https://pubmed.ncbi.nlm.nih.gov/1588892/

“The cumulative impact of excess medical care required by smokers at all ages while alive outweighs shorter life expectancy, and smokers incur higher expenditures for medical care over their lifetimes than never-smokers. This accords with the findings by Manning et al. (1989) of positive lifetime medical care costs per pack of cigarettes, but disagrees with the results found by Leu and Schaub (1983, 1985) for Swiss males. The contradictory conclusions of the analyses are undoubtedly due to a large difference in the amount of medical care used by smokers relative to neversmokers in the United States and Swiss data”

The only studies I can find that confirm shortened longevity incurs lower costs occur outside of America, which shifts things greatly due to cultural differences in receiving medical care and Americas totally fucked healthcare billing

Also I’ll point out that I said I don’t agree with the original poster, that I don’t care if you smoke, and now I will say that you’re a fucking moron with poor reading comprehension. Sorry that I won’t confirm your bias so you don’t feel worse about smoking, idiot. But again, smoke all you want, I don’t care, but don’t act like it doesn’t increase the cost burden on public health (as do your other examples but I also don’t care if you eat cheeseburgers every day and drink yourself to death)

https://pmc.ncbi.nlm.nih.gov/articles/PMC12474721/

“873 studies identified, 11 were included in quantitative synthesis, which compared 19,759,529 smokers with 206,913,108 non-smokers for direct health care costs. Mean age ranged from 34.5–60.6 years for smokers and 34.3–65.1 years for non-smokers. Mean annual health care costs ranged from $65,640–$1297.1 for smokers and $54,564–$724.4 for non-smokers. Annual incremental direct health care costs for smokers versus non-smokers ranged from –$458 (95% CI [confidence interval]: –2011.0 to 1,095.0) to $11,076 (95% CI: 10,211.9 to 11,940.1) in 2025 US dollars. Meta-analysis revealed smoking generally incurred greater health care costs than non-smoking, with a mean annual incremental cost of $1916.5 (95% CI: –439.9 to 4,272.9). The result was not statistically significant (MD = 1,916.5; p = 0.111). Substantial heterogeneity was observed (I2 = 99.9%). Sensitivity analysis excluding studies of chronic disease yielded a reduced incremental cost for the general population, with a statistically significant difference (MD = 583.9, p = 0.02), although heterogeneity remained high (I2 = 98.0%).”

Literally the first recent meta I found. If you want to smoke I don’t care but suggesting it isn’t a public health burden is asinine

Not that I agree with that person but smokers objectively cost more than non smokers even with a shortened lifespan. Smoking increases the risk of and worsens basically every chronic condition as well as being a well linked factor to critical loss of lung function and several cancers. Unless you like, just let someone die if they get a smoking related illness (which is basically all of them depending on how liberal you are with the word “related”)

It means do you sit or lie around most of the day. Do you have an office job where you sit at a computer all day then go home and play on your phone or whatever until you go to bed? That’s sedentary. If you exercise that’s good but if it’s something like a radiculopathy you’d benefit from seeing a physical therapist who can target the section of the back that is impacted (though you may need to start with primary care or orthopedic and mri). If it’s the other stuff treatment is generally medications and varies from stuff like NSAIDs or proton pump inhibitors (though if it’s gerd and you treat with NSAIDs that may worsen things)

Basically go see a doctor

Pleurisy, costochondritis, gerd, or referred pain from radiculopathy, maybe. Especially if you have a sedentary lifestyle or back trauma

I will just give yoko taro my money if he does something, basically

Although imo replicant was better, albeit more tedious to get to the end. He really has a disdain for the people that consume his media and I love it

No don’t you see, they ran their findings past a mother, as all archaeologists do (the implication of course being none of those dumb science idiots could handle being a mom as people can’t do 2 things). The mother then corrected them, likely with folded arms, likely going “mmmhmmm” once they realized that her wisdom beat their book learnin’

thus, she cemented her legashe. And that is why we all know her today: random nameless mother.

Not shocking to hear, he’s a scumbag at heart. But now if you say that people will be like “uhhh how can you say that he’s donated so much money”

Then when you point out he’s donated literally 0% of his overall current net worth, his past (and current, apparently) behavior has arguably as much humanity if not more than he has offset, etc you’ll get whataboutism. “What have you done??”

I don’t want philanthropy to be contingent on the whims of billionaires. Gates has done a lot but it still has major issues, there is no real transparency, and it’s still authoritatively controlled because he has a great deal of influence over his foundation. The even bigger issue is that he is by far the exception. Other billionaires donate minimally only to maximize tax benefits and only to issues they have been personally impacted by.

The other day I was with people who were watching a football game. The eagles won and I asked why the owner gets to speak first at the trophy ceremony, let alone at all, given it was the teams effort. This led to a whole discussion but one thing that came up was how he donates so much money to autism research because he has a grandson with autism. This was meant to appeal to me because I have a background working in autism research and I work with people with autism a lot.

all I could think is “how fucked up is it that we have to hope that an obscenely rich person personally experiences the issue for them to decide to bequeath funding?” This inherently means that things with a much higher rate of prevalence, like autism (1 in 36, roughly) or dementia (prevalence varies widely by age range (2% to 13%) but ~10 million cases per year), will get tons of money. But what about far less common things? I’ve worked with people who have extremely rare conditions. Angelmans syndrome, prader willi, chromosomal deletions, (rates of 1-2 per 10,000) or extremely rare things like hellers syndrome (rates of 1-2 per 100,000).

This is why we fund things like NIMH, so that money can be fairly dispersed to ensure that all things are researched. Teams of people research what needs to be researched. This isn’t even just about equity; sometimes researching lesser known disorders leads to discoveries that are applicable in a broader context

But instead we let a few oligarchs hoard money. Most of them don’t bother to fund this stuff at all and they few that do only bother to do so when it’s something personally relevant to them. We have no say in the matter.

80s, 90s, and a few years into early 2000s. Gates ruthlessness lasted decades, destroyed many businesses and lives, and is mostly whitewashed thanks to his philanthropic efforts and a few reddit amas and some secret santa participation

Not to mention the destruction he did to computing as a whole. The nightmare of proprietary bullshit is something that he did not architect but he pushed heavily and lobbied for constantly. He had the position to push for interoperability from an early stake in computing, to set the stage for computers to have a strong precedent to work together. Instead he and microsoft made every effort to work against open standards. They would adopt open standards and extend them with proprietary extensions to intentionally ruin them. A lot of what is infuriating about modern tech can be traced back to precedent that microsoft set at his direction

Reminder despite every donation he has made his net worth is higher now than it ever was and this has essentially always been the case. His philanthropy, while objectively good, is a measured pr effort that does not impact his overall obscene wealth and basically never has