NEW YORK, Oct 05 (Reuters Health) -- Smoking-related diseases cost the Medicare system $20.5 billion in 1997, accounting for nearly 10% of the federal program's costs that year, according to estimates from researchers at the University of California, San Francisco (UCSF).
"It's the largest burden to any individual (health insurance) program," study co-author Dr. Wendy Max, an associate professor of medical economics, told Reuters Health.
Smoking cost Medicaid, the federal insurance program for the poor, $17 billion in 1997; and the burden to all other public and private programs totaled almost $52 billion, according to study results published in the current issue of Health Care Financing Review.
In the study, which was led by Dr. Xiulan Zhang of the UCSF Institute for Health and Aging, the researchers analyzed data from two large national surveys to estimate national and state Medicare expenditures in 1993 for smoking-related illnesses such as heart disease, emphysema, and certain types of cancer. They updated their estimates to 1997 based on increases in overall Medicare spending.
Putting a price tag on smoking's burden to Medicare is important both because of the program's ever-increasing size -- it currently covers 34 million Americans age 65 and older and 5.5 million people with disabilities -- and because of the current federal lawsuit against the tobacco industry, Max noted.
The two surveys the researchers used were the National Medical Expenditures Survey, which included the smoking histories and medical expenses of 35,000 Americans, and the Behavioral Risk Factor Surveillance System, which provided state-by-state health information on residents 65 and older. In 1993, the UCSF team estimated, smoking's total healthcare cost to the nation was $72.7 billion. Medicare bore more than $14 billion of the expense; on the state level, California's Medicare program had the highest smoking-related expenditures at $1.5 billion, followed by New York at $1.4 billion. Alaska had the lowest smoking-related costs at $8 million.
Attaching dollar figures to smoking's health effects also provides another way to view the importance of getting smokers to drop the habit, according to Max. "Many people in the Medicare program have been smoking for 40 years," she said. "(This study) illustrates that it's important to get people to stop smoking at all ages."
