Obesity and Health Care

Great Debates
1

Looking at Japan and the US, which are respectively the countries with the lowest and highest obesity rates, and also noticing that Japan had nearly the highest lifespan of all nations in the world where the US has a non-impressive value although we spend the most on health care per nation, it seemed worth studying the relationship between these various values.

Firstly, here is a plot of the amount spent per individual versus the average lifespan of that nation. As you can see, there’s quite a bit of a diminishing return over $1000 per year. There is a rather obvious relationship though.

Now, here is a comparison of the percentage of the population that is obese versus the average lifespan. The relationship here is much less strong. Japan is in the upper left, the US on the far right.

Now, theoretically, if the percentage of obese people in the nation has a particular link to the average lifespan removing that difference should make the graph of health spending to lifespan a smoother curve. It should reduce overall noise.

My first guesstimate (by eyeballing the graph) was that there’s something like an average of a 0.3 year loss of lifespan per 1 percentage of obesity, but on applying this correction to the spending graph, the results weren’t pretty. Figuring that the spend-light countries were messing me up, I then tried drawing a line straight from Japan to the US, which is about a 0.167 year loss of life. Again, applying this to the spending graph, the results were more jumbled than before. Looking at the original spending graph, I figured that if the US has “average” health care based on where it should be based on spending, it would be about 2 years higher. To achieve that, I’d need to apply a 0.067 year loss of life due to obesity. The result of that transform is below:

Overall, this does seem to make there be fewer outliers. Looking at the obesity percentage graph, the 0.067 rate of decline seems to be a line which follows the top of the scatter. Perhaps that makes sense?

Well so, assuming that we should trust that–that the “corrected” graph is more accurate than it was pre-correction–then overall we could expect up to a two year increase in overall national lifespan by reducing obesity. And either way it seems likely that spending more than ~$1500 per year per person on health care is mostly wasted.

A food tax (for instance, one which was based on calories per volume) would likely be profitable for the government, and would probably be the most surefire way to reduce the national rate of obesity.

http://www.nationmaster.com/graph/hea_obe-health-obesity
http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person

2

Is it? I’d like to see evidence that rates of obesity go down in times of higher food prices before advocating such a policy. Is there any such evidence?

3

One possible argument to the contrary: From what I’ve heard (sorry, no cite), average food prices are higher in, say, the UK than in France or Spain, but obesity levels are also higher in the UK. Higher food costs don’t necessarily mean less obesity.

4

The poor in America are more obese than the wealthy. They can not afford to be selective. They buy in quantity and can not be picky.

5

Perhaps the best evidence would be that it’s been falling food prices over the last couple of decades that have brought us to the modern problem of obesity. But I would indeed need to search for any actual research on that point.

But I don’t see any argument against the idea that at X tipping point, food cost becomes prohibitive. What X may be is unknown but it can certainly be achieved.

A) I advocated a targeted tax, not an overall tax. Items of a lower calorie-per-volume rating could have their prices reduced, for instance.
B) Having to stretch their bulk purchases to last longer would be equivalent to eating smaller portions.

So unless you’re worried that people will somehow jump all the way from obese to famine, I don’t see how your point is an argument against the idea. Obviously, excessive taxation would have that result, but why would anyone do that?

6

Would this tax apply to food shelves? I also assume that foods like baby formula, which have a high calorie-per-volume rating, would not have this tax applied. And would peple using food stamps have to pay this tax?

Regards,
Shodan

7

Why not tax just junk food? No one needs soda, potato chips, and candy, as these are generally empty calories. But it is possible to have nutritious foods that are calorie dense, like whole wheat breads.

8

So fruits, vegetables and meat are more “fattening” than cheezypoofs and potato chips? Cartman would approve.

9

It’s a terrible idea. High calorie foods are so cheap (McDonalds dollar menu, for example, which I assume already has a state sales tax applied), that to be meaningful, any tax would have to be huge. And if its prohibitive for the middle class, then it’s going to end up meaning either starving the poor or building in a bunch of complicated exceptions for them.

And from your post, I’m not even sure what the benefits are supposed to be. Your graph seems to show that there might be some correlation with lifespan, but there’s so much scatter it’s obvious that there are enough confounding effects that lowering obesity could not make much difference. Your basically proposing a huge, very likely ineffective gov’t program to enact a change that may, but quite possibly won’t, bludgeon people out of behaviors that may or may not be causing them to die slightly earlier, which is at least arguably, not really the responsibility of the gov’t in any case.

10

When food prices go up, poor people resort to calorie-dense processed foods in order to get by. Mac and cheese is much cheaper than lean chicken or fish.

thus, when prices go up, or when people become poor, obesity actually rises.

A tax on processed foods, which was then used to subsidize fresh veggies and whole grain foods, would counteract this.

11

That is the biggest and nastiest myth anyone has ever put forth. You don’t have to eat TV dinners to eat cheaply. I can make shrimp stir fry for about $ 6 per person and it takes all of about 20 minutes to prepare.

I had breakfast at McDonald’s today and I am about 40 pounds overweight, but I know why I am overweight, because I love rich foods and drink lots of soda. Put the Coke and the Beer down and you’ll weigh a whole lot less.

God I hate this superstition so much.

12

Since a lack of exercise is, I believe, much more likely to be the culprit in the higher obesity rates, why not have the government round up people over a certain BMI rating, put them on chain gangs and force them to jog everyday? That would be every bit as sensible as what you’re suggesting.

13

The OP isn’t sensible, but we have a crisis in healthcare and to fix it we need to get away from the sense of entitlement that tells us we can live any lifestyle we want and just expect the Doctor to fix it.

Seriously, Soda and Beer are probably a huge portion of our obesity causes. I know lots of people who will not drink just plain old water. When I cut down on soda and beer I can literally feel myself losing weight.

And yes, 20 minutes of exercise daily would cut down on our obesity rates drastically. As it is we are a country that will not walk half a mile to the 7-11, it’s sick, it’s a pathology, and we need to stop treating it as a legitimate lifestyle choice.

A sin tax on calories however, is a ridiculous proposition.

Here in NYC, people are a lot less often fat than anywhere else because we walk everywhere. If cities were planned around city centers and walking around plazas, people would be much thinner and we’d reduce our fossil fuel dependency greatly.

14

I love the idea. If a pint of Ben & Jerry’s were 20 bucks, ice cream might go back to “special treat” status and people might actually get four portions out of a pint.
Make candy bars five bucks apiece. Make a 12-pack of Coke 30 bucks. Raise the price enough that it’s something you think about and have to decide if it’s worth it.

And then make a head of lettuce cost a dime. Maybe even give them away for free. Make it so you could load up your cart with more vegetables than you can carry…for five bucks. Free to people on food stamps.

Of course it’d never happen, for a million reasons, but it’s a good mental exercise to think about how much your food is actually costing your body and to treat it accordingly.

15

It’s not a matter of what you eat but how much. I would put my body up against anyone’s here and I eat junk and am just fine. It’s all about calories not the kind of food you eat, as long as you get the minimum protein, carbs and fats required, any extra can come from any source.

People are always shocked at how can you eat cookies, and chips and stuff and look like you do. I tell them I just don’t eat a lot, when I hit 1800 calories in a day, I STOP eating.

Also Japan is also a relative homogeneous society. There could very well be a racial (or ethnic or whatever you want to call it) element. America is made up of all sorts of people. To be fair you need to only compare Japanese-Americans with Japanese from Japan. Then you should compare poor Japanese Americans to Rich Japanese Americans. And do the same with Japanese from Japan. Then compare the graphs.

I do agree food is cheap, at least fatty food is. I go to the store and simple thing like Mayo is on sale but the fat free version (OK it’s not very good but it’s only 10 -15 calories per serving versus 100+ for regular mayo) is rarely on sale.

The lean meat is easily 50% more than fatty meat. Also studies in buying in bulk show that it doesn’t usually work 'cause people start out well meaning but wind up eating MORE of it.

I’m the same way. If there is food in the house, I’ll eat it, but if I don’t keep food in the house, I’m too lazy to go get any extra.

I am totally against a food tax in any form, simply because well it’s a basic need.

16

I’m always amazed that so many people steadfastly believe that the government can fix issues such as obesity. Over the past century or so, the government has gotten more and more involved in food. First came official dietary guidelines, then subsidies, then labeling requirements, public health campaigns, then legal restrictions on school lunches, and now we’re seeing the first total bans. The result of all this is clear. Americans have gotten fatter and fatter. (One possible reason is what I suggested in my recent IMHO thread, that as the government gives more advice, people start ignoring their own good sense and taking the government’s advice. Unfortunately the government’s advice is always bad.)

The bottom line on food is that it’s always a personal choice. If I choose to eat unhealthy things, that’s my choice. If my health suffers as a result, that’s the consequence of my decisions. The government should not have any role in that. I do agree that food companies should be required to tell the truth about what’s in their products, but that’s where the government’s role should end. More government involvement will lead to worse decisions, not better ones.

17

And that’s an expensive stirfry.

I’m into frugal cooking. Dinner last night was avocado chicken salad. Around $1.25 per person.

18

Um, the flirt threads are over in MPSIMS. :wink:

True, but obesity has much more definite negative health impacts than just its effect on lifespan.

I tend to agree that an obesity-targeted food tax of any kind is probably unworkable, but I think it’s fair to argue that society as a whole does have a responsibility to try to reduce the incidence of costly “lifestyle diseases” such as obesity somehow.

19

I didn’t quite do that, but actually I found a source last night which split up the lifespan of Americans by race. Asian Americans have an average lifespan of 84, where Caucasians only get to 78. This is possibly evidence that they’re just genetically more long-living. (Though it could be a factor of income distribution. I’d need to look that up.)

20

Figure that the Libertarian argument is that there shouldn’t be social security or medicaid or any of these things because individuals should be allowed to make their own choices and sleep in the bed of their own making. Everybody who’s reasonable, though, says that you have to look at reality, and the reality is that people are stupid, don’t set up plans for their future, don’t enroll in insurance plans, etc. unless the government or their place employment set it up for them and don’t give them a choice about joining.

The government, by most reasonable people’s standards, exists to counteract and correct mass stupidity. Their job is to fix problems that effect all of us.

What’s the difference exactly between removing more money from people’s pockets to pay for more health care–and thus giving them less money to spend on food–or simply making food cost more? If I can balance out the cost of foods towards healthier foods at smaller portions such that people are eating healthy, proper portions, and spending no more nor no less than they were before, then really I’m getting a free result. I’ll increase the average lifespan of America by two years for no cost to myself outside or the tax payer.