Is Paying Off Someone Really What it Comes Down to?

After reading the article, “Should we pay people to stop smoking?” by Jody Sindelar, I had a lot of thoughts run through my mind.  I believe the author Jody Sindelar’s intended audience would be people that are smokers in need of Medicaid.  Sindelar appears to have great credibility because she is a health economist and professor at Yale School of Public Health, and she also has performed some research that could help support her reasoning. 

I am a bit confused why our government would want to pay someone to quit smoking?  It’s obvious that a large portion of our healthcare cost goes to people that smoke or do not have the money to take care of their health because of smoking, but why spend a penny rewarding people?  In my opinion anyone smart knows that if money is waived in front of someone’s face, this would tempt them or temporarily stop their habit, but it never actually last in most cases.  The author uses previous studies to support her theory.  The author quotes, “Research on addiction has repeatedly demonstrated that small payments have persuaded even cocaine addicts to stop using”.  How long does it actually last is the real question.  There is a saying that goes, “money does not buy happiness”, so why does it have to try and buy someone’s choices?  Also how do we know the money they receive will be used for a good cause and not used to buy other drugs?

The author uses the following quote to try and help support she believes that paying smokers to stop would help with the cost of Medicaid, “Thirty-three percent of the Medicaid population smokes, compared with 20% of the U.S. population, according to the Centers for Disease Control and Prevention”.  This is a high percentage but again why reward people with money?  They will already save money by choosing not to smoke. 

The author also mentions, “what if there was a way to save taxpayers dollars and improve Medicaid patients’ health?” First of all who would pay to have people administer the test or counseling?  There goes more money from everyone’s pocket.  I think just refusing to provide Medicaid for smokers would be a better idea and more cost efficient.  Why pay someone to do something that they know already would be good for their health?  I do not believe the author is not completely convinced it would be an easy fix as she quoted, “Another obstacle to implementation is a lack of research on how best to design such a program for low-income populations. While in previous studies of heroin users I found that paying higher incentive payments is both more powerful and more cost-effective, we do not know the best level of payments for Medicaid smokers.”  There are so many things to consider before a decision could be made.

I just do not feel this would be a fix.  Money would still be wasted administering the test, counseling, researching, and then paying off the recipients.