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Good Is Good: Is It Time For An Obesity Tax?

Friday, December 14, 2012


Tom Matlack is the former CFO of the Providence Journal and is the founder of The Good Men Project, a non-profit charitable corporation based in Rhode Island and dedicated to helping organizations that provide educational, social, financial, and legal support to men and boys at risk.

Sunday morning I was watching the ABC national news.  I would prefer to keep my head in the sand but my wife likes to know what is going on in the world for some reason. One of the lead stories caught my attention for its stupidity. A bar somewhere in the SouthWest had been serving three obese women and the bar tender had entered into his computer the words “Fat Girls” on their check as a way to keep track of who they were.  Apparently it was for his eyes only but he forgot to erase it before handing them their bill.  The women were very upset–”scarred” in the words of the crack ABC reporter who provided footage of the bar manager being interviewed, the FB comment from the bar owner, and the first person testimony from the ladies in question with tears running down their quite full faces.

I watched the story and just asked myself what the heck? Is this really even a news story?

As luck would have it a few hours later I was at a neighborhood Christmas party.  I live in the “Longwood” section of Brookline which is literally a stone’s throw from the most prestigious cluster of hospitals and medical research facilities in the world. As usual I was awkwardly holding my diet coke as my wife socialized with ease.  I found myself standing with an older gentleman in a bow tie and 60s era black-rimmed glasses who I had seen at church but never spoken to.  He asked me a few questions about where I lived and what I did and then I asked him what his line of work might be.  He allowed that he was the head of cardiology at one of the best known hospitals in the world.

“But I will never see you at my practice,” he said quickly.  I asked why.  ”Because you are not obese,” he responded.

What followed was a fascinating, if troubling discourse on medicine and our health care system that I can’t say that I fully understood but certainly caught my attention.

“I’m from Texas,” Mr. BowTie said. “Back in the day you had a heart attack and you died. Now we have all these drugs to keep people alive for years and years, wheeling them around in chairs and replacing their knees and all kinds of crazy stuff when the whole problem is a self-induced one to begin with.”

Mr. BowTie proceeded to tell me that indeed heart disease can be caused by a family history. But what use to be the norm is now a tiny fraction of the cases he sees.  ”All I treat now are morbidly obese people whose hearts give out,” he said.  ”And then we keep those obese people, more men than women mind you, alive forever at huge cost to everyone in the health care system.”

I thought back to John Stewart’s debate on the Daily Show with Chris Christie of New Jersey over Obamacare when he talked about the working mother with cancer and no coverage being just as much of an emergency as the victims of Sandy.  The thought crossed my mind for just an instant, even as a bleeding-hearted liberal democrat, maybe that is a false comparison based on what this guy is telling me.

Pretty soon my little Christmas party chat became an all-out discussion of national health care policy.  ”One third of the health care costs in this country are directly or indirectly caused obesity,” he claimed.  ”And that number is going down.”  I later sought to confirm that number and found a bunch of lower estimates online.  But even the ones put out by places like the national institute of health are alarmingly high. And no one seems to refute the idea that the percentage of our national health care dollar going to care for the obese is growing.  And growing quickly.

“What we need to do is force every citizen to pay for health care premiums based on their BMI,” he concluded.  ”It’s the only fair way to force the issue.  Make people who consume more of the resources pay for it and hopefully incent people to grapple with the magnitude of this issue.”

I had to admit that between the fiscal cliff, global warming, and war in the Middle East, I really hadn’t been focussed on the impact of obesity on us as a people.  But Mr. Bowtie made a lot of sense as far as a complete non-expert could tell.

What do you think?

For more of Tom's works, as well as other pieces on related topics, go to The Good Men Project Magazine online, here.


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