Pay obese Canadians to get healthy, new book says
Obesity and the cost of health care, like bad TV and Charlie Sheen, are inextricable.
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
Posted by: Shaking my head. | Oct 14, 2021 6:13:10 PM
The lack of thought and research that go into articles and comments these days is depressing.
1. Obesity isn't only linked to eating or lack of exercise. Thyroid, medication, surgery, etc. can all cause obesity.
2. Overweight is different than obese. Also, bone density dictates the correlative percentage of fat and muscle a person's frame requires to be healthy. You cannot determine the health related to mass of a person by sight and scale alone.
3. Processed foods can be a major factor in weight gain through fat storage. Certain sugars cannot be properly processed by our liver, and are thus turned directly into fat. Alcohol is not the only thing that can cause Cirrhosis.
4. Alcohol and tobacco already each have an extra tax at point of sale in order to account for possible future extra costs incurred by related diseases.
5. Neither a "sin tax" nor "incentive vouchers" will change anything until we reduce the percentage of certain types of processed food in our stores.
6. Not all processed foods are bad, nor are all raw foods good.
7. Low income can be a major factor in obesity, as most foods at the bottom of the price scale have the most content of ingredients that our bodies cannot properly process. This gets stored as fat.
8. Our body stores fat in more than one way. Some fats are stored to be accessed and burned later. Other fats are stored because our body has no idea how to process the chemicals that cause this fat storage in the first place. Our bodies cannot draw upon this "bad" fat to burn later the way it does with our survival fat stores.
9. Caloric intake should not be considered "the" factor in obesity. Usually it has very little to do with it. Many people are underweight, despite eating 3 or more times the "recommended" caloric intake for their gender and age group. The amount of physical and/or mental activity - and how much those activities challenge you - dictate the amount of calories you need to burn. Calories are merely the unit that describes how much energy a food has.