Smoking Is a ‘Preexisting Condition’

April 10, 2013 4:00 A.M.

The District of Columbia’s Obamacare czars — the board that sets rules for the phony insurance marketplace, or “exchange,” that the law creates — have decided that henceforth insurers shall be forbidden by law to charge smokers higher rates than non-smokers. Smoking, as it turns out, “is a preexisting medical condition,” according to Dr. Mohammad Akhter, the chairman of the D.C. Health Exchange Board. Two liberal states, California and Connecticut, have decided likewise, while Colorado and Alaska have rejected the idea.

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As expected, the definition of “preexisting condition” is proving infinitely malleable, with behaviors born again as conditions. If smoking is a condition, then drug addiction is a condition, self-mutilation is a condition, a penchant for BASE jumping is a condition, juggling ampules of penicillin-resistant syphilis — practically anything qualifies as a condition under such a plastic understanding.

There are many ways to implement a bad idea. For instance, Congress might have passed a law requiring that all U.S. insurance companies no longer charge smokers more for their coverage. The state of Connecticut might have passed a similar law. New York City might have passed that law. But in each case, voters who saw that stupidity for what it is would have somebody to vote against. Obamacare eliminates the option for democratic response. Instead, it creates a body of political appointees immune from being held accountable at the ballot box. And who are those appointees? In the case of D.C., you will find few surprises: The SEIU has a man on the board, along with a lot of time-serving political types, a fellow from the Brookings Institution, a lobbyist, etc. Don’t like their boneheaded decisions? Too bad.

There will be thousands and thousands of decisions like this in the coming years, and voters will have very little recourse against them. That is part of the genius of bundling the welfare state with the regulatory state: Whether you are a Democrat who basically likes Obamacare and wants to revisit a few of its flaws or a Republican committed to tearing it up root and branch, you have basically the same hurdle to clear. It might be easier to sell the idea of revision to the general public, but the structural legislative barrier is the same as if you were repealing the law wholesale. The question of ending “discrimination” against smokers is so many levels removed from democratic accountability that even those who are strongly opposed to the idea will probably have no effect. To get to the board, you basically have to fire the mayor, which is no small thing in a corrupt and backward place like our nation’s capital.

Obamacare was sold as a way to help poor people and sick people get health insurance, but, as the D.C. decision shows, the actual intent of the law is the abolition of health insurance. The notion of insuring a preexisting condition is an oxymoron; insurance is by nature concerned with that which may happen in the future rather than with that which already has happened. In very large groups, human health outcomes are predictable with a fair degree of precision: Given 10 million people, actuaries can make pretty accurate predictions about how many people are going to get lung cancer and how many are going to be in car accidents. Some factors are relevant to some conditions: Being 17 years old and getting in a car accident, for example, or smoking and heart disease, emphysema, cancer, etc. Insurance, which places a price on calculated risks, will take some of those factors into account. But you cannot in any meaningful sense insure somebody against cancer when they already have cancer.

Obamacare is designed to destroy the insurance market. Markets do not function without prices, and Obamacare ensures that prices will not be allowed to emerge. There is a medical price associated with smoking, but the District of Columbia has decided to suppress that price by law. Pretending that smoking has no relationship with health-care costs does not make it so — it is only a way to push costs around in a way that is agreeable to the likes of Barack Obama, converting a system that prices risk into a system of entitlements.

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Sen. Paul: Obama, Bush ‘lucky’ they weren’t arrested for smoking pot as kids

Sen. Rand Paul (R-Ky.) said Sunday that President Obama and former President George W. Bush “got lucky” by not being arrested for smoking marijuana as young adults.

Arguing against mandatory minimum sentencing for pot use, Paul said that a marijuana-related arrest for either Obama or Bush could have ruined their lives.

“Look, the last two presidents could conceivably have been put in jail for their drug use,” said Paul on “Fox News Sunday.”

“Look what would have happened. It would have ruined their lives. They got lucky. But a lot of poor kids, particularly in the inner city, don’t get lucky. They don’t have good attorneys. They go to jail for these things. And I think it’s a big mistake.”

Paul said he was not in favor of using marijuana, because it makes people less productive. But he said he doesn’t support punishing people who use the drug with jail time.  

“I don’t want to encourage people to do it. I think even marijuana is a bad thing to do,” said Paul. “I think it takes away your incentive to work and show up and do the things you should be doing. I don’t think it’s a good idea. I don’t want to promote that.

“But I also don’t want to put people in jail who make a mistake. There are a lot of young people who do this and then later on, in their 20’s, they grow up, they get married, and they quit doing things like this. I don’t want to put them in jail for the rest of their lives.”

Earlier this week Paul introduced a bill with Senate Judiciary Committee Chairman Patrick Leahy (D-Vt.) that would relax the mandatory minimum sentences handed out to marijuana offenders who do not pose a violent threat to the public. The bill has gained the support of some influential conservatives, including anti-tax activist Grover Norquist.

Soon after announcing his bid for the presidency, Obama admitted to reporters in 2006 to smoking marijuana as a teenager. And one year before that, a series of secretly recorded conversations between Bush and a former adviser to his father documented the former Texas governor admitting to trying marijuana as a younger man.

President Clinton has said he did not inhale when presented with marijuana in his younger days.

This story was updated at 10:41 a.m.

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Chart Of The Week: China’s Pollution Crisis Is Worse Than Living In A Smoking Lounge

So it turns out that burning nearly as much coal as the rest of the world combined is not good for public health.

“Beijing’s daily peak and average concentrations of PM2.5, the airborne particulate matter that raises risks for lung and heart diseases, as measured by the U.S. Embassy. The 2013 daily average was 194 micrograms per cubic meter, with an intraday peak of 886 on Jan. 12, the data show. By contrast, PM2.5 levels averaged 166.6 in 16 airport smoking lounges in the U.S.” (Via Bloomberg)

Significantly, though, as one Brigham Young University professor points out, “Unlike cigarette smoking, exposure to ambient air pollution is involuntary and ubiquitously effects entire populations.”

And that reminds me of the line from the Hitchock-esque movie, Diabolique, where a man says to the femme fatale as she lights up a cigarette, “Second-hand smoke kills, you know.” Blowing smoke in his face, she (Sharon Stone, of course) replies, “Not reliably.”

Living in Beijing kills far more reliably. Indeed, during the peak pollution weekend, “the number of emergency room patients with heart attacks roughly doubled” at one hospital.

A World Bank study performed with China’s national environmental agency, concluded “outdoor air pollution was already causing 350,000 to 400,000 premature deaths a year. Indoor pollution contributed to the deaths of an additional 300,000 people, while 60,000 died from diarrhea, bladder and stomach cancer and other diseases that can be caused by water-borne pollution.”

And that was in 2007! One can only imagine what the deaths from pollution in China are now that it burns 40% more coal than it did 6 years ago

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