In recent columns Paul Krugman and Michael Fumento both argue that what you eat and how much exercise you get are not private matters because the cost of your extra pounds is borne by other people through health insurance and taxpayer-funded medical care. Neither distinguishes between the voluntary risk pooling of private health coverage and the compelled subsidies of Medicare and Medicaid. Yet private insurers are free to charge fat people more, and their customers are free to shop around for a better deal if they don't like the terms of their current coverage. By contrast, government-supported health care imposes the costs of obesity-related illnesses on people who have not agreed to the arrangement and cannot opt out.
Even here, the net financial impact is unclear. If overweight people tend to die earlier and therefore draw less on Medicare and Social Security in old age, their adiposity may save taxpayers more than it costs, as appears to be the case with smokers. Or it could be a wash. You can't simply assume that the net effect is to increase government spending, unless you're just grasping at post hoc rationalizations for a policy you think is justified on other grounds.
It looks like that's what Krugman is doing. "More important" than costs paid by others, he says, is the fact that people are not truly free to choose what they eat. Hence the government must save them from the consequences of their excesses. More broadly, Krugman thinks the "public health" mantra justifies any government policy that reduces disease, whether it's building sewers, taxing cigarettes, or discouraging people from having another slice of pie. "Obesity is America's fastest-growing health problem," he concludes. "Let's do something about it." It almost doesn't matter what, I guess, because he doesn't suggest any specific policies.
For his part, Fumento (a former Reason science correspondent and author of a book on obesity) insists that your weight is not "strictly a personal issue"; calls fatness a "sociogenic illness" (because the more fat people there are, the more acceptable it is to be fat); and suggests it's a threat to national security (because so many young men and women are too fat to serve in the armed forces). "It's long past time to accept…that being overweight…is bad [not just] for individuals, but for all of us," he writes. Like Krugman, Fumento is strangely silent on the practical impact of that realization.
Since neither Krugman nor Fumento thinks it's worth even suggesting what, exactly, the government should do about the extra helping of meat loaf you had last night–as long as we all recognize that fatness is a crisis requiring collective action–let's forget about the details for the moment. Let's just reflect on whether we want to accept the proposition that everyone's unhealthy habits are everyone else's business. Contrary to Krugman's implication, one needn't be a "blind ideologue" to worry about living in a world governed by that principle.
[Thanks to Michael Stack for the Krugman link.]