FEDERAL SUIT: Smoking Cost Medicare $20.5B in ’97
The total cost of cigarette smoking to the Medicare program amounted to $20.5 billion in 1997, according to a study conducted by researchers at the University of California-San Francisco. "This is the first study that documents the smoking-attributable costs to Medicare that are now part of the federal lawsuit against the tobacco industry," said Xiulan Zhang, lead author of the study and research analyst at UCSF's Institute for Health and Aging. The researchers found the total cost of smoking to the nation in 1993 amounted to $72.7 billion. Of this total, the cost of smoking to Medicare amounted to $14.2 billion (9.4% of total Medicare costs). Of that amount, in turn, $10.8 billion was for hospital care, $2.4 billion for ambulatory care, $488 million for nursing home care and $473 million for home health care. The researchers then updated the 1993 cost estimates to 1997 based on the increase in Medicare expenditures. Dorothy Rice, co-author and professor emeritus of medical economics at UCSF, said, "Our estimates for 1997 smoking-related costs to the Medicare program are only one out of 30 years of payments by the Medicare program for aged and disabled persons who have suffered from smoking-related diseases, suggesting that the aggregate Medicare payments over the 30 years could have exceeded $600 billion in current dollars." The findings appear in the Summer 1999 issue of Health Care Financing Review, released Sept. 29 (UCSF release, 9/30).
Tobacco Companies Pursue Secondhand Smoke Data
"Mobilizing against smoking bans and lawsuits that could cost them billions, tobacco companies are engaged in a far-reaching campaign to discredit evidence that secondhand smoke is harmful to human health," the Los Angeles Times reports. Already engaged in court battles in at least 10 jurisdictions to obtain various plaintiffs' evidence, the industry now "is fighting USC researchers to get access to a single computer disk containing raw data from an influential, five-city study, known as the Fontham study, that found a casual link between lung cancer and secondhand smoke." U.S. District Judge Richard Paez will decide if USC must provide the data. He has already ruled in favor of the tobacco companies once. USC officials, for their part, say the data sought is personal information about the study subjects, which the researchers pledged to not divulge. Peggy Reynolds, chief environmental epidemiologist for the California health department and a Fontham investigator, said, "We have to be able to make promises we can keep, and to me that's really the essence of the litigation over this." But Philip Morris attorney Barry Davidson said, "Methinks they (researchers) doth protest too much" (Levin, 10/4).
Supreme Court Arguments Forthcoming
As the Supreme Court session gets underway, the nine justices prepare to hear arguments over whether the FDA may regulate tobacco as a drug -- the "most closely watched case" in the court's new term. Charles Blixt, executive vice president of R.J. Reynolds Tobacco Co., said, "The issue here is who has the power to establish the social policies of the country. Is it the elected officials in Congress or the unelected bureaucrats in the" FDA? But even if the industry wins, says Matthew Myers of the Campaign for Tobacco-Free Kids, the case simply underscores Big Tobacco's legal troubles. "We're seeing the dawn on a new era in which the tobacco industry will constantly be under attack from one place if not another" (Johnson, Media General/Tampa Tribune, 10/4).
On the federal suit, columnist George Will writes that the government "is committing the sin -- fraud -- that it supposedly is suing about." If the tobacco companies lied about the health effects of smoking, the nature of the suit still requires that the public believed the lies. Will lists several figures and institutions, among them William Lloyd Garrison, John Quincy Adams, the Supreme Court and the New York Times, that suggested they did not believe this fact as early as the 1800s. Noting that the "government knows something about tobacco-related fraud," Will points to widespread questions about the validity of the research for the 1993 Environmental Protection Agency report on second hand smoke. But "EPA's fraud was minor compared with the government's pretense that smoking costs it money," because premature deaths from smoking save the government substantial funds. He concludes: "When you hear a figure like 427,743 'premature' deaths from smoking (according to the Centers for Disease Control, that is the annual average, 1990-94), bear in mind that nearly 60 percent of those deaths were people 70 or older, nearly 45 percent were people over 75, nearly 17 percent were people over 85. With what certainty in those cases can the government establish 'smoking-attributable mortality?' But, then, one certainty is that accuracy is not the hallmark of the government's tobacco policy" (Washington Post, 10/3).
In the Washington Times, columnist Jacob Sullum picks up the point, noting that the "same allegations were made in Cipollone vs. Liggett Group" 16 years ago. While jurors returned a verdict for the plaintiffs, they did not buy a conspiracy theory. Sullum writes: "[T]he basic story of the industry's behavior remains the same, and so does the main objection to any case based on it: So what? ... If no one was fooled by the industry's frequently expressed doubts about the hazards and addictiveness of cigarettes -- and given the anti-smoking messages that have saturated our culture since the 1960s, it's hard to see how anyone could have been -- the government has no case" (10/3).