Arizona is considering a “fat tax” of $50 per year for anyone on Medicaid who is overweight, smokes, or has diabetes.
It’s a move that’s half tough love and half reality check as the state tries to cope with the soaring costs of medical care brought on, in part, by people living an inattentive lifestyle.
After the Democratic/Republican budget showdown last week both parties publicly stated that they’d be looking at cutting costs in Medicaid. Could this idea, both villified and cheered in Arizona, be one of the steps the U.S. government considers or even enacts nationwide?
Some details on the Arizona proposal:
- This would only apply to adults without children living in the home
- The diabetic fee would only kick in if patients didn’t lose weight after being told to do so by their doctors
- For the obese and smokers, patients would develop a plan to get healthier; if they fail to meet the plan, then they would be hit with the fee
- The fee would have to be approved by the U.S. government; I tend to think they would be inclined to allow it
So really this proposal is not just, “You’re fat; pay up.” It is a system of carrots and a somewhat puny stick. Let’s face it; if you think about spending $50 at fast food outlets over a period of time and instead put that toward your fat tax, you wouldn’t be significantly impacting your personal bottom line. A pack a day smoker probably blows through $50 in less than two weeks.
The point here is to get people to pay attention to what they’re doing to their bodies. Obesity is 100% reversible; there is a very easy cure: eat less, move more. I know that’s easier said than done but if Arizona is prodding their doctors to come up with a plan to sit down and discuss weight loss with their patients that’s huge!
A recent Harvard University study said that 61% of doctors “didn’t have time” to talk to their patients about weight loss. So just getting a guy in a white coat to talk with a patient about living a healthier life is a big achievement.
Come to think of it, that stick is way bigger for the medical community than it is for the patient. They will have real consequences of scheduling and time management.
So what do you think? Is $50 too much to ask? Can the medical community handle the patient overload if they have to start dispensing healthy advice? Will this change our white coat brigade from a group of symptom prescribers into a true preventive medical team? Do you think a system of carrots and sticks is really going to be effective against the onslaught of American culture?
I’d love to get a discussion going on this. Let me know your thoughts,