WWL>Topics>>10-11-11 1PM Dr. Jody Sindelar

10-11-11 1PM Dr. Jody Sindelar

Oct 10, 2011|

Dr. Jody Sindelar, Professor and Had of the division of health policy and management school of public health, School of Medicine and Institution of Social and Policy Studies at Yale University and the National Bureau of Economic Research joins Tommy Tucker to talk about how it would be cheaper to pay people to quit smoking than to cover the damage it does with medicaid.

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Automatically Generated Transcript (may not be 100% accurate)

Undersized CS. Plan here whenever they call on me and you'd be surprised when I can accomplish. We have -- show planned for you today -- talk about the saints and LA issue at 3 o'clock with Tim Brando from CBS sports. And then at 2 o'clock hour we're gonna talk about TV. And some of the things going on in prime time TV has some of which I I found the sound bites -- I'm gonna play him because. Idol and I am not a prude but I don't think it's appropriate for prime time and I'll listen to dominance like no I'm -- -- play that on the radio. And some of the references I couldn't believe and and and this is inspired by NBC's decision to cancel Playboy club in the parents' council -- the Parents Television Council objected to event. But I did find that anywhere near as objectionable as some of the things I heard on the office and Whitney and parks and rec. So we'll talk about -- at 2 o'clock hour but we Begin by talking about smoking. And who would you quit smoking if somebody paid you to do that. End -- would you mind your tax dollars going to pay somebody to quit smoking well believe it or not. That might be the most efficient thing. Your dollars could pay for. And we -- you only conversation NT six -- 1870 toll free 8668890878. And if this sounds like snake oil is somebody's peddling. Rig at the facts right now from somebody who is far from a snake oil peddlers -- is soccer -- recent alarm professor and head of the division of health policy. And management at the school of public health school of medicine and institution of social and policy studies. At Yale university in the national bureau of economic research and we need to Begin by congratulating doctors sandal are on Yale's. Hounding of Darden miss. 38 enough then they destroyed the Dartmouth big Green this weekend I don't like to single I'm fine thank you very much what this tailgating like video game do you guys have caviar and nine and champagne in the catered affair not. I don't have their email that I don't -- now I just didn't -- I was just wondering. Tell me about your plan now to pay people would quit smoking. We were lucky recently together grant from. Medicaid. Which is related of that Health Care Reform with the idea of changing the way we. Incentive because the current consent of the medicated that -- -- that you spoke a lot you have lung cancer emphysema. But -- when you're pregnant. It gives you lots of different problems and right now the way Medicaid -- exactly is once -- effect and Medicaid paid. The -- the idea is to think about. It there is no way to encourage people to be healthier in the first place. Which would help. Could of the individuals that they didn't possible productivity gains but it could -- Medicaid money. In the long run so could be win win. And you've. T use the phrase crunched numbers horror determine what kind of of way you would determine. From that they did that people actually smoke in would you do it with test or how much would you pay amend. I know at some point economists talk about. Diminishing returns or breakeven point so every need to phrase it have you done something like this -- And at what happened part of the reason we started that the idea -- there have been quite a bit of evidence. Both on smoking and also I did some work on of people you know -- it. And I got into -- and I was so surprised that really small amounts of money could make a pretty big different but somebody with addictive opiate for the wouldn't help them to stop. And I think part of the reason it can be effective but two important reasons one of people you know some of these things and bad it is for their -- trying to quit. With their desire to smoke so company that tipped the balance in the Paper of quitting is good. Also people have a present oriented and wants something now he's the kind you can smoke now but always quick tomorrow but round number com. So can provide a little bit of -- is now at the time to quit. And we might be able to change behavior so evident that the in previous studies. Of pregnant women of smokers who were employees and also -- into each other even why and maybe now more addictive but other drugs. Looking at my payment and mattered quite a bit. How small. When it -- the payments. Of the can vary quite a bit though it sometimes in the nonpayment that I looked that they were. Somebody would earn 36 dollars over a twelve week period. And the payment could be as -- as. -- zero actually a probability of winning the lottery. Can. My and I think that five dollars. Every time I can go on. To a fashion or tried to quit and then one -- actually quit which they've attacked. They would be a fifty dollar payment. While at the and I know and heads up the you know cumulatively in the aggregate but that that really doesn't seem like a lot of money compared to end it -- thank you if you could compare it Flores. What kind of money you talking about that Medicaid puts up puts out once somebody is diagnosed with what is it CO PDR emphysema because I know my dad died from it. Up from smoke and look what. He exact number for -- particular case because it. I'm gonna have an estimated that I have been testament that. And Medicaid paid 22 billion dollars a year over. On the whole nation. Second -- that far off the grid and the United States not related health I think billion by the way twenty billion dollars okay dealing with a DeLia right. It's similar but in the United States whether it's -- expected that there are. Almost a 100000 dollar and medical can't do that smoking is not the Medicaid but everyone and almost the equal amount another hundred billion dollars. Related to -- productivity. So we wouldn't what is the next step as far as scene of this program is viable or not you conduct more tests are what are you do because OS ISO was op Ed piece that you wrote -- you do you've done some studies. Went so it is is the beginning of this where we actually have a plan figured out how we're gonna bring in my guess starting. Two runs and the question that I -- -- back. -- -- paid an outcome like -- quitting I do you pay for people trying to quit because. Most people have to do three different attempts to quit before their successful but 70% of the smokers who want a quick so. We wanna help you might encourage them to try to quit which parity act and and the job when encourage. That is paying them. When -- actually put. Quick and OK okay here verifiable objective measures under the -- Pain for people think something's actually -- -- hard evidence that they need to try and by attending a conference session. Try -- Kinda quit line. Or actually quit and then we didn't -- attack. I was discussed in this is somebody in the well legacy where was any office let's just leave it at that in any -- kind of cynical person. And immediately there's thoughts turn to people trying the game system and one thought was well. They did take the money and they -- know that it was a very minimal amount is sometimes zero in terms of winning a lottery five dollars a session -- or fifteen dollars. That they were -- games is -- either buying. Not quitting and then going back to it after they got paid or. In this first and even suggested this starting smoking to get paid and then. IA quitting but did did did do the numbers indicate that they wouldn't be enough money to state to they encourage a kind of behavior. Well I think that in the really important question and it is a risk but that's apparently why we paid people to make it happen so for example. For fifteen dollar the going to conference actually get paid five dollar -- have to go to the confrontation. And I doubt that things -- -- little amount to make people. Go to tobacco cessation counseling. Session so we think that -- -- other -- a moderate trip about that we designed to prevent that from being. Important also as someone tried the quick fix the liquid. They might not go right back on smoking again because most people want to quit they know it's not good for them in contact that can kill them. So it might even be if someone thinks -- gaming system by quitting. I can't believe they made a quick. Game themselves and away I -- about it right now yet be happier. And they would actually equipped. It is this would work in a Medicaid environment do you think this could be a model for an insurance company but obviously the payments would have to be higher because you'd be dealing with. Maybe some money and higher socioeconomic strata. And helping them experiment at MI employee group and employers. Like to see this as an investment in them inner workers to keep them healthy and keep on the medical care can't. What happens -- it would have been both experiments and that's actually admitted being in front of them being used more and more. Employees situation. And that's why I like to think about the Medicaid also at that investment of tax payers but you'd rather have people be healthier more productive. And so I would always wondered who'd be willing to invest in the Medicaid population. Can't -- it but. It Medicaid look at it carefully it might be a better investment and that pain when people got sick. I NL's -- being said you probably get have a political challenge when it comes this is it just sounds wrong do you think you're not. Yes I think a lot of people have a -- tomorrow and that why would you pay. People can do what is the right thing. Can do in the first place so yes that that potential on the other hand if you can show and that's what we're gonna look we're not gonna but the a look at it that save money. In the longer run an assortment -- well but. If you could tell that they actually saving money even if you had somewhat of a moral. And again that. There would be of an argument that that makes everybody better off. Well we thank you for taking anti money dame before we let you go is there anything you wanted to head that we might be missing. Today yes and lots of things that I am -- paid them. Lots of interesting issue of whether we're being too paternalistic in the other side of the question people being unhappy about that they think should -- help. People what to do an -- that in this case that could and sent to that the voluntary not. Required we have lots of other interesting thing that probably did not time to go and all of. Well any other thing is it bottom line I always try to take the politics out of things like this when it comes to policy in just look at it try to look at it this isn't a good business deal. For the taxpayers and it seems to me at the numbers add up then. When you're telling me at least at this early stages it is a good thing writing good business deal for the taxpayers. Well we haven't. Actually found that data we've looked at all kinds of information that -- up to it and we're asking that question I think there's no other way to find out other than trying. -- Doctor I appreciate your time and only have a great day ever. I think they don't talk T again as the as the tests continue in the study progresses that would be great thank you so much doctor -- send alarm professor and head of the division of health policy and management school of public health school of medicine an institution of social. And policy studies at Yale university in the national bureau. Of economic research. -- and she might be a little smarter than 9 AM. But it was interesting to hear what He had to say so now we open a phone lines and talk to you if you smoke. What do financial incentive be enough to get you to go to -- she said some of the sessions. To at least get some information. And then the Indian cinema goes up. Is you. As you proceed in progress in the in the cessation program and use any maybe stop smoking. Would that be enough to get you to quit. And have you been through a program like dealt with your insurance company. And as a taxpayer would you mind if the numbers showed. Me is gonna be cheaper in the long run coming right back -- -- W. ID phone lines are open so that doctors don't know pay people to quit smoking because it's gonna be cheaper in the long run. Then it is still pay for what happens to someone Medicaid. Once again. Sick with emphysema or. Corn area obsessive whatever it is as CO PD. And text comes in is. It seems like almost all the people complain about smokers are out of shape and overweight. I don't understand what this text means because. We're talking about money here. 22 billion dollars is what because Medicaid -- tax dollars that go to war -- so if you wanna smoke and you have insurance it's fine you're probably paying a higher premium or. Maybe pass that along no other people. To bottom line is. I saw -- happen with my father's so we give you money. Think that your impervious to the effects of it now but he's spent and a -- trying to preach and his -- you what happened He spent the last week of his life. In and out of consciousness thrown out blunt. Seal I think you Billy -- behind now -- -- -- -- is something but unfortunately it's not always quick like a heart attack it's gonna take you out immediately so enjoy his cigarettes if you like that your -- is an American. My only problem is when you pass those costs along to me in terms of higher insurance premiums. You know if you -- drive your car new and oak tree. If you're alone. And those costs don't get pass along to me. And I don't have to pay for you you if it's quick and cleaning you take yourself cloud and I don't have to pay for your extended care and nursing home railing and I don't care. That's up TO as so long as you provide for your family. So long as I don't have to put money in a basket a church to take care you family are paid well it's a higher taxes for social programs or welfare. I don't care. If you wanna be a rugged individualistic and that's what you choose to do with your life and it's did I guess you gotta look at property rights of the -- owner. In the in the nth degree I don't care ain't sure lights do would you want just don't leave anything behind that goes and in my wallet that I have to take care of so if you're gonna be a rugged individual -- to be a rugged individualist and take care of all your stuff. That's fine I got no problem with that. We're talking about here is a business deal for the nation this shield doctors says that there have been programs. That the improves a little bit of money if there's just the slightest bit of small incentive. That it can get people off of opiates some popular open if you know what opiate sock. -- their pain pills like heidrick coat on and OxyContin and all these things. These pills are so powerful. And so much in demand that they have and then there's so much money chasing them. But they've cause. Doctors and pharmacists to go to jail and lose their licenses. So -- little bit of -- monetary incentive. Can get people off of opiates than maybe it'll work for cigarettes now all that being said. My opinion on this and I don't wanna hear what you have to say it is just my opinion. My opinion is to get the federal government involved in paying people of the -- Other people quit smoking is gonna be a disaster. Because I think He had to have people gain in this system I think -- they have money flying out of the treasury and think people are gonna continue to smoke anyway. So it's gonna happen is you're gonna wind up -- in the additional Medicaid costs anyway. And meanwhile you -- -- spending a ton of other money to pay people would quit smoking that's and I can have an impact. That's just my opinion I'd like to hear what you have to say NT six -- 1870 toll free 866889087. -- to say something like it seems like almost all the people complain about smokers are out of shape and overweight and a text means you didn't hear anything. Of anything -- we've just been talking about for the last 25 minutes. I appreciate your listening and I appreciate your texting and just trying to get the message across to. So all that being said if you do smoke and you are rugged individualist. Would our financial incentive be enough to get to the stop or not. Because you have a double edged kind of thing near where you'd save. Money from not buying the cigarettes and you have money coming in to pay -- not to smoke. And secondly do you agree with me that although it may be a good business deal and and may be. Paying people to quit if the incentive works to get them off of opiates. Mike worked to get them off nicotine the administration and this is going to be a disaster plus politically there's no way they'd ever get it to pay as. Because I don't see any congressperson in their right minds and we know what I'm gonna vote for this. And now all of a sudden next election cycle comes up and -- a -- rear end that's I think phone lines are -- the public see what you think -- come back. 1:30 AM Tommy Tucker interest but right now time for -- WL first news today. Tommy and respond I was confused unsealed CDS and any text in any chronic obstructive pulmonary disease. Number two killer after cancer miserables wrote debilitating disease includes emphysema. Bronchitis. And sent a regular phone lines we go to beaming and went home hanging near under the WL. Key play you went good. I wouldn't call and say yeah I don't smoke and I -- I have a hard time being around people that smoke. But I also had my grandfather died. About it and pretty much slowly suffocated to death and I do -- -- they had people that I am very close to -- that is smoke. And if it helps. Just a handful -- obviously you know people do we wanna get approach. If they're gonna stop smoking -- -- -- -- and I and I but the people rush ugly with and it may. Help an -- people. I wouldn't mind putting my tax dollars towards that on in. In a sense of what she's talking about however I'm not sure lesbian and it would be enough to work for people who actually love to smoke. Do you think there's any way the government could administer this where it wouldn't be. Just full of fraud is is that my two things are are this Amy got a look at it like Ayatollah it was asking that doctor where. Let's try to take the politics out of it in the emotion out of it and well Lowell congressman X did this and He did that bit but that's not really the truth let's look at the truth of it and if it makes more sense and it works to do that. Then pay all the bills after people get sick like you grandfather even though maybe wasn't on Medicaid. But for people that are on Medicaid if it makes more sense to do that then I'm all for good business deals for the taxpayers would. Then that the other issue is well it's gotta be administered by the government men. That's why go put my -- my hands and say oh lord here we go. So I don't know do you think they'd be able to administer it in a manner where it wouldn't get abused and get full of fraud. I don't think any parent any system that anybody can click into place that would not be. And abused in some way. I mean it's happened in almost every every situation where government tried to help people I actually gonna have people who'll try to work the system yeah. So I agree with that but I do think that there are people who benefit from comedy program as well. Well on. So I'm not edit as a different business deal similar to -- to more people getting help then. Screw us so for I guess are exactly exactly and then look at our step back. Ireland. Chinatown I guess on how can anybody does anything is something thousand -- an -- taken -- -- -- I usually do okay in that place and they I don't Tyler and continue to try to pack that's only done exactly that's -- duke and -- Wait for the next LSU into -- to get us through it get ready go to work on Monday morning. Say yeah okay game and -- -- -- I think about Craig inside else's He participated in getting paid for quitting hey Greg you're on Devin have you well. Good afternoon mr. kagame you do so well -- do and our lives for no money in here you -- -- happened to me about the program. Well. It wasn't my mother's idea. She said that. Great I'll I'll pay you 101000 dollars -- he'll quit. I'm not so well that certainly weren't that good bet but I'm not ready. And when I get ready then bimbo look how -- and where you create. Oh gosh I don't know the exact stage without -- -- and in and so on 66 now so you learn you -- a young adults or anything you're I don't know but many they belonged yeah. So anyway she's should know. Matching list 700 miles away. So more unlikely -- wanna -- that could say sure sure and it can't all smoke and you'd never know that there. But I would so I didn't do that so probably I guess it was about six months later. I told said. Alright I'm ready to quit smoking now. She said okay -- I'll -- and I said no don't pay me until He would make sure that I hope it takes don't start back again. So anyway. I -- September the twelfth 1999. Check -- -- my -- nine and I haven't spoke sent. So about six months after I quit I went back there and said all right mom I quit. I -- Adams spoke first six months. She knows she wrote that check for 101000 dollar. These amounts so whether certain no no she died December 7 2001. It's probably Iran are now that's keeping you from gone back to it is relative decision as the -- said what what I meant by your -- this -- first sauce. You said during courses conversation you said she would nobody you would which makes any means think your man monitor. Then you said you wouldn't take the money until you were -- six months to make sure that it stock and now would seem to me. It's bad if you would build deal when you go back to it is if you could pay her back in -- no way you could pay airbags -- -- just I think your code of honor keeps you from ever gone back to. Well -- and I did. Well the total -- certainly does -- because that's one thing in the lord let you do you know it as a proto honor but. I think the main thing is in relationship a year per person your program today. Money in and of itself is not gonna do like if you're not ready to quit you're just gonna vote you're not gonna quit. So either it's a mental thing where you have to be pro prepared -- ready to fight the battle major ready. I couldn't I could talk on the telephone. Without call -- -- but could not hold a and you -- conversation without properly and that's important men in my work so. I've said that there that's the -- I -- I gotta get this monkey off my back. And so I used -- I guess I could say this -- -- surely would have you. You desire band. I and a candidate needs ban I achieve that -- and can be India put anybody in my mouth as fit. But. I think that that was a trick for me was that and I did did irritable that's what. -- really surprised because I could quit before as as everybody. -- smoke but. It it just took because I think I was mentally ready. So. He's giving those best. Oh they had the issue mom or was right at 101000 dollar check. Well I can say there's only she -- did it and yeah things are pretty happy to do and yet He was too real proud of that thank you Craig alleged cult all right thanks. Have a good day would take a break pick it up right here since you're on hold. Hang on please is that like to hear what you have to say you thought it was important enough to call -- and I think is important -- -- -- to hang on. And talent sunny and responded a big 87 intended -- you can't hide in sunny in the Darren Sproles market -- are in agreement that wouldn't Darren Sproles embedded video radio. -- Alexa and on there but undersized. But it's ready to do whatever I'm called upon him doing guarantee young pitchers. -- -- wearing Darren Sproles number was 43. And I load -- -- gentler opinion poll would you quit smoking and somebody pages 84% are saying and yes. And they usually have a double. Ready jaguar opinion poll would you pay somebody to quit smoking. Because that's -- -- Yale professor -- smart lady who. Smart and I'll ever be I'll tell you that did a study in -- and indicated that He didn't take a lot of money at all. Maybe getting -- people five dollars a session go to. Didn't quit smoke concessions and then fifteen dollar incentives if they pass the tests. Indicated that they. I quit smoking -- or Medicaid patients because. What happens is if He -- he'll pay him now and let him continue to smoke at least the preliminary tests show. Then you're talking about 22 billion dollars what it's gonna cost to pay form after they get CO PD. Say they ranked yet. Or maybe cancer. From smoking it's terribly expensive to deal with the results of it. Problem is as far as I see it once you get the federal government involved in. Administering the program and handed out money a lot of people -- surrogate and -- -- aren't entitled to it and you say it was only five of fifteen dollars but enough people get it. And He got a mess -- hands couple attacks that came in if financials sent incentive would work smokers are quick to save the cost in 101000 dollars is too much draws people's honor. Did the government -- given anybody 101000 dollars gentlemen and called in Craig just said his mother offered him 101000 dollars and a gentleman of honor obviously no way He carried himself. That's what his mother gave him an Andy He did it did and you -- confidence and advise him to stop or not because. He said was finally when He couldn't talk over the phone. And it seemed to me like. The 101000 dollars just -- yet another one instead of payment -- -- we just give -- medication stop smoking. Because I guess that doesn't give people over the hobbled one -- Another one asking if He believes Jesus is god which I gotta believe was sent to somebody else and we got by mistake. And I love what we get the wrong tax Tommy I smoked two packs a day for 25 years and -- 99 the chance to be mentally ready. That's what I think happening Craig. And finally another one says I quit using champ takes chance takes two years ago cost a 144 dollars nobody helped me pay for it. Took me three weeks and uneven crave of a crave them best movie ever. And I guess if -- Medicaid patient maybe don't have a 144 dollars and pay for it again maybe needs something to -- -- over the hump. AJ on a cell a year on that WL. Okay a couple of questions here yeah it got a pump cool it and it became a -- -- comptroller rush to text and I got it that's not about Kerry. We need -- yeah. -- well I doubt maybe Yale you know consular -- -- from people like -- it's Korean she really dumb is that do. Dot com okay and how much it -- Contra went up our little happy drive. Will it be more about -- -- mom out of some like their consumers do not. If I don't do any tape you know I can't get in anyway but the if if you're talking about poor people on Medicaid. I presume they would put him in the neighborhoods where people can get to. And not it would have to be very close our policy debate and again as transportation I have hurt. -- -- to go to this can't chilling column you. Yeah yeah yeah yeah that's where I hate issued a federal gun market and some bit where I'll have to be pain but He -- control until. Or save button on the same token you know AJ you paying a lot now with Medicaid. But the -- out. And -- -- on -- go right now. We're knowledge fourteen year dole out call our younger -- smoke -- like regular. Trade at -- in high school color barrier or. I wanted -- like get a scholarship in track and vote led to believe that -- -- okay what kind of I'll make -- -- bread stick on it brings -- a quick look at it quit smoking and well I didn't get a college scholarship could -- introduction -- that -- quit being -- a okay you pregnant anyway I thank god don't like it involved in -- you've got. I don't see where it didn't. Hey anybody any money and now anybody who doesn't. Glad quit smoking or quit smoking. Now. I agree with DA in a way Jane and I think the administration now that would be a mess but I also know business -- just looking minute as a business deal. It's costly new NB a ton of money now people are coming after our wallets now with the Medicaid 22 billion dollars -- years what they're saying it's costing. If there was a way which I don't think there is. Take headed off but the pass before it got that 22 billion dollar level. I'd be deployed but I don't think there's away so I think I might just be a good idea at this point but I don't know -- you don't make it work. 8 that I am here. Calorie -- you know what else I admire budget. You're honest enough not to blame anybody and its scholarship you said you didn't get it did you were not thank you my friend -- -- -- are trying to help I think I you know who they don't have a good day would be right Baghdad take your phone calls on this. When we return Tommy and his spot on the big 870 WW I got a slow start and Mozilla spark off the side yards and get the phone calls Sony and better read this is something -- looks like He got to say -- you doing your -- WL. -- about an opinion about spot in minutes got caught the last few caller. And my theory mich light on the radio -- that at the government come out you know at some kind of what legislation that. Well -- -- really we had a Yale professor on and she did a study and they found that if they give people incentives and this is even get off of opiates things like -- -- code known in numb do woody Colin of the self OxyContin that even a five a fifteen dollar incentive can get them to quit and she made the point that she wrote an op Ed piece. They're dead pointed on the S and research the data indicates this. -- work He will pay and as taxpayers 2.2 billion dollars a year right now. For the effects of cigarette smoking on Medicaid patients. So it's costing you money right now. And they were saying she was saying DNA got more studies to come she's not saying it's a done deal. But that may be if you would you pay Medicaid patients and give them incentives to quit smoking it may be cheaper and better business -- for the taxpayers. In dealing with the effects of it after they've been smoking for all of those years in the form of emphysema bronchitis. Pneumonia. Cancer all of those things and and my take on it was all of that sounds good in theory but I think once you get the federal government involved. And administering the program is going to be a mess. You know I'm I'm you know I didn't realize don't had a professor on this is what she's she's she's proposed and -- -- would help the country because this is science did you did you listen -- I thoroughly disagree with Paper -- from the get involved. If people on Medicaid. The need to sit there and I think smoking in front -- I mean at it I -- -- -- court order I was -- they could afford -- at. They don't need Medicaid. I don't know with the guidelines are for Medicaid I don't know -- I mean you can always say that people use crack to put my -- I yeah I guess they don't say and. -- -- -- -- -- -- -- And you know we go to work everyday work out there yeah it opened the program out there or people that need it I'm I'm I'm met with Tony Tony Wheeling him He didn't totally of people that they. Take advantage of that -- that are smoking and they import car for the cigarette they don't need Medicaid. We -- we had thirty seconds Deanna and I agree with -- but I think it's always going to be. The issue where you got people who do without stuff to do the right things and any other people who -- on the dole and don't do without. It's things that they really should do without to have a better life -- you and I wind up paying for it that's a different -- and I'm glad you called all right thank you I would take a break come back we'll continue our conversation. About this and we'll also fact now working.