Saturday, 27 August 2011

Obesity and the Food Tax

It has been one of the biggest dilemmas since they found out smoking is actually really bad for you. What do you do about people choosing deliberately unhealthy lifestyles, who then burden everyone, even those who look after themselves, by costing the NHS a lot of money?

With the announcement this week that 40% of British adults are expected to be obese by 2030 this problem is bigger than ever. No pun intended.

What has been proposed is a tax on "unhealthy" food similar to taxes on cigarettes. But herein lies the problem. Eating is not the same as smoking, for several reasons.

Firstly, the vast majority of smokers are regular smokers, due to the additive nature of nicotine. This means that when you put a very high tax on cigarettes, you generally punish people who are putting their health at risk. This isn't the same with food. Everyone enjoys foods that have a high calorie content or that are high in fat sometimes, and there is absolutely nothing wrong with eating these things in moderation, or not in moderation if one does sufficient exercise or has a naturally high metabolism, so by putting a high tax on them you are punishing everyone, not just those who eat specific types of food in excess.

Another argument often used against smokers is the dangers associated to passive smoking, which creates health problems associated with smoking to people who aren't bringing it upon themselves. It's impossible to passive eat (unless you're being fed intravenously, I suppose), making it a self-regarding action on which imposition is much harder to justify.

It is also enormously difficult to define what constitutes an unhealthy food. On the clich├ęd news report I just watched on this they showed footage of chips and burgers in a similar way to someone who advocates the death penalty citing Hitler or Saddam Hussein as an example. What is more difficult to assess is, for example, a ready meal which includes some vegetables but also has high salt content, or dairy products, which are high in fat, but can also be an excellent source of calcium and are often crucial to vegetarian diets. Furthermore, if we try and price the poor out of buying typically "unhealthy" foods, but don't put any effort into educating people, it's likely that they will continue to consume the same foods anyway. Fast food takeaways and ready meals already work out more expensive than home made food and fresh fruit and vegetables. The problem is to do with education and culture, not price.

This brings me on to another point. Those who support measures to try and change the way people consume to make them healthier are generally (but not always) on the left, and are similar voices to those who oppose indirect taxation for impacting on the poor to a greater extent than on the rich. However, taxes on food or cigarettes or alcohol do the very same thing, effectively saying it's fine to be unhealthy as long as you can afford it.

So what is the solution? The answer is, there is no easy solution, which is why we end up with bad ideas like taxing "unhealthy" food. A lot of it has to come from education. I'm a firm believer that parents should have to take responsibility for teaching their children about things like nutrition and cooking and that it shouldn't be the job of the education system. However, we now live in a culture where an alarming number of parents clearly don't share this view, needless to say that many don't have that knowledge themselves so are unable to pass it on. Education appears to be the only way to change people's habits without hiking up taxes in strange places. I also feel I should point out that I was not a fan of the awful and patronising "Change 4 Life" campaign that was mercifully ended just over a year ago.

Changing the laws on advertising junk food to children may also help. It's much harder to tell adults what to eat in a liberal society, but the need to guide children's decision making is much more widely accepted, and if children learn about healthy eating, they are more likely to stay in good habits late in life.

But education will only work in the longer term. The problem facing us immediately is one that cannot be fixed in schools. Changes in lifestyle are resulting in greater pressure on our health services which costs everyone, not just those who choose to keep in a bad state of health. I think that a solution to this would be a kind of health MOT. Every couple of years everyone should have to have a brief health check-up on general health and fitness. People who are obese, or heavy smokers or drinkers, should be given time and support to improve their health or face being automatically placed at the bottom of NHS waiting lists. Those who are consistently in a good state of health should have to go less often. This scheme would probably (this is a big assumption) save the NHS money as people seeing a doctor regularly would result in early diagnosis diseases, and the improvement of the health of the general population as a result of the support and education they would receive would also be in the long term financial interests of the NHS.

This probably sounds a bit too radical and is no doubt full of flaws, but we have a big problem in this country, and making people pay more for for foods which the majority enjoy responsibly seems to be difficult, unfair, and quite probably ineffective.