March 27, 2004

Fat Tax

Russell Roberts argues against a tax on fat. Specifically, he addresses the "externality" argument, the idea that because obesity is extremely expensive to the public health system, we should regulate it:

But if obesity causes health problems, doesn't that justify government's involvement? After all, if we taxpayers have to foot the bill for some of those higher health care costs, don't we have the right to intervene in each others lives?

This argument has been used to justify the on-going and growing regulation of tobacco. It's actually a lie. Smoking causes people to die earlier and relatively quickly, saving enough in Social Security expenditures to overwhelm the health care outlays. That actually justifies subsidizing tobacco rather than taxing it if you think that we should base public policy based only on the impact on government spending.

I think that logic is grotesque. But it's more than grotesque. It's dangerous. AIDS is a very costly disease, and some of those costs are born by taxpayers. AIDS is associated with certain sexual practices. Does that justify government regulation in the bedroom?

I don't think so. But my eating habits or yours don't justify the government's involvement in the kitchen, either.

Good point.

Posted by richard at March 27, 2004 02:49 PM

Fat people have enough problems in this world, so let them be. But what about smokers: is Roberts arguing against excise taxes on cigarettes?

Posted by: Michael Weiksner at March 29, 2004 10:45 AM

I'd like to see this guy's numbers — sure, people who smoke die earlier aren't drawing money from Social Security. And they aren't drawing on health care resources for their hip and knee replacements and Viagra prescriptions, etc.

But they also aren't paying into Social Security if they die while they're still working. And speaking from what I've seen, I can tell you that dying of lung cancer, at any age, is not cheap. It comes with oncologist consultations, biopsies and lab work, chemotherapies, surgical interventions, hospital care, and ultimately enrollment in hospice. It's not like we leave smokers (or former smokers) to die — we spend hundreds of thousands of dollars pulling out all the stops trying to save their lives — as well we should.

I'm not saying this character is wrong: I'm saying I'd like to see his numbers.

I agree with his position on STDs — that the government ought not leverage health care costs to legislate in the bedroom — but that seems to go beyond the scope of the discussion, doesn't it? If society has to bear a certain burden (that is, if you decide that the government is going to pay for all this anyway, a question that I understand is unsettled and just a bit controversial these days . . . but taking it as a given), and if you can target taxes on consumer goods that increase that burden, why wouldn't you do it? There's no correlative case for sexual conduct — you might choose to buy condoms before you have sex, but condom use actually decreases the risk of STDs. What would you tax? K-Y jelly? Barry White music?

I don't see why taxing cigarettes or fatty foods (particularly when one of the draws of fatty foods is that they come cheap), or even springboarding from there to taxing polluters to pay health care costs (they say that living in Boston is like smoking a pack of cigarettes per day), of necessity would lead the government to "regulation in the bedroom."

And for that matter, governments seem to insist on regulating the bedroom anyway, and on less rational and high-minded principles than improving the nation's health. Not that I would favor mandatory condom use for nonprocreative sex — but if it came down to that law or a sodomy proscription, I would go with the health rationale.

Posted by: Brad A. at March 29, 2004 03:09 PM