The Food Police (18 page)

Some health advocates have resorted to downright falsehoods to promote their cause. A recent ad run by Mayor Bloomberg’s New York City Health Commission featured an amputee with the caption “Portions have grown. So has Type 2 diabetes, which can lead to amputations.” Here’s the problem: the man’s leg wasn’t amputated as a result of diabetes but rather by Photoshop.
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As if that weren’t bad enough, the ad ran a week after the CDC reported that the rate of diabetes-related amputations had fallen by more than half since the 1990s.
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I’m not against our getting to the bottom of the cause of diabetes or carefully considering strategies to help mitigate the disease, but we need to look before we leap. And we need to ensure that the solutions don’t cause more damage than the problem they’re designed to fix.

One detail overlooked in these discussions is that the prevalence of many diseases, and even weight itself, is correlated with age. A nation with a large number of aging baby boomers is biologically bound to be a nation that, as a whole, weighs more and is more likely to develop diseases such as cancer and diabetes. We are living longer, and as a result Americans are suffering more today from old-age illnesses. In the past, we didn’t live long enough to contract the things that now kill us.

Careful researchers calculate age-adjusted measures of obesity, cancer, and diabetes incidence (each of which has risen over the past two decades), but these are statistical extrapolations, not undisputable facts. Ultimately, the question isn’t whether we will die; it’s when and from what. Citing
statistics on the number of people dying from this ailment or that—with some supposed link to obesity—sounds scary, but let’s face it, we will all die of something someday. But not as soon as we once did.

Since 1990, during a time when obesity was supposedly taking its huge toll, Americans’ life expectancies have risen 2.5 years. Even those of us who make it to age 65 can expect to live almost 1.5 years longer than 20 years ago.
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Not only are we living longer, but the quality of our lives is better.
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Some of these gains have occurred due to advances in medical technology and increased medical spending. Yet it seems to have escaped the imaginations of many medical health professionals that rising obesity is a rational reaction to better medical technology and to a government-run health care system where the sick no longer have to pay the full costs of treating their ailments.

About 33.8 percent of Americans are today classified as obese.
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This is up from about 14 percent in the early 1970s. Hence the newspaper headlines such as “Obesity Rates Surge, with No End in Sight.”
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The problem with this rhetoric is that the end
is
in sight and perhaps has already been reached. There has not been a measurable increase in the rate of obesity among men since 2003, and there has not been a measurable increase in the rate of obesity among women since 2000. One group of medical researchers concluded that the prevalence of obesity “may have entered another period of relative stability.”
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I’m not trying to belittle the problems of obesity or diabetes, many of which are real. I’m asking that we take a step back, eschew all the hype, and think through the consequences of
the proposed policies. Clearly there are those who are already overweight and want to shed some pounds. The billions of dollars spent annually on weight loss in this country show that many people wish they weighed less. Some of our desire for weight loss is due to status-seeking, but there are legitimate health concerns, too. We all know and love people who suffer from health problems associated with being overweight. While compassion might be a good reason to do something for a friend or family member, it isn’t sufficient justification for government action. When did my weight become someone else’s problem?

In a recent nationwide survey, I asked folks whether they thought different groups—such as food manufacturers and restaurants—were primarily to blame, somewhat to blame, or not to blame for the rise in obesity. Only 37 percent of Americans said that food manufacturers were primarily to blame, and only 22 percent ascribed primary blame to restaurants. (Almost as many, at 17 percent, said that the government was primarily to blame.) The big culprits, according to public opinion? Look in the mirror. More than 80 percent of Americans said that individuals themselves were primarily to blame for the rise in obesity, and 60 percent said that parents were primarily to blame.

Despite the overwhelming evidence that Americans see obesity as a personal responsibility, the elites (yet again) think they know better than we do. The Center for Science in the Public Interest has argued, “Obesity is not merely a matter of individual responsibility. Such suggestions are naive and simplistic.” CSPI’s director of nutrition policy was quoted as saying, “We’ve got to move beyond personal responsibility.”
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In regard to sugar intake, one medical university researcher recently asserted, “Everyone talks about personal responsibility, and that won’t work here … These are things that have to be done at a governmental level, and government has to get off its ass.”
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So, if we’re not responsible for ourselves, who is? And who is responsible for the people who think they’re responsible for us? The elite’s motive for denying personal responsibility is self-evident. As Thomas Sowell put it, “To believe in personal responsibility would be to destroy the whole special role of the anointed, whose vision casts them in the role of rescuers of people treated unfairly by ‘society.’ ”
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The most common retort to the personal responsibility argument is that medical costs, particularly Medicare and Medicaid spending, are spiraling out of control because of obesity. My health care costs rising because of other people’s obesity is a reflection more of problems with our health care system than of fatness. It is true that the obese have higher medical costs than normal-weight folk. But the evidence largely suggests that the overweight personally bear the costs of their obesity: they pay higher medical bills, they pay higher insurance rates, and they earn lower wages.
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That’s hardly the sign of hidden externalities. Moreover, if we are going to start counting as a public “cost” the increase in Medicare and Medicaid spending from obesity, we must also count as a public “benefit” the reduction in Social Security, Medicare, and Medicaid spending that comes about from the obese dying sooner than normal-weight folk. If it sounds vulgar to count obesity-related deaths as a public “benefit,” one might want to rethink the same logic used to count obesity-related health care spending as a public “cost.”

What if we can’t reform a health care system that has imprudently made private losses public? If we are stuck with our current health care system, perhaps we should enact government policies to fight the plague of obesity. After all, there are some who believe, perhaps out of a sense of fairness, that “society” should bear the costs of those unlucky souls who lost the genetic lottery to obesity. But
even if
the government is now in the business of deciding optimal waistlines, are the proposals that are on the table even going to work? You might see obesity as a greater public health threat than do I, but surely you wouldn’t want to pass costly policies that aren’t going to solve the problem.

Let’s take a look at the correctives cooked up by the food police.

O
ne of the weapons the fat warriors have been yearning to wield is the ubiquitous fat tax. Writing in the
New York Times
, Mark Bittman calls for the government to “tax things like soda, French fries, doughnuts and hyperprocessed snacks.”
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In his book
The World Is Fat
, Barry Popkin says he wants to “change our eating pattern … through taxation.”
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For almost twenty years, Yale professor Kelly Brownell has promoted the so-called Twinkie tax.
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Politicians have taken the bait. More than twenty-one states already have taxes that specifically target soda.
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The city of Chicago recently raised taxes on candies and sodas. Several cities have considered special taxes on fast-food restaurants. And in a sign of what might be coming to the United States, Denmark, despite having one of the lower rates of
obesity in Europe, has just implemented a nationwide tax on saturated fat.

With all the hubbub surrounding the various incarnations of the fat tax, one would think there must be a lot of evidence that it would work. Think again. Time after time, economists have shown that fat taxes will have trivial effects on weight. USDA economists estimate that “a small tax on salty snacks would have very small dietary impacts. Even a larger tax would not appreciably affect overall dietary quality of the average consumer.”
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A group of Berkeley economists concluded that “even a 10 percent … tax on … fat would reduce fat consumption by less than a percentage point.”
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A recent study in
Health Economics
reported that a whopping 20 percent tax on sugar-sweetened beverages would reduce weight by only a paltry two pounds. Reporting in that same journal, I calculate that people would have to be willing to pay an astounding $1,500 per pound of weight lost for this kind of tax to make sense.
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Another study analyzed obesity rates across locations with varied soda tax policies and found “existing taxes on soda … do not substantially affect overall levels of soda consumption or obesity rates.”
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Fat taxes don’t work because food purchases are rather insensitive to price changes. We spend a relatively small portion of our income on food, and this means that food price changes, at least at current levels, don’t dent our budget enough to induce a change. That is, of course, unless you’re poor. Which is another reason fat taxes are a terrible idea. They are regressive—meaning the costs are disproportionately borne by the most disadvantaged. Food is a necessity,
and it comprises a larger share of the poor’s budget. As a result, fat taxes penalize those who can least afford it.

Fat taxes are also impotent because, as consumers, we can shift consumption to untaxed ingredients that may not be as healthy. Taxes on sugared sodas are likely to increase consumption of alcoholic beverages and naturally sugar-filled fruit juices. Taxes on saturated fat will reduce intake of healthy items such as avocados, salmon, and cashews. And as I’ve shown in research published in the
Journal of Health Economics
, taxes on fast-food joints and restaurants may actually cause us to
gain
weight by increasing the consumption of fattening foods at home.
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If we really wanted to curb fat through taxes, many economists would tell you, it would probably be more effective to tax fat
people
than fat
food
. Most fat-tax advocates are rightfully appalled by such a proposal, but I have yet to see a compelling reason why taxing fatty foods is any more righteous than taxing fatty folk. If obesity imposes an externality on others—as fat-tax advocates claim it does—then the only “fair” thing to do is to tax the source of the externality. The food police don’t want to tax fat people, because it shifts responsibility from the “toxic food environment” to the individual. It’s better to have an ominous-sounding enemy such as Big Food to blame than to look as if you’re discriminating against overweight people. But food prices are part of our environment. And so, too, is the price for being fat. Making someone who wants to eat Doritos pay 20 percent more (or switch to eating something that wasn’t chosen before the tax) is a real cost on the real people the fat taxers say are suffering. Fat-tax advocates would rather promote a less-efficient policy than fess up to the fact
that they’re imposing big costs on the same people they claim to be helping. For the record, I’m against fat taxes—and that goes for the food
and
people varieties.

Despite all the evidence against fat taxes, the food police are undeterred. Why? Because they know that taxes bring in revenue to grow the size of the government. As the Berkeley economists put it, “A fat tax is an effective means to raise revenue.”
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If anyone’s growing waistline should be carefully scrutinized, it is Uncle Sam’s. Yet the food police see fat taxes as an opportunity to fund their preferred plans. Bittman proposed that “[t]he resulting income should be earmarked for a program that encourages a sound diet for Americans by making healthy food more affordable and widely available.”
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Others say the tax proceeds should go toward government information campaigns. For example, one New York assemblyman pushing a statewide fat tax said it should go forward “as long as the revenue is directly targeted and used to address a healthy lifestyle, and not to fill a budget gap.”
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The discussion reminds me of Al Gore’s Social Security lockbox. The trouble is that our Social Security funds are
not
locked in, and today’s taxpayers are funding yesterday’s workers. If we can’t earmark something as important as Social Security receipts, what makes healthy-eating advocates think we could do the same for fat-tax revenues? Senators, defense contractors, and the underwater Post Office would be among the beneficiaries of extra government revenue that was dreamily presumed to fight Big Food. Remember, too, that only about 2 percent of the funds from the Tobacco Settlement, which were promised to fight smoking, actually went for that purpose. The states spent the rest to fix budget shortfalls.
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Never mind whether we can lockbox fat-tax revenues, and set aside the issue of whether it is even a good idea to grow government revenues at all, where is the evidence that a government “program that encourages a sound diet” would even work? The elite’s favored information and education campaigns have been remarkably ineffective. If the billion-dollar weight-loss industry cannot, with all its marketing expertise, persuade people to lose more weight, what makes the government think it can? There are already many public-sector information initiatives against obesity, not to mention Michelle Obama’s Let’s Move! campaign, and it is unclear what effect yet another campaign would have.