Fat Load

A slimmer America won't save taxpayers money.

Lately President Obama has begun calling his plan to reinvent America's health care system "insurance reform." Yet the version of the plan moving through the Senate also includes restaurant menu reform (a mandate requiring the conspicuous posting of calorie counts) as well as grocery reform, transportation reform, and recreation reform (money to build farmers' markets, bike paths, sidewalks, and jungle gyms).

These provisions are all aimed at making Americans thinner, on the theory that doing so will reduce medical spending. It won't. Even if it did, we should be wary of a political theory that says taxpayer-funded health care makes everyone's personal habits everyone else's business.

There are reasons to be skeptical that the anti-obesity provisions in the Affordable Health Choices Act will have a noticeable impact on Americans' waistlines. The same research that nutritional nags cite in support of menu mandates indicates that even in restaurants like Subway, where the clientele is unusually diet-conscious, most consumers prefer to avoid calorie counts, enjoying their food in blissful ignorance.

To justify government funding for farmers' markets, which would be supported by a $10-billion-a-year Prevention and Public Health Investment Fund, the Trust for America's Health cites a survey in which 90 percent of visitors to two inner-city farmers' markets in Michigan said they "wanted additional markets and had learned from the experience." But the fact that people who go to farmers' markets like farmers' markets does not mean subsidizing them will change what Americans eat.

Still, let's say the various anti-fat measures in the Senate bill work exactly as intended, improving diets, increasing exercise, and reducing obesity rates. Surely that will save taxpayers money. After all, the U.S. Centers for Disease Control and Prevention says obesity-related health care costs something like $147 billion a year, accounting for about 9 percent of Medicare spending and 12 percent of Medicaid spending.

"The connection between rising rates of obesity and rising medical spending is undeniable," the authors of the Health Affairs study cited by the CDC conclude. "Without a strong and sustained reduction in obesity prevalence, obesity will continue to impose major costs on the health system for the foreseeable future."

Far be it from me to deny the undeniable, but the fact that obese people have higher annual health care costs, which is what this study found, does not mean they have higher lifetime costs. It therefore does not follow that reducing obesity would reduce total medical spending in the long run.

In fact, a study published last year in PLoS Medicine reached the opposite conclusion: Because obese people tend to die sooner than thin people do, the researchers found, eliminating obesity would increase spending on health care. "Although effective obesity prevention leads to a decrease in costs of obesity-related diseases," the authors wrote, "this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

In a December report, the Congressional Budget Office likewise warned that "any savings to the federal government" from discouraging unhealthy habits such as overeating or smoking "could be at least partially offset by additional expenditures as healthier individuals live longer." For example, "Medicare costs could rise for the treatment of other diseases and conditions during those extra years of life, and expenditures for programs that are not directly related to health (such as Social Security) could also increase as life spans are extended."

Overeating, like smoking, seems to be one of those risky habits that saves taxpayers money. If reducing demands on the public treasury is the aim, such habits should be encouraged.

Or maybe we should question the idea that every citizen is a cost to be minimized for the greater good, without regard to his own wishes. The bigger the government's role in health care, the stronger the rationale for such collectivist thinking.

Jacob Sullum is a senior editor at Reason and a nationally syndicated columnist.

© Copyright 2009 by Creators Syndicate Inc.

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  • Art-P.O.G.||

    Besides, once anyone hits the motorized scooter/Walmart-aisle stage, it's hard for me to believe a gov't initiative would make a difference anyway.

  • <strike>strike through</strike||

    taxpayer-funded health care makes everyone's personal habits everyone else's business

    Of course it does. That's why it must fail. At this point in the history of our nation, when new "crises" are revealed hourly by Administration officials, Congress and their obedient lackeys in the news media, ordinary citizens must decide how to act on a genuine crisis: the takeover of their very bodies by a federal government that's on the verge of achieving totalitarianism. Once it's here, there's no turning back.

  • Art-P.O.G.||

    P.S.: It's clear from the photo that before the advent of motorized scooter-carts, the morbidly obese traveled by giant tortoise.

  • kilroy||

    Thanks for collecting all my comments in one blog post Jacob. :-)

  • Art-P.O.G.||

    I will add that one gov't program did help me with weight loss, though: Army Basic Training. :P

  • Art-P.O.G.||

    kilroy,

    Cross your arms, close your eyes and wait for the royalty check. ;)

  • kilroy||

    I'm still waiting on a check from the first Bush stimulatin'. I'm sure they're all "in the mail".

  • Art-P.O.G.||

    Damn, kilroy...what rotten luck...waitaminute, did you pay your taxes?

  • Cabeza de Vaca||

    Someone should tell that obese young man, that sodomizing a tortoise is wrong.

  • Art-P.O.G.||

    Yeah, but the tortoise's expression is hard to read. And you can't sodomize (definition 2) the willing.

  • kilroy||

    "Damn, kilroy...what rotten luck...waitaminute, did you pay your taxes?"

    Yeah. Unfortunately I committed the sin of paying too much in taxes. My girlfriend's brother almost made the same mistake. I shit you not, he got a stimulus check for $1.00. He put it in a frame on the wall with the caption: In case of recession, break glass.

  • Art-P.O.G.||

    Crap, well...then I guess you wouldn't want the (of course, massive) royalty check from Reason to put you into an even higher tax bracket.

  • Rich||

    "... the fact that obese people have higher annual health care costs ... does not mean they have higher lifetime costs."

    When do we think the morbidly obese federal budgets will die of natural causes?

  • kilroy||

    There was a time when making more money was never a bad thing but based on the "surtax" schemes they are working into the healthcare bill, that day is over.

    Very soon there will be a point where it will make sense to say "No, I don't want that raise because then I'll have to kick an extra 5k to the government because you're paying me 1k more". Moving to a higher bracket is good, moving from upper-middle class to rich will soon be penalized and disincentivized.

    The net result will be instead of productive people being more productive for the extra cash, the response will be "No, I don't want that raise, I'll take an extra week's vacation".

  • ||

    Wow, with all the profit at stake in the private sector, I am surprised it has gone this far! Itll never happen.

    RT
    www.anon-web-tools.net.tc

  • ||

    he got a stimulus check for $1.00. He put it in a frame on the wall with the caption: In case of recession, break glass.

    That's the funniest thing I've read all day. Granted, I've only been at work for half an hour.

  • Warty\'s Mom||

    I said get off that turtle NOW!

  • Spoonman||


    That's the funniest thing I've read all day. Granted, I've only been at work for half an hour.

    Obviously you haven't read the anonymity bot's confession in the opium thread yet.

  • ||

    I don't know Jacob, sounds like a broke windows argument to me.

  • ||

    It's funny, but I grew up with a (very) miniature version of that statue in my house. I think my dad got in when he was in the service in Europe. Anyway, none of us are fat. Do you think that statue keeps people skinny? Maybe the U.S. should seize it!

  • Art-P.O.G.||

    Pro Lib,

    Maybe it's a stretch, but I think looking at that statue a lot would subconsciously discourage anyone from gaining too much weight.

  • ||

    Or riding turtles.

  • Buzz||

    Sybian technology has come a long way.

  • ||

    Very soon there will be a point where it will make sense to say "No, I don't want that raise because then I'll have to kick an extra 5k to the government because you're paying me 1k more". Moving to a higher bracket is good, moving from upper-middle class to rich will soon be penalized and disincentivized.

    It is amazing how much ignorance there is about how the income tax works. Yes, there will someday be a 500% marginal tax bracket or a 500% surtax.

    Marginal brackets and surtaxes are not retroactive.

    Even if it did, he argues, we should be wary of a political theory that says taxpayer-funded health care makes everyone's personal habits everyone else's business.

    Since the Gov't already pays the bills for 40% of the population, they can probably do what they want in this area now. Especially, since most people are fat before they reach medicare. The only thing that stops them is the food lobby, which will probably stop them even if the Gov't insured everyone.

    Look at the ethanol fiasco, and then explain to me how Congress would pass laws telling Americans not to buy meat or dairy.

  • Art-P.O.G.||

    Patrick,

    I don't understand your post at all.

  • Warty||

    People that fat never have dicks that big.

  • Art-P.O.G.||

    People that fat never have dicks that big.

    I have no idea as to the veracity of this statement, but it is indeed funny as hell.

  • ||

    People that fat never have dicks that big.

    The voice of experience.

  • kilroy||

    "It is amazing how much ignorance there is about how the income tax works. Yes, there will someday be a 500% marginal tax bracket or a 500% surtax.

    Marginal brackets and surtaxes are not retroactive.


    Patrick,

    Pay fucking attention for about 30 seconds ok? I know exactly how marginal tax brackets work. The tax on the rich being proposed for the healthcare bill is not a new tax bracket it's a specific fixed tax based on crossing specific income level.

    I'm the first person to call bullshit on tax bracket stupidity. If you had any reading comprehension you would have understood that from the first sentence of my post.

    There was a time when making more money was never a bad thing but based on the "surtax" schemes they are working into the healthcare bill, that day is over.



    Learn what the fuck you're talking about before getting on your horse.

  • ||

    Marginal brackets and surtaxes are not retroactive.

    Tax code changes frequently are retroactive, if they apply to the tax year in which they are passed. That is often by design, to prevent people from dodging the change in the tax code.

    If Congress raises the top marginal rate in July 2010 for tax year 2010, it will apply to all income earned in 2010, even that earned before the change was passed.

  • ||

    People that fat never have dicks that big.

    Speak for yourself, Pudgy McFatPants.

  • ||

    Damn straight. Since when did govt get the right to mandate what we do and can eat. Oh my bad, since we gave them that right. wake up people for if govt gets this HC bill passed what is in it will come to fruition and not only will the govt have control of your care but what you CAN eat, drink and do period.

  • ||

    Pay fucking attention for about 30 seconds ok? I know exactly how marginal tax brackets work. The tax on the rich being proposed for the healthcare bill is not a new tax bracket it's a specific fixed tax based on crossing specific income level.

    I'm the first person to call bullshit on tax bracket stupidity. If you had any reading comprehension you would have understood that from the first sentence of my post.


    I comprehended your post just fine. You were to be taxed $5K on $1K of marginal income. That is a 500% tax rate. You can state you understand things, but I can only go by what you write.

    The 1% surtax is not retroactive. It starts on the first dollar after $250K. So, If you made $251K with your raise, you would pay $10 in surcharge tax. $4990 less than you were saying.

  • ||

    For me, mandating what types of cooking oil etc that restruants use is going to far, but I really don't have a problem with them saying you have to display callorie info.

    Sure it probably won't matter much, then again maybe it will.

    Overall, I think disclosure is a good thing, whether in finace or in food.

    I think it can be especially important with kids food. Knowing that the mac and cheese kids dinner has twice as many calories as the kid should consume all day might make a couple more parents think twice.

  • Blueberry Hill||

    Another scary part about all this is that the government would undoubtedly continue to encourage the low fat Dr. Ornish diet! 30 years of Ornish fat phobia nonsense is a large piece of the puzzle on why a majority of Americans are obese today.

    There is a heart healthy prevention doctor whose blog I enjoy reading. As far as I know he is the only prevention cardiologist that has been published in scientific papers as being able to stop the growth of heart attack causing plaque consistently in his patients.

    His office created a cost savings report that I found interesting. The report shows that if just American males, ages 40 to 60, followed an effective/ proven heart disease prevention program, the USA could save around 200 billion dollars in medical costs over 10 years. If adding the elderly and females, savings would several-fold.

    The savings report can be seen at:

    http://www.trackyourplaque.com/library/fl_hh005bankrupt.asp

    The doctor's blog can be seen at:

    http://heartscanblog.blogspot.com/

  • Michael Ejercito||

    Who wants to be obese (unless they themselves are attracted to obese people for some reason)?

    I wonder what proportion of obese women complain that men do not ask them out?

  • ||

    Has anyone considered that while people treated for obesity may live longer and result in the same overall medical costs that they will be offsetting those costs by earning more over the years than if they die prematurely? This is not a zero-sum game.

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  • abercrombie milano||

    My only point is that if you take the Bible straight, as I'm sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won't get the full deal by just doing regular skill english reading for those books.

  • nike shox||

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