THE BLOG
04/02/2013 08:14 am ET Updated Jun 02, 2013

We Don't Need a Nanny State: Just Pay Your Way

America has a long heritage of freedom and letting people find their own ways to do the right things. We all remember Patrick Henry's "Give me Liberty or give me death" cry, before the revolution. So as the brouhaha about Bloomberg's proposed size limit on soda size flies, it's time to suggest an alternative to government prohibitions.

We have a tradition in this country of how to deal with people who make poor choices: we tax it rather than actually prohibiting the behavior. Why don't we prohibit it? Well, take a look at prohibition itself and how well that worked. So rather than solve the problem, we tax it -- and we then use the taxes to cover the costs of these poor choices. This is what the U.S. has done for alcohol, cigarettes and gas. You can do what you choose, but you at least help cover the costs and pay your way.

Why do we need a tax? The simplest thing is to do nothing, and just accept the fact that in the last 25 years alone, obesity rates have tripled to now affect one third of Americans (and the situation is on a path to still get worse). There's a small problem here, however: hordes of people are getting sick as a result of these very poor lifestyle choices and costing the U.S. hundreds of billions of dollars -- and healthy people who are still able to work are being asked to pay for it.

You may not think so, but they are -- and here's just one example. Common healthcare costs related to obesity, including diabetes type II treatment, cancer and heart disease, are usually tens of thousands of dollars per year, and often $100,000 or more per year. Let's say these costs hit you, as they often do, in your sixties and Medicare pays for them. Well you probably haven't paid in nearly enough to cover them. If you have earned $50,000 a year (above the U.S. median income)> for 20 years, then you and your employer will have paid a total of less than $29,000 in Medicare to cover your costs in total or about enough to keep you healthy and alive for one year, not for the rest of your life. Others who are able to work and are working hard to be healthy are being asked by you to pay your bills for the rest of your life.

What should we do about this? Is it fair to ask those who work at being healthy and making healthy lifestyle choices to fund those who just don't care? Is Mississippi right? Indeed, given that Mississippi doesn't pay more in Medicare withholdings than the rest of the country, do they have the effective right to do this to the rest of the country, especially states with relatively good health like Colorado?

Doing the math. What would a fair tax be? Let's do the math. A low estimate is that $200 billion is at least the annual healthcare cost to this country, due to all of the super-sized Happy Meals, Big-Gulps and deep-fried Twinkies, as well as all of the other foods loaded with trans fats or excess sodium. Note that it could really cost much more. The Harvard School of Public Medicine suggests that 20.6 percent of our healthcare costs are obesity related and doing the math, 20.6 percent of $2.7 trillion per year is about $500 billion. Reasonable people can disagree here but since either way it is hundreds of billions of dollars a year in additional healthcare costs so this is close enough. About one third of this country is obese (more in Mississippi), which is about 100 million people in the U.S. overall. That means that roughly 100 million people a day choose food that will, if only because of its volume in calories, make them sick over the long-term. If you continue to do the math, that's just fewer than 40 billion poor food choices each year, more or less.

Thus, unhealthy eating and voluntary obesity is costing the U.S. at least $5 per sale or more. That's right, $200 billion divided by 40 billion is approximately $5 per meal in imputed health care costs required to pay for the consequences. As it stands, those who make healthy choices and exercise self-discipline are being asked to subsidize the massive costs of those who do not. This is the morality of moochers. Do we want the hard working to pay for the moochers?

Instead let's ask those who choose an unhealthy lifestyle to pay their way as they go. Any sale of any meal that is twice the amount of sugar you need (call it 300 calories or more) or twice the fat or sodium you need or that is over 1,500 calories each day (almost the total calories you should have for an entire day) should have a tax of at least $5 and arguably as much as $10. Isn't that fair? Now you aren't bankrupting your neighbors and healthy friends, and destroying the competitive economy here with unhealthy behaviors; you're paying as you go. Yes, if you choose to inundate yourself with sugar or calories, you will pay an extra $1,500 per year or so but coincidentally, that's about the incremental average cost of treating the obese overall.

You have a choice my friend. Which choice will you pick?