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| May | 27 |
| 2004 |
The coverage of the ‘obesity epidemic’, which has dominated the newspapers and radio this morning, misses the point completely. It’s not, as the coverage suggests, a problem for the NHS and government to deal with. It’s a problem which is caused by the NHS and government.
Yes, it’s right to be worried at yet another example of the ‘nanny state’: what possible business is it of government if I want to eat doughnuts for breakfast, lunch and dinner? If I eat stupid food and get fat, it’s not Krispy Kreme’s fault for making such heavenly doughnuts. It’s mine alone.
And that’s what I used to do, until I realised – I realised, not the government or the NHS – that I needed to lose weight or have a heart attack or diabetes. So I did and lost 4 stone. No one - other than the tiny number with a relevant medical condition - needs to be overweight. It is entirely a matter of personal choice. Rich or poor alike, we all have choices, and it is up to us how we excercise them. Eat too much and you'll end up a porker - and you alone are to be blame. Not McDonalds, not Mars, not Pizza Hut. You.
But the real issue is not the nanny state but the NHS. In a health system paid for by the government then, yes, it is the government’s business what I eat, since my obesity costs money.
The problem is that we have things the wrong way round, and that leads directly to the obesity epidemic. Although it is my responsibility what I eat (and as for the 3 year old girl who died of heart failure, whose fault is that but the parents?) the NHS system of taxpayer funding blunts the critical element of individual responsibility.
In a system where it wasn’t the state which funded healthcare but individuals, whether through insurance, medical savings accounts or another method (when people have, in other words, direct control of their health care funding) then people have an incentive to look after themselves.
That’s why obesity is so much less of a problem on the continent, where healthcare is insurance-based. (And as for the US, obesity is primarily a problem for the poor, and they are covered by the state funded Medicare, which has a similar impact on incentives as the NHS.)
So the solution is not to impose rules which deaden the role of individual responsibility even more by restricting our right to eat what we want, but to construct a health system where the incentives point to taking responsibility for our own health.
MessageSpace
'what possible business is it of government if I want to eat doughnuts for breakfast, lunch and dinner? If I eat stupid food and get fat, it’s not Krispy Kreme’s fault for making such heavenly doughnuts. It’s mine alone'
That's how we use to think about tobacco.
Substitute the relevant words above for 'cigarettes' and 'Marlboro' etc and, depressingly, all of a sudden you can see into the future.
Enjoy those doughnuts -tax free- while you can.
Yoy, there are a couple of rather glaring differences between the fast food and tobacco industries. First off, and one would think rather obviously, no one NEEDS to smoke, but food in some form is an essential of life: don't smoke and you get healthier; don't eat and you die. Of course, there are vastly better alternatives to fast food, but fast food is certainly a far sight better than starvation. Fast food may not be healthy, but it's cheap and convenient. It's a consumer choice to be made based on individual priorities, just as Stephen said.
This ties into the second point: fast food, unlike tobacco, is not addictive. The tobacco companies have a captive market, since what they sell is a severely addictive drug, comparable to heroin in its difficulty to quit. Someone claiming to be addicted to Big Macs or whatever just doesn't pass the laugh test.
DaveJ
I am not sure of the point you are making because I am agreeing with Stephen and just predicting what may happen in the next few years.
I am lamenting the fact that the thought police have now directed their aim at fast food as once they did tobacco.
The differences between the industries are irrelevant compared to their similarity.
The Govt sees how much money there is in fast food and wants a cut of it.
It will do this by imposing a tax on its consumption and couching it in terms of public health concerns.
''It's a consumer choice to be made based on individual priorities, just as Stephen said. ''
Absolutely. As was once tobacco.
Krispy Kreme has just posted its first loss. McDonald's is advertising low-salt Chicken Nuggets for kids and salads for career women. Be afraid, be very afraid. By 2010 fish and chips will have gone underground.
You know, looking back at your comment, it seems completely obvious that I got your position 180 degrees wrong, yoy, so apologies for rambling. Having dealt with these issues in the US, I think the public here sees the differences more than the similarities and simply wouldn't stand for it being treated the same way as tobacco, which has a small enough market share of the consumer that it can make a much better scapegoat in a way that fast food couldn't be. But you're probably also right how it'll be treated in the UK: the "mustn't grumble" relative indifference of the British public to practically anything has always boggled my mind.
I don't think obesity has much to do with whether healthcare is privatized or not.
Here in Kansas there are plenty of people who are very, very fat and who have private health insurance. It is not only the poor who are obese in America.
I think the problem is more along the lines of a sudden environmental change. Our bodies evolved in situations where acquiring sufficient calories and nutrition were rather urgent matters, but today all manner of gastronomic delights are instantaneously available to us. The human urge to eat is too strong for an organism that has such easy access to food.
No doubt we'll learn to deal with it but in the meantime we have created a generation of fatties.
So how, precisely, does this system of "individual responsibility work"? I presume we can't really decide precisely which illnesses are the individual's fault and which aren't. All the things which can be caused by obesity can also just happen by chance, and thin people can lead unhealthy lifestyles, too. I guess everything will have to work on the basis of "well, if you don't deserve it it's just tough!" As if life's not enough like that already. Just to use an example, a close relative of mine has never been able to work due to severe schizophrenia and the drugs he takes have made him obese. How would we work that one out? Since the chronically ill who have never worked will be least likely to have good health insurance, and more likely to lead "unhealthy" lives, does this mean we just ignore them? So we just abdicate any sense of responsibility towards fellow human beings? I'm just not in favour of having an underclass of poor, sick, badly-cared-for people who just don't make the master race (sorry, "individual responsibility") grade.
RR, you do not demolish Stephen's argument by pointing out a special case - one of a fairly small number I would imagine - where an unrelated health problem has caused obesity.
I am sorry for your relative, whose condition is undoubtedly unpleasant (though perhaps less unpleasant than the alternative(s), otherwise why are they taking the pills or whatever?), but it has nothing to do with overweight in the general population.
That occurs because people don't care what they look and feel like.
Whether that is really because the State will (pretend to) look after their health, I have no idea: it seems plausible, but I think laziness more likely.
In either case, it's nothing to do with the Government, who should imho abolish the FSA and get out of the preaching business.
I completely agree with you Stephen, and while I feel terrible for the parents of the 3 year old who died from being fat, I do not understand why the police arent investigating them on a charge of manslaughter or at least negligence. We have a 5 year old and we watch his diet like a hawk - mostly because I am myself overweight (although now 3 stone less than before and reducing every day!). A child's intake is the responsibility of the parents - period. If the child is fat, it is the parent's fault - not the school, not the government, not society, not McDonald's. If parents want to know that their 14 year old is having an abortion, then they need to take responsibility for what they had for lunch as well.
This really is the weakest argument I've seen you advance so far, Stephen. What is your evidence that people make dietary decisions based on the type of health coverage that they have? I very much doubt that there is any credible research to support your claim. This is an extremely spurious way to justify your existing views on health policy.
Hey, Can't people who think like me that the NHS is totally immoral, badly run, and counter-productive to health maintenance opt out and take MY money elsewhere including the tax?
Those who want to keep the National Illness Encouragement system can do so, But I WANT OUT!
I think obesity may be overcome by proper nutrition, healthy living and good eating habits. Proper nutrition is an important factor in maintaining proper body weight because essential nutrients are critical for burning fat and removing carbohydrates from the body.