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PRI in the News
By: Richard Samuelson
6.23.2007

Real Clear Politics, June 23, 2007


What do smoking and overeating have in common? They both cost the taxpayers money. "The health care costs associated with obesity now rival those attributable to smoking," WebMD notes. Moreover, the site declares, "obesity costs in the U.S. totaled up to $92.6 billion last year, and government-funded public insurers Medicare and Medicaid financed about half of those expenses." In sum, as The Washington Post reports, "more than a quarter of the phenomenal growth in health care spending over the past 15 years is attributable to obesity."

Diet, formerly a personal concern, has become a public one. Marion Nestle, Chair of the Department of Nutrition and Food Studies at New York University, suggests that we no longer regard "obesity only as a personal or family responsibility." Instead, we see it "as a societal problem with societal solutions." In 2003, the Surgeon General declared that "obesity has reached epidemic proportions," proclaiming that "every American needs to eat healthy food in healthy portions and be physically active every day." Pork Chop Hill is no longer a battle in the Korean War. It's a domestic health campaign.

Wherefore this crusade? Some of it has to do with who is paying the tab. The Wall Street Journal reports that "business, labor and health policy advocates prepare to push in 2008 primary states to highlight obesity as a driver of health-care costs. 'We need to put this on the agenda of the presidential candidates,' former Bush Medicare chief Mark McClellan says." Conservatives in Britain complain about the rise of the "nanny state" that cares for us as children. In the US today, we're discovering the fanny state--it butts into everything.

Given the size of the problem, the solutions proposed thus far are woefully inadequate. Banning trans-fats and regulating fast-food, the latest battles, will trim little from our collective waistlines. And why shouldn't fancy fatty fare like fois gras be taxed along with humble fast-food? Breads are fattening, why not impose a carbo-tax? Over in England, the Times of London reports, the National Health Service is seeking to regulate the consumption of alcohol, even at home, because alcohol related illness costs the state a few billion dollars per year.

The logic, Jacob Sullum notes in a recent essay, points beyond consumption taxes to a national fat tax. The IRS will ask each of us to weigh-in. Those who are above a certain standard will carry an additional tax to cover the expense to which we put our neighbors. That way those who eat responsibly won't be taxed for the occasional ice cream. To be sure, as Diana Ernst of the Pacific Research Institute points out, according to the government's currently favored statistic, Body Mass Index (BMI), Michael Jordan is overweight. But having a reliable statistic has never been as important to bureaucrats as having an easily calculable one.

A decade ago many of our public servants said that tobacco companies should help cover the cost smoking imposes upon our health-care system. Now the same people are making the same argument about fatty foods. But why stop with obesity? Those who engage in extreme sports, or in other risky behaviors, or even those who have long commutes to work, are much more likely to suffer from what actuaries might call "a major health event." Skiers are much more likely to break a leg than are the rest of the population. Why not impose a special tax on lift-tickets to cover the cost?

In the 1940s the government extended benefits to universities without strings attached, but it soon added a few threads, then some more, and it has now woven those into a fairly heavy cord of regulation. There is no reason to expect health-care to be any different. With universal health insurance gaining supporters, the campaign against eating too much is a sign of worse to come. This is not a matter to be taken sitting down.


Dr. Samuelson is the Salvatori Visiting Scholar in the American Founding at Claremont McKenna College and an adjunct fellow at the Claremont Institute.

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