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Berger on the Nanny State

Fellow AI blogger Peter Berger is always a stimulating read. This week, he tackled the anti-obesity movement as embodied in Mayor Bloomberg’s ban on sales of large sodas in New York City. Peter has studied how the anti-tobacco movement gained legitimacy and finally succeeded in its goals beyond its wildest dreams, and finds many parallels in today’s crusade:

It is not difficult to predict the trajectory which this project will follow. Very probably it will replicate, step by step, the war against tobacco.  Once again, the basic rationale is the prevention of illness. Heart disease is the illness most closely associated with obesity—not as scary as lung cancer, but scary enough. The scientific validation of the project is clear—obesity is unhealthy. The same interests that supported the anti-smoking crusaders can be mobilized once again—doctors who jump on the prevention bandwagon when their ability to cure is often limited, researchers in need of funding, bureaucrats looking for new behaviors to regulate, activists in search of employment opportunities, and of course, legions of tort lawyers, salivating at the prospect of gargantuan settlements from the food and drinks industry. Pizza Hut and Pepsi Cola may take the place of Philip Morris as public enemies (and defendants in class-action lawsuits). The same arguments will serve to counter libertarian scruples—social costs and innocent bystanders. Children will again be featured in the litany of victims. (Michelle Obama understandably likes to preach in kindergartens and elementary schools.) Finally, class is again involved here: Upper income and higher education is associated with virtuous slimness, while all these fat working-class types waddle from Burger King to the unemployment lines. Just as the Victorian bourgeoisie tried to convert the poor slobs to its table of virtues (alcohol of course was then the most targeted vice), so the new bourgeoisie bombards the lower classes with its temperance crusade. (One might speak of the eternal return of the Salvation Army—George Bernard Shaw’s Major Barbara would today be reincarnated as a coach with Weight Watchers). It remains to be seen how far this will go before the Great Unwashed remember that, after all, they are (still) allowed to vote.

We’re no fans of Bloomberg’s nanny statism here at Via Meadia, so we enjoyed Peter’s latest immensely. Read the whole thing.

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  • thibaud

    That wicked nanny state again. Perhaps nanny wouldn’t be necessary if the fattest nation this side of Tonga were to figure out how to stem an obesity epidemic that is burdening an already-collapsing healthcare system with an extra $190 billion each year in unnecessary costs, plus nearly one billion additional gallons of gas consumed each year.

    Interestingly, while the nanny-haters snark, the Obama admin’s ACA is actually tackling the problem, as Forbes points out:

    Obesity Now Costs Americans More In HealthCare Spending Than Smoking

    A report out today on the high cost of obesity serves to highlight, once again, that there is so much more to the Affordable Care Act than what has met the public’s eye.

    Reuters is reporting that obesity in America is now adding an astounding $190 billion to the annual national healthcare price tag, exceeding smoking as public health enemy number one when it comes to cost.

    “Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics.

    Obese women account for an extra $3,613 a year.

    Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.”

    The high cost of being significantly overweight manifests in a variety of ways, ranging from the increased insurance premiums we all pay to subsidize the added medical charges incurred by the obese to the surprisingly dramatic impact our collective pounds has on energy costs.

    According to Sheldon Jacobson of the University of Illinois, the extra weight carried by vehicles as a result of obese and overweight Americans is responsible for almost one billion additional gallons of gasoline being burned each year by our automobiles—nearly 1 percent of our total gasoline usage.

    What you may not know is that the Affordable Care Act directly confronts this crisis in a number of ways— beginning with empowering employers to battle obesity by allowing them to charge obese employees 30 to 50 percent more in what they contribute toward their health insurance benefit should an employee refuse to participate in a qualified wellness program designed to help them lose weight.

    You may also not know that the reform law includes incentives to Medicare and Medicaid beneficiaries to get them into a primary care doctor to discuss and execute a weight loss program. Obamacare even funds community programs designed to help people take off the extra pounds.

    How serious is the problem? Obesity has risen a full 34% since 1960 while morbid obesity is up sixfold.

    Making the cost impact all the more troubling is the fact that, unlike smokers, obese people tend to live almost as long as those who keep their weight under control. ”Smokers die early enough that they save Social Security, private pensions, and Medicare” trillions of dollars”, said Duke’s Eric Finkelstein. “But mortality isn’t that much higher among the obese.”

  • thibaud

    For those who actually want to do something about the obesity epidemic while avoiding paternalism – of both the “nanny” and the libertarian varieties – here’s a blog based on the “nudging” or “choice architecture” approach pioneered by U Chicago Law professor and Obama friend/adviser Cass Sunstein.

    The goal is to subtly influence people’s choices without heavyhanded intervention. Here’s the “nudge blog” section on obesity:

  • jh79

    Thibaud – I’m not sure who you’re arguing with here. I believe few would argue that 1. Americans have not become more obese, 2. That it is, on the whole, quite unhealthy for us to be obese, 3. That this unhealthiness imposes costs on individuals and on societies. The objection is that these efforts will be ineffective (which has been openly admitted); that (being as they are targeted disproportionately at the poor simply as a matter of circumstance) they will be informed by the preoccupations and prejudices of the wealthy and the credentialed; and that these measures have at their core a conception of man’s relationship to government that we find abhorrent. (Some large proportion of us also dislike having the costs of other persons’ poor choices displaced onto us – it is demanded that we pay for their health, and then it is demanded we all submit to nutritional regimes for the sake of their health, a health which they are unable to pay for and unwilling to maintain.)

    Speaking strictly for myself, it seems clear that the obesity epidemic has been caused by the low cost of food, and by cultural shifts which have deprecated self-control.

    The former, I believe, is attributable at least in part to ag subsidies, and in much larger part to income maintenance programs financed by the government; so perhaps on this score we might try less government before we try more government, or perhaps we might find some way to make all of us poorer. We must, of course, acknowledge that making food expensive enough (relatively or absolutely) that the many not get fat will also make it expensive enough that the few at the margin go hungry.

    As for the latter cause, reinstating self-control as a valuable personal trait in and of itself would seem to be antithetical to the instincts of those such as yourself or bloomberg. It is preferred that we submit to operant conditioning.

  • thibaud

    “Self-control” is a lost cause, jh79.

    Agree totally with your point about removing ag subsidies for the HFCS-mongers. Raising the cost of the main input into our food manufacturers’ fat bombs would do a world of good.

    Re your comment as to not being sure “who [I’m] arguing with,” I’m pointing out once again the extremism of those who deny any value to state intervention to solve pressing national problems.

    Obesity is a huge problem for our nation. Simply smirking and sneering at every attempt by the state to remedy the obvious and massive failure of the marketplace – in this case, the American market for garbage food delivered in absurd portions – is not helpful.

    We need a return to non-ideological, pragmatic, good governance in this country. That begins with a recognition of the role of, well, GOVERNANCE, ie intelligent and on occasion enlightened, out-ahead-of-the-public, progressive government policies.

    Before we all resemble those cruise-ship denizens in Pixar’s “Wall-E” (see 0:28, below):

  • Jim.

    So the war on AIDS and other STDs should open up a new front too, eh? Hey, it’s worked in past centuries.

    The debate here should get really interesting when the anti-War on Drugs posters find this thread.

  • rose

    wow, what faulty reasoning on the cause of obesity. if diet and exercise were the cure we would all be thin, how many obese people have tried to follow the “experts” advice what a quadzillion?. only the “experts” are not so expert. the nannies you speak of don’t know squat about anything, except increasing their revenue and power over others. period. concentrate on reforming yourself and stop trying to reform others through force such as the state, that would be enough work right there.
    obesity is a metabolic disorder caused by severe nutrtional deficienies that are not even addressed in the medical community for the most part,to long to elaborate.

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