I am sure you will agree with me that public health promotion programs designed to reduce smoking, drinking and obesity are a good thing. After all, we live longer, and our quality of life is higher. Well, both of these claims are correct. There is just one problem that economists have been aware of for some time. The problem is this: People that eat too much, drink too much and smoke big-time have a habit of dying in the average about 7 or so years earlier than comparable people who do not over-eat, drink and smoke. Now, it's possible to parcel out what does more damage, but this isn't the point I am going to make. From a public interest perspective those of us who don't smoke, drink crazily and eat as if there's no tomorrow, should be grateful to those behaving differently. After all, these people kindly pay into our welfare system, pension schemes and so on and so forth, but thankfully they die sooner than those of us who happen to choose a healthier life-style. So, they're subsidising our old-age care, because they usually don't reach old age to begin with. Not only that, overall their health care comes cheaper, too, because us healthier-living characters, while we also get sick, have a habit of escaping death time and again, while the live fast and die young crowd actually achieves at least the dying younger objective, and so, overall turns out to be even cheaper (over a life-time) in terms of health care costs.
Dutch scientists published in PlosMedicine their main finding: 'Until age 56 y, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions.' They conclude: '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.'
This strongly suggests that people like the Scots and US Americans (mind you, the Germans are catching up rapidly) may have got it right after all: Live fast (and unhealthy) and die young. It seems our current pension systems are not designed to handle our longevity anyway, so why not make the best of it.
I am kind of kidding, of course, but there is an important lesson in this: If we succeed in getting people to live healthier and live quite a bit longer, we got to find a way to pay for that, too. An average of another 7 years added to our lives adds huge burdens to any pension system.