Saturday, April 02, 2011

Fat Tax

Granted, times are tough. People are doing whatever they can to cut back to save money. Governments across the board are cash strapped. Many municipalities and states are staring financial insolvency in the face like death at the door. We got a full court press on to cut and tax everywhere at a time when no one, literally no one, can afford it. So, I guess kudos of sorts needs to go to Arizona for a unique, though impractical, partial solution to their financial problems. Arizona legislators are looking at taxing that Whooper and fries you’re setting there eating (or maybe, it’s that pizza and beer).

Arizona is considering a $50.00 tax per year on fat people. Why only $50 bucks and not by the pound, is beyond me. I suppose the legislators don’t want to appear too greedy in grabbing their “pound of flesh” (sorry, couldn’t resist). However, according to the Arizona Health Care Containment System, individuals who are obese, smoke, or even have diabetes, could face the annual $50 charge if it was determined that they’re not following their doctor’s instructions to develop better health habits. Arizona’s legislature has been trying to come up with $500 million dollars in cuts to reduce its $1.5 billion deficit. Taxing people with unhealthy life styles is one option being considered given their cash strapped Medicaid program.

It’s no secret or great revelation that people with unhealthy lifestyles are more prone to diseases or illnesses than people who take care of themselves. Businesses penalize individuals who engage in unhealthy or unsafe behavior while those who do comply are generally rewarded with either additional benefits, or benefits at a cheaper cost. I see two issues with this move by Arizona’s legislature.

First, individuals have a right to make specific behavioral choices for themselves. In doing so, they must bear the responsibility of their actions in terms of cause and effect (bad things will lead to bad results), and their associated costs. In the private sector, businesses try to spread the costs among its participants, but more often than not, companies are requiring individuals to bear the financial costs of their habits through higher premiums, limited or even denied coverage. It’s a choice issue. Others shouldn’t bear the costs of your choices. Fair enough right? But, what about government?

Putting aside for the moment whether or not government should be in the healthcare business, the issue of whether government has the right to regulate your lifestyle choices. Two points must be understood before we can go further. One is that government does not generate money. The argument that the government is paying for it doesn’t hold. Government, at all levels, derives its income from you and me through taxes and hidden taxes known as fees. In short, government takes from us and redistributes to others, allegedly, for the betterment of society as a whole. Sometimes it’s with our consent; sometimes not. Now, secondly, individuals who engage in unhealthy behavior use more (and more expensive) health care services, and over longer periods of time. That costs us more money. This is Arizona’s argument.

However, should, in the name of eliminating these extra costs, government be able to dictate specific behavior to us? If you want to set on the couch and stuff your face while watching Oprah, that’s your business. If you want to eat foods high in transfats, that’s a personal decision right? What about smoking? You know it’s stupid. You know what you’re doing to your body. But it isn’t anybody’s business but yours right? You and you alone should be expected to bear the costs of your actions. But, what about diabetes, heart disease, arthritis, or high blood pressure? What if you are trying to get these under control but can’t? Should you be fined? At what point does government have a right to impose any type of control on your behavior? Should government mandate a minimum amount of daily exercise? Where does it stop?

Well, government does, in fact, impose controls on your behavior already. It’s called laws, and they’re enforced by the judicial system. Some of these are health related, such as drug and alcohol use and abuse, food, water, and air standards, as well as clean and safe work areas or age restrictions. Even sex is regulated! There are penalties for violating and enforcing these rules which you and I pay for as taxpayers. So, there is some legal precedence for what Arizona is considering. But, it still doesn’t address the issue that, while possibly legal, is it justified from an ethical perspective? Just because you can do a thing doesn’t mean you should do it.

There is one more factor to consider. A disproportional number of individuals who use government services, and who lead unhealthy life styles, are the poor; the very people who could least afford to penalized any amount of money. So, does government require these individuals to see a doctor (at taxpayer cost) and enroll in some sort of modifying behavior program (again at taxpayer cost), and who'll monitor them (we can already guess who’ll be paying for it). One could argue that if they can afford a carton of cigarettes every few weeks, they can afford a $50 dollar fine once a year. But is this what we want government to do; to become our “mother”?

Since you and I are paying for the welfare of our fellow citizens who use government services in the form of taxes, we should have a say in how our money is spent. Recipients should be allowed to buy only healthy items (many states already require this). That is means no unhealthy snacks or drinks, and certainly no booze or cigarettes. Recipients should be required to perform some type of public service if they aren’t actively looking for a job or preparing for a job (like school) while they’re on the public dole. Random drug and other screenings should be required. Three strikes and no benefits for 90 days; no exceptions and no excuses. Yes, we would still have to pay for it, but the numbers (and costs) will be lower and the uncertainty of coming up for a test would serve as a deterrent. Conditions which are genetic should be exempt. If you aren’t a US citizen or in the process of becoming one, you receive no taxpayer based assistance. Of course, you can always choose to opt out altogether.

On a related note, healthy habits are generally acquired young. Schools should remove all soft drinks and unhealthy snacks from vending machines. School cafeterias should serve only healthy foods (perferably bought locally) and some sort of exercise programs should be required. Informational flyers (aimed as much for the parents as anyone) about preparing healthy meals, snacks and exercise should be sent home often. It’s not a perfect solution, but I think it’s better than the alternative.

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