Last year, I showed an image of evolutionary stages that was so accurate that it would earn approval even from many strict creationists.
Here’s a new image of evolutionary stages that sets the stage for today’s discussion. Simply stated, Americans are becoming bigger. In some cases, a lot bigger.
Is this trend toward greater obesity a bad thing? As a reader asks, is it something that requires a government response?
The answer is yes…and no.
Libertarians believe people should be free to make their own decisions so long as they’re not infringing on the rights of others. And that includes the right to eat too much and exercise too little.
But the “yes” part of the answer is that we can think obesity is unfortunate and we can encourage our friends and family members to live healthier lifestyles. And if we’re willing to be pests and to run the risk of being told to mind our own business, we can even encourage strangers to shape up.
The “no” part of the answer refers to whether the government somehow should get involved. I shared a great video from Reason TV several years ago that explained why paternalistic anti-obesity programs don’t work. And just this week, one of my colleagues at the Cato Institute, Michael Tanner, addressed this issue. Here’s some of what he wrote for National Review.
Recently the American Medical Association declared that it will consider obesity a disease. …the AMA’s move is a symptom of a disease that is seriously troubling our society: the abdication of personal responsibility and an invitation to government meddling. …the AMA’s move is actually a way for its members to receive more federal dollars, by getting obesity treatments covered under government health plans. A bipartisan group of congressmen has already seized on the AMA declaration as they push for Medicare coverage of diet drugs. Observers also expect an effort to expand Medicare reimbursement for bariatric surgery, a.k.a. stomach stapling. And there will almost certainly be pressure to mandate coverage for these things by private insurance carriers, under both state laws and the Affordable Care Act. …After the AMA decision, John Morton, treasurer of the American Society for Metabolic and Bariatric Surgery, was almost giddy, calling the AMA decision a “tipping point” and adding that “now coverage policy must catch up to that consensus.” Since a typical bariatric surgery costs as much as $40,000, that could be interpreted as a warning for all of us to get out our wallets. In the end, we will be paying more, through either taxes or higher premiums.
And don’t forget that the price of treatments such as surgery almost surely will climb as there’s more “third-party payer,” so our taxes and premiums will climb by a lot more than what it cost to provide these services today.
But that’s only part of the story. Since government is picking up the tab, that gives politicians a green light (at least in their minds) to pass laws and rules designed to control and influence our behavior.
…expanded Medicare and insurance coverage socialize the cost of treating obesity, thereby inviting all manner of government mischief. After all, if being fat is not our fault, the blame must lie with food companies, advertising, or other things that need to be regulated. And if you and I have to pay for the food and exercise choices of others, we should have a say in those choices. Already, Harold Goldstein, executive director of the California Center for Public Health Advocacy, has cited the AMA declaration to boost his group’s efforts to ban junk food and tax soft drinks. …The nanny state can now claim medical backing.
Mayor Bloomberg doubtlessly thinks this is a wonderful idea. Maybe he can ban snack food as well as 17 oz. sodas.
Heck, why not have a cop in every house to make sure we consume 5 servings of fruits and vegetables every day? Actually, I shouldn’t say that too loud. Given the Supreme Court’s Obamacare decision, there’s apparently no limit to the federal government’s power to control our behavior through the tax code, so I’d hate to give politicians any more crazy ideas.
If you think I’m engaging in a bit of hyperbole, just remember that New York City already has gone after bake sales for peddling sweets.
So what’s the big picture? Mike nails it, explaining that the medicalization of obesity is symptomatic of the effort to undermine individual responsibility.
Much of public policy these days seems designed to eliminate personal responsibility. Take efforts to reduce poverty, for example. How much of poverty is due to poor lifestyle choices? We don’t want to blame the poor, nor should we forget that there are those, especially children, trapped in poverty by circumstances beyond their control. But we also know the keys to getting out of or staying out of poverty: (1) finish school; (2) do not get pregnant outside marriage; and (3) get a job, any job, and stick with it. Unfortunately, much of the welfare state we have constructed is perversely designed in ways that end up encouraging destructive behaviors.
In other words, the welfare state hurts the poor, as Thomas Sowell explained the other day. Though I suppose fairness requires me to admit that there are those who benefit from all the various income-redistribution programs. A vast army of bureaucrats get very comfortable salaries to administer these program, and these poverty pimps, as Walter Williams describes them, enjoy much higher levels of compensation than they could earn in the economy’s productive sector.
But I’m guilty, once again, of digressing. Let’s get to the rest of Mike’s final point.
Big government reduces all of us to the status of children. We have no responsibility for anything in our lives; therefore, government must take care of us. All we have to do, like children, is give up the freedom to make our own choices — good or bad.
Amen. A “good choice” isn’t good if it’s the result of coercion. Paternalists sometime have admirable goals, but they err when they want to turn big government into big daddy and big mommy.
P.S. Several readers have noticed that I’m now writing one post a day instead of two and have asked whether this is a permanent change. The answer is yes. With all the other things I’m trying to juggle – researching and writing, dealing with Capitol Hill, talking to the press, giving speeches, etc – this seems like the best way to allocate my time. Particularly now that my posts tend to be a lot longer and more substantive than when I began blogging.
P.P.S. Since we’re on the topic of obesity, it goes without saying that our real problem is bloated government, not bloated people. Which is why I always enjoy cartoons that portray DC as the true home of gluttony. For good examples, see here, here, here, here, here, here, here, here and here.
International Liberty 
[…] think politicians and bureaucrats should try to dictate our lifestyle choices, so I’m not overly sympathetic to imposing special taxes on things like […]
[…] And I’ve also cited his analysis and commentary on issues such as Obamacare and obesity. […]
The government definitely has a stake in obesity. Fen-Fen being the first thing that comes to mind. The unhealthy interference with health food is another. Protecting unsafe food sources like Monsanto and bending over backwards to cater to pharmaceutical companies that offer drugs that affect metabolism and endocrine systems without full disclosure of the long term harm these things can do. I have long held the belief that free markets and libertarianism only work on drugs and food if we are given transparency about what the ingredients are, and whether the risk equals the reward for pharmaceuticals. When they say, may cause… rectal bleeding etc., I want odds on the label, like 3/100 is a bit risky, 3/1000 isn’t as bad. But, the main thing is.what are the long term affects after I have quit taking a pharmaceutical or is it worth risking a life long relationship with merck (the guys that developed morphine). What I’m trying to say is that the government seems to have a stake, because they so, for my protection. So, while they allow carcinogenic sugars, unknown food coloring, and devastating preservatives, I can’t get raw milk and (goat is my preference) small farm chicken (without prozac, caffeine, and antibiotics). If those bastards think they have a stake in my health, they better quit trying to kill me w/ a slow death that takes away the quality of life.
The government has a dog in this fight only if they are illegally picking up the tab for unhealthy lifestyles, which they have decided that they are. The solution is for the House of Representatives to actually represent Americans who are finally finding out that Obamacare is bad and who dislike it. The Obamacare monstrosity only hits us if the House continues to fund it with their benignly named “continuing resolutions”. A nice way of saying that they are continuing to borrow money to pay for all of the obsene, unconstitutional things that they have done.
Obesity is now declared a disease! If so, it is a disease of affluence and most people afflicted by it, are obsessed about the difficulty of losing weight, whereas I believe the solution is quite simple.
As a kid I grew up in New Zealand during the 2nd world war, when food was scarce and rationed. I remember only 2 kids at primary school who were overweight. One lived on a farm and ate dairy and other foods which were obviously not rationed or at least, were hard to ration by the authorities. The other had no interest in physical activity, but loved eating, particularly fatty fried food. Overweight adults were a rarity, as they are still in poorer societies.
I walk along the streets of Balmain in Sydney after schools are out and most kids are eating ice creams, or consuming sugary drinks, bought for them by their mothers! When I grew up, the standard of living was much lower, but an ice cream or lemonade was a special treat, bought for me rarely.
Today, in the 1st World, the majority of adults are overweight, many grossly and hideously obese. During my frequent business trips to the USA in the nineties, I was taken once to dinner by an obese company representative to Ur Cooks in Houston, Texas, where we selected our own steaks, cooked them and added cooked vegetables. The concept was ideal for feeding yourself a healthy nutritious meal. My host selected an enormous steak about 2 inches thick, covering most of his plate, cooked it and added copious vegetables that almost fell off his plate. I selected the smallest steak available – still large in my view, added vegetables, ate my meal, feeling I probably could have eaten more, but pleasantly satisfied.
The answer to obesity is common sense. If anyone is overweight, they must stop being be so greedy, but select nutritious food of a quantity that doesn’t make them feel (and look like) like a stuffed pig.
Most obese people blame everyone but themselves – they have tried everything, they say – their genes are wrong (if so, they are lucky, they have an efficient metabolism and don’t need much food to remain functioning and healthy – would have been great in the ‘hunter/gatherer’ days) – they love sweet things – fast food is so tasty (lots of salt and fat!). There were no fat people in those horrendous concentration or POW camps during the 2nd world war.
Has old fashioned, self discipline just gone out the window? For goodness sake, can’t humans stop putting food in their mouths! They don’t need a fad diet. In the blog on my site, ‘Lose Weight’, (See http://fitnessforum.us), I specify how to live a life that will banish obesity – to live longer and enjoy the years much more – obese people must simply resolve themselves NOW – only they can do it and it is simple.
We’ve gotten it wrong all these years. It’s not “big brother”, it’s “mommy dearest”!
perhaps the nsa can identify all of the overweight Americans in the country by monitoring their electronic communications… and then reporting them to the proper local authorities… it’s a good thing santa lives at the north pole… otherwise we might lose Christmas…
The 33rd Amendment to the U. S. Constitution was written by First Citizen Barack Obama and ratified by the Senatorial Politburo in 2014, and implementation began by Internal Responsibility Service Commissioner Lois Lerner in 2015.
Where have you been?
http://www.redstate.com/hogan/2010/03/24/the-good-and-welfare-clause-by-john-conyers/
I’m sorry, I must have missed it, where is that in the constitution?
Authorized under the “good and plenty” clause. And of course the government can now tax you for not eating your broccoli, for not running 5 miles a day, and for not getting a weekly enema.
Setting up a Twinkie smuggling ring to do an underground economy to undermine the government twinkies.
Reblogged this on Right From Yaad and commented:
Let the “War on Obesity” begin!…..I’m just waiting on the sugar, soda and candy bar cartels to emerge to wreak havoc on the inner-city communities across America!
Let the “War on Obesity” begin!…..I’m just waiting on the Sugar, Soda and candy bar cartels to emerge and wreak havoc on communities.
With the FAIR TAX obese people would feel more secure and start a weight loss program.
But a majority of the people who smoke would not be able to afford such increase in their insurance, if they have any. The same is probably true of most motorcycle riders.
OTOH, the extreme sports folks, like mountain climbers or wind surfers, probably could afford it, but since some of them are the very elites (or their filies) who run federal and state governments, you can expect to see such an idea passed when the Cubs win the Stanley Cup.
Calling obesity a disease will also remove some of the social stigma, allowing even more people to let it all hang out.
Obesity is not the only health cost problem. Other high risk behaviors, such as drinking, smoking, driving late at night, extreme sports, and many others add tremendously to health costs. The only way to reduce such behavior is to force those involved to bear a significant portion of the cost. For example, the standard health policy might exclude coverage for lung cancer or emphysema caused by smoking. If the individual wants coverage, they would have to add “smokers coverage” at significantly increased cost.
Because these behaviors all have degrees of excessiveness, focus should not be on randomly stepping over the line. Consequences should fall on those whose excesses are the direct cause of a large medical bill.
Just think: we could declare ugliness a disease (after all, how can one be personally responsible for being ugly), and then plastic surgery could be paid for by others!
If I were overweight and it cost me significantly more for my insurance, my health care and more, as it should, I would do something about it.
Seventy percent of Type 2 diabetics can be cured – or rather, no longer need insulin. Imagine, a large group of people happier and healthier if they made this decision and WE save a ton of money.