Who Else Wants to Tax Fat People?

Wow. Talk about being cranky this morning. Here’s the story. I managed to run 10 miles over the weekend. Did five on the concrete Saturday and another five on the towpath trail near where I live Sunday. This morning my foot hurt so bad — chronic nerve inflammation — that I could barely stumble out of the house and make it to the health club for an engaging 50 minutes of gliding on the elliptical trainer. Oh, mama.

Yet I learned something. Prez O and gang appear to be giving up on the so-called public option that once was a centerpiece of the health care reform package. That proposal had and has strong supporters inside the Beltway. But it’s not playing so well out in the real world. And I’m not sure why. We already have a large public option provider. It’s called Medicare (and Medicaid as well). And I’m sure it can be improved. But my sense is that for most seniors (myself included in a little more than three years) it works well.

So there are a couple problems facing the administration and the Dems in Congress in the current debate about health care. First, they have lost control of the message. Here’s what the opponents are saying. One, the plan takes away choice and will lead to government control of health care. Two, it’s expensive — and the winners in all this will be the lobbyists and special-interest groups. Three, do you really want Grandma hauled before a “death panel” that may place some limits on the time left in the golden years? Sheesh.

Those are the points that I hear over and over again. And they are sticking. Factual or not.

On the other hand, any idea what the administration and Congress are actually proposing? That’s the more difficult position — talking about what it is versus what it ain’t. And it’s a lesson for all of us in the communications business. It’s tough to gain understanding and acceptance for complex issues. And in an environment of uncertainty, people will resist change. For those of you with a background in employee communications, think about how hard it is to explain health care plans and coverage. And remember years ago when we first started to talk about deductibles and co-payments?

So here’s my plan for the Prez and his supporters. Change the argument. Get away from telling people that you plan isn’t about sending Grandma before a death panel. And tell them that a big part of the solution — from reducing the need for medical services to costs for health care — relates to preventing illness in the first place.

And as a start: tax fat people.

Crazy? Unfair? Well, I thought so too — until I read this article in The New York Times, “Should Fat People Pay More for Health Care?” The article, in part, focuses on the views of Delos M. Cosgrove, CEO at the Cleveland Clinic. Here’s part of the story:

You can disagree with the doctor — you can even be offended — and still come to see that there is a larger point behind his tough-love approach. The debate over health care reform has so far revolved around how insurers, drug companies, doctors, nurses and government technocrats might be persuaded to change their behavior. And for the sake of the economy and the federal budget, they do need to change their behavior. But there has been far less discussion about how the rest of us might also change our behavior. It’s as if we have little responsibility for our own health. We instead outsource it to something called the health care system.

The promise of that system is undeniably alluring: whatever your ailment, a pill or a procedure will fix it. Yet the promise hasn’t been kept. For all the miracles that modern medicine really does perform, it is not the primary determinant of most people’s health. J. Michael McGinnis, a senior scholar at the Institute of Medicine, has estimated that only 10 percent of early deaths are the result of substandard medical care. About 20 percent stem from social and physical environments, and 30 percent from genetics. The biggest contributor, at 40 percent, is behavior.

Today, the great American public-health problem is indeed obesity. 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. As a convenient point of reference, a typical car tire weighs 20 pounds.

I’m sure that “taxing fat people” is an idea that won’t fly for a host of reasons. But I do believe there should be some serious discussion about health and preventing illness — and about obesity in this country which is a major health and economic issue.

As someone who is both old and overweight, I would much rather go before a “fat board” than a “death panel.”

And the notion of a fat tax has already generated some advertising. According to USA Today, the American Beverage Association has uncorked a $2 million campaign to oppose a tax on sugar-sweetened drinks. That trial balloon has been floated in Congress and elsewhere. But it’s not part of any specific proposed legislation — as yet.

Stay thirsty, my friends.


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