Is the Arizona Fat Tax the Right Move?

This pretty much sums up the Arizona fat tax proposal

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? According to The Washington Post, some private insurers and state governments are already charging a fat tax. 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, Lisa

About Lisa Johnson

Lisa Johnson here. I've been a personal trainer since 1997, a Pilates instructor since 1998 and the owner of Modern Pilates since 1999. I'm hoping to give you some good ideas to get or stay in shape with a healthy dose of humor and reality. Thanks for joining me.

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12 Responses to Is the Arizona Fat Tax the Right Move?

  1. angela April 12, 2011 at 9:08 am #

    I don’t think that’s right. It’s not always easy to lose weight. So they want these people to go pay money to see a doctor, be put on a plan, and then how much time do they have to succeed? Because it’s not always the first try that gets it right. I think it’s a little bit nuts, and I think it’s especially weird that they’re lumping overweight people together with smokers. Diabetics can be a result of obesity (it isn’t always) but smokers have nothing to do with it. I got help from my doctor in quitting smoking about 2 years ago and it worked and I never looked back. I think that part is likely doable for many smokers. But being told to lose weight (enough to be a healthy weight?) in a set amount of time seems a bit more difficult. I don’t think they’ll succeed with this. There are too many reasons why people are overweight, and everyone is different and loses weight differently. Also not liking the prejudice involved. Who should we judge and throw a tax at next?

  2. Tara Burner April 12, 2011 at 12:45 pm #

    I totally agree with it.
    Reality is this, if people can blow $8 on a ‘value meal’ of processed junk that they want to believe is ‘food’ or inhale a pack of cigs for something like $8/pack now well then $50 is ‘nothing’ for them to balk at.
    Yes, it’ll take some effort and work on their part to lose weight, eat healthier but why should the healthy tax payer be paying for the health care of those who opt to live an unhealthy lifestyle?
    I personally have been to the dr twice in over 30 yrs–both times to give birth! 22 and 15 yrs ago! and that was it!
    I take care of myself, eat properly/healthy, exercise, dont drink, dont smoke, so I wont have health issues & problems later on.
    And, sadly I don’t think that if they do instill this that many will make the required changes to not have to pay the $50. They obviously don’t care about themselves or their health so what’s $50 to them? 6 packs of cigs or 6 meals at a fast food place. That won’t be incentive enough to get them to make an effort and change :(
    Angela said it’s weird that they’re lumping in smokers with obese people…why? They both do something that’s detrimental to their health…over-eating or smoking. Both have major health risks and consequences. So, makes totally perfect sense to lump them together. They should throw in alcoholics too, in my opinion.

  3. Lisa Johnson April 12, 2011 at 12:55 pm #

    Angela and Tara,

    You both make good points for both sides. Angela I found it interesting you were giving more leeway to people who are overweight vs. people who smoke. My understanding is that nicotine addiction is monstrous to break. Most people fail at least twice before they get it right.

    Tara, I’d say you should be going for annual checkups, at least once in a while, to make sure you’re fine and there’s no underlying something going on that you don’t know about.

    I think there are lots of ways to motivate people, there are carrots and sticks. Some people will respond better to carrots, others sticks.

    All of this being said, to me the real plus is that doctors will *have* to make time to talk to their patients about living healthier lifestyles. To me, this is far and away the most important aspect of this legislation. I’m not sure exactly how they’ll find the time to do that. But a doctor’s recommendations or even “prescriptions” for weight loss carry a lot of weight (pardon the pun) for patients. People might ignore their spouse or their parents but they’ll do what a doctor tells them to do. To me that’s worth the nuisance of the $50. Plus you’d be surprised how much that would motivate people to get off their duffs. It’s not whether or not they can afford the $50, it’s the fact that they don’t want to “lose the bet.”

    Just some thoughts,


  4. LC April 12, 2011 at 1:07 pm #

    Just interesting to see there is no differentiation between type 1 and 2 diabetes, can we also fine people who have high cholesterol, BP, etc… as these can be treatable conditions….

    And where does this extra 50 dollars go? Into programs to provide the patch, gum, nutritional clinics, gym access somehow I think not?

  5. Lisa Johnson April 12, 2011 at 1:16 pm #

    Very good point LC … I think it’s just supposed to “defray costs” of treating “irresponsible” people … ;-)

  6. angela April 12, 2011 at 1:25 pm #


    Nicotine addiction IS monstrous to break. I quit once on my own and it was extremely difficult. Unfortunately started again and decided to go on medicine for it to make it easier on myself. Still wasn’t easy. I’d still say it was easier than losing weight, though.

    Tara, not all overweight people are over-eaters. Shall we try only to tax/punish those that are fat intentionally? And yes, by all means, if we’re going to tax fat people and smokers, we’d better tax the alcoholics, the crackheads, the gamblers, the sex addicts, and everyone else with any bad habits at all.

    Or maybe as Lisa said, doctors could actually put some of their time into talking to people about weight loss and how to be healthy, and work on helping people instead of punishing them. I’ve taken my daughter to our family doctor specifically to talk about how to maintain a healthy weight and discuss exercise and nutrition. I wonder if part of the problem isn’t that we don’t ask our doctors for appointments like that often enough.

    Those are just my thoughts. ;) Interested to see what others will have to say about it.

  7. Lisa Johnson April 12, 2011 at 1:34 pm #

    Sin taxes, they are a slippery slope … Angela, what would you suggest as an alternative to get people’s attention. I would say the majority of people who are overweight actually are overeaters. It’s only a tiny percentage who have a thyroid, or other problem. So assuming those people aren’t targeted (and I think the AZ proposal did screen that type of person out.) what do you think is a good way to encourage them to lose weight?


  8. Tara Burner April 12, 2011 at 2:11 pm #

    Lisa, I trust God to heal anything that may go wrong…at one point I did screw up my back. Had x-ray, it showed 5 herniated discs, they said that I ‘had’ to have surgery…I said no thanks, went home, prayed and 2 days later was back up running around and no probs :)

    Angela, sadly the majority of overweight people are because they overeat or eat processed junk/garbage…only a slight percentage of obese are from other issues/problems.

    Lisa, since I haven’t been to dr in forever I’m assuming by what everyone’s saying is that it’s not the norm for them to discuss weight/health/nutrition…which makes sense–sadly…because reality is this…without obese people, without diabetes, without other health issues (running the realm from weight to cancer and all in between) the dr’s, hospitals and big pharma won’t have as much of an income! Now, mind you this is only my opinion but really…if everyone took care of themselves and everyone was healthy without meds then where would that leave big pharma? lots of money in meds and keeping people sick :(
    So, if the tax made it mandatory for dr’s to invest time and actually help people get healthy..then YES again to the fact they should do it!

  9. Jill May 21, 2011 at 3:00 pm #

    All I have to say is who will be next? Remember, if you give an inch they will take a mile. With one precedent a judge can rule in favor again. Freedom is gone, my friends unless we stand together and say no more.

  10. Austin Kobs July 29, 2011 at 12:42 pm #

    This Arizona law is a much needed step in the right direction. Those who argue against it say “But what about personal choice?”. Well, judging by the fact that 2/3rds of Americans are considered overweight, i’d venture to say that it doesn’t work! A fat tax does not mean you can stuff your face with BurgerKing frecnh fries, it’s simply a way of holding people accountable for dooing so…

  11. koolaide36 October 3, 2011 at 11:42 pm #

    Hi Lisa,
    I dont think that a “fattax” is good for our society its bad enough that we have to pay taxes and still nothing has change now a fattax is just another way for the goverment to implement more money from the citizens. some people have weight problems along and have been trying to lose weight but cant are they going to tax for being fat as well this bill is beyond the beliefs of a person self -esteem alone with depression and a number of other things will they be charge for that as well I am against this bill.

  12. Lisa Johnson October 4, 2011 at 8:20 am #

    koolaide, I see you point, the government collects the money and either sets up useless programs or diverts the $$ elsewhere in the budget. Both of those options would stink. I was thinking more like the cigarette tax they had in Massachusetts where the money ONLY went into a fund for anti-smoking campaigns. But as I type this I think after a few years the money did get diverted to other stuff so … you might be right there. L–

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