Education, Incentives Are Best Choices

The hot idea in the war on obesity? Taxes.

In Arizona, policymakers are considering a tax on obese Medicaid patients. In Philadelphia, Mayor Michael Nutter launched his second attempt to impose a city soda tax weeks ago. President Obama’s debt commission has championed the idea. In California, Assembly member William Monning (D-Carmel), the Assembly Health Committee chair, introduced a bill in February to tax soda.

It’s not just here. Across the Atlantic, France just levied a soda tax. Denmark’s new tax on fat takes effect in October; and the Swedes are considering a calorie tax.

Among these different tax proposals -- the soda tax clearly being the most popular -- one common idea emerges: if people are eating too many calories, hit them in the wallet.

But call me a fat tax skeptic. By all accounts, even the most favorable studies argue that dietary taxes have to be very high -- in the 18% to 25% range -- before they’ll have any real impact on consumers. Even then it’s not clear that people will eat healthier; they may just shift their calories. People may put down the root beer when it’s taxed heavily and pick up the potato chips.

The approach is overly simplistic. Coke isn’t the reason why Americans are too heavy. It’s our entire diet -- and lack of exercise.

What then is to be done?

At a time of rising obesity rates, we should emphasize physical education in our schools and better food in their cafeterias.

Washington, D.C., spends billions of dollars subsidizing big business and bad health choices through agricultural subsidies. It’s difficult to ever see the justification for this, but, at a time of record deficits, there is none.

Health insurance needs to move from a model of sick care to one that promotes wellness. That means, yes, incentives for better health choices.

And, finally, we need to practice more restraint in our eating habits.