No, Fat People Won't Pay for Health Care Reform

Slate's Culture Blog
July 29 2009 11:10 AM

No, Fat People Won't Pay for Health Care Reform

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Daniel Engber Daniel Engber

Daniel Engber is a columnist for Slate

In recent days, the health care debate has shifted back to an idea that's been kicking around since Barack Obama first started talking about universal coverage on the campaign trail: Let's stick fatties with the tab. The director of the Centers for Disease Control and Prevention spoke out (

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) this week in favor of

to fight the obesity epidemic and raise federal revenue. The

Los Angeles Times

spelled things out: "

."

The recent push comes in the wake of a report published Monday in Health Affairs that purports to compute the annual medical spending attributable to obesity . According to author Eric A. Finkelstein, " obesity is the single biggest reason for the increase in health care costs " in the United States, contributing $147 billion to our national tab in 2008. A similar study from a few weeks ago pinned California's budget problems on the $41 billion cost of "obesity and inactivity." ) Predictably, media outlets have jumped on the story .

This isn't the first time we've been led to believe that we can pay for universal health care by taxing fat people or making them lose weight. During the presidential campaign, both Obama and Hillary Clinton were asserting that preventing obesity could save the Medicare system a trillion dollars . But the idea that a national diet could solve all our problems is purest fantasy. (Or should I say pie-in-the-sky?) If we were really dedicated to cutting healthcare costs—if pinching pennies were a more important goal than making people well—then we wouldn't tax soda and cheeseburgers. We'd subsidize them .

The fact is, fat people aren't breaking the bank at all—they're saving us money. While it's true that someone who's grossly overweight might rack up bills for obesity-related ailments like diabetes and hypertension, those added costs would be more than offset by his shorter lifespan. The rest of us tend to suck more resources over the duration of our slim and fruitful lives on account of all the expensive degenerative diseases we develop in our
bonus years. That's not to say we shouldn't try to prevent obesity. But let's stop pretending it's a reasonable way to pay for health care reform.

(For a more detailed discussion of this topic, see my piece on the fat tax from February of last year.)