Close window | View original article
The holidays are past, and for many of us, the time has come to avoid looking at the scale for a while. Rare and disciplined indeed is the person who doesn't gain an ounce during the time of turkey, eggnog, pie, and everything else so good to the taste and yet, we are incessantly told, so bad for our health.
Jokes about holiday weight gain have probably been around as long as holidays and scales. Our concern today is not a temporary spike in the waistline; it's permanent membership in the club of beached whales.
Anyone with eyes to see knows that America is plagued with an obesity crisis. Why? A recent news article is surprisingly illuminating.
According to Fox News,
When a 5-foot, 275-pound woman found out she had a tumor on her spine, she was told by her local hospital to go the zoo to have a MRI because a regular MRI machine could not hold her weight. [emphasis added]
To add insult to injury, it turned out that even the zoo didn't have a big enough MRI scanner to do the job.
The thing is, an MRI scanner's name stands for Magnetic Resonance Imaging. It creates a tremendously powerful magnetic field and uses various computer magic to sneak a peak at your innards.
Super-powerful magnetic fields are extremely dangerous if not properly controlled; both patients and doctors have been gruesomely killed by MRI accidents. In telling this woman that their MRI machine couldn't do the job, these doctors weren't being unfair; they were saving her life, and their own lives. The last thing you want to do is to try to cram someone into an MRI who doesn't fit.
What's the solution for this problem? No surprises for guessing what the patient thought:
They should have machines that fit most everybody.
And therein, we have identified the true source of the obesity crisis. Did this person take any responsibility for her size, shape, diet, or health? Did she even deem it reasonable for her to have to do the necessary research to find somewhere with the equipment to address her health needs? No.
It's the responsibility of the World At Large to do whatever needs to be done for her; she bears no responsibility for helping herself.
In America's traditional capitalist system, children used to grow up with an understanding that you get what you pay for, and that you pretty much need to plan on paying for what you get. If you want a loaf of bread, go pay the baker for one; if you want money, go find a job that someone will pay you to do. Through the invisible hand of the market, prices adjust to meet supply constraints and demand requirements, and over time the forces of competition work to provide more of whatever's wanted.
The free market is not perfect, though; nobody ever claimed it was. There are some situations in which the true cost of a good is not reflected in its price.
The classic example is a coal-fired electric power plant. The electric company has to pay the mining company for the coal, the railroad to get the coal to the plant, and all the various employees. However, there are other costs that result from burning the coal which traditionally the company does not have to pay: costs of asthma from the smog, mercury runoff from the ash, and (if you believe in such things) global warming from the carbon dioxide emissions. At least some of these costs are very real; but they aren't easily charged to the company, or the users of the electricity.
The result is that coal power is cheaper than it "should" be and more of it gets used than otherwise would, because those who choose to use it are not paying the proper, full price of their choice. In effect, they are getting somewhat of a free ride from Everybody Else.
The environmental movement and government regulation have tried to allocate the costs where they should go; there's a lot of argument about the best and fairest way to do this, but the principle isn't unsound.
Now, sometimes there are good reasons for leaving negative externalities alone. Anybody who has traveled on a full plane to Florida or stood in a shopping line is probably aware of the negative externalities of small children. Because, by definition, society has to have children in order to perpetuate itself, wise public policy has traditionally encouraged childbearing by making life easier for families than it otherwise would be.
In recent years, things have changed, we note smaller families, more childless couples, and fewer kids all round - and, sure enough, American society being replaced by immigrants with totally different cultures. We'd have done better to leave that particular negative externality alone.
We know all about the price paid by the obese for their obesity, but what about the negative externalities? A fat person who does not fit in their airline seat is unfairly imposing a negative externality on their neighbor, who is not enjoying the full seat that they paid for. Companies such as Disney have to make expensive modifications to their equipment because tubby tourists jam rides designed in earlier, thinner days.
Is Disney charging an excess-blubber surcharge? Of course not - everyone buys tickets from the same rate sheet, and the thin subsidize the obese.
MRIs are far from the only medical equipment that has a size limit; ambulances do as well. Ordinary ambulances and gurneys can handle people only so big; when it takes ten EMTs to lift the stretcher, there's a problem.
Paramedic groups now find themselves forced to buy special heavy-duty bariatric ambulances at vast expense, equipped with power winches, ramps, and industrial-strength cots. Again, is there an oversize charge? No - everyone subsidizes the obese through their tax dollars.
The paramedics no doubt are pleased to have fun new toys to play with, no complaints there. Their overweight customers are happy too - they don't have to pay!
The insidious ratchet of government provision means that, once something is handed over to the government, nobody cares how much anything costs. Not the government employees, who are all too happy to increase their budget. Not their clients, who aren't paying for it. The long-suffering taxpayer might object, if he knew - but with millions of government programs, how can you know which ones to attack?
Only when the costs are truly outlandish does a politician, sometimes, refuse to succumb. The Americans with Disabilities Act famously requires pretty much every public area to be made handicapped-accessible, at the property owner's expense of course. The New York City subway system, being well over a century old, is about as far from wheelchair-friendly as it's possible to imagine.
The story goes that when disabled activists attempted to demand that the MTA put elevators in all subway stations, Mayor Guiliani flatly refused - he said, quite rightly, that it would be far cheaper to simply provide every handicapped person in the city with a chauffeured limousine than to rebuild the entire transit network. And that was that.
We find, though, that as public infrastructure gets remodeled or expanded, it's almost always required to be handicap accessible. This doesn't seem so bad; but are we even considering the cost?
Are we better off as a society putting elevators and ramps everywhere? Or would the money be better spent on, say, more train cars or longer subway lines so more people can use public transit instead of driving?
This should be a cause of internal debate for liberals, but it isn't, because nobody even bothers to ask. And unlike the obese, at least most of the disabled aren't that way as a consequences of their own actions.
Well, they may not be asking now, but as the government lards on more and more requirements and our fiscal situation grows ever bleaker, the questions will ask themselves. Our overweight folk who refuse to accept responsibility and pay the price for their own choices should take warning from other countries who have already gone down this road.
Japan, not exactly noted for a supersized citizenry, is applying government pressure to keep folks nice and trim. The New York Times reports:
Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.
Those exceeding government limits - 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks - and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.
To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets.
The Japanese government is trying to make companies pay extra for their fat employees. How long will this have to go on before companies realize that fat employees are expensive, and try to avoid hiring any in the first place? We've already seen this effect here in the U.S., where an MIT study showed that unemployment rates for the disabled went up after the Americans with Disabilities Act was passed.
The ADA was supposed to make it easier for the disabled to work by requiring companies to accommodate them; instead, companies didn't want to get involved with all the regulations and lawsuits, and avoided the issue by finding plausible reasons not the hire the disabled in the first place. Result of government help: the disabled are worse off, not better.
Politicians still take credit for the "great victory" of the ADA, even though it hurt the very people it was supposed to help. Will Japanese companies be any dumber, or Japanese politicians more wise?
Not likely; watch for average weights of employed Japanese to drop as ordered, but weights of the unemployed to rise.
Not being able to get a job is bad enough. Not being able to get medical care is something else again. Seeking to cut costs, British medical writers are already arguing that "The obese should receive less than the non-obese or nothing." These aren't just marginal views, as the Kent News reports:
A recent magazine survey of doctors found that more than half believed the NHS should not fund treatment for diseases linked to obesity. [emphasis added]
And you know what? They're absolutely right. Why should I be expected to pay more in taxes because you can't lay off the chips? Why should any employer be expected to hire somebody who will result in higher costs because of that person's refusal to get off the sofa and exercise? If your freedom and your rights to swing your arms end at the tip of my nose, then surely your choices shouldn't penalize my wallet.
The golden rule of politics is, "He who has the gold makes the rules." As long as you are paying for your own medical care, it's entirely up to you what treatment you receive.
As soon as you've contracted with a health insurance company to take care of you, you're subject to their rules on what doctors you can visit and what medications you can have - but at least you can, in theory, change to a different company or sue them if things get bad enough. Once we have national health care, however, there will be no escape.
Today, the obese are following the path blazed by the disabled: make us pay the costs of their differences. Tomorrow, this act of greed will return to bite them, when the costs grow too great and their once-savior, the government, leaves them in the lurch. Gerald Ford may not have been our greatest president, but he made a statement worth remembering whenever someone calls for the government to solve a problem for them:
A government big enough to give you everything you want is a government big enough to take from you everything you have.
We'll all be in the zoo when government takes over health care. Pay your own way, or be at the mercy of somebody else.
The elephants and hippos may seem to have a pretty cushy life with their every need provided by the keepers; but given the choice, they'd probably rather be out on the savanna fending for themselves and profiting by their own prowess. We should be so wise.