Here’s a letter that I just sent to USA Today:
Asserting that “something must be done” to reduce obesity in America, David Zinczenko proposes a “calorie-added tax” (“Fight obesity by taxing calories,” Oct. 14).
Nonsense. Nothing must be done (beyond eliminating government subsidies to sugar and corn farmers) to ‘fight’ obesity. Obesity is the result of individual choices. If my neighbor prefers the enjoyment he gets from eating lots of fatty and sugary foods to the satisfaction that he would get if he were thinner, who am I to second-guess his preference? Who is Mr. Zinczenko to do so? My neighbor’s eating habits are my neighbor’s business and his alone.
The real and truly harmful epidemic in America is not obesity, but meddlesomeness. I dislike taxes, but if government is destined to create yet another ‘sin tax,’ I propose that it be, not a calorie-added tax, but a meddlesomeness-added tax. It’s time that Mr. Zinczenko and other busybodies pay for the harm that they impose on others.
Sincerely,
Donald J. Boudreaux
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{ 81 comments }
What is the externality?
Meddlesomeness.
Ah – I see. Yes, that’s a real externality
And it’s a truly perverse one – usually with externalities you simply don’t have to pay for the costs you impose on others. With meddlers, they usually ENJOY imposing costs on others, which suggests that the Pigovian tax on that ought to be even higher.
I thought the guy was making the case that obesity was an externality, which I just don’t see. Are we too fat? Sure. Is that anyone’s business? I don’t see how.
Well no, meddlesomeness isn’t an externatility but an inevitable reaction when obesity problems start rolling on in and the costs are socialised. The real externalities from obesity would be lost productivity when the obese person is no longer up to par and creates downtimes for those around him.
It is hard to talk about costs or benefits that aren’t incorporated into a price when there is no price to speak of – which is why a “meddlesomenss tax” is obviously just a nice rhetorical device and really nothing more. But it is a cost that people impose on others and it’s not compensated. In that sense it’s akin to an externality.Certainly more so than obesity. What does it matter if their productivity is lower? If their productivity is lower their employment rate will be lower and their wages will be lower. How does that affect you? If your employer can’t assign tasks and hire workers in a way that maximizes efficiency, that will obviously impact you – but in a competitive market that employer will improve his organization or fail. The way you frame the issue, anything that reduces an individual’s productivity imposes costs on other people. I’m not quite sure that make sense.If an obese person has reduced productivity, well – that’s what we have a labor market for. They will fare accordingly.
The cost of obesity is “externalized” only if someone other than the obese person bears the cost. His lost productivity is not a cost to anyone else, unless he may consume the produce of others regardless of his productivity. If loses too much productivity and bears this cost himself, he can’t afford to overeat anymore, so this problem seems self-correcting.If overeaters bear the cost of overeating already, taxing their calories only adds to the burden. Taxing calories enough to affect obese people would probably starve others. The whole idea is incredibly silly. It can only be a BS argument for increasing the statesmen’s booty.
That’s the problem with “sin taxes” generally. Sins typically harms the sinner. A tax can only make the harm a bit more acute. Even if the sinner sins a bit less, he also suffers the tax, so it’s not clear that he’s better off. The taxing authority still gets the booty though.
Presumably the costs that occurs when obesity bites the fatso in the butt and they are incurring a great many medical expenses at taxpayers’ expense.
On the other hand, it is interesting to note that Baby Boomers by rights should be the longest living generation as the generations before usually didn’t have enough food and people nowadays have too much food.
They might be the longest living generation, but they are the most diseased-ridden as well.
Social friction
Bureaucracy
Enforcement
Resource misallocation
Yep – we’re on the same page on that. I wasn’t sure what the externality associated with obesity was. I didn’t want the idea of a calorie tax to gain creedance by the claim it’s an externality, or the idea of taxing externalities when it’s feasible to lose credibility by being associated with something like a calorie tax.
But we mustn’t offend the obese.
I was citing these as external costs of meddlesomeness.
I disagree. My neighbor’s eating habits are his business if he pays for his cardiac bypass out-of-pocket. If I am subsidizing his surgery, then they become my business. So, either you say that “nothing must be done (beyond eliminating government subsidies to sugar and corn farmers AS WELL AS health-insurance regulations forbidding price discrimination AND tax-funded health care programs like Medicare)”, or you admit that something CAN be done, and perhaps should be done while we wait for the messianic era in which all regulations will be rolled back.
Perhaps a tax on calories is not the appropriate choice, but this doesn’t exclude others. We are not talking about sin taxes here, or Hillary Clinton wanting people to exercise and smoke less because this conforms some progressive utopia, but rather the economic costs of obesity, which has been well documented.
You don’t dig your way out of a hole. Along these lines of butting into people’s personal lives, perhaps we should go back to the early 1980s when then Mayor Dianne Feinstein of San Francisco closed the bath houses to combat the spread of AIDS. However, a tax on “actions that are likely to spread AIDS” would be more 2009, doncha think? Or maybe since some elderly people often screw up the dosages of their meds and end up hospitalized, we could tax pharmaceuticals. The possibilities are endless.
This was my thought as well. My health insurance costs me (well, my employer actually pays for all of it, but if it was cheaper, her could give me a raise) about $5,000 annually.
Based on my explanation of benefits, I received about $1,200 worth of care this year. So while I’d love to allow my neighbor to have free market KFC, I’m going to need true free market health care first.
What’s not free market about your current insurance arrangement?
Apologies if my sarcasm detector isn’t running at full speed. Almost everything isn’t free market about his current insurance arrangement. As heavily regulated industries, healthcare and health insurance have enormous obstacles to overcome in being efficient markets.
Well right – but I mean the arrangement as he described it.
He seems to attribute the fact that some of his contractual compensation comes in the form of health benefits is somehow important here. There are important ways in which the market for health insurance isn’t free… I was just curious and asked for clarification because he never mentions any of those but does mention something that (in and of itself) seems perfectly consistent with markets to me.
You’re comparing apples and oranges. Your employer pays for health insurance, which insulates you from the cost of (for example) a knee surgery if you twist your knee while running your 5 miles per day. So the value of your benefits is much higher than the $1200 in care you received. Perhaps it’s not $5K, but it’s closer to that than $1200.
There is certainly value in knowing I am covered should something serious happen. But in the 4 years I’ve worked there, my employer has paid just she of $20,000 in premiums, and I’ve received less than $2500 in care. If my health insurance was roulette, I’m due to hit my number any minute now.
I still think you’re looking at it wrong. Even if actuarially speaking, the costs of regulation double your premium (perhaps, but not likely), you’d be comparing $2500 in benefits to $10,000 in premiums. Maybe at your age, the insurance is just a bad bet. Or maybe you’d be better suited with a more catastrophic offering. All that aside, if you’re not liquid enough to cover injury recovery after a car accident or a myriad of things that can go wrong with internal organs even at a young age, you probably want to keep the insurance. Insulating you from those costs is worth a lot more than you seem to believe.
well, my employer actually pays for all of it, but if it was cheaper, her could give me a raise)
Actually, you pay for it. Your employer figures it into the cost of hiring you and expects that your service is worth more than your cost to him.
That’s what I was getting at with the raise bit. If I make $50,000, plus $10,000 in benefits, my boss deems I’m worth $60,000 a year to him. If my benefits only cost him $8,000, and my value to him is unchanged, he can give me a raise to $52,000.
The problem is too much government regulation and intrusion on the rights, liberties, and properties of individuals. The answer to that is not to combat it with more government regulation and intrusion.
We’ve already opened that Pandora’s box in the 1930s when government social benefits exploded. Too late to put the genie back int the bottle.
I see, so you get a say in my diet because you’re going to give me a health care subsidy, which I didn’t ask for, but you’re making me take it. Moreover, you’re not really giving it to me; I pay for my own “subsidy” with higher taxes. Then, once you’ve forced me to pay higher taxes for the subsidy you’ve forced me to take, on that basis you claim the right to “help” me run my life. Poppycock. If you want to subsidize people’s medical expenses, you need to accept that some of them are going to do things that cost you money. Don’t like it? Then don’t subsidize health care.
Of course, I can’t stop you and your fellow travelers from either subsidizing health care or passing laws regulating my diet, but don’t pretend for a moment that cramming those laws down my throat makes you anything but another tin pot despot.
I agree with your logic entirely. My problem is with the structure of our health care system, where the externalities are aligned totally backwards. Those that are responsible enough to carry insurance are forced to pay for those that choose not to carry insurance.
I’d rather have national competition between insurers, and those without coverage can either pay cash, or they’re out of luck. But that’s “insensitive” and not politically palatable to the ruling party.
If funds are going to be confiscated one way or another, I’d prefer that it be done in a way that’s at least somewhat just, instead of in a manner that is totally illogical.
Mr. Zinczenko would be better served arguing for abolition of the FDA if he wants poor people to have better dietary choices. Instead of raising the cost of things they can afford, thereby limiting their choices even further, such action would instead lower the costs of things they can’t afford, expanding their choices.
If there were a free market in insurance products, health insurance could be sold in the same manner as life insurance or long term disability (really also health insurances). Then premiums would take into consideration individual health issues and lifestyle preferences. That would result in persons overweight, smoking, and skydiving paying more for health insurance than others with fewer risks to the insurer. Under the current system, at least here in New York, all of the insureds pay higher premiums to subsidize more risky behaviors and lifestyles. If you want to see a dramatic drop in national obesity, just allow for a free market in health insurance.
That makes total sense, but barring privatization of the health care system, is it right to view obesity as an externality that tax payers are forced to pay for? I’m honestly wondering, because it seems to me that if there is scientific evidence that shows that obesity is a burden on the health care system (which we as tax payers must pay for, at least in part), then the choice of being obese is in fact an externality and might be taxed as such. Thoughts?
Here’s one. There should be a credit for heavy smokers. Heavy smokers die earlier, saving future Social Security and Medicare payments. Reason magazine once carried a good estimate of the savings imposed by an average heavy smoker. Since all of these “sin taxes” really boil down to aesthetics, do you think the meddlers will go down the road of crediting smokers?
I’ve always thought about this logic too… particularly with people who claim investing more in “prevention” will save money. Granted, doing more to stay healthy is great – but that’s not the same thing as saying it will save money.
We know most medical expenditures come in the last several months of life. So how do these costs compare for people who live healthy lives vs. unhealthy lives? It seems to me people who live unhealthy lives probably die quicker deaths – heart attacks, etc.. Healthy people have long, drawn out end of life illnesses that cost a lot more. Maybe there’s evidence prevention lowers expenditures, but it seems weird to me just to claim it. I wouldn’t necessarily assume it’s true.
These sin tax ideas make much more sense when you consider the sins from an aesthetic point of view rather than an economic point of view. It usually makes them doubly bad. For example, dust to dust energy consumption of a Prius exceeds that of a Hummer assuming a 300K mile lifetime. That shouldn’t surprise anyone who has a laptop battery. But to those who hate the Hummer because it’s extravagantly large, it’s heresy.
These kinds of things remind me of an old locker room saying popular among those of us that could lose 10 or 20 pounds. At least we’re just fat, and not both fat and ugly. We can always lose the weight.
Daniel,
Don’t take this as an attack, but do you have any evidence to support that suggestion that healthy people incur greater medical costs over their lifetimes? or that unhealthy people die quicker deaths?
My wife has been an operating room nurse and supervisor for over 30 years, and assisted in over 25,000 surgeries. She has told me many times that obese patients are more costly to treat. They often require special equipments and supports, their surgeries last longer for several reasons, and they are more likely to require follow-up treatment.
If you know much about Type II diabetes, you are aware that obese victims of this disease are much more likely to require expensive and legthy treatment. You are probably also aware that obese persons are much more likely to contract diabetes. 2007 medical expenditures for diabetes in the U.S. were estimated to be $116 billion.
I also know that diabetes victims do not die quick deaths. Although many if not most succumb to heart failure, they usually incur many months and often years of treatment prior to death.
danielkuehn: “We know most medical expenditures come in the last several months of life.”
Are you sure we know this? I do not often quote USA Today, but they don’t lend support to that assertion:
“Estimates show that about 27% of Medicare’s annual $327 billion budget goes to care for patients in their final year of life.”
Do you have some other evidence to support your argument about medical expenditures in the last several months of life?
While I agree with having a more free-market approach to health care, I don’t agree that doing so would necessarily result in a reduction in obesity — “dramatic” or otherwise. There are already costs associated with obesity, and they don’t seem to provide much incentive for people to reverse their obesity-promoting habits.
I would point out that obesity (like smoking) probably leads to a cost savings, since people die at an earlier age. It is longevity and healthy living that is costly.
Aging imposes a cost on the system. People should be taxed more as they age to offset the costs they impose:)
Or we could just stop the forced wealth transfer from the young to the old.
There use to be an obesity tax. It was called paying for health care from your own pocket. When you bore those costs directly, you had more incentive to take care of yourself and incentives matter.
I wonder what the correlation is between the levels of obesity in the U.S. and the percentage of medical payments paid by third parties without a significant amount of other rationing mechanisms like supply constraints, wait times, health committees, apprehension of using a low quality medical system for fear of contracting a deadly infection and things like that?
You are cruel. Everyone deserves the very best health care!
Great! When can we expect you to reach into your own pocket and finance the your convictions?! (I know – DA)
Um, I’m already paying for other people’s “free” healthcare through my tax dollars and higher premiums.
I’m on an HSA with a high deductible policy for health care. I write the checks directly on the first $5,400 of my family’s medical expenses. And, I can attest, compared to when I had full coverage, I do consider the cost and benefits more carefully, just as Milton Friedman would suggest I might.
Same here. Took me 2 years to fully fund my high deductible, now I’m covered for any amount of medical expense (below the $5 million lifetime limit). Of course I don’t use nearly that much every year, so the HSA just keeps accumulating. Now I have several years of deductible funded, and that tax savings pays for 95% of my low monthly premium. By the time I retire, the HSA may very well be my Medicare replacement–if I spend it wisely.
Can’t wait for PelosiCare to declare my high deductible policy incompatible with the new national standard, and therefore illegal.
I agree, everyone deserves the best health care. That’s why first party payments should be encouraged whenever possible.
I’m willing to bet the correlation is high, but causation will be harder to prove. Lots of other things happened over the same period to encourage people to eat more and exercise less. I don’t think the vast majority of people really think “Oh, who cares if I get diabetes? Someone else will pay for the insulin!!”. Third party pay probably has a role in people’s lackadaisical attitude toward improving their own health and habits once they become obese and ill but I don’t think they even think about it on their way to obesity.
“I don’t think the vast majority of people really think ‘Oh, who cares if I get diabetes? Someone else will pay for the insulin!!’”
Sounds strikingly familiar to statements made about the mortgage market cratered. I don’t think any mortgage investors thought, ‘Oh, who cares about defaults, taxpayers will bail out Fannie.’
We are at a point now where 50% of the population pays income taxes and the other 50% doesn’t.
And with the power of the vote, that’s like a wolf and sheep deciding what’s for dinner.
I have to agree it’s a definite correlation between the overall lax attitude people have towards their health and support for big government.
I’m not so sure obesity is just about individual choices. Some people are genetically more predisposed to adiposity then others, and the government subsidizes high-carbohydrate food sources like corns & soybeans. You can’t escape High fructose corn syrup in any processed food.
You can. Just buy from the kumbaya brands.
Not to be callous, but who cares? Some people are genetically more predisposed to having low IQs. Should we guarantee them high paying jobs?
All of us are dealt a certain hand and it is no one’s responsibility to correct it. It is our personal responsibility to make the best of it.
My friend, the debate has gone beyond this but I have to answer anyway.
Yes there are many people who are disposed to weight gain more than others, it is genetically so. But, regardless of one’s genetic disposition one must eat something in order for weight gain to occur. Pure simple fact of nature. Nothing in, nothing out. Something in something out.
To all people who question this pure simple straightforward statement of logic and fact, I say bring me a picture or other reliable believable evidence of a fat person who starved to death and I might bend in your direction a little.
All documented photographic evidence points to one inescapable conclusion, when people have starved to death they are skin and bones.
People who are genetically disposed to weight gain simply have to eat less in order to remain reasonably slim, that that may be difficult and temptation hard to overcome I admit and agree too, but nothing in, nothing out is just a fact of life.
Something in, something out.
“simply have to eat less”
Appetite is a much stronger motivator than you understand. The congenitally obese don’t have less will power than you, just more appetite.
High fructose corn syrup is used because government subsidies to sugar growers makes the cost of sugar significantly higher than corn syrup.
Eliminate that bit of corporate welfare, and Coca-Cola will start using sugar in its US-bottled products, and Hershey will start using sugar in US-made candy.
Good luck eliminating that bit of corporate welfare, though. Sugar, and corn-growers are focused interests in this debate, and they like things as they are.
Since when was cane sugar a magical healthful sweetener?
For some people, it’s healthier than HFCS, which was what I was replying to in ArrowSmith’s post.
The larger point being that HFCS is only used so extensively because government interference has made the cost of sugar artificially high in the US.
I personally prefer taxing things that most of society perceive to be bad things (like smoking and eating junk food) to taxing things that we almost all agree are good things, like working and investing. If people on the left are going to admit that taxation can provide a powerful disincentive to do certain things, then they should have to explain why it is so great that the majority of the revenue of our present tax system is on productive activities. I would much rather live in a world of large and punitive sin taxes than with the large and punitive labor and income taxes we now have.
The only reason we tax producers and workers at the current rate is to pay for parasitic welfare programs. If we only taxed to pay for the things that were truly “common good” like the military & transportation, I bet we could reduce the size of the federal budget to 40% of the current.
joe teicher: “I personally prefer taxing things that most of society perceive to be bad things (like smoking and eating junk food) to taxing things that we almost all agree are good things, like working and investing”
I understand your sentiment, joe. But I do not believe it is consistent with the freedoms upon which our nation was founded – freedoms which I believe should not be trampled on.
Are you sure that most of society perceives junk food to be bad thing? Their revealed preference for what you probably consider to be junk food cannot be denied. Are you sure that most of society agrees on what is junk food? Even if most of society did agree, do you really advocate trampling on the freedoms of those members of society who disagree?
For me, a general tax paid by everyone is far preferable to a targeted one. IMO, everyone should contribute something to the funding of common goods. That way, everyone has an incentive to ensure tax monies are not wasted or used to benefit the few at the expense of the many.
I think you deliberately misunderstand what Joe was saying.
Joe simply expressed his opinion that if taxes must be imposed, tax the nonproductive things rather than the productive things. In other words, tax the frivolous, the froth, the meringue, the icing, not the essential. I seriously doubt, as does Joe, that humanity will have a violent disagreement on what constitutes frivolous, froth, meringue, icing type behavior……in whatever form of society any particular group of humanity exists.
I can get behind that idea.
“I seriously doubt, as does Joe, that humanity will have a violent disagreement”
Keynesiacs think government spending can be productive.
Progressives think that minimum wage is productive.
Obama thinks monopolization is productive.
I think it would be better to leave judgments of productivity out it, simply because those empowered to make those judgments are vicious idiots.
Only government can determine how much liberty a man needs in order to be free. – Yasafi Muirduck
Only government can determine how many calories a man needs in order to be healthy.
What’s the difference?
Now this is a tax that even I, a dedicated libertarian, could love!
I’m really an economist and I must admit that I don’t know much about dietetics, but if groceries are to sell “calorie-less” food I don’t know what they’re going to sell besides spring water…
A total tangent on my part, but it’s not really energy consumption that the Prius claims an advantage in – it’s gasoline consumption. For people concerned about emissions, it’s not “energy” that’s the problem – it’s where that energy comes from.Granted, as long as that Prius plugs into a coal plant it’s really a moot point that it consumes less gasoline than a Hummer. But once we get alternatives and nuclear online, the fact that they consume the same energy won’t really matter – the advantage is in the emissions.
Daniel, are you advocating for nuclear power plants? While I think we should also pursue wind, solar and hydro we shouldn’t be deluded as to what % those will constitute of total generation capacity.
Of course!
I agree – there’s not going to be a silver bullet in our energy future. And so long as we’re sitting on a bunch of coal, these should be part of our energy future too – we just need to try to clean them up a little.
Re: “Do you have some other evidence to support your argument about medical expenditures in the last several months of life?”Are you really going to play the same stupid game you did with “small businesses” the other day?No – I don’t. That wasn’t my argument, that was a guess that has little to do with the underlying argument. Change it to “last several years”, and it doesn’t change the argument at all. And again, the argument was never that I know that prevention raises costs. The argument was that I’m not so sure about claims that it lowers them. I’m not so sure either way.
No, I don’t have any evidence which was the purpose of phrasing a lot of it in the form of a question. Like I said “maybe there’s evidence prevention lowers expenditures, but it seems weird to me just to claim it. I wouldn’t necessarily assume it’s true.”. You hear a lot of people make the claim that prevention lowers costs. It certainly may be true. I haven’t seen much evidence for it which makes me wonder.
Diabetes is one that is drawn out. Dying of a heart attack isn’t. Pointing to one or even a couple examples doesn’t give us the answer. My experience with death in my own family (which is fairly healthy and long-lived) always involved many years in long term care facilities and hospices.
So no, I never claimed evidence. I’m actually lamenting the lack of evidence for the position you hear more often – that prevention will lower costs. It might in terms of diabetes expenditures. It might not in terms of LTC expenditures. I have no clue how that nets out, and I’m not sure if anyone else really does either.
The problem, Daniel, is that you start your arguments with words such as:
“We know most medical expenditures …”
when in fact you do not know this.
DanielKuehn: “Change it to “last several years”,
But you do not know your statement would be true if you changed the wording to “last several years”. You just do not know, Daniel, even though you write as if you do.
DanielKuehn: “Diabetes is one that is drawn out. Dying of a heart attack isn’t.”
I’m not sure what you mean by this, Daniel. Few victims of heart attacks die quickly. In fact, 75% of men and 60% of women live at least one year after a heart attack The treatment for heart attack victims, whether they live 30 days or 30 years is hardly inexpensive. Furthermore, the treatment of heart disease even before a heart attack is very costly. Heart disease is the most costly of all medical conditions in the U.S.
It may be true that immediate medical costs for heart attack victims are lower than victims of other disease. But the collective costs for heart disease in the U.S. are exceeded by no other medical condition.
Please, Daniel, consider doing some research before you present your arguments.
Daniel,
I don’t have the evidence at my fingertips, but prevention may or may not lower costs – depending on what is meant by “prevention”.
Engaging in preventative behaviours is a huge cost saver. The reasons are obvious – people who take care of themselves have fewer medical issues. Preventive medicine is usually much more expensive unless we’re talking about vaccines and routine, reliable and cheep tests like pap smears.
Type II diabetes can most often be prevented with certain behaviours but never because of medical intervention. By the time you get medical intervention, you’re treating an existing condition, not preventing one. And there’s no way for doctors to prevent type II diabetes if it’s obesity related.
They’re looking into just that:
http://en.wikipedia.org/wiki/Carbon_capture_and_storage
Isn’t the power of the human mind wonderful? You just have to know that such technologies would not come about in a slave society like North Korea or the USSR.
RE: “The problem, Daniel, is that you start your arguments with words such as”
First, I didn’t start my “argument” with that – it came in the middle of the comment. I started with “I’ve always thought about this logic too… particularly with people who claim investing more in “prevention” will save money.” Nothing declarative on my part.
Even so, how much of a problem is my statement about the majority of medical expenditures, really? I’m wrong on that, and it needs to be changed. I’m not sure why you’re picking at it. My underlying argument (which wasn’t even an argument – it was a question) doesn’t change in the slightest by you picking at this point.
RE: “In fact, 75% of men and 60% of women live at least one year after a heart attack”
Which is why I explicitly spoke of people who DIE of a heart attack, not people who survive a heart attack. If you’re going to be so nit-picky (which is your right) at least read what I write.
RE: “Please, Daniel, consider doing some research before you present your arguments.”
I wasn’t making an argument at all. Show me where my argument was. I was raising a suspicion and a question. Please take that seriously before you address tangential points. I address tangential points a lot too – usually because those can be more interesting than the main point. But johndewey, try not to mistake a statement of mine that doesn’t really change the crux of the question I asked with an argument in and of itself. I don’t have the time or inclination to read up on prevention in costs, which is precisely why I phrased it as a suspicion or a question. So I appreciate the extra information you’ve provided, but I don’t know why you’re acting like you’ve refuted an argument I never made in the first place. The whole point was, as I said: “maybe there’s evidence prevention lowers expenditures, but it seems weird to me just to claim it. I wouldn’t necessarily assume it’s true”.
I’m still wondering about that, although I am much better informed than I was about the survival rate from heart attacks and the distribution of medical spending.
Exactly – and because nuclear is still an expensive endeavor, these innovations are that much more important to push ahead with. I’m surprised you’re a clean coal guy, Arrowsmith! That’s great.
Although I have to say, their approach to burning coal ranks low on my list of reasons why I despise the idea of a North Korean or Soviet system
Ya – and if we’re staying focused just on obesity here, I think prevention probably pretty clearly pays for itself.
When it comes to a more nebulous understanding of “prevention” I just don’t know and have always been curious about how proof-free those declarations are. And ultimately – even if we are paying more that isn’t necessarily a bad thing. We’d be paying for a much better life.
I appreciate you understanding my comment as skepticism and questions rather than a declaration!
Daniel,
You made several statements which are either wrong or misleading:
“We know most medical expenditures come in the last several months of life.”
“Healthy people have long, drawn out end of life illnesses that cost a lot more.”
“Diabetes is one that is drawn out. Dying of a heart attack isn’t.”
The last one is misleading because it implies that the diseases which cause heart attacks less lengthy (less drawn out) than the disease diabetes. That was the sense in which you originally made the comment about quick deaths and heart attacks.
Those statements were in support of your argument. Otherwise you would not have included them. If you continue to make incorrect statements, I’m going to continue to correct you. I would much prefer that you have enough respect for the readers of this blog that you check your facts before you state them in your comments.
I can’t keep playing this game johndewey. It’s pointless to argue with you. All I can say is that those statements started with “it seems to me”, and were immediately followed by “maybe there’s evidence prevention lowers expenditures”, but you’re pulling them out of that context. It is and always was a question johndewey. People say that prevention saves money, rarely furnishing any truth – and I wonder about that. There was no argument to support, johndewey – just a question.
And the wolf licks his lips in anticipation of dinner!