Society pays tab for personal liberty

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sardia
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Society pays tab for personal liberty

Postby sardia » Wed May 25, 2016 8:44 pm UTC

https://www.washingtonpost.com/postever ... -for-them/
For better or worse, the United States tries to let people take risks as long as they do not interfere with others. Want to smoke? Do it outside away from buildings. Want to ride a motorcycle? Get a license — adults can even skip the helmet in 28 states. We don’t like imposing our understanding of the good life on one another, so if fewer total years (or fewer with functional body parts) on a bike is your ideal, ride on! But calculating the cost of risk-taking to others is not that simple.

The problem with this tolerance is threefold. First, your lung cancer from smoking and brain injury from a bike wreck tax the health-care system: Close to $170 billion is spent on smoking-related medical services each year, and more than 156 billion is lost in productivity due to premature death and exposure to secondhand smoke. Injuries and deaths from motorcycle crashes cost approximately $12 billion in one recent year, and one study of 105 hospitalized motorcyclists showed that 63 percent of their care was paid for with public funds. Second, few people are capable of accurately weighing the benefits against such unfamiliar risks as inability to breathe unassisted or suffering locked-in syndrome because of a brain injury, so it’s difficult to say thrill seekers are taking fully “informed” risks. Third, we feel obligated to help our fellow citizens, and are usually willing to rescue the barely sane — whether naive first-timers or skilled experts bored with available risks — when their feats go awry. As much as we encourage athletes to engage at their own risk, the downside when it happens is shared.

I'm not quite sure if this is a critique/test of libertarians but should we rescue these kinds of people?
I don't sympathize with rich white guy's with more money than sense but the article slips down the slope to drug users. Logically it makes sense but I don't like the conclusion of not treating the (self imposed) sick. Like it's one thing to leave a frat boy on the mountain to die, but it's another to leave thousands of smokers or drinkers to succumb to their illnesses. The idea of a 'Do not rescue' order like they do with old people is a possible solution.

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Re: Society pays tab for personal liberty

Postby leady » Wed May 25, 2016 9:16 pm UTC

The libertarian question isn't really should "we" or not, to which the answer is yes to an extent in most cases. The question is really whether "we" should be forced to, the answer to which is typically no.

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Re: Society pays tab for personal liberty

Postby LaserGuy » Wed May 25, 2016 9:24 pm UTC

I see three possible approaches. One is the strictly actuarial approach... everybody pays a health insurance premium based on their risks, and unusual or especially risky things (base jumping, say), may require its own special insurance. This is arguably the most fair in principle, except that risk isn't well-correlated with income. This can lead to all kinds of undesirable outcomes--people with family histories of condition X being unable to afford coverage for that disease, for example. You could try to link it purely to behaviour things only, but even still you run into problems--you can't prove that, for example, a given person's lung disease is a result of their history of smoking. It could be, but it may be unrelated.

The second approach is that you significantly tax risky behaviours that you want to stop people from doing, but provide universal coverage in the event of tragedy. This has the benefit that you don't penalize people for being sick, or having a family history of being sick, and don't penalize people from seeking preventative treatment, but instead can micro-target the behaviours that are problematic. So you might add a $1000 renewal fee on motorcycle licenses or a 30% tax on cigarettes. This requires a lot more work and a lot more government intervention than maybe people are comfortable with, but it allows society as a whole a method to both acknowledge that these things have costs that aren't being accounted for, deter the behaviour from happening in the first place, while still allowing people to engage if they really, really want to.

The third is you make things illegal. This is a really blunt approach and generally doesn't lead to a lot of good outcomes, IMHO, unless the behaviour is so obviously bad that you can't compensate for the externalities in any sensible way through market mechanisms.

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Re: Society pays tab for personal liberty

Postby sardia » Wed May 25, 2016 11:51 pm UTC

leady wrote:The libertarian question isn't really should "we" or not, to which the answer is yes to an extent in most cases. The question is really whether "we" should be forced to, the answer to which is typically no.

Are you saying a libertarian world would rescue them? You're vague as to who you're referring to.

The insurance model doesn't really work (or requires you to be very very heartless). I remember during the height of fire season, nobody would pay their premiums until their house/area caught on fire. That defeated the purpose of the premiums. In the end, the firefighters took a hard line approach (after multiple warnings), and let the guy's house burn down.

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Re: Society pays tab for personal liberty

Postby leady » Thu May 26, 2016 8:46 am UTC

I think yes a libertarian world would help them, just not in a "zero fault" way and not in an indefinitely enabling way. Naturally not all libertarians would, because some are more heartless like myself (I have no desire to subsidise other peoples life choices or moralise at them, I'll just let the market do it for me).

Of course libertarians generally also believe that the removal of the incentives to make deleterious choices minimises the issues in the first place

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Re: Society pays tab for personal liberty

Postby Neil_Boekend » Thu May 26, 2016 9:02 am UTC

The medical issue is not that simple. Yes, there are medical costs directly related to smoking, but that doesn't mean a smoker is by definition more expensive. Smokers don't get as old, and the last few years of a life are medically expensive. When a smoker enters those last years the costs associated with it are smoking related, but are they more than when a non-smoker enters their final years? I don't know. I can not find any research on the total medical cost of large groups of people over their entire life. I have seen a lot of research only looking at the cost of smokers, but none looking at the cost of non-smokers. AFAIK that's not science, that's politics.

Same with helmet free motorcycle riding: There is a good chance a helmet free motor cycle driver will simply be killed on impact in a crash, and thus never cause the cost of being old. Is that sufficient to compensate for the cost of the brain injuries? I do not know. I have not seen any research on it.

If and when there is complete data on the subject that determines my opinion: choices that actually increase medical costs should incur additional insurance costs. I specifically say choices, because having a medical condition for any other reason is not a choice and can not be subject to these things. (full disclosure: I have several medical conditions that have, will and continually do incur major medical costs. I don't smoke, I have a healthy BMI and I don't take unnecessary risks, but in medical costs I am bound to be more expensive than the average smoker or morbidly obese person)


As for forbidding it: I am against forbidding anything that only harms the person doing it. Be it smoking weed in their own homes, riding a motorcycle without a helmet or snorting coke (assuming this causes no additional costs or risks to others). Live and let live.
I am a bit in conflict over protecting young ones against themselves. Risk estimation is difficult at best for teenagers.

Also, I'd like drivers licenses to include some education on the risks involved. Be it driving without a seatbelt or riding a motorcycle without a helmet.
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Re: Society pays tab for personal liberty

Postby Chen » Thu May 26, 2016 11:49 am UTC

@Neil_Boekend: I was thinking pretty much the same thing when reading the OP.

A quick search found me: http://bmjopen.bmj.com/content/2/6/e001678.full

Results/Conclusion wrote:Results: Smoking was associated with a greater mean annual healthcare cost of €1600 per living individual during follow-up. However, due to a shorter lifespan of 8.6 years, smokers’ mean total healthcare costs during the entire study period were actually €4700 lower than for non-smokers. For the same reason, each smoker missed 7.3 years (€126 850) of pension. Overall, smokers’ average net contribution to the public finance balance was €133 800 greater per individual compared with non-smokers. However, if each lost quality adjusted life year is considered to be worth €22 200, the net effect is reversed to be €70 200 (€71.600 when adjusted with propensity score) per individual in favour of non-smoking.

Conclusions: Smoking was associated with a moderate decrease in healthcare costs, and a marked decrease in pension costs due to increased mortality. However, when a monetary value for life years lost was taken into account, the beneficial net effect of non-smoking to society was about €70 000 per individual.

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Re: Society pays tab for personal liberty

Postby Neil_Boekend » Thu May 26, 2016 1:58 pm UTC

I bow to your GoogleFu.

I think the value of years of life is irrelevant in this regard. If we assume the smoker was informed properly then the smoker chose to smoke and thus chose to lose these years of life. IMHO this makes them irrelevant for this discussion.
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Re: Society pays tab for personal liberty

Postby HES » Thu May 26, 2016 2:30 pm UTC

Neil_Boekend wrote:If we assume the smoker was informed properly

Is that a fair assumption?
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Re: Society pays tab for personal liberty

Postby Neil_Boekend » Thu May 26, 2016 2:39 pm UTC

HES wrote:
Neil_Boekend wrote:If we assume the smoker was informed properly

Is that a fair assumption?
Let's put it this way: the lost years of life are a cost to the smoker. Fining the smoker for this cost does not offset these costs, but sort of exacerbates them.

Also: I nowadays smokers are quite well informed here in the Netherlands. This does not prevent teenagers from starting, but they are informed. They do not care. They weigh the additional coolness of smoking over the lost years.
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Re: Society pays tab for personal liberty

Postby Chen » Thu May 26, 2016 2:50 pm UTC

I'm not sure if they're saying that 1 year of time is worth €22 200 to society (say including things like productivity) or if its worth that amount to the person in question. If it's worth it to society in terms of productivity and the like, then yes it should be included in the net value. If it's just the value to the person in question though, I don't think it should be brought up in terms of net effect on society. As was said, the smoker made the choice to shorten their lives by smoking. The cost, those €22 200 per year lost, is borne by them alone in that case.

The biggest issue is that end of life care (those last few years) is ridiculously expensive. From a pure economic point of view an earlier death that avoids these years is a large benefit. That said unless we want to move to a sort of Logan's Run scenario I don't think we really want to be acting on this type of economic analysis.

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Re: Society pays tab for personal liberty

Postby sardia » Thu May 26, 2016 3:16 pm UTC

Chen wrote:I'm not sure if they're saying that 1 year of time is worth €22 200 to society (say including things like productivity) or if its worth that amount to the person in question. If it's worth it to society in terms of productivity and the like, then yes it should be included in the net value. If it's just the value to the person in question though, I don't think it should be brought up in terms of net effect on society. As was said, the smoker made the choice to shorten their lives by smoking. The cost, those €22 200 per year lost, is borne by them alone in that case.

The biggest issue is that end of life care (those last few years) is ridiculously expensive. From a pure economic point of view an earlier death that avoids these years is a large benefit. That said unless we want to move to a sort of Logan's Run scenario I don't think we really want to be acting on this type of economic analysis.

Ignoring the situation didn't really solve it. It just pushes the cost onto the most vulnerable and poor. Maybe we need to become more accepting of 'cessation of services' instead of constant treatment. If you're OK with do not resuscitate orders, then you can have an acceptable Logan's run scenario.

Leady, we can fine people as a disincentive but that doesn't recoup the cost. It merely reduces the bill at the margins and society eats the cost. Hopefully the article is just fear mongering and we aren't experiencing a rash of dumb white people rushing into danger because they saw it on video.

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Re: Society pays tab for personal liberty

Postby Chen » Thu May 26, 2016 3:26 pm UTC

sardia wrote:Ignoring the situation didn't really solve it. It just pushes the cost onto the most vulnerable and poor. Maybe we need to become more accepting of 'cessation of services' instead of constant treatment. If you're OK with do not resuscitate orders, then you can have an acceptable Logan's run scenario.


Well it kind of depends on if you want society to pay for your survival when you're old and enfeebled. As a society we tend to agree to pay for that and hence end of life healthcare is a significant cost. The other extreme is the Logan's Run scenario where we don't consider the cost because we just ensure no one lives that long. In between you can certainly limit what the government can pay for, but that too just pushes the burden onto the poor. The wealthy spend their wealth and get the care privately.

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Re: Society pays tab for personal liberty

Postby leady » Thu May 26, 2016 3:41 pm UTC

sardia wrote:Leady, we can fine people as a disincentive but that doesn't recoup the cost. It merely reduces the bill at the margins and society eats the cost. Hopefully the article is just fear mongering and we aren't experiencing a rash of dumb white people rushing into danger because they saw it on video.


Sure, but the apparatus to invoke & enforce the fines coupled with the need to cover the scenarios where people do it anyway makes it horribly inefficient. Or actually I suspect its so, because modern social systems are based on a zero failure like model and converting any system from say 95% to 99.999% successful is hideously expensive normally.

on the Brightside, extreme sports are shall we say "self limiting" in the gene pool :) (or the male gene pool at least, male risky behaviour kills them, female risk behaviour creates babies)

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Re: Society pays tab for personal liberty

Postby Zamfir » Thu May 26, 2016 7:37 pm UTC

female risk behaviour creates babies

There's guys involved in that as well. Ask your parents for more details.

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Re: Society pays tab for personal liberty

Postby morriswalters » Thu May 26, 2016 8:57 pm UTC

The article is primarily about extreme athletes rather than behaviors like smoking which is highly integrated into society. But it is foolish to think that people will be deterred, base jumping is already illegal in a lot of cases. It just adds one more behavior that shows that something other than intellect is pushing the buttons. Speeding, drug use(of any kind), no helmets and so on. However I wouldn't risk my life to save you because you want to climb Everest or El Capitan. 500 years ago the same type of people discovered new land and mapped unknown continents. They just has the good sense to die out of sight.

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Re: Society pays tab for personal liberty

Postby LaserGuy » Thu May 26, 2016 11:33 pm UTC

Zamfir wrote:
female risk behaviour creates babies


There's guys involved in that as well. Ask your parents for more details.


Females can also engage in risk behaviours that result in death, IIRC.

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Re: Society pays tab for personal liberty

Postby Tyndmyr » Tue May 31, 2016 6:59 pm UTC

sardia wrote:
leady wrote:The libertarian question isn't really should "we" or not, to which the answer is yes to an extent in most cases. The question is really whether "we" should be forced to, the answer to which is typically no.

Are you saying a libertarian world would rescue them? You're vague as to who you're referring to.

The insurance model doesn't really work (or requires you to be very very heartless). I remember during the height of fire season, nobody would pay their premiums until their house/area caught on fire. That defeated the purpose of the premiums. In the end, the firefighters took a hard line approach (after multiple warnings), and let the guy's house burn down.


Volunteer fire departments are quite common. Still the majority of firehouses in the US, if I'm not mistaken. But of course, fire's only one risk, and one that is particularly appealing to volunteers because of how obviously it spreads. Not every similar aspect can be dealt with in the same manner.

From a social perspective, the free rider problem is a big issue in many aspects. Do people always do risk analysis correctly? Obviously not. However, forcing them to submit to someone else's risk analysis has problems as well. The guy in charge might also err. Overhead costs exist. The position of power might become politicized, and public benefit might go by the wayside.

Basically, the libertarian position is that not all morals can be practically enforced by law. Yeah, maybe you SHOULD help people in need, but requiring it by law can be tricky. Sometimes it works out. Sometimes, in doing so, you can create a lot of unintended consequences. And there's a certain cost, which may not be entirely fiscal. Yeah, you could ban motorcycles as unsafe, the stats do bear that out. And continue banning everything else that's risky, but...that does rob society of a certain diversity of experience. Even leaving aside the practical issue of "people who take unwise risks" maaaybe considering breaking laws as an acceptable risk, you run into the issue of people stamping out entire subcultures.

Laws stopping people from victimizing OTHERS are usually rather easier to justify, but laws preventing risk to oneself can potentially run into some nasty areas. I mean, yeah, we can agree that suicide is bad, but...does making it illegal actually help? Punishing a person who attempts would be counterproductive, and in the case of success, punishment is irrelevant. Drug abuse is likewise often not well handled through a strictly punitive approach, and treatment appears to be far more effective. The libertarian ideology may not be ideal in *every* such situation, but there's certainly evidence for it in a good many.

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Re: Society pays tab for personal liberty

Postby moiraemachy » Tue May 31, 2016 8:22 pm UTC

Neil_Boekend wrote:I think the value of years of life is irrelevant in this regard. If we assume the smoker was informed properly then the smoker chose to smoke and thus chose to lose these years of life.
22,200 euros is about half of Finland's GDP per capita. According to the wiki, their tax rate is 43.6% of the GDP. So this is somewhat close to what would have been paid by in taxes by the diseased if it were alive and working.Take away some from that because people who die tend to be old, add something because of the positive externalities of having one more person in the work force... I'm guessing this 22,200 euro figure is "value to society", not "value to person".

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Re: Society pays tab for personal liberty

Postby Neil_Boekend » Wed Jun 01, 2016 8:14 am UTC

moiraemachy wrote:
Neil_Boekend wrote:I think the value of years of life is irrelevant in this regard. If we assume the smoker was informed properly then the smoker chose to smoke and thus chose to lose these years of life.
22,200 euros is about half of Finland's GDP per capita. According to the wiki, their tax rate is 43.6% of the GDP. So this is somewhat close to what would have been paid by in taxes by the diseased if it were alive and working.Take away some from that because people who die tend to be old, add something because of the positive externalities of having one more person in the work force... I'm guessing this 22,200 euro figure is "value to society", not "value to person".

The years most likely lost are those in retirement, where there is no actual value creation.
(Note: that is not intended in any way as a comment against retirement or retirees. On average they have earned their retirement and have done their part.)
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Re: Society pays tab for personal liberty

Postby leady » Wed Jun 01, 2016 8:48 am UTC

On average retirees haven't even come close to covering their own social costs, which of course is why risky behaviours are a saving generally.

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Re: Society pays tab for personal liberty

Postby sardia » Wed Jun 01, 2016 12:31 pm UTC

leady wrote:On average retirees haven't even come close to covering their own social costs, which of course is why risky behaviours are a saving generally.

Only if it's significantly risky, you don't want them surviving with crippling injuries or expensive rehab. That's why retirees should try sky diving with only one parachute.
Last edited by sardia on Wed Jun 01, 2016 12:53 pm UTC, edited 1 time in total.

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Re: Society pays tab for personal liberty

Postby leady » Wed Jun 01, 2016 12:39 pm UTC

Too much clean up - carousel is the way to go

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Re: Society pays tab for personal liberty

Postby lorb » Wed Jun 01, 2016 1:31 pm UTC

Some solutions already exist. Most of them should be applied more imho, but that needs to be discussed in detail for each instance.

One of the easy solutions seems to just ramp up taxes on stupid/risky behaviour and things. High cost acts as a deterrent and those that still do it are billed for the cost they cause at least in part. Look at prices of cigarettes in UK and Australia for examples.

For things that can't easily be taxed society is fine with making it illegal except to qualified people. If the cost that some behaviour incurs to society seems too much increase the cost or difficulty for getting a license and the cost again shifts more toward the individual doing it. It can also screen out people that are most likely to act irresponsible. It's what we did for driving, hunting or owning guns for example.

Or make stuff outright illegal and get some money back from those that still do it by fining them. Most places do this for driving a motorcycle without helmet for example.
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Re: Society pays tab for personal liberty

Postby morriswalters » Wed Jun 01, 2016 2:20 pm UTC

sardia wrote:
leady wrote:On average retirees haven't even come close to covering their own social costs, which of course is why risky behaviours are a saving generally.

Only if it's significantly risky, you don't want them surviving with crippling injuries or expensive rehab. That's why retirees should try sky diving with only one parachute.
Why give them a parachute at all?

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Re: Society pays tab for personal liberty

Postby quantropy » Wed Jun 01, 2016 2:39 pm UTC

Maybe some activities should be forbidden as too risky, but the question is 'Who gets to decide?'. And on what criteria - risk per activity, risk per hour or what. It's too easy to use risk as an excuse for forbidding activities which are seen as socially unacceptable, while allowing more risky activities which are seen as socially acceptable. Motorcyclists may be seen as thrill seekers who are to blame for their injuries, but if a horse rider is injured it's likely to be a different story.

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Re: Society pays tab for personal liberty

Postby sardia » Wed Jun 01, 2016 3:11 pm UTC

I think a better solution is to heartlessly watch them die for their mistakes.
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Re: Society pays tab for personal liberty

Postby leady » Wed Jun 01, 2016 3:13 pm UTC

Maybe an advanced society could introduce something I'd call "national insurance"

and then make this insurance keyed to your reasonable life choices, demographics & SES for both pensions and healthcare.

Of course the howls of outrage generated by such a thing would be amazing to behold

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Re: Society pays tab for personal liberty

Postby sardia » Wed Jun 01, 2016 3:16 pm UTC

Do emergency services bill insurance companies in the US?

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Re: Society pays tab for personal liberty

Postby leady » Wed Jun 01, 2016 3:29 pm UTC

probably for paramedics

but I'm more alluding to the fact that NI for a woman generally would be (guessing) 40% more due to healthcare and pensions and that actually extreme sports risks are relatively low as you can show by just getting annual holiday insurance (ok sky diving and paragliding are a grade less risky than base jumping, but the pre-insured risks are low still I imagine). Other demographics would spawn similar outrage if Actuaries could go to town :)

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Re: Society pays tab for personal liberty

Postby morriswalters » Wed Jun 01, 2016 4:21 pm UTC

sardia wrote:Do emergency services bill insurance companies in the US?
Yes.

leady wrote:Maybe an advanced society could introduce something I'd call "national insurance"

and then make this insurance keyed to your reasonable life choices, demographics & SES for both pensions and healthcare.

Of course the howls of outrage generated by such a thing would be amazing to behold
Oh, like private insurance in the US? We are half way there, now to kill Social Security.

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Re: Society pays tab for personal liberty

Postby Tyndmyr » Wed Jun 01, 2016 4:47 pm UTC

lorb wrote:Some solutions already exist. Most of them should be applied more imho, but that needs to be discussed in detail for each instance.

One of the easy solutions seems to just ramp up taxes on stupid/risky behaviour and things. High cost acts as a deterrent and those that still do it are billed for the cost they cause at least in part. Look at prices of cigarettes in UK and Australia for examples.

For things that can't easily be taxed society is fine with making it illegal except to qualified people. If the cost that some behaviour incurs to society seems too much increase the cost or difficulty for getting a license and the cost again shifts more toward the individual doing it. It can also screen out people that are most likely to act irresponsible. It's what we did for driving, hunting or owning guns for example.

Or make stuff outright illegal and get some money back from those that still do it by fining them. Most places do this for driving a motorcycle without helmet for example.


These are terrible examples. Cigarettes kill your lifespan, sure. But the big self destructive behaviors, Obesity, Smoking, and Alcohol, all tend not to cost society more in care. Why? Because dying faster reduces old-age care. So, all of this sin tax business isn't really driven by that.

I also note that your definition for "irresponsible" with this system is "poor". There are certain problems with this.

If we're honestly worried about health care costs, why the hell are we talking about skydiving, and not end of life care?

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Re: Society pays tab for personal liberty

Postby LaserGuy » Wed Jun 01, 2016 8:19 pm UTC

Tyndmyr wrote:
lorb wrote:Some solutions already exist. Most of them should be applied more imho, but that needs to be discussed in detail for each instance.

One of the easy solutions seems to just ramp up taxes on stupid/risky behaviour and things. High cost acts as a deterrent and those that still do it are billed for the cost they cause at least in part. Look at prices of cigarettes in UK and Australia for examples.

For things that can't easily be taxed society is fine with making it illegal except to qualified people. If the cost that some behaviour incurs to society seems too much increase the cost or difficulty for getting a license and the cost again shifts more toward the individual doing it. It can also screen out people that are most likely to act irresponsible. It's what we did for driving, hunting or owning guns for example.

Or make stuff outright illegal and get some money back from those that still do it by fining them. Most places do this for driving a motorcycle without helmet for example.


These are terrible examples. Cigarettes kill your lifespan, sure. But the big self destructive behaviors, Obesity, Smoking, and Alcohol, all tend not to cost society more in care. Why? Because dying faster reduces old-age care. So, all of this sin tax business isn't really driven by that.

I also note that your definition for "irresponsible" with this system is "poor". There are certain problems with this.

If we're honestly worried about health care costs, why the hell are we talking about skydiving, and not end of life care?


Well, alcohol in particular is arguably more problematic because its self-destructive tendencies manifest in a lot of other ways besides just making you sick. Yeah, drinking too much can cause liver disease and things, but I think the focus for alcohol is less about that and more about the social issues that results from alcoholism, as well as the dangers associated with drunk driving, etc. Since these kinds of things tend to effect people other than the imbiber, there's a much more compelling reason to constrain them even if alcohol is a net gain in terms of cost of care for the individual.

Something like base jumping is a little trickier to tease out. If something goes wrong, odds of survival are not great. But base jumpers tend to be fairly young on average, and would likely have many more years of productive work ahead of them... so (from a purely accounting point of view), while you save on end-of-life healthcare costs, you lose out on the bulk of the tax revenue that person was to generate. It's definitely a net-loss for society, especially because the education system has already invested many tens of thousands of dollars into those people's education.

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sardia
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Re: Society pays tab for personal liberty

Postby sardia » Wed Jun 01, 2016 9:19 pm UTC

If they keep jumping into danger, do we have an obligation to save them every time? I have a harder time buying the "freedom"argument when they are forcibly spending our tax dollars on the ones in needless danger.
http://www.pbs.org/wgbh/frontline/artic ... insurance/
Is actually a metaphor about flooding and perverse incentives. Why are we rescuing these people again and again? If I pulled you off the train tracks three times, isn't it about time you move your house off the tracks?

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Re: Society pays tab for personal liberty

Postby lorb » Wed Jun 01, 2016 11:44 pm UTC

Tyndmyr wrote:If we're honestly worried about health care costs, why the hell are we talking about skydiving, and not end of life care?


Because the thread topic is that society pays the tab for (health care) costs that have been incurred by exercising the right to freedom in an (arguably) irresponsible way. If we are worried that some kinds of behaviour will create a lot of societal cost, but we don't want to forbid them because people have rights, "sin taxes" can be a proper solution. Or as mentioned earlier: stop incentives.

Addendum:
sardia wrote:http://www.pbs.org/wgbh/frontline/article/five-questions-to-ask-about-flood-insurance/
Is actually a metaphor about flooding and perverse incentives. Why are we rescuing these people again and again? If I pulled you off the train tracks three times, isn't it about time you move your house off the tracks?


NFIP has a ton of problems. One of them is that same states (Texas) and communities actually see it as a way to channel federal money their way. Make it cheap and easy for folks do build in flood-prone areas, and every time a flood does come your way be happy for NFIP basically becomes a federal subsidy for local construction companies et.al
Last edited by lorb on Wed Jun 01, 2016 11:51 pm UTC, edited 1 time in total.
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Re: Society pays tab for personal liberty

Postby morriswalters » Wed Jun 01, 2016 11:50 pm UTC

If you live along a major river than is is likely that you are aware that, even if you never have insurance that the Nation overall has made a massive investment in keeping you dry.
Well, alcohol in particular is arguably more problematic
Especially if you consider that no country has ever permanently banned it. People want their hooch.
Tyndmyr wrote:Obesity, Smoking, and Alcohol, all tend not to cost society more in care. Why? Because dying faster reduces old-age care.
That's an interesting assertion, I'm curious, can you support it?

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Re: Society pays tab for personal liberty

Postby lorb » Wed Jun 01, 2016 11:55 pm UTC

morriswalters wrote:
Well, alcohol in particular is arguably more problematic
Especially if you consider that no country has ever permanently banned it. People want their hooch.


Saudi-Arabia? (And some others in the general area of the globe.)
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Re: Society pays tab for personal liberty

Postby Mutex » Thu Jun 02, 2016 12:44 am UTC

He said permanently, maybe he can see into the future and knows they'll legalise it again at some point.

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Re: Society pays tab for personal liberty

Postby morriswalters » Thu Jun 02, 2016 1:39 am UTC

I was drinking. Or I should have been.

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Re: Society pays tab for personal liberty

Postby Tyndmyr » Mon Jun 06, 2016 5:12 pm UTC

sardia wrote:If they keep jumping into danger, do we have an obligation to save them every time? I have a harder time buying the "freedom"argument when they are forcibly spending our tax dollars on the ones in needless danger.
http://www.pbs.org/wgbh/frontline/artic ... insurance/
Is actually a metaphor about flooding and perverse incentives. Why are we rescuing these people again and again? If I pulled you off the train tracks three times, isn't it about time you move your house off the tracks?


Welcome to libertarianism.

But yes, saving people who do not want to be saved, and who keep endangering themselves is...quite costly. The question of how far is proper to go is certainly something people disagree over, but there probably needs to be SOME point at which you call it quits. Helping someone rebuild, great. Helping someone rebuild ON the place that's going to flood again...cmon.

morriswalters wrote:If you live along a major river than is is likely that you are aware that, even if you never have insurance that the Nation overall has made a massive investment in keeping you dry.
Well, alcohol in particular is arguably more problematic
Especially if you consider that no country has ever permanently banned it. People want their hooch.


Permanently is a high bar. But generally speaking, yes, prohibition has been tried, and has been messy, ugly, and costly.

Drawing parallels to the war on drugs is, of course, pretty easy.

A big problem is that people often overlook perverse incentives, and it's really common to underestimate the costs of a new project. So, banning something can be way more costly than just treating it.

Tyndmyr wrote:Obesity, Smoking, and Alcohol, all tend not to cost society more in care. Why? Because dying faster reduces old-age care.
That's an interesting assertion, I'm curious, can you support it?[/quote]

Here's one article, if you like: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwiKz5i68pPNAhUJaD4KHepUAlcQFggiMAE&url=http%3A%2F%2Fwww.forbes.com%2Fsites%2Ftimworstall%2F2012%2F03%2F22%2Falcohol-obesity-and-smoking-do-not-cost-health-care-systems-money%2F&usg=AFQjCNFwjOeysk1GSFt50Tn4RR5E8lbDGA&sig2=lt5-lMXbDXWu1LMd8cgaJg

Note that we are essentially discussing only their cost to the rest of society, not the costs to themselves, which is obviously great.


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