What Are Our Obligations to Each Other?

By one estimate, roughly $243 billion in spending on healthcare in the US is due to obesity.  That money comes from tax dollars and health insurance premiums.  That’s approximately $775 per year for every man, woman and child in the US.  The number is probably a conservative estimate; the real figure could be a lot higher.(1)

Full disclosure:  my weight is up there.  I thought I was under the threshold for obesity, but now in my sixties, I’m shrinking, literally.  I’ve lost an inch in height and that lowers the magic number for being obese.  The calories I can afford to consume each day have dropped as well.

Do those of us who are overweight have the right to impose these extra costs on our friends, neighbors and other taxpayers?

That logic was the basis for introduction of a “fat tax” in Denmark in 2011.(2)

US law is ambiguous.  Common law holds that the right does not exist.  If my apple tree damages the siding on your house, I’m responsible for the cost of repairs.  However, more recent legislation on handicapped access suggests that there is a right to impose costs on others.  I need a wheelchair and I can make you pay for the cost of a ramp so that I can access your town hall or library.

The question of obligation has clear implications for tax policy.  There are those, usually quite wealthy, who say they have no obligations, even though their wealth in built on the labor or people who may be drawing on Food Stamps to make ends meet.  Logically, it makes no sense to condemn welfare programs for individuals while asking for handouts for corporations — yet this is what many do.

The fat issue offers clear incentives for individuals to diet regardless of taxes or cost.  Available data link overweight with diseases ranging from allergies to cancer.  Basically, if you want to feel better, you lose weight, which is what I’m doing now.  I don’t like the idea that I’m imposing extra costs on anyone, but I simply want to be able to breathe more easily.  So, if that’s what I need to do, let’s do it.




(1)Finkelstein, Eric A., et. al.  “Annual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates”. Health Affairs, 28, no.5 (2009):w822-w831.  I did a simple, linear estimate based on the 1999 and 2008 figures provided in this article.  The rate of increase shown in their article between 1999 and 2008 is actually less than current estimates of the inflation factor for healthcare costs during that period.
(2) Vadi, Valentina. Public Health in International Law and Arbitration.  Routledge, 2013.

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