The World Health Organization estimates that over 500 million people worldwide are obese. This pandemic has its epicenter in the USA where obesity rates have been skyrocketing for over 40 years and comprise fully 20 percent of the WHO figure. As the rate of obesity climbs, the costs of healthcare for obese patients and for treating the diseases associated with obesity have risen dramatically. Complicating the economic picture is the rapid entry of obese baby boomers into the Medicare population. This impending crisis of demand has led state governments throughout the nation to seek new sources of revenue to offset their overstressed healthcare budgets.
The Fattening of America
In 1960 the population of clinically obese Americans was estimated to be about 9.7 percent. By 1980 that number had risen to 24 percent. As of 2008, 68 percent of the U.S. population was listed as overweight and 31 percent obese, according to BMI (body mass index) tables. Assuming that this trend has continued in the ensuing five years, those numbers have climbed even higher, as has the incidence of the health complications of obesity, such as:
- Coronary heart disease
- Type 2 diabetes
- Cancers (endometrial, prostate, colon, breast, uterus, kidney, gallbladder, etc.)
- Liver and gallbladder disease
- Chronic kidney disease (leading to dialysis or transplant)
- Osteoarthritis and gout
- Infertility and pregnancy complications
- Alzheimer’s disease
The disturbing aspect of these statistics is the fact that these health consequences are no secret. Information on the health risks of obesity and the lifestyle contributors to this disease is readily available to the general public in multiple languages. Of even greater concern is the tripling of obesity rates in American adolescents since the mid-1970s. The healthcare community, government and educational institutions nationwide have mobilized to educate and create public awareness of this epidemic. Still, the numbers rise.
The Economic Costs
As obesity rates spiral out of control the short and long-term costs of managing the negative health effects of this disease have increased concomitantly. In 2008 an estimated 147 billion dollars (10 percent of all medical spending) went to treating the diseases resulting from obesity. Of this number, 50 percent went to Medicare and the rest to private insurers, private pay and, ostensibly, the taxpayer to cover unfunded hospital and emergency room care for the uninsured.
If more recent figures are to be believed, total medical expenditures in the U.S. have risen to over 2 trillion dollars with treatment for obesity-related illnesses comprising at least 10 percent of that figure. Contributing to the exponential increase in these costs, now and in the future, is the technological advances that allow doctors and hospitals to manage these illnesses and sustain patients rendered inform and disabled by these conditions well past the age of 65.
The economic burden created by this lifestyle-related condition alone has created an economic burden that threatens the fiscal solvency of our Medicare and social security institutions, and puts enormous financial stress upon private insurers and the nation’s taxpayers. Clearly, a tipping point has been reached and our state governments are mobilizing to confront this beast.
The Fat Tax
In numerous states throughout our nation, laws have already been passed restricting the sale of junk foods in public schools, and fast food chains are required to post information on fat and sugar content of foods on their menus. In New York City, Mayor Bloomberg famously pushed through legislation outlawing sale of soft drinks larger than 16 ounces in city restaurants, movie theaters, stadiums and arenas. These laws have met with controversy from those who believe that the government should not be involved in legislating eating behavior.
The next step – and it is coming – will be to levy a tax on all foods deemed to contribute to obesity. Legislation may even target other non-food aspects of sedentary living including movie tickets, video games, DVD rentals, etc. The rationale offered for these statutory strategies is to control the rate of obesity and promote a healthier population. Many believe that a nuisance tax on Big Macs will do little to reduce the rates of obesity in this country.
It may well be that the legislators are not all that concerned about the public health beyond the economic effect it has on their state budgets. Many believe that the use of a special tax on fatty foods is a matter of expediency. States see an opportunity to create new revenue streams for their overburdened treasuries. One can only hope that as these laws are passed and implemented, that the money raised is actually earmarked for healthcare and used to offset the enormous costs of this nation’s collective descent into nutritional oblivion.
The Inconvenient Truth
To borrow a phrase from the musical genius and eminent rock and roll philosopher Frank Zappa, the “crux of the biscuit” is that Americans must come to terms with the truths about obesity and other “diseases of lifestyle.” The downstream health and economic repercussions of their choices must be met and the financial burden of these consequences must be shouldered by those who choose to place themselves at risk. While the idea of another tax is unpleasant, this progressive, user-targeted assessment may be the only answer that works.