By Sheryl Smolkin
Read this article and comments at Moneyville.ca
If I had the cure for obesity I’d be much thinner and a whole lot richer. But one thing I know for sure is that imposing taxes on people who are overweight isn’t the answer.
That’s why I think that Arizona’s proposal to levy an annual $50 fine on overweight Medicaid recipients who don’t follow a strict regime developed by their doctor is a dumb idea.
Childless adults who are obese and/or suffer from a chronic disease such as diabetes will be obliged to work with their primary care physician to develop a care plan. Individuals who do not adhere to the plan and meet specified goals will be required to pay an annual fee of $50. The program will also fine the parents of some obese children
Medicaid is the means-tested U.S. health program for people and families with low incomes and resources. It is jointly funded by the state and federal governments, and managed by the states. The program costs both levels of government over $339 billion a year and costs are escalating by over eight per cent annually.
What’s more, it is expected that costs to U.S. states of the Medicaid insurance program for the poor will grow by hundreds of billions of dollars under Obama’s healthcare law passed last year. So it is not surprising that Arizona and other states are looking for ways to reduce Medicaid costs.
But I can’t imagine that avoiding an annual $50 fine is enough of an incentive for anyone to embrace a healthier lifestyle. It also may not result in quantifiable savings for Medicaid if the cost of medical oversight for people on doctor-supervised diets is higher than the charges levied on those who do not get with the program.
This proposal is simply a mean-spirited attack on low income people. Nobody wants to be fat and losing weight is tough, particularly if you have little or no money to spend on healthy food or gym memberships. Even medically supervised diets frequently do not result in long term weight loss.
Furthermore, the mechanics of administering a “fat” tax simply boggles the mind. What does obese mean and who gets to decide if you have to pay the tax? I can’t imagine that doctors will want to be the gatekeepers. If they do have to turn people in, won’t it simply discourage the people who may need care the most from seeing their physician regularly? If obese Arizona residents don’t get an annual check up, will their neighbours be rewarded for snitching on them?
In a recent blog post, University of Alberta Chair in Obesity Research Dr. Arya M. Sharma suggests that the public health discussion on preventing obesity by eating less and moving more may do little more than perpetuate the already widespread stereotype that overweight people weigh more just because they eat too much and don’t exercise enough. Instead he says legislative measures should include policies that would address drivers of overeating like poverty, lack of sleep, lack of time, or stress and depression.
I think Sharma has got it right.
Instead of playing the “blame and shame” game, the government of Arizona should address the real underlying problems leading to obesity. Then perhaps 25.5 per cent of Arizona residents who are overweight will have access to the education and resources they need to embrace a healthier lifestyle.