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July 18, 2021

Pay obese Canadians to get healthy, new book says

Obesity and the cost of health care, like bad TV and Charlie Sheen, are inextricable.

1352387_pink_donuts_series In Canada, at least, with our public medical coverage, they are direct rivals. So we experiment, most notably with “sin taxes": charge obese people more for choosing  to be obese, because the whole country has to pay for their future health care expenses.

And so it’s gone, rather unsuccessfully, the decades-long fight to curb obesity. We’ve tried large-scale cultural movements – public education campaigns, for instance – but never have we taken healthy living awareness directly to the individual.

So, meet the obesity voucher.

That’s the proposal by two Massey College (University of Toronto) fellows, Neil Seeman and Patrick Luciani. In their new book, XXL: Obesity and the Limits of Shame, the two scholars suggest a scrap of the conventional methods used to reduce overweight Canadians (ie. public education) and a move to what they call “healthy living vouchers.”

By their pitch, healthy living vouchers would reward Canadians for a number of pro-fitness behaviours, such as buying health-related foods and gym memberships. Participants would work with their doctors and health care providers to keep tabs on their goal of long-term weight reduction. (More details here.)

Dollar figures aren’t mentioned too much in the book’s rundown on the U of T magazine page, but the vouchers could result in the transfer of “hundreds or possibly thousands of dollars to every Canadian,” says the site. Seeman and Luciani propose allocating between two and four per cent of Canada’s $230 billion annual health budget to the voucher program, which would be available to anyone over 16, not just lower-income Canucks or those already obese.

“If your neighbour’s fat you pay for it anyway, in terms of lost productivity and higher health care costs,” Luciani argued on CNBC last week. “So putting our vouchers out there or subsidizing some programs might actually be a cheaper alternative than leaving the problem alone.”

It’s a proactive, solid argument – engage obese people, however way you can, from the get-go as a means to save on crippling health care costs in the future – but my, could you imagine the uproar if such a program was ever implemented?

Critics have already slapped the healthy living voucher program with the, “Why should we pay fat people to be skinny?” tag, however unfair it may be. In my view, the healthy living voucher idea would be akin to handing out clean needles and condoms in neighbourhoods with high drug rates and active prostitution. Yes, you may be saving money (and lives) in the long-term, but you’re also, in the minds of some, advocating such behaviour in the short-term, a big no-no to many conservative societies.

What do you think? Do you think healthy living vouchers, which would aim to “attack the problem (of obesity) at the individual level instead of using population-based approaches,” in the words of Seeman, would work, or would they set a nasty precedent of paying Canadians for their perceived misbehaviours?

By Jason Buckland, MSN Money



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Gordon PowersGordon Powers

A long-time fund company executive, Gordon Powers now heads up the Affinity Group, a financial services consulting firm. Gordon was a personal finance columnist for the Globe & Mail for many years, has taught retirement planning...

Jason BucklandJason Buckland

The modern-day MC Hammer of money, Jason can often be seen spending cash that isn’t his with the efficiency of a Wilt Chamberlain first date. After cutting his teeth as a reporter for the Toronto Sun, he joined the MSN Money team with...