weight issues and taxes

Good Friday morning....hope the weekend has some fun for you....

Controversial subject time....Yesterday I had a patient express concern about potential "penalties" enacted for overweight people. We have heard previously of having to buy another seat on an airline if above a certain weight and having certain highcaloric food sources taxed extra, like sodas. This patient heard that proposals are in place of having overweight people pay an extra "tax" (perhaps higher insurance premium?) based on being overweight.

Let's provide an analogy: The cigarette smoker. The smoker has higher rates of COPD, cancer, heart disease, etc and there is no question that the smoker will spend more money on physician visits, medications, hospitalizations etc. Should non-smokers pay more health insurance premiums to offset the additional costs to the system that the smoker incurs? Should the smoker pay more money into the system because of being a smoker?

The overweight person: Higher rates of diabetes, heart disease, cancers etc....more money spent on medical issues. Should the non-overweight person be expected to incur costs involved in treating overweight people for the co-morbidities?

I think most people think that it comes down to "choice". The person born with cystic fibrosis has no choice in this disease. Therefore, monies spent on medical treatment are not due to the "fault" of the affected person. I believe few, if any, of the general population would expect the person with CF to "pay more" into the system or be "taxed" extra. Is cigarette smoking a choice? Is being overweight a "choice"? If it is deemed that these medically affecting situations are under the control of the affected person, is it therefore "fair" for that person to be taxed or otherwise pay extra into the system?


Your thoughts? Mine opinion is the following: We need to focus not on finger pointing and affixing "blame" and trying to monetarily hit people but rather do something about this devastating problem immediately and aggressively. Not everyone can afford the BEST weight loss program ever (OURS!!!) so the government should fund weight loss clinics that are affordable or free for the poor...more education at the schools...perhaps POSITIVE incentives for people to be at a healthy weight,...taxing the hell out of the fast food chains, soda companies and every other entity that are contributing to this deteriorating situation...and other measures that proactively address the obesity epidemic.