#30: Tax Fat People

If Americans were paid to eat less and exercise more they might be motivated to lose some weight—and save us a bundle on health care—says Dr. Barry M. Popkin, director of University of North Carolina-Chapel Hill's Interdisciplinary Center for Obesity.


According to a report released by the Center for Disease Control this month, 26.7% Americans are obese and they're only getting fatter. "The statistics have become rote, but consider that people in their 50s are about 20 pounds heavier on average than 50-somethings were in the late 1970s," wrote economics journalist David Leonhardt in a 2009 New York Times article, "As a convenient point of reference, a typical car tire weighs 20 pounds."

Obesity is defined by having a Body Mass Index (BMI) of over 30. You can calculate your BMI by dividing your weight (in kilograms) by your height (in meters) squared. By state, obesity prevalence ranges from 18.6% in Colorado to 34.4% in Mississippi. Colorado and the District of Columbia (19.7%) are the only two states with prevalences under 20%, while nine states, predominantly in the South and the Midwest, have prevalences of over 30%. To make matters worse, these rates rely on self-reported height and weight data, which likely produces underestimates because both men and women tend to overestimate their height and women tend to underestimate their weight. 

"From a societal standpoint, if a third to a half of Americans weren't so fat, the idea of the government providing tax incentives for the obese to eat less and exercise more wouldn't be so controversial," Dr. Popkin told Big Think, "In 1955, if you'd thought about taxing cigarettes you would have been run off the planet. The only difference is we have a smaller population that is healthy and thin, so we have more people who take offense because it's affecting them. But we had the same issue with cigarettes."

Popkin proposes two possible ways of using taxes to motivate people to lose weight. His first policy suggestion is to demand that anyone with a BMI greater than 30 who receives Medicare, Medicaid or government administered health care pay a fee if they are unwilling to prove they've undertaken a few predetermined exercise activities or show that they are consciously watching what they consume. Popkin admits that taxing bad behavior is different and more challenging than placing a tax on consumers products like cigarettes and alcohol, but he says there are technologies available that could enable the government to monitor obese people's diets and exercise. 

"We have devices that we could put on your throat that could measure your swallows," Popkin explains. "We have devices now to measure how much you move, so we can see when people are engaged in activity like walking or jogging. He even suggests that obese people could wear ankle bracelets or collars similar to those used to monitor DUI felons and people on probation to prove that despite their high BMI, they're active and eating properly. "If Americans are going to be serious about losing weight," says Popkin, "then they need something that's serious."

If the idea of asking obese people to prove that they're exercising and eating well, or else face a tax, sounds far too Orwellian, Popkin's second suggestion is to make all Americans pay an additional flat-tax of, say, $100 a person per year, to build a pool of money which is then returned to people who either have a BMI lower than 30 or have somehow proven that they're dieting and exercising. Popkin points to corporate weight-loss programs, in which employees are rewarded with cash for partaking in exercising, dieting, and smoking-cessation programs, as an example of how there are already versions of what might be considered a "fat tax" being administered not just in America, but around the globe.

"You could definitely look at a federally administered program like large corporate program," says Pat Sukhum, co-Founder of RedBrick Health, a company that works with Fortune 1000 companies to create cost-neutral programs for giving employees cash incentives to lose weight. Sukhum says the right combination of extrinsic rewards (like cash) and intrinsic motivation—prodding by co-employees, friends, and perhaps government-funded publicity campaign—might even result in a return on the government's investment. "In the long-run many of our companies more than reclaim the cost of their incentive programs," says Sukhum.  

Takeaway

Approximately 72.5 million U.S. adults are obese. It is an indisputable fact that, on average, Americans need to lose weight. As a factor contributing to several leading causes of death, including heart disease, stroke, diabetes, and cancer, obesity must be met head-on by a government-administered tax rebate program that motivates the obese to eat less unhealthy food and engage in more exercise.   

Why We Should Reject This

"We don't tax people based on physical characteristics for a whole host of reasons," says Dr. Henry Aaron, Senior Fellow of Economic Studies at the Brookings Institute.

"The first order of importance when in comes to any tax policy, is how much it costs to administer them," says Aaron, "you're talking about an expense that would approximate the value of the rebate. Furthermore, the medical relationship between BMI and health status is very much in dispute. Instituting incentives for improved behaviors can certainly be helpful, but in the case of obesity the causes and cures are too diffuse."

Dr. Aaron also rejects any parallels drawn between the "sin tax" placed on alcohol and cigarettes and a "fat tax" levied to fight obesity. "Tobacco and alcohol used as recommended in any form are poison," he says. "Qualitatively there is no doubt that higher taxes have reduced smoking, but with that said, it's very difficult from a statistical standpoint to figure out what caused the real reduction. There were also the Surgeon General's warnings that smoking was bad for your health, labels were put on products, people were told they couldn't smoke indoors. It became distinctly uncool to smoke and the masses acquired a new norm."

More resources

-- A New Weight-Loss Plan: Getting Paid to Shed Pounds; Time magazine article says dieters who have a financial incentive to lose weight are nearly five times as likely to meet their goals when compared with dieters who had no potential for a financial reward.

-- Germany Weighs Tax on the Obese; Marco Wanderwitz, a conservative member of parliament for the German state of Saxony, says it is unfair and unsustainable for taxpayers to carry the entire cost of treating obesity-related illnesses in the public health system.

-- Big Brother Is Watching Your Weight; Your tax dollars may be at work, penalizing fat people, says Slate journalist William Saletan.

-- Alabama To Place "Fat Tax" On Obese State Employees; Alabama's State Employees' Insurance Board requires all Alabama state employees to receive medication screenings for several conditions, including body mass index.

​There are two kinds of failure – but only one is honorable

Malcolm Gladwell teaches "Get over yourself and get to work" for Big Think Edge.

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  • Learn to recognize failure and know the big difference between panicking and choking.
  • At Big Think Edge, Malcolm Gladwell teaches how to check your inner critic and get clear on what failure is.
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Is this why time speeds up as we age?

We take fewer mental pictures per second.

Photo by Djim Loic on Unsplash
Mind & Brain
  • Recent memories run in our brains like sped-up old movies.
  • In childhood, we capture images in our memory much more quickly.
  • The complexities of grownup neural pathways are no match for the direct routes of young brains.
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Scientists study tattooed corpses, find pigment in lymph nodes

It turns out, that tattoo ink can travel throughout your body and settle in lymph nodes.

17th August 1973: An American tattoo artist working on a client's shoulder. (Photo by F. Roy Kemp/BIPs/Getty Images)
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In the slightly macabre experiment to find out where tattoo ink travels to in the body, French and German researchers recently used synchrotron X-ray fluorescence in four "inked" human cadavers — as well as one without. The results of their 2017 study? Some of the tattoo ink apparently settled in lymph nodes.


Image from the study.

As the authors explain in the study — they hail from Ludwig Maximilian University of Munich, the European Synchrotron Radiation Facility, and the German Federal Institute for Risk Assessment — it would have been unethical to test this on live animals since those creatures would not be able to give permission to be tattooed.

Because of the prevalence of tattoos these days, the researchers wanted to find out if the ink could be harmful in some way.

"The increasing prevalence of tattoos provoked safety concerns with respect to particle distribution and effects inside the human body," they write.

It works like this: Since lymph nodes filter lymph, which is the fluid that carries white blood cells throughout the body in an effort to fight infections that are encountered, that is where some of the ink particles collect.

Image by authors of the study.

Titanium dioxide appears to be the thing that travels. It's a white tattoo ink pigment that's mixed with other colors all the time to control shades.

The study's authors will keep working on this in the meantime.

“In future experiments we will also look into the pigment and heavy metal burden of other, more distant internal organs and tissues in order to track any possible bio-distribution of tattoo ink ingredients throughout the body. The outcome of these investigations not only will be helpful in the assessment of the health risks associated with tattooing but also in the judgment of other exposures such as, e.g., the entrance of TiO2 nanoparticles present in cosmetics at the site of damaged skin."

Climate change melts Mount Everest's ice, exposing dead bodies of past climbers

Melting ice is turning up bodies on Mt. Everest. This isn't as shocking as you'd think.

Image source: Wikimedia commons
Surprising Science
  • Mt. Everest is the final resting place of about 200 climbers who never made it down.
  • Recent glacial melting, caused by global warming, has made many of the bodies previously hidden by ice and snow visible again.
  • While many bodies are quite visible and well known, others are renowned for being lost for decades.

The bodies that remain in view are often used as waypoints for the living. Some of them are well-known markers that have earned nicknames.

For instance, the image above is of "Green Boots," the unidentified corpse named for its neon footwear. Widely believed to be the body of Tsewang Paljor, the remains are well known as a guide point for passing mountaineers. Perhaps it is too well known, as the climber David Sharp died next to Green Boots while dozens of people walked past him- many presuming he was the famous corpse.

A large area below the summit has earned the discordant nickname "rainbow valley" for being filled with the bright and colorfully dressed corpses of maintainers who never made it back down. The sight of a frozen hand or foot sticking out of the snow is so common that Tshering Pandey Bhote, vice president of Nepal National Mountain Guides Association claimed: "most climbers are mentally prepared to come across such a sight."

Other bodies are famous for not having been found yet. Sandy Irvine, the partner of George Mallory, may have been one of the first two people to reach the summit of Everest a full thirty years before Edmund Hillary and Tenzing Norgay did it. Since they never made it back down, nobody knows just how close to the top they made it.

Mallory's frozen body was found by chance in the nineties without the Kodak cameras he brought up to record the climb with. It has been speculated that Irvine might have them and Kodak says they could still develop the film if the cameras turn up. Circumstantial evidence suggests that they died on the way back down from the summit, Mallory had his goggles off and a photo of his wife he said he'd put at the peak wasn't in his coat. If Irving is found with that camera, history books might need rewriting.

As Everest's glaciers melt its morbid history comes into clearer view. Will the melting cause old bodies to become new landmarks? Will Sandy Irvine be found? Only time will tell.

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