Tough love for fat people: Tax their food to pay for healthcare

http://latimesblogs.latimes.com/booster_shots/2009/07/tough-love-for-fatties-tax-their-food-pay-for-healthcare.html

When historians look back to identify the pivotal moments in the
nation's struggle against obesity, they might point to the current
period as the moment when those who influenced opinion and made public
policy decided it was time to take the gloves off.

As evidence of this new "get-tough" strategy on obesity, they may
well cite a study released today by the Urban Institute titled
"Reducing Obesity: Policy Strategies From the Tobacco Wars."

In the debate over healthcare reform, the added cost of caring for
patients with obesity-related diseases has become a common refrain:
most recent is the cost-of-obesity study, also released today by the
Centers for Disease Control and Prevention. It finds that as obesity
rates increased from 18.3% of Americans in 1998 to 25% in 2006, the
cost of providing treatment for those patients' weight-driven problems
increased healthcare spending by $40 billion a year.

If you happen to be the 1-in-3 Americans who is neither obese nor
overweight (and, thus, considered at risk of becoming obese), you
might well conclude that the habits of the remaining two-thirds of
Americans are costing you, big time. U.S. life expectancies are
expected to slide backward, after years of marching upward. (But
that's their statistical problem: Yours is how to make them stop
costing you all that extra money because they are presumably making
poor choices in their food consumption.)

"Facing the serious consequences of an uncontrolled obesity epidemic,
America's state and federal policy makers may need to consider
interventions every bit as forceful as those that succeeded in cutting
adult tobacco use by more than 50%," the Urban Institute report says.
It took awhile -- almost 50 years from the first surgeon general's
report on tobacco in 1964 -- to drive smoking down. But in many ways,
the drumbeat of scientific evidence and the growing cultural stigma
against obesity already are well underway -- as any parent who has
tried to bring birthday cupcakes into her child's classroom certainly
knows.

Key among the "interventions" the report weighs is that of imposing an
excise or sales tax on fattening foods. That, says the report, could
be expected to lower consumption of those foods. But it would also
generate revenues that could be used to extend health insurance
coverage to the uninsured and under-insured, and perhaps to fund
campaigns intended to make healthy foods more widely available to,
say, low-income Americans and to encourage exercise and healthy eating
habits.

If anti-tobacco campaigns are to be the model, those sales taxes could
be hefty: The World Health Organization has recommended that tobacco
taxes should represent between two-thirds and three-quarters of the
cost of, say, a package of cigarettes; a 2004 report prepared for the
Department of Agriculture suggested that, for "sinful-food" taxes to
change the way people eat, they may need to equal at least 10% to 30%
of the cost of the food.

And although 40 U.S. states now impose modest extra sales taxes on
soft drinks and a few snack items, the Urban Institute report suggests
that a truly forceful "intervention" -- one that would drive down the
consumption of fattening foods and, presumably, prevent or reverse
obesity -- would have to target pretty much all the fattening and
nutritionally empty stuff we eat: "With a more narrowly targeted tax,
consumers could simply substitute one fattening food or beverage for
another," the reports says.

Of course, the United States also would have to adopt extensive menu-
and food-labeling changes that would make "good foods" easily
distinguishable from the bad ones subject to added taxes. Not to worry
though: Several European countries, most notably Great Britain, have
led the way in this area.

And here's the payoff: Conservatively estimated, a 10% tax levied on
foods that would be defined as "less healthy" by a national standard
adopted recently in Great Britain could yield $240 billion in its
first five years and $522 billion over 10 years of implementation --
if it were to begin in October 2010. If lawmakers instituted a program
of tax subsidies to encourage the purchase of fresh and processed
fruits and vegetables, the added revenue would still be $356 billion
over 10 years.

That would pay for a lot of healthcare reform, which some have
estimated will cost as much as $1 trillion to implement over the next
ten years.

There can be little doubt that lobbyists for the food, restaurant and
grocery industries would come out swinging on any of these proposals.
But the report cites evidence of a turning political tide for
proposals that would hold the obese and other consumers of
nutritionally suspect food accountable for their choices. A recent
national poll found that 53% of Americans said they favored an
increased tax on sodas and sugary soft drinks to help pay for
healthcare reform. And even among those who opposed such an idea, 63%
switched and said they'd favor such a tax if it "would raise money for
health-care reform while also tackling the problems that stem from
being overweight."

-- Melissa Healy