Tough love for fat people: Tax
their food to pay for healthcare
by Melissa Healy
http://latimesblogs.latimes.com/booster_shots/2009/07/tough-love-for-fatties-tax-their-food-pay-for-healthcare.html
July 27, 2009
Comments by John Cartmell, MS, at end of article.
When historians look back to identify
the pivotal moments in the nation's struggle against obesity, they might point
to the current period as the moment when those who influenced opinion and made
public policy decided it was time to take the gloves off.
As evidence of this new "get-tough" strategy on obesity, they may well cite
a study released today by the Urban Institute
titled "Reducing Obesity: Policy Strategies From the Tobacco Wars."
In the debate over healthcare reform, the added
cost of caring for patients with obesity-related diseases has become a common
refrain: most recent is the cost-of-obesity study, also released today by the
Centers for Disease Control and Prevention. It finds that as obesity rates
increased from 18.3% of Americans in 1998 to 25% in 2006, the cost of providing
treatment for those patients' weight-driven problems increased healthcare
spending by $40 billion a year.
If you happen to be the 1-in-3
Americans who is neither obese nor overweight (and, thus, considered at risk of
becoming obese), you might well conclude that the habits of the remaining
two-thirds of Americans are costing you, big time. U.S. life expectancies are
expected to slide backward, after years of marching upward. (But that's their
statistical problem: Yours is how to make them stop costing you all that extra
money because they are presumably
making poor choices in their food
consumption.)
"Facing the serious consequences of an uncontrolled
obesity epidemic, America's state and federal policy makers may need to consider
interventions every bit as forceful as those that
succeeded in cutting adult tobacco use by more than 50%," the Urban Institute
report says. It took awhile -- almost 50 years from the first surgeon general's
report on tobacco in 1964 -- to drive smoking down. But in many ways, the
drumbeat of scientific evidence and the growing cultural stigma against obesity
already are well underway -- as any parent who has tried to bring birthday
cupcakes into her child's classroom certainly knows.
Key among the "interventions" the report weighs is
that of imposing an excise or sales tax on fattening foods.
That, says the report, could be expected to lower
consumption of those foods. But it would also
generate revenues that could be used to extend health insurance coverage to the
uninsured and under-insured, and perhaps to fund campaigns intended to make
healthy foods more widely available to, say, low-income Americans and to
encourage exercise and healthy eating habits.
And although 40 U.S. states now impose modest extra sales taxes on soft drinks
and a few snack items, the
Urban Institute report suggests that a truly
forceful "intervention" -- one
that would drive down the consumption
of fattening foods and, presumably,
prevent or reverse obesity -- would have to target pretty much all the fattening
and nutritionally empty stuff we eat: "With
a more narrowly targeted tax, consumers could simply substitute one fattening
food or beverage for another," the reports says.
Of course, the United States
also would have to adopt extensive menu- and food-labeling changes that would
make "good foods"
easily distinguishable from the "bad ones" subject to added taxes. Not to worry
though: Several European countries, most notably Great Britain, have led the way
in this area.
And here's the payoff: Conservatively estimated,
a 10% tax levied on foods that would be
defined as "less healthy"
by a national standard adopted recently in Great Britain could yield $240
billion in its first five years and $522 billion over 10 years of implementation
-- if it were to begin in October 2010. If
lawmakers instituted a program of tax subsidies to encourage the purchase of
fresh and processed fruits and vegetables, the added revenue would still be $356
billion over 10 years.
That would pay for a lot of healthcare reform, which some have estimated will
cost as much as $1 trillion to implement over the next ten years.
There can be little doubt that lobbyists for the food, restaurant and grocery
industries would come out swinging on any of these proposals. But
the report cites evidence of
a turning political tide for proposals that
would hold the obese and other consumers of nutritionally "suspect" food
accountable for their (lifestyle) choices.
A recent national poll found that 53% of Americans said they favored an
increased tax on sodas and sugary soft drinks to help pay for healthcare reform.
And even among those who opposed such an idea, 63% switched and said they'd
favor such a tax if it "would raise money for health-care reform while also
tackling the problems that stem from being overweight."
-- Melissa Healy
John Cartmell, MS, comments
A little bit of information is a dangerous thing. As a professional nutritionist, I can tell you something good or bad about any food. One of the common misconceptions of nutrition is that fat people are obese because of excess food consumption. But research reports a significant association of obesity with Irritable Bowel Syndrome ((BS), independent of dietary intake. How unfair it will be to tax fat people for eating "fattening foods", when the real problem may be digestive disturbances which cause calories to be absorbed too rapidly, with excess calories in the blood being converted to fat and stored. Such misconceptions of nutrition and obesity are only one example of why a national health care system, with non-health-professional government bureaucrats making decisions that impact your health, may be dangerous to your freedom of choice and quality of health care.
Unlike private health care, where people at high risk pay higher premiums for their insurance, under a nationalized health care system where the premiums tax funded, it becomes everyone's business how you live your life. First a tax on foods perceived to be fattening, then on foods that may increase your risk or aggravate you condition of cancer, diabetes, heart disease, arthritis, high blood pressure or depression (to name a few).
We should be careful we don't inherit the same problems of Britain's nationalized health care system by blindly adopting its design. We should also consider whether the increased revenues from taxing "fat promoting foods" will be offset by the decreased profits and tax revenues of companies that produce these food products.
The state of health comes from within; the result of a proper balance of nutrition and healthy lifestyle; making each individual their own, best, primary health care provider. Maintaining health is therefore each individual's responsibility, independent of whether the system of health care is public or privately owned.
John W. Cartmell
www.dietadvisor.com
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