NEW YORK CITY’S health-minded Mayor Michael Bloomberg had a proposal to outlaw big sugary drinks shot down by a state Supreme Court Judge hours before it was to come into effect. The plan had been to limit the sale of drinks in sizes over 16 ounces (473 millilitres) in places like fast food restaurants and at petrol stations. The judge said that it was arbitrary and overreaching government interference into personal freedom.
Like ground-breaking smoking bans before it, this law was being watched around the world by health policy makers who are trying to get to grips with the Battle of the Bulge that is engrossing the western hemisphere. Rich and largely sedentary populations combined with easy access to cheap, calorific food is having a visible impact on waistlines and health spending in many countries.
Nearly 36 per cent of US adults and 17 per cent of US children aged 2 to 19 years old are obese, according to the Center for Disease Control (CDC); with costs associated of about $147 billion in 2009. Here at home we’re experiencing similar figures for obesity, and the state body Safefood reckons that treating obesity is costing some €400 million a year; with a further €700 million in indirect costs around related illnesses, absenteeism and premature deaths.
The CDC reckoned in a November 2012 study that sugary drinks account for six per cent of American adults’ calorie intake, and a more significant portion among children. The average American adult consumed 44.6 gallons (167 litres) of carbonated drinks in 2011. It may sound like a lot, but it’s easy to rack up that kind of consumption when fast food restaurants, grocery stores and petrol stations will sell you drinks from fountains of up to and even beyond 64 ounces (1.9 litres) for around $2.
There’s a lot more to fighting obesity than just tackling the size of soft drinks, but like making smokers go stand out in the rain the law to limit the size of beverages sold in fountains to 16 ounces was touted as a gentle prod in the right direction. Buying a coke wasn’t intended to become like trying to buy a packet of Solpadine is nowadays here. Consumers could always buy two or three or four drinks if they really wanted that much, though they would inevitably end up paying more as the price difference between sizes is only a few cents.
I viewed this proposed law as something that both makes good sense and is utterly appalling at the same time. As a (mostly) libertarian thinker where social issues are concerned, I believe that we all have a right to do as we please free from interference from government or others; so long as we don’t harm anyone in the process and we can afford it.
In general when gorging oneself on massive amounts of calorific soft drinks or fatty foods, no harm is done to others. As a libertarian I’d say go right ahead and enjoy that slow disintegration. Unfortunately, when it comes to ‘affording’ the vice of gluttony it’s not so clear cut. It’s cheap to get fat, but the healthcare and other costs associated with it are spread around in our beautiful little socialist paradise.
If, heaven forbid, you and I are rushed to A&E some evening, you because of a genetically inherited heart condition and me because I finally ate that one spare rib I was away from having one; we get charged the same fee at the door and for our stay and care. While there’s a very real and substantial material hazard associated with over eating and other pursuits such as smoking, there’s very little moral hazard associated with the monetary fallout.
That’s why a fine small government advocate like myself can look positively on a law that is nanny stateism at its best: government trying to control your body. Well, if government is paying for the damage you do to it then it starts to make sense for them to have a say in how you manage it.
This is one of the troubles with a big nanny state: The more we expect government to do for us, the less control we inevitably have over what we do and how we do it. Just as I believe in the right to freedom of speech, no matter what stupidity you want to spout (and hey, one could argue it works well for me); I believe in the right to gorge oneself to excess if that is your preferred pastime. But, I think you ought to pay for it.
We’re all familiar with ever skyrocketing health insurance costs, and medical inflation will probably become a watchword of the public lexicon once the government introduces mandatory universal insurance in the next few years. How and ever health insurance is blind to whether or not you’re a smoker, a drinker or obese.
To an extent in a socialised system it is right and proper that people with, for example, congenital conditions are protected from massive costs that are not of their making. We already load younger health insurance customers with the higher costs associated with older ones, and go so far as to spread this between companies in a state-regulated system.
It is not proper however that people with more self-inflicted ills should pay the same as the health freaks among us. In the US people with a body mass index of 30 or higher, considered obese, pay an average of 22 per cent more to buy health insurance according to data released by eHealthInsurance.com from 2012. Smokers pay on average 14 per cent more, and female smokers in particular are hard hit with a 22 per cent premium on female non-smokers.
Under Obamacare, the US version of mandatory health insurance, smokers will still be liable of premiums of up to 50 per cent more than non-smokers; but people who are obese and overweight will no longer pay extra for their gluttony. This will inevitably lead to the cost being spread around among healthier individuals, as we do it here today.
In Ireland there are no premiums for obese individuals, nor are there plans for any. At a recent Oireachtas health committee meeting about rising insurance costs consultant oncologist and Senator Professor John Crown asked whether more of a premium could be put on smoking. The insurers said they would be open to it, but it would demand the Department of Health making legislative changes to allow it. This should be done, particularly in an era of universal health insurance.
Paying for bad habits through health insurance, that represents the true costs of bad habits, is a lot better than letting the government control our fluid intakes, as the old Dr Strangelove joke goes.
Aaron McKenna is a businessman and a columnist for TheJournal.ie. He is also involved in activism in his local area. You can find out more about him at aaronmckenna.com or follow him on Twitter @aaronmckenna. To read more columns by Aaron click here.
To embed this post, copy the code below on your site
have your say