Writers of Pro Football Prospectus 2008

13 May 2013

Do No Harm

Sally Jenkins and Rick Maese on the unanswered question of who should bear the medical costs of retired players with long-term injuries.

Posted by: Rivers McCown on 13 May 2013

24 comments, Last at 16 May 2013, 1:18pm by Insancipitory

Comments

1
by David :: Mon, 05/13/2013 - 6:34am

In the UK, which has a universal healthcare system, there is often a debate about whether smokers and the obese should pay extra (whether at the point of care, or through taxes) for healthcare

10
by Karl Cuba :: Tue, 05/14/2013 - 3:58pm

Both tobacco and alcohol are already heavily taxed, sugary and fatty food could indeed be next.

23
by Mr Shush :: Thu, 05/16/2013 - 11:39am

Which is idiotic.

People who do unhealthy things like drinking, smoking and eating wall-to-wall Bodean's cost less over the course of their lives, by a considerable margin, because they (we) die so much younger rather than hanging around for ages being old and unhealthy.

2
by justanothersteve :: Mon, 05/13/2013 - 7:31am

I do not know how much of this is obfuscation of the issue by the league and how much is just denial by the players. It's not as if this is anything new. Knowledge of post-career health problems of NFL players has been known since I was young, and I was born in 1956. Some of the old-time Packers who still lived in Green Bay would get an article in the local paper during the off-season. Most of them were covered by their employer's health insurance back then, but a few were either self-employed or unemployed and had no coverage. People would boo-hoo, but nobody did anything.

It's probably gotten worse over the years. Unfortunately, most players - like most young people - tend to think only in the short term. Players need to get long-term health care written into the CBA. I doubt current players realize just how important that is.

3
by MC2 :: Tue, 05/14/2013 - 4:27am

Honestly, this situation isn't much different than people who get lung cancer trying to sue the tobacco companies. Surgeon General's warning or not, it should be obvious to anyone with half a brain that constantly inhaling smoke isn't good for one's long-term health, and neither is playing a sport that involves repeated high-speed collisions with very large men.

And I say this as someone who smoked two packs a day for about ten years. I was fully aware that I was engaging in risky behavior, but I chose to do it anyway, and if I end up with COPD or lung cancer or whatever, I will have no one to blame but myself. No one put a gun to my head, and as far as I'm concerned, the same thing applies to people who choose to play pro football.

4
by Pat (filler) (not verified) :: Tue, 05/14/2013 - 8:39am

I don't think anyone would disagree that today, people understand the risk involved with football. But in the 1970s-1980s? I think that's a stretch. The game was still evolving at that point - free substitution wasn't even a generation old, and the trend that it created (towards larger and larger players on the line) hadn't had time to run its course.

Put another way, the players in the 1970s had never seen a retired NFL player with the kind of injuries in this article... because they didn't exist yet. It looks obvious in hindsight, but everything is obvious in hindsight.

5
by Aaron Brooks Go... :: Tue, 05/14/2013 - 9:41am

Free substitution came about originally in WWII. By 1980, it was more than a generation old. I doubt any active players in 1980 had ever played football when free substitution was illegal. That's like arguing that today's basketball players find the 3-point line to be an alien concept.

And there have always been hobbling old retired players. But then, for most of football's history, there have also been millions of hobbling old factory workers, and miners, and soldiers. Manual labor wears your body down, and professional sports are definitely manual labor.

7
by Pat (filler) (not verified) :: Tue, 05/14/2013 - 2:53pm

Ooh, ooh! Football history!!

In the NFL, free substitution was instituted in 1950. I'd say most people wouldn't call that WWII. However, in college football, free substitution was implemented in WWII... but taken away again in 1952. It was, in fact, only instituted due to WWII, because they couldn't find enough 2 way players.

College football actually only gained free substitution permanently in 1965, and people were still calling for the return of limited substitution (one-platoon football) through the 1970s.

Free substitution allowed linemen to grow dramatically, and increased the damage and health problems players faced. The effects of that really didn't come to fruition until the 1990s, when linemen regularly exceeded 300 pounds.

9
by DisplacedPackerFan :: Tue, 05/14/2013 - 3:50pm

The 300 pound lineman as the norm was the late 90s at that.

# of 300 pound players in the NFL (mostly taken from an AP survey of NFL rosters, I believe all of these numbers are opening day rosters from the various sources)
1970: 1
1980: 3
1990: 94
2000: 301
2004: 339
2009: 394
2011: 426 (with 5 over 350)

Other trivia related to this. The heaviest player on Packers when the won Super Bowl 1 was 260 pounds. The average weight of a player in the NFL in 2010 was 252 pounds so not quite the weight of the heaviest player on the Super Bowl champs back in 67 (66 season). The 1979 Super Bowl Champion Steelers averaged 229 pounds. Last years champs, the Baltimore Ravens averaged 244.1 (according to PFR) with the lightest player at 179 and the heaviest at 370 with 14 players over 300 lbs.

As you point out the league has changed, and it's still changing.

6
by MC2 :: Tue, 05/14/2013 - 9:55am

I have heard numerous players who played in the '70s and '80s talk about the laundry list of injuries, surgeries, etc. that they went through, and they weren't even including all the "minor" injuries that left them in pain for a couple of days after each game. To argue that these players were too dumb to understand that such constant wear and tear would eventually take a major toll on their bodies is absurd.

8
by Pat (filler) (not verified) :: Tue, 05/14/2013 - 2:57pm

You're a generation off.

The players in the 1970s and 1980s would grow up expecting football to look like the 1950s and 1960s, and those players did not play the same kind of game. Did the players in the 1970s and 1980s get a ton of injuries, surgeries, etc? Yes. Of course. And of course they probably figured that this would be bad in the future.

But they had no reason to expect football to be that bad. By the time they had all of those injuries it was too late.

11
by MC2 :: Tue, 05/14/2013 - 7:53pm

You're ignoring all of the injuries (both major and "minor") that they surely sustained in high school and college, which should have given them plenty of incentive to avoid pro football entirely, if they were really so concerned about their long-term health. And if they still hadn't figured it out, it certainly shouldn't have taken more than a year or two in the NFL to convince them.

The fact that most of these guys played for as long as they could find a team to employ them indicates that even once they had indisputable evidence of how dangerous the game was, they voluntarily chose to continue playing. In other words, they understood the risks, and chose to accept them.

Was that a wise choice? Maybe not, but that doesn't matter. Imprudence cannot be excused by feigning ignorance.

13
by Pat (filler) (not verified) :: Wed, 05/15/2013 - 12:59pm

It's not feigning ignorance. They didn't have as good information as we do now, because it didn't exist. Now, you can see the players from the 80s and 90s, in the era of 300-ish pound linemen after 20 and 30 years removed from the game.

You can't claim that they would necessarily reach the same conclusion then that we can now. We can't place ourselves in their situation, because we know what happened.

No matter what you think of their decision, it's indisputable that they did not have as much information as we do now on the long-term effects. It's easy enough to think "well, they should've known that all those injuries would do bad things." Yes, I'm sure they knew that it would affect them long term.

Did they know it would affect them this much? Very, very unlikely. They were extrapolating from evidence from the 1950s-1960s, when the game was less dangerous.

16
by MC2 :: Wed, 05/15/2013 - 10:30pm

Let me make sure I understand. Are you saying that someone is only liable for the consequences of their decisions if they made those decisions with perfect knowledge of the risks, even if such knowledge did not exist at the time?

If that's your position, not only is it a silly one, but it also doesn't explain why the NFL should be held liable, since they also lacked a crystal ball to see into the future and predict exactly how much danger that they were exposing the players to.

14
by LionInAZ :: Wed, 05/15/2013 - 6:38pm

The tobacco argument is particularly inapt for many reasons.

1. It wasn't 'obvious' that smoking tobacco was harmful until the major science studies and the Surgeon General's announcement in the 1960s. 100 years ago the tobacco companies claimed through advertising that cigarrette smoking was actually *beneficial*, despite claims otherwise by doctors. Even after the Surgeon General's report, the tobacco companies denied the science tooth and nail, even though their own company scientists showed the links to cancer were correct, for more than 20 years. Meanwhile, they started marketing so-called "safer" cigarettes which nothing of the sort, and knowingly promoted smoking to children.

In the meantime, they created a population of tens of millions of people dependent on a highly addictive drug, many of them addicted long before it was 'obvious to the public' but well known to tobacco companies.

How do we know that the NFL hasn't been making similar lies about the long term effects of football injuries?

17
by MC2 :: Wed, 05/15/2013 - 11:28pm

Wow. I don't even know where to start. You seem to assume that prior to being blessed by the sage wisdom of the Surgeon General, people were as easily manipulated as Pavlov's dogs.

100 years ago the tobacco companies claimed through advertising that cigarrette smoking was actually *beneficial*, despite claims otherwise by doctors.

Yes, advertisers make all sorts of outlandish claims, but what makes you think that people back then were gullible enough to believe everything they heard? I have had many discussions with people who were around way before the Surgeon General's warning, and not a single one of them has ever said that they ever thought smoking was good for you.

But if you don't believe me, go back and look at movies and TV shows from the '40s, '50s, etc. You frequently see parents punishing their kids for smoking. Why? If your claim is correct, parents would have been encouraging their kids to smoke, or at the very least, they would have been apathetic about it. Do you really believe that was the case?

In the meantime, they created a population of tens of millions of people dependent on a highly addictive drug, many of them addicted long before it was 'obvious to the public' but well known to tobacco companies.

You make it seem as if these people had no choice, as if the tobacco companies had cast some sort of spell over them, apparently by use of nothing more than clever advertisements.

Look, even today (in fact, especially today), there are tons of outrageous claims made in ads. For example, they tell you that all you have to do is use a certain brand of mouthwash or a certain type of hair product, and you will be surrounded by gorgeous women who can't keep their hands off you. Or if you take these diet pills, you can eat as much as you want, and the pounds will magically melt away.

Do you just accept these claims at face value, or do you treat them with a serious dose of skepticism? Assuming that it's the latter, then why do you automatically assume that people in the past were so much more gullible than you are?

18
by Duke :: Thu, 05/16/2013 - 12:34am

But if you don't believe me, go back and look at movies and TV shows from the '40s, '50s, etc. You frequently see parents punishing their kids for smoking. Why? If your claim is correct, parents would have been encouraging their kids to smoke, or at the very least, they would have been apathetic about it. Do you really believe that was the case?

If you actually did go back and watch those shows, you would also see several advertisements of doctors approving of and endorsing the smoking of cigarettes. Smoking was considered to be much more benign back then--even a healthy habit.

Look, even today (in fact, especially today), there are tons of outrageous claims made in ads. For example, they tell you that all you have to do is use a certain brand of mouthwash or a certain type of hair product, and you will be surrounded by gorgeous women who can't keep their hands off you. Or if you take these diet pills, you can eat as much as you want, and the pounds will magically melt away.

Do you just accept these claims at face value, or do you treat them with a serious dose of skepticism? Assuming that it's the latter, then why do you automatically assume that people in the past were so much more gullible than you are?

I WOULD accept the fact that those mouthwashes/hair products were no less safe to put in my mouth/hair than other types of toiletries I use. Certainly I wouldn't expect that mouthwash to give me cancer.

19
by Intropy :: Thu, 05/16/2013 - 2:47am

Not even in California?

20
by MC2 :: Thu, 05/16/2013 - 3:10am

Again, why would parents bother to punish their kids for engaging in what (according to you) was widely considered a "healthy" habit? Did they also punish them for eating their vegetables?

Seriously, these claims you're making have absolutely no basis in reality. I challenge you to show me one single video clip where any actual doctor is actively encouraging people who don't smoke to start smoking (as opposed to saying that they themselves smoke, or that some particular brand is better than others). Once you do that, then we can have this debate.

21
by Jerry :: Thu, 05/16/2013 - 7:36am

This is the summary of American smoking rates I found in a quick search. And here is some innocuous advertising.

There's a risk/reward calculation in any of these behaviors. When people perceived the downside of smoking as the occasional cough, 40% were willing to partake. As we've learned more about what we now know are the actual consequences, the smoking rate has gone down, and will presumably continue to.

There's a similar calculation for football. It may be that some players were willing to accept joint damage and even a permanent limp, but not the sort of brain damage we're now finding is too common. To suggest that someone decades ago should have have been able to figure out what you know now and act accordingly is a disservice to anyone who did his best with the information he had.

22
by MC2 :: Thu, 05/16/2013 - 10:30am

I have repeatedly tried to post a reply to this comment, but it keeps getting caught in the spam filter. I guess you guys have finally caught me. I've been reading here, commenting here, and even purchasing products and services here for the last 6 or 7 years, not because I like the site, but rather, as a cover for my nefarious plot. All along, I've been biding my time, just waiting for an opportunity to post some spam, just when you least expect it. But now, you're on to me, and have managed to foil my dastardly plans. Kudos, gentlemen. Kudos. Well played.

24
by Insancipitory :: Thu, 05/16/2013 - 1:18pm

Include a link to a sportsbook out of Dubai and the spam filter will let you sail right through

12
by Intropy :: Wed, 05/15/2013 - 12:42am

Ultimately it doesn't matter because ultimately it's the fans who fund it. The business has a certain value, and the players have a certain value within that business. Whether teams pay for medical treatment* for retired players or those players first receive their pay and then pay for their own treatment is just accounting.

*And by treatment I almost certainly mean insurance.

15
by LionInAZ :: Wed, 05/15/2013 - 6:51pm

I agree that fans (and taxpayers) ultimately pay for it all, but fans don't have much say over the issue as long as TV and advertising revenue constitute the bulk of team revenues.