs

chicago.suntimes.com

24 pointspaulpauper38 comments

yes, but it has also to be compared to the toll of not paying for these drugs

IIRC, moves like this actually increase health care costs. This and the anti smoking crusades. Because if people due suddenly at 45 it's much cheaper than paying for a bone marrow transplant and chemotherapy and assisted living at age 75.

Also the extra burden on social security where all people would die at 65/70 due to smoking now die at 85/90.

I feel the anti-smoking crusade wasn't about health, it was about neurotic people using the government as a weapon to bludgeon people because they didn't like the smell of cigarette smoke. The government were happy to oblige because they liked all that settlement money and extra taxes.

DeSantis in Florida recently said he didn't want to decriminalize pot because he didn't like the smell. Funny.

We reap what we sow.

I suspect it's more to do with being the number one cause of preventible cancer by far.

>I suspect it's more to do with being the number one cause of preventible cancer by far.

Yes, I'm sure. How altruistic. If only all the vitriol wasn't there, that would be a lot more believable.

Now we get to pay around ~$500K for memory care for each of the 400,000 people a year we saved from dying in their 60s.

Shouldn't we be happy that we have a society where people got to live longer lives? That at least they got to meet their grandchildren? Sure, maybe it raised our taxes, but it created a real palpable good in our world.

My aunt is in her 60's and currently dying of cancer most likely caused by a lifelong smoking habit. Her sons would rather she kept living.

I think the drop in smoking rates are good, I think the tactics used to get there were pretty bad.

Think of all the side eyes and snide remarks she received throughout her life because of it. Smokers became the new national villain between communism and terrorism. Treated like complete pariahs, and still so.

>Her sons would rather she kept living.

Absolutely.

Here's the historical smoking rates. The biggest drop came around 2010, 2011, right around when vapes really became a thing. All that public shaming was probably unnecessary.

https://www.statista.com/statistics/261581/current-adult-smo...

Who dictated "the tactics"? Welcome to humanity and the way it is. I've been obese and I've been in shape - guess what; people treat you differently and make different assumptions about you. If you're drunk or high all the time, people judge you (guilty of that in my past too). My cousins lovingly encouraged my aunt and uncle to quit smoking throughout their lives, but that didn't seem to have much effect either.

Ya smoking is addictive as hell to a lot of people, particularly if they got hooked young. They all know it's bad for them too.

So what judgements do you cast on smokers?

My best friend in the world literally told me this morning that he's trying to quit again (we've been friends long enough that I remember when he started smoking). He said he wishes he could "bitchslap" his younger self. The odds probably aren't good, but I'm going to encourage and help him in any way I can. He's young enough that he can probably still recover from most of the ill effects.

I wish him luck. I'm sure he's tried it but substitutes like vapes or gum at least get the tobacco out. That would be a significant improvement over cigarettes.

>I'm going to encourage and help him in any way I can

Imagine how counterproductive it would be to call him a dirty, stinky smoker, take some of his money and not allow him in your house. That's kinda my point with this whole diatribe.

I don't allow him to smoke in my house or car, but I'm not mean about it. He's doing the gum this time; I encourage vaping, but he believes that that is as bad for the lungs as smoking which I doubt highly.

Have him read this from the NHS. They recommend vaping as a substitute for smoking. I feel they are less compromised than US institutions.

https://www.nhs.uk/better-health/quit-smoking/vaping-to-quit...

Will do. He’s not really into the medical establishment regardless of the country of origin, but it can’t hurt. I do appreciate any suggestions.

I would highly recommend against using him or a vape. When you use gum or the vape you aren't combatting the addiction or the habit. Using the patch is more effective as it allows you to tackle the habit while weening yourself off the nicotine

The patch works really well. When I quit I bought the step 1 patches and just cut them down to ween myself off the nicotine. They work good because they help you tackle the habit while keeping the nicotine cravings down. The habit is actually the tough part to overcome.

A vape where he can control the nicotine and lower it progressively works well. Start kinda high while he gets off cigarettes and lower it once he starts to think of cigarette smoke as less appetizing than before. I found that nicotine is not the only addicting thing about cigarettes, and I don't mean just the habit, so vaping helps as an intermediate step.

> Smokers became the new national villain between communism and terrorism. Treated like complete pariahs, and still so

Now do obesity. Unlike smoking, we now have a cure.

In Canada they add fire retardant chemicals to the cigarettes... So the whole it's about health argument kinda goes out the window. The truth is that some people hate smoking and so what it to be banned

My dad was a firefighter and worked in fire prevention as well as investigation back in the day. It was a rather common cause of death that someone would fall asleep smoking and ignite their mattress. Also tons of fires were caused by flicked butts (I have to say that treating the world as their ashtray is one aspect of smokers that I find rather angering). So I believe there was good reason for the fire retardants to be added.

Also, I do appreciate the other comments/suggestions down the chain.

This is weird complaining about old people dying at 85/90 as opposed to 65/70.

The solution to the social security burden is not to get rid of old people but to make them live longer and healthier lives, the more the better, preferably indefinitely youthful. Then you don't need social security.

> I feel the anti-smoking crusade wasn't about health, it was about neurotic people using the government as a weapon to bludgeon people because they didn't like the smell of cigarette smoke.

This just says that you should learn the history before dismissing decades of work by medical and public health professionals. Smoking has significant negative impacts on everyone around the smoker, and when it was legal attempts at isolation were often comically ineffective. Banning it in public spaces or around children and others who can’t consent makes sense on those grounds alone.

There’s also a significant time lapse between when people start and when they realize the mistake. Discouraging it significantly reduces the number of people wish they’d understood the negative impacts when they were young, or tried to kick the habit but were unable to do so.

There’s a 3rd option: what’s the cost of figuring out why we need these drugs in the first place?

But that’d require investing in research that likely isn’t profitable. Best to just keep investing in both fattening ourselves up and making drugs to counteract that.

> just keep investing in both fattening ourselves up and making drugs to counteract that

The drugs have already caused junk-food companies’ stocks to drop. I know two people who took them, lost weight by changing their eating habits, stopped and kept the weight off. These are cures. The whole it’s unprofitable to cure things hypothesis is bunk to start with, but it’s doubly stupid here.

There is an argument to be made for natural selection letting this work itself out. Some people might not be suited for an environment of low-cost unlimited calories floating around them.

> an argument to be made for natural selection letting this work itself out

This is like, after discovering vitamins exist, arguing that anyone who didn’t luckily eat a balanced diet has useless genes.

> people might not be suited for an environment of low-cost unlimited calories floating around them

Nobody is genetically suited for modern society. We’re barely suited for an agrarian one.

Like other eugenics claims, this is both insulting and ignorant. Natural selection is a slow process for most organisms, especially for anything living as long as humans do, and it’s primarily driven by the likelihood of successful reproduction. Diseases caused by being overweight which mostly affect people by the time they could be grandparents seems unlikely to ever see a significant effect.

What’s really bad about this is the assumption that there’s only one axis for measuring fitness when in reality there are many, and ignoring environmental factors as well. Callously saying “let the fat people die off” is implicitly saying that none of them will have a net positive impact on society, and it’s refusing to consider whether some or the blame lies in our culture: for example, we have redesigned life to minimize exercise, heavily subsidize the least healthy foods and lifestyles, and the poor people who are disproportionately affected by this also have the worst access to healthcare. There’s nothing natural about the resulting selection pressure.

Would you say that approach has been working as you desire over the past several decades?

I’m noting one argument among many for why the government shouldn’t spend an extra half million over a lifetime for this treatment, not that I desire anything one way or the other (beyond wishing people were more active).

If one were to point to the far lower fertility rate associated with obesity, then the answer might be maybe.

Between personal finance and a basic understanding of nutrition works it’s unbelievable how poorly equipped the average adult is.

>a basic understanding of nutrition

There's a loooong history in the US of nutrition misinformation. A couple of examples:

  - The food pyramid.
  - Eating fat makes you fat, therefore sugary food being labeled as "fat free," implying healthy.

One thing to remember is that the original food policy guidelines were decidedly not what the industrial food procedures wanted. The policies you’re referring started with a mistake made by a Nixon-era task force responding to what was then seen as an obesity crisis, even though it was notably lower than now.

Here are some period news stories:

https://www.washingtonpost.com/archive/lifestyle/1977/01/20/...

https://www.washingtonpost.com/archive/lifestyle/1977/08/18/...

There’s an especially interesting quote from one of the doctors involved:

> "What are the risks associated with eating less meat, less fat, less saturated fat, less cholesterol, less sugar, less salt and more fruits, vegetables, unsaturated fat - and cereal products - especially whole-grain cereals? There are none that can be identified and important benefits can be expected."

They were wrong on the salt for most people & cholesterol, but in general that’s not especially bad advice. The problem was that they didn’t think about how well people would follow any of this – taking away most of what makes food taste good, especially in the era before white Americans used spices - and especially how the manufactured food industry would take this as a massive growth opportunity and key qualifiers like switching to a higher ratio of complex carbohydrates were largely forgotten.

I've also read that the food pyramid was apt for the time since meat and whatnot was so expensive. They were trying to get enough calories in people.

The food pyramid has its origins not in recommendations for a balanced diet but in food shortages. The USDA released the Basic 7 food guide in 1943 to help U.S. citizens cope with food rationing during World War II.

https://www.britannica.com/science/food-pyramid

That was a huge shift indeed - when my grandmother took “Home Economics” it was all about having enough safely-cooked calories for manual laborers (Illinois where she grew up ran to farm and factory workers) and nobody could afford anything like the amount of meat or dairy we now eat. My grandfather used to eat beef a few times per year, when the cousins who had dairy cattle culled the herd.

It's not unbelievable, it's by design. The consumer economy depends on it

I’ve never been obese and, judging by my family, likely never will be. I still think GLP-1 drugs should be free for anyone eligible. We have industrial complexes at both ends of obesity and diabetes. This is a trillion-dollar boost to the American economy in cost savings alone.

Has anybody attempted to show the actual math here in a serious manner?

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