Fixing Our Fat Problem

In this election cycle, health care has garnered a lot of attention. But amid the hotheaded debate, one very simple solution to a major health problem in America has never been seriously considered: a tax credit for those responsible enough to watch their weight.

Obesity is a major public health crisis in the land of the free, and it brings with it a host of undesirable complications and hidden costs. In 2007, almost two-thirds of all American adults were either overweight or obese, and about 30 percent had a body mass index (BMI) of over 30, generally considered the threshold for clinically significant obesity. This epidemic has been associated with a wide variety of high-risk side effects, including ischemic heart disease, congestive heart failure, high blood pressure, and diabetes. Medical obesity leads to a 200 to 300 percent increase in the risk of death for middle-aged patients.

Contrary to the claims of the so-called “fat acceptance” movement, obesity has a real impact on the American economy and creates a large public burden for the entire country. Obesity cuts into the American labor force’s productivity—Californians with a BMI greater than 40 took twelve times as many days off as their thinner counterparts in 2005. It also creates a large economic burden on all of American society—a recent study demonstrated that almost 10 percent of all medical expenditures can be directly attributed to obesity. And in an era where military recruitment is suffering from two very real wars on the ground, it’s truly depressing to note that the leading cause of early discharge from the armed forces is excess weight. Former Surgeon General Richard H. Carmona has even gone so far as to argue that the public health risks of obesity are as serious as those of weapons of mass destruction.

Given the major impact that the obesity epidemic has had on American society as a whole, it’s not surprising that some efforts have been made to combat the plague of excess pounds. Public education campaigns, including a very noticeable series of Internet ads depicting the average American’s stomach as an inflatable beach ball, have been a cornerstone of efforts by various government agencies and the Ad Council to increase awareness of the problem.

Others have turned to traditional grassroots efforts, including projects to ban soda from school cafeterias and reduce the amount of direct junk-food advertising available on TV. These efforts are noble in intent, but lack the essential incentive so critical to the decision-making processes of the average American: the prospect of cold, hard cash. The easiest way to get Americans to lose weight is to offer a $1,000 tax credit to adults who sustain a BMI between 18.5 and 25—the range considered to be healthy by most medical professionals.

American taxpayers can already earn deductions and credits in various ways: the religious types can deduct their tithes to the church from their tax returns, while married couples with children can file for child tax credits. The more environmentally minded have benefited from tax credits that essentially subsidize the purchase of hybrid cars and energy-efficient home improvements, while the poor enjoy the redistributive effects of the Earned Income Tax Credit. As such, it only makes sense that Washington provide strong incentives for every American to maintain or achieve a healthy body weight.

In fact, it’s not hard to envision a future where legislators and advocates from both sides of the aisle could craft a working and durable system to ensure that this new credit is not only verifiable—the easiest solution would be a simple annual checkup at the doctor’s office—but also relatively painless for the average taxpayer. Fiscal conservatives and public health advocates alike would welcome the market-based improvements with open arms.

Incidentally, requiring the taxpayer to get medical verification of their weight would increase the number of annual checkups, incentivize the elective purchase of health insurance to cover the costs of said checkup, and help in the provision of preventive care, a crucial factor in identifying high-risk patients at an early age and steering them towards lower-risk lifestyles. This alone would likely save millions of dollars down the road, given the sadly preventable nature of many First World diseases, such as heart disease and cancer. Any talk of discrimination from the Marxist and populist critics could be easily dismissed—after all, this is a conscious choice that a taxpayer has to make in order to save money.

Unfortunately, in a country where two-thirds of the electorate is overweight, it seems unlikely that it will ever be seriously considered. But such is the tragedy of mass politics.

Eugene Kim ’10, a Crimson editorial editor, is a government concentrator in Kirkland House.