Many of us have the illusion that each person is responsible for his or her own health care cost. Each person pays his or her health insurance premiums and co-pays, and how he or she chooses to manage his or her health is nobody else’s business.

However, that is not how health insurance works.

All health insurance policies are group policies; even individual policies are groups of people mixed together. All health insurance works the same way, whether private, employer-based or governmental health insurance, such as Medicare and Medicaid. Premiums and taxes are collected and put into a big pot. That money is then used to pay out for the treatment and benefits that people receive, plus administrative costs and profits.

It doesn’t matter if a person is covered by an employer-based insurance, private insurance or Medicaid or Medicare, it is all the same. Money goes in from premiums and taxes; money goes out to pay for hospitalizations, treatments and prescriptions. The more that comes out, the more that has to go in to cover the costs.

A good example is smoking.

Many people would argue that they have the right to choose to smoke. They are taking personal responsibility for their choice by paying tobacco taxes and their health care premiums. That it is none of my business.

Unfortunately, that is not the case.

I researched a number of different sources in order to determine the total cost of treatment for smoking-related illnesses in the United States every year. The Centers for Disease Control places this total at $170 billion a year.

All tobacco taxes, state and federal, bring in $12.86 billion a year.

That means that $157.14 billion a year in smoking-related medical treatment is not covered by tobacco taxes.

Who pays that amount? We do, though our Medicare premiums, state and federal taxes and private insurance premiums. The higher the cost of treatment, the more we are all charged. The more money employers pay for health care premiums, the less they can pay in salaries. The higher the cost of treatment, the more you have to pay in co-pays.

According to the IRS, in 2018, there were 57.572 million taxpayers. Dividing $157.14 billion by 57.572 million gives us the average cost that all U.S. taxpayers and health insurance premium payers each pay to cover smoking related health care and treatment — $2,726 a year. Remember, that is the average, so folks who pay more in taxes and premiums pay more to treat smoking-related illness; and folks who pay less in taxes and premiums pay less.

Whether you chose to smoke or not, you are paying an average of $2,726 a year to treat smoking-related medical costs.

We need to break ourselves free of the myth that each individual is responsible for his or her own health care cost. We are all in this together and your health care costs impact my pocketbook.

So what can we do?

1. We can require folks who choose to smoke to take personal responsibility for all of their smoking-related health care costs. That could be done in one of two ways: Increasing the tobacco tax to $43.55 a pack and using that funding to pay for smoking-related health care costs; or deny smokers coverage of their smoking related treatment.

2. My preference is that we switch to a single-payer health care system, accept that smoking costs all of us money and attack it as a public health problem. That would include a variety of approaches, such as increased taxes, total funding for smoking cessation programs and other incentives to help folks give up tobacco.

When it comes to health care, we need to accept that we are all in this together. The choices other people make impact my pocketbook, and vice versa.

Dean Bailey MPA, CRC, LSW has worked for more than 40 years in social services, mostly in the area of behavioral health. He lives in Auburn.

 

 

 

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