What to do to deal with the obesity epidemic in America? (And not just in America, either — recent studies also are showing increasing obesity in places like Scotland.) Normally you might say that the eating and exercise habits of individuals are their own business. The problem, however, is that obesity, like smoking, is statistically likely to cause significant increases in health care costs. And when most working people participate in group health care plans, where expensive health problems inevitably produce increased premium costs, individual cases of obesity and cigarette smoking end up being everybody’s problem.
The companies that sponsor group health plans for many Americans have tried to deal with this problem by sponsoring wellness programs and offering incentives to employee participation. But you can’t force a person to exercise or quit smoking. Now some companies are taking a harder line, and making obese employees and smokers pay more for health coverage to reflect their increased likelihood of incurring health care costs. Predictably, those efforts are being met by questions about the legality of distinguishing between people on the basis of weight, whether the programs have a disproportionate impact on the poor, who are said to be unable to afford health clubs and good nutrition, and the propriety of companies getting into the personal lives of employees. Those on the other side of the debate argue that non-smoking, non-obese employees should not pay the tab for the risky, costly lifestyles of co-workers who can’t curb their appetites for cigarettes and sugar.
It will be interesting to see how this issue plays out — and even more interesting to see what happens if President Obama’s health care statute is upheld and the federal government becomes increasingly involved in health care. Does anyone think that federal regulators, having been given the power to require people to buy health insurance, would hesitate to mandate certain kinds of individual behavior — like eating less, quitting smoking, and exercising regularly — and punish non-compliance in an attempt to hold down costs?