The Waiting Room

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Monday, October 27, 2008

Get Fit or Pay Up

Posted by Seeking Solace |

A Fat Tax?


This offends me mostly becuase I abhor any sort of "sin tax". These kind of taxes make me believe that government is running out of ways to raise revenue. Also because I don't believe that the government should be in the business of regulating behavior.

I disagree with the premise that this is not a punishment. There are those situations where people gain weight due to circumstances beyond their control. For example, when I first came down with RA, I was prescribed high dose steriods which resulted in a 40 pound weight gain. The weight gain was one of the side effects. Despite some of my best efforts, I had a very difficult time losing weight. Being sick with a debilitating condition didn't help.

So, should I be penalized?

As we all know, losing weight is a very difficult process. There are many ups and downs (No pun intended). Should we penalize because some bureaucrat says we have not done enough? How do we define "fit"? Even BMI can be misleading.

It bothers me that we use negative reinforcement as a means to change behavior. Sure, it will work in the sense that people will lose money in the pocketbook if they don't lose the junk in the trunk. But is that the right way to encourage a fit lifestyle.

Many private insurance carriers, mine included, have means to encourage healthy living by using positive reinforcement. Giving a discount or credit toward a health club membership would help those who would like to get fit, but can't afford the high cost. Employers can encourage healthy lifestyle by providing access to fitness equipment and healthy food at work. My husband's company has a fitness center in the building that employers can use anytime, free of charge. Many private insurance companies provide programs that encourage healthy eating, cooking and choices.

The bottom line is that it is up to the individual to choose to live healthy. We can tax, we can do other forms of negative reinforcement, but will that really change behavior. Cigarettes are taxed, and yet, people still smoke.

What do you think?

Cross posted at Active Academic.


phd me said...

Umm, no. Like you, I'm in favor of positive reinforcement, especially discounts for gym memberships or employee programs that promote healthier living. People need support to make lifestyle changes, not punishment.

Of course, this is a society that likes to blame the victim. Not that people can't and shouldn't make better decisions about what they eat, drink and do, but those decisions might come easier if it were easier to make them - like more farmers' markets and fewer fast food restaurants.

Seeking Solace said...

Exactly! Instead of people taking responsibility for what they do, society says "Oh no, you are not to blame." Incentives can go a long way.

Abbey said...

Ok, so I just went to get a couple pieces of halloween candy before I sat down to respond...

I'm going to take the unpopular side in this. I took a look at the link you posted. I think from a 'government' perspective a fat tax is inapropriate. However, from an employer perspective who just happens to be a government agency, I don't disagree. Providing healthcare to employees is an expensive endevour. And, as we all know some of us are a more expensive investment than others from the perspective of healthcare claims. So, do I believe it is fair to expect an employer to pay higher costs because I choose to eat more (and am therefore severely obese) and am therefore more likely to have heart problems, diabetes, physical disabilities, etc?

Maybe this is my republican showing, but no, I don't think it is fair. So, instead of a 'tax' perspective, it might be asking these people that aren't taking an active approach to losing weight (and I understand steriods and have a close friend that gained a lot of weight because of them and it being out of her control) to pay some of those additional costs. So I don't think it is blaming the victim, but rather saying, we're going to need you to subsidize your health costs because your choices have made you a greater liability than other employees that are trying to be healthier and have lower health claims. And, I might even go so far as to say that the government agency is being a bit (unusually) fiscally responsible with its budget by doing this.

Now, if it was truly the government - not just an employer that happens to be a government agency - then no, I wouldn't support a fat tax. I think it would be a double standard to say across the board to an American society that we're going to charge you for being fat (how could that be implemented wide scale anyway?), hit you in the pocketbook, but ignore the fact that healthier food costs more than a box of mac and cheese and fast food. Besides, I think the government has bigger fish to fry with things like the war and homelessness and drugs, etc then to start getting in everyone's bathroom behind their scales.

Arbitrista said...

Talk about taking a good concept and implementing it terribly! It would make far more economic sense to tax actual food products with lots of fat in them than tax individuals. And I concur with phd me's idea about rewarding positive behavior. But this is a silly, and frankly insulting, proposal.

RageyOne said...

I recall hearing about this awhile back, and I totally disagree with the concept. Losing weight is not easy, and one shouldn't arbitrarily put a monetary value (penalty) on it.

rented life said...

lol at abbey getting candy. I think Ragey is referring to a piece NPR did awhile ago (I might be wrong) when employers wanted to dock people's pay if their BMI wasn't at the appropriate range. It didn't happen because it was seen as prejudice.

But I can fairly see both sides of the issue. food is expensive enough-it's expensive to eat healthy. I don't like blaming the number of fast food places though. I drive by tons of them but NEVER stop. The decisions aren't easier to make because of the price of food, not because of the number of places.

and I can see why employers wouldn't want overweight people. They may have depression, health and medical complications, general things that cost the company more in health insurance...and the company might just want to present a certain image. our college recruiters for example...well I'm not pretty enough or thin enough to be one of them. That's a deliberate choice on the college. I'm not saying it makes it right, it's just a reality.

There's more at issue here than punishment or reward for being fat. Let's look at the reality that we're the fattest nation, that there are plenty of rewards and punishments out there and we're not doing a damn bit better about it. So yeah, I'm ok with placing the blame on people because it's over due. I don't mean legit weight gain, because that's never what this is really about. I mean people who are just overweight--myself included. It's my own fault.

shrinkykitten said...

What about thin people who are unhealthy? thin people who only eat junk food but have fast metabolism? What about smokers, sky divers, people who have unprotected sex, people who drive without seat belts, or who don't wear helmets on their bikes, or people who refuse vaccinations, or people who have uncontrolled diabetes (but are of normal weight), what about marathoners who destroy their knees, people who starve themselves, or any other number of risky health behaviors? There is very little evidence to directly connect weight with health - usually there is some moderating variable there.

Why it this one health behavior seen as so much worse than all others?

Brigindo said...

Well now the cigarette tax actually does work to lower the number of smokers...especially kids who are experimenting and might become addicted smokers, so I'm all for that. However eating is something we all have to do, smoking is not. Also, as you mentioned weight isn't necessarily only tied to poor eating habits. I agree with incentives that have us eating healthy and exercising at any weight.

JaneB said...

It would make far more economic sense to tax actual food products with lots of fat in them than tax individuals. Definitely! I've seen it argued (but am too lazy to look it up) that the UK's NHS would actually save money if it gave free fruit and vegetables to every citizen, just because of the improvement in diet.

And overweight is not just about poor choices or lack of knowledge or some kind of laziness. Causes can include medication side effects, atypical depression and other mental health issues, binge-eating (the overeater is as trapped by their eating disorder as the anorexic, but get mocked rather than helped because they're fat not thin), poverty... eating, like drinking alcohol and smoking cigarettes, can be driven by far more complex, hard to fix emotional and psychological issues than just boredom/fulfilling a need. For many people food is as much of an issue as any other drug, but it's one that you can't quit, you have to be moderate with it every day. Imagine telling an alcoholic that they have to have a fixed number of drinks every day; not easy.

As an overweight person who struggles with food, I find this sort of tax just another insult in the daily parade of labelling and prejudice. I have a colleague who's thin as a stick, who smokes a pack of cigs a day, drinks several glasses of wine every evening, has permenently damaged skin from excessive sunbathing and often replaces meals with strong coffee. Yet, she's thin. I'm the one who is offered unsolicited and unhelpful advice, seen as weak willed, lectured every time I go to the Drs, occasionally jeered at by kids in the street - I'm non-smoking, non-alcohol-drinking, one cup of caffeinated drink a day, vegetarian, 6-10 portion of fruit and veg every day, high factor sun-cream wearing... but overweight. It's frustrating and it drives one to the chocolate machine...:-)

Seeking Solace said...

My issue is that I don't think my tax dollars should go to fining people for their behavior. If a private company wants their private insurance carrier to charge a higher premium to an individual, I have no problem.

I do think that when we choose a behavior, we choose the consequence. Even though I have a chonic illness, I work hard to maintain my weight. If I can't work out, I make sure that at least I am eating healthy. Many people make excuses, but force or negative reinforcement only makes a person do the exact opposite of the desired behavior.