In April of 2010, Jonathan Gruber, one of the architects of ObamaCare and an adviser to the Obama Administration, suggested that we tax people based on their weight. (Full essay here.) The theory is that fat people spend more in health care dollars, so we can tax to “modify behavior and raise revenue.”
If people who smoke, drink, don’t work out, or are professional bungee jumpers have higher health care costs than everyone else, then I have no problem with a private insurance company raising their rates. We do this for auto and homeowner’s insurance all the time: you pay more if you speed, drive drunk, or live in a place that gets hit by hurricanes. A private insurance company that charges people too much for various “sins” will lose those customers; an insurance company that charges too little will lose money. The force of the free market will push companies to get the most accurate risk assessment possible, and those companies would be just as happy with people quitting smoking and paying less as they would with smokers paying a penalty to cover their additional costs.
None of this is true about government sin taxes. Aside from the creepy and coercive nature of the government attempting to regulate our lives through financial penalties, extorted from us with the threat of jail if we do not comply, the government will tend to rely on increased ‘sin’ revenue. The money from cigarettes or adipose that pays for schools will no longer be there if people quit smoking or slim down. The government also has an incentive to increase this tax to the point just before political backlash: there is no downward pressure from competing governments that are ready to charge an amount that is more tailored to the expenses incurred from such weight.
Economics of sin taxes and insurance premiums aside, this is also problematic because weight is not what causes people to incur excess health care costs: it is fat, lack of physical fitness, high blood pressure, low muscle mass, and a host of other things. Most likely, the government will simply calculate our BMIs and tax us, rather than attempt the fine-tuned calculation of taxing people whose body composition puts them at a higher risk for health problems. It also highlights one of the many problems with socialised medicine: once you are forced to pay for some stranger’s health care, you have every right and incentive to stick your nose in that stranger’s business and dictate how his life ought to be run. It’s an ugly business, served up to us in the name of compassion.