2010-02-03 14:29:51 - A new study, which reaches the same conclusion as earlier ones, suggests that funding health care reform by slashing $40 billion yearly from Medicare may cost more money in the long run by discouraging seniors from seeking health care early on before small problems mushroom into big ones, thereby leading to substantial increases in expensive hospitalization, and perhaps other costs of providing long-term care.

That's why, rather than funding health care reform on the backs of seniors, and probably harming their health as well as increasing overall medical care expenses, it would be better to raise the same amount of money with a modest surcharge on health insurance premiums for smokers.

This, explains public interest law professor John Banzhaf, would require smokers to assume some personal responsibility for the huge costs their behavior imposes on society, and provide them with a strong additional incentive to quit -- a process which would lead to fewer expensive hospitalizations and long-term care for the many diseases caused by smoking.

The new study, published in the New England Journal of Medicine, found that an increase in Medicare copays by

just a few dollars led to fewer doctor's visits when problems could be detected and treated early, and to correspondingly more and longer hospital stays.

As the chief researcher reported: "patients may defer needed care and may wind up with a serious health event that might put them in the hospital. That's not good for the patients, not good for society, not good for anybody,"

This new report validated the conclusions of several earlier studies. These studies reported that even a tiny $1 copay under California's Medicaid program led to an 8% decline in hospital visits, but to a much larger 17% increase in far-more-expensive hospital days.

This is an ill-advised cost containment strategy . . . The increase in outpatient co-pays appears to produce both greater health care spending and worse health” said the chief researcher.

Prof. Banzhaf suggests that a better and fairer funding strategy for health care reform when it is reconsidered would be a modest surcharge on the approximately 46 million smokers who already spend over $90 billion annually on tobacco products, and whose choice to smoke adds almost $200 billion in totally unnecessary health-related and other economic expenses each year to our already overburdened health care system and ailing economy.

Requiring smokers to pay only an extra $75/month for health insurance -- a fraction of what they now pay on the average for tobacco products, and an even smaller fraction of the costs they impose on the great majority of Americans who are nonsmokers -- would bring in over $40 billion annually; about the same as the Medicare cuts.

But, unlike the Medicare cutbacks, the surcharge would target those who are the major cause of totally unnecessary health care expenses, and actually help to bring down the costs of treating the many major and very expensive diseases caused by smoking.

A copy of the proposal prepared by Prof. Banzhaf for Action on Smoking and Health (ASH), America's first antismoking organization, can be found at: ash.org/proposalsurcharge

PROFESSOR JOHN F. BANZHAF III
Professor of Public Interest Law at GWU,
FAMRI Dr. William Cahan Distinguished Professor,
FELLOW, World Technology Network, and
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America's First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 // ash.org/