Should We Tax Poor Nutrition?

Soda tax worth 14.9 bn annually. http://health.usnews.com/articles/health/health...

@scunning, good that you bring out this important distinction. I agree with you that the public issue is the free rider problem. I wouldn't care what the poor eater does if it doesn't affect other people.

In terms of how such tax revenue would be spent, Ace and I were discussion some options that I'd like people's opinion on:

1) Personal Medical Accounts: tax goes into a "lockbox" for the individual's later medical costs, and cannot be used for any other purpose. If you die with a surplus, money goes to a general "backup" fund.

2) Good Food Offset: You buy a Twinkie at the register and are taxed a dollar, which you can use as a coupon to buy foods that are good for you (exact formula and details TBD).

Thoughts? Alternatives?

To estimate the optimal food tax, you need to estimate the marginal social cost of each kind of calorie. You also need to explain why the actor fails to internalize these costs. After all, on the face of it, he is eating bad food and that bad food affects him later on. So either he is sufficiently myopic about his own health (which is not in my mind obviously a market failure - it may still be optimal for him to shift consumption to the present, since he gains more utility from present consumption versus those later additional years of health), or the market failure is rooted in him free-riding off the public provision of insurance (eg, Medicare). I am not 100% on this, but it may be the optimal food tax depends on which of these is the case.

Here's the total nutritional value score system I was referring to above: NuVal

Could easily be used for a food tax...

Rafe--interesting concept to "tax the end product on total nutritional value and let the producers figure out how to make something both affordable and yummy"
Since incrementalism will likely be the way forward one easy thing to implement would be to prominently label food/drinks in restaurants with calories/fat content---this might effect some peoples purchases.
And per the movie Food, Inc. we all already vote on our future food choices via the grocery store scanner...

***The problem is, those who are opposed because something "seems a little too socialist" are [...] not realizing that the status quo already is half socialist, but it's the wrong half.***

OK, that's kinda funny. I can totally buy that.

Dan, I'm not saying I want to tax risk. I want to make sure that those who are taking the risk are the ones bearing the cost, not the rest of us. We've heard a lot recently about how Wall Street has become corrupt because it "privatizes gains and socializes losses". Same thing happens when you decouple risky behavior from its consequences in the health arena.

I agree with you that there is a philosophical split on this issue and that's why we are not getting anywhere on health care reform. The problem is, those who are opposed because something "seems a little too socialist" are hiding their head in the sand and not realizing that the status quo already is half socialist, but it's the wrong half.

I can't think of anything more UN-American than someone remaining willfully ignorant of the risks they are taking and then when their actions cause them harm down the road, expecting everyone else to suffer and bail them out.

(ps, Ben, thanks for sharing the MediaCurves link, that's a cool application!)

MediaCurves.com just conducted a study exploring American’s opinions regarding the proposition of a tax on fatty foods. Results showed that while 68% felt there should not be a tax placed on foods higher in fat, 76% of viewers also felt that the rise in medical costs has been moderately or highly impacted by the increase in obesity and obesity-related conditions. More in-depth results can be seen at http://www.mediacurves.com/HealthCare/J7474-Fat.... Thanks.
Ben

***I actually WANT to be taxed at a level that is commensurate with the risk involved.***

***I am pro-choice too, but more importantly, I am pro INFORMED choice.***

I'm glad you brought all this up, because I do think these are the types of policy issues that will be in play in the 21st Century Q1. And glad you weren't offended by my screw-off commentary ... just playing devil's advocate while challenging myself as, honestly, for other reasons I am thinking about health for the first time in my life these days.

Though I know you started this just looking at the effectiveness of a policy, I think what you've stumbled on is how a philosophical split will play out in American politics. Because while you may be right on the math and science, I gotta think at least half the country will resist your overall view on taxation. If you and Tiltmom win, great, fair enough. But I hope you don't because:

1) you say it yourself, you want to tax risk; and I'm of the belief that taxing risk will discourage risk ... and to me that is downright un-American. Imho, risk is part of the American ethos, and you have to take the good with the bad.

2) the notion of informed choice vs. choice ... well, i can think of a few examples where the "informed choice" would be to have an abortion, as opposed to keep the baby, but let's not even go there, LOL ...

It's all just a little too socialist for my taste.

(Thanks for the reading recs, btw, TM.)

I hear you, Dan, but here's the reality. I'm already paying for your red meat consumption through higher healthcare costs (one third of the U.S. tax revenue goes to healthcare, not to mention all the businesses that waste money and go bust over it). As Tiltmom points out, I'm not saying you can't eat poorly, just that when you do, you pay a little extra so that the heart attack you are going to get doesn't cost me down the road.

And yes, I support a risk-tax for engaging in activities like bike riding and mountain climbing for the exact same reasons.

As an aside, and as someone who sometimes engages in riskier-than-average activities (skiing, driving in traffic, etc), I actually WANT to be taxed at a level that is commensurate with the risk involved. Why? Because then I will have a much better understanding of the risk than I do now and I will be able to make an informed decision on whether the benefits outweigh the risks. Currently I am flying blind and deluding myself. As we all are.

I am pro-choice too, but more importantly, I am pro INFORMED choice.

Rafe isn't dictating what you can and can't eat; he's talking about a tax that will change the pricing of foods. He's not banning transfats like they did in NYC, or instituting regulations about salt like they're trying to do.

And here's some interesting but not-as-nuanced-as-I'd-like info on caffeine:

http://www.diseaseproof.com/archives/hurtful-fo...

Again, if you liked Pollan, the best books I've read on the subject are Marion Nestle's _What To Eat_ (a serious must-read) and David Kessler's _The End Of Overeating_ that I referenced above.

_Stuffed and Starved_ by Raj Patel is also good, as is _Appetite For Profit_ by Michele Simon.

i'm digging the discourse here, but still can't help but wanna default to personal freedom. do i really want rafe deciding what is good or bad for me? slippery slope, you know? what's next, red meat?

after all, his point about life expectancy decreasing in impoverished parts of the world practically contradicts the original premise -- because they aren't drinking Coca-Cola there. i semi-jest and understand there's far more complexity to the matter ... but at the same time, what you're essentially asking me is to declare the way i've eaten my whole life as unacceptable -- and that's gonna be a bitter pill for many to swallow.

you want me to pay more because i'm running up health care costs? well, with all due respect, screw you! it's in my interest to fight back, and say why don't we make all the "healthy" people pay more? after all, they are the ones suffering injuries from bike-riding and mountain-climbing accidents.

just as you can find research saying caffeine is healthy, i'm sure i can find (or theoretically pay for) research that says it is not. After all, I KNOW it's addictive. but you don't want me to get it from Coca-Cola, but you are OK with me getting it from Starbuck's ... so long as I don't put too much chocolate and sugar in it?

even if i were to agree with all your points about soda, i just can't like the premise it sets up for who says what about what i can put in my body.

pro-choice, ya know?

and what about Malthus? plenty of research to suggest that more people on the planet for longer periods of times can be pretty costly.

again, i know i'm going off a deep end there ... but with so much uncertainty related to what you propose, it tells me this has to be a local issue at best.

Pollan's book was definitely an eye-opener, and it's frightening to think that mcdonald's can change the genetic make-up of potatoes ... so maybe there's a corporate issue there for the Feds to contend with.

@scunning, thanks for this very relevant piece of research.

I will point out that in the short term, a significant tax on bad-for-you foods would raise significant revenue that could go to easing the health care burden caused by the poor nutrition. In fact, it could be set up so that each individual's food tax revenue goes into an account that can only be used for medical expenditures...

Brown rice and beans have always been cheaper than just about any other option, but you don't see many people making them a staple in their diet.

The great, addictive triumverate of Sugar-Salt-Fat is going to win out almost every time for reasons that have nothing to do with how cheap or expensive it is. Most food today is produced in labs where millions of dollars are spent inventing new ways to make food addictive. And despite what our body needs over the long-haul, there is some evolutionary design built into our desire for sugar and fat. [What evolution didn't count on was its constant availability.]

Take a look at Vegas. Looking at upscale restaurant prices, there's no question that there's plenty of disposable income for food. Yet it's nearly impossible to get a healthy meal there.

That's not about income. That's about people making choices that have nothing to do with economics.

MUST READ REC: The End Of Overeating by David Kessler

See this recent working paper by RAND economists, Goldman, Lakdawalla and Zarius entitled "Food Prices and the Dynamics of Body Weight".

http://papers.ssrn.com/sol3/papers.cfm?abstract...

Abstract

A popular policy option for addressing the growth in weight has has been the imposition of a "fat tax" on selected foods that are deemed to promote obesity. Understanding the public economics of "fat taxes" requires an understanding of how or even whether individuals respond to changes in food prices over the long-term. We study the short- and long-run body weight consequences of changing food prices, in the Health and Retirement Study (HRS). We found very modest short-term effects of price per calorie on body weight, and the magnitudes align with the previous literature. The long-term effect is much bigger, but it takes a long time for the effect to reach the full scale. Within 30 years, a 10% permanent reduction in price per calorie would lead to a BMI increase of 1.5 units (or 3.6%). The long term effect is an increase of 1.9 units of BMI (or 4.2%). From a policy perspective, these results suggest that policies raising the price of calories will have little effect on weight in the short term, but might curb the rate of weight growth and achieve weight reduction over a very long period of time.

@Bobbie, I personally would prefer to simply tax the end product on total nutritional value and let the producers figure out how to make something both affordable and yummy. In the end, if the tax is correctly set up, people will gravitate to mostly whole plant foods, which is what the science overwhelmingly says we should be eating.

Rules could mandate that taxes on sodas and unhealthy foods be turned around to make healthier food more accessible and affordable.

Clearly to make a diff the tax would have to be significant...

Another issue is on the food production end. Seems even in health oriented grocery stores there is still too much sugar in foods like yogurt and chips. How about more product options with significantly less natural sugar?

One improvement might be to add an alternative between surupy regular coke or diet coke using sugar substitutes.....use 8 teasp of sugar in a coke instead of 16.

Tiltmom sez:

I think you misjudge the effect of a tax. It will make unhealthy foods more expensive, but I do not believe it will bring down the price of healthy foods.

Michael Pollan argues that we don't pay enough for food and I suspect he's right. This is, in part, because corn and soy are so subsidized and those ingredients appear everywhere. If you remove those subsidies, the cost of fast food goes up, but it still costs an organic farmer what it costs to grow spinach.

Huh? Aren't you contradicting yourself? Pollan says we don't pay enough for food. And if we tax it, the price goes up, esp of the bad stuff. Isn't that mission accomplished?

Let's remove the subsidies entirely, then tax foods that are bad for you in proportion to their total nutritional score. BTW, corn syrup and soy milk would be taxed much higher than whole corn and whole soy beans.

Part of the problem is that there is overwhelming evidence of what is good for you and what is not, yet this information doesn't seem to make its way into the general public. To wit, caffeine has been shown to be surprisingly safe and one of the only substances to safely raise IQ (temporarily of course), while everything else in Coca Cola (besides the water) is bad for you if you drink it every day.

As for lifespan, the gains are in the developing world where diseases of poverty are slowly being eradicated. The diseases of affluence mostly stem from poor nutrition and lack of exercise and are what's keeping us from making better gains on life expectancy. For instance, type 2 diabetes -- which is almost entirely the result of poor nutrition -- reduces
your life expectancy by 30-50% vs that of a non-diabetic person from the time you are diagnosed.

isn't it only a matter of time (and maybe a study or two) before we officially acknowledge the health dangers of, say, caffeine? at that point, it will be clear that Starbuck's is addictive and Coca-Cola will get the Joe Camel treatment for marketing to children.

the one thing that prevents me from getting behind your efforts, btw, is that the average human lifespan continues to increase. it's the factoid that has to be overcome for this to be seen as anything more than just a money grab, imho.

Here's a recent WSJ article about the cost of poverty, in particular why it's hard to eat healthier in poorer nabes:

http://www.washingtonpost.com/wp-dyn/content/ar...

For the answer to your last question, I cannot recommend this blog highly enough:

http://www.foodpolitics.com/

Here's a recent post on the subject:

http://www.foodpolitics.com/2009/07/whats-new-w...

And here's a bunch on the soda tax issue:

http://www.foodpolitics.com/tag/soft-drinks/