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With all the talk about healthcare in Washington, few people are willing to discuss one of the factors driving up costs nationwide: Americans are fat. Which is odd because even President Barack Obama noted in his campaign that if we returned to the obesity levels of 1980 it would save Medicare $1 trillion. According to a recently published study in the New England Journal of Medicine, in ten years, half the nation will be obese. I don’t know why anyone is surprised, you can pretty much watch the pedestrian traffic on any corner in America and arrive at the same conclusion. Given that up to 15% of all deaths are linked to being fat, you'd think there would be more of an outcry over it.
At the risk of ruffling some feathers, I’m going to make this very simple - half of us are obese because we eat too much. That’s usually what it takes to develop a certain girth. I’d make certain allowances for those with hereditary medical conditions but, beyond that, it really comes down to the excess calories that we take in. Like it or not, excess weight is simply the accumulation of far more calories taken in then expended through normal metabolism and exercise. And we are getting fatter at an alarming rate - obesity has skyrocketed 48% over the last 15 years. If you want a really powerful image, find any old pictures of people at the beach from the sixties and seventies and compare them to a recent one. It's as if you were looking at a different species.
Now not everything in the Journal study was negative, it did report that smoking rates have dropped by 20% over the last fifteen years. The sad thing is that our increasing bulk will nearly wipe out all the medical gains from our drop in smoking. Some people will attribute the decline in smoking rates to the anti-smoking campaigns and laws that ban smoking everywhere all the time. How many “no smoking” signs do you see plastered everywhere? You can’t even smoke in a bar anymore. Now compare that to the number of “no over-eating” signs you come across. Maybe it’s time for the FDA to mandate warning labels on certain foods - “eating this will kill you - keep away from children.”
But aside from the general awareness about the haphazards of smoking, I think the major reason that smoking rates have plummeted is the astronomical rise in the price of a pack of cigarettes. It can run you as much as eight bucks in places like New York. That’s almost half a buck every time you light up. A lot of that money is local and federal taxes meant to penalize smokers for increasing the nation’s health care costs.
I remember buying a carton of cigarettes for two dollars in North Carolina. Now that was thirty years ago and it was tobacco country; but even so - it’s still punitive to pay 40 cents for the same nicotine stick you could have scored for two pennies back when the Marlboro Man could advertise his product on milk cartons.
No matter how addicted they are, there is a breaking point at which people just won’t pay for a product. Some people kicked the smoking habit at two bucks. Others persevered until they were obliged to let go of a five dollar bill for their daily fix. The pivotal moment in the life of every smoker will come when the price of a pack goes to ten dollars. That’s when you’ll see die-hard smokers moving to Thailand to trim the expense of their $600 a month habit.
The problem with food in America is that it’s cheap relative to income, it’s available everywhere all the time, nobody tries to stop you from eating it, and the government doesn’t impose punitive taxes on those who over-indulge. You can publicly sneer at a smoker but you have to pretend not to notice the perfectly rotund guy snacking on a leg of lamb. We treat smokers like lepers but there is no social stigma to over-eating.