The U.S. Preventative Services Task force has issued a new recommendation: annual CT scan screening for lung cancer for high-risk smokers between the ages of 55 and 80.
Who is a high risk smoker? Anyone with a 30-pack year smoking history (meaning a pack a day for 30 years or 2 packs a day for 15 years etc) and either currently smokes or quit within the last 15 years. Anyone with a significantly reduced life expectancy or someone who couldn’t medically handle the surgery for lung cancer is excluded from screening.
All I can say is wow, because this translates into at least 7 million additional CT scans a year for the health care system. A low dose CT of the chest is supposed to be $300 or so and FairHealthConsumer.org quoted me $282.03 for a cash price in my zip code. Multiply $300 by 7 million (some people say up to 10 million) every year and the amount is astronomical. This affects all of us, via our premiums for health insurance as well as our taxes, which pay for Medicare.
The task force indicates that this screening could prevent 20,000 smoking-related lung cancer deaths a year in the United States. I’m not arguing with this (although I do wonder how many cancers 20 or more chest CT scans could cause, and in my opinion this fact was glossed over in the article that looked at benefits vs. harm), but I just think we need a more creative model to cover tobacco-specific health screening expenses.
Since the only risk factor for this screening guideline is cigarette smoking, the obvious answer is a cigarette tax to pay for screening (I propose $2 a pack). The tax would have to be federal as many states have shown an extreme reluctance when it comes to cigarette sales taxes. The screening could be performed at accredited CT screening centers to prevent price escalation/gouging. If these centers only performed lung cancer screening maybe they could be even more cost effective?
The other upside of my proposed tax is cigarette price has the biggest impact on deterring younger smokers (ages 18 to 39), so down the road we would see fewer 30-pack year smokers. Never having a population who needs this screening would truly be a wonderful thing.
We already tax cigarettes, so the idea of adding a screening tax is nothing new. This tax wouldn’t affect health care premiums or deter anyone from seeking medical care, although it might deter someone from smoking. My $2 a pack tax should be more than enough to cover the cost of the CT scans, but I admit I’m no economist so it might need to be a little higher or lower.
If any other commercial product killed more than 23,000 people a year it would surely be banned (I’m adding the more than 3,000 deaths/year due to lung cancer from second-hand smoke), but we are so much at Big Tobacco’s mercy that we can’t even get graphic ads on cigarette packages.
I don’t believe in punitive health premiums or rationing care, but I do object to Big Tobacco laughing all the way to the bank on the backs of Americans. It’s time to build the cost of screening into the price of cigarettes.