On the other hand, American health insurance is arguably the most aggressive in the world at punishing overweight individuals and smokers through penalty fees.
the fees are bought upon by the partakers of food and cigarettes.
do they realize the strain excess weight carries for organs? would it be cheaper in china or Europe to be that size? No. Logistically, other countries would not have equipment readily available and having your poor lifestyle choices subsidized doesn’t mean the cost isn’t there
Obese individuals & smokers actually cost the system less money overall vs slim & healthy people because they die so much earlier - think of the 30+ years of savings!
Dutch researchers compared three cohorts (healthy-living nonsmokers, smokers, and people with obesity) from age 20 to death. They found annual costs were higher for obesity through midlife, but lifetime spending was highest for healthy-living people, lowest for smokers, and intermediate for people with obesity, due to shorter life expectancy in the latter two groups.
Another study found total lifetime costs were ~14% lower for the obesity cohort and ~26% lower for smokers versus healthy living peers, again because longer life spans among the healthy group accrue more late life costs.
“Punishing overweight individuals and smokers”, I’m sorry, while I wish America’s healthcare system was better in terms of cost, some things are choices/habits that have consequences in terms of health and subsequently the care required to treat..