Sunday, January 8, 2012

The Rejection of the Will and the Creation of the Victim

The victim, the creation of our current society, is the person who through their own overt actions has found themselves in a bad situation and demands the rest of us bail them out. Drugs, bad school choices, homes they cannot afford, and of course obesity.

The NY Times epitomizes this today with an article on childhood surgery for obesity. They state:

There was no question, at 5-foot-1 and more than 250 pounds, she was overweight. But she resisted, saying she could diet. “I’ll lose weight,” (the patient) assured her doctor. (The doctor) said, prophetically, “It’s not your fault, but you’re not going to be able to do it.”Along with the obesity epidemic in America has come an explosion in weight-loss surgery, with about 220,000 operations a year — a sevenfold leap in a decade, according to industry figures — costing more than $6 billion a year. 

The article continues:

The operation took about 25 minutes. Child Health Plus, a state insurance plan for low-income families, covered the $21,369 cost. Medicaid in almost every state and many private health plans now cover bariatric surgery, often more readily than diet or exercise plans. On many days, (the surgeon) performs three or four operations in a row. 

 The cost is not Medicaid, it is the taxpayer, that 50% of the working force who pays for the rest of the workers and those not working.

The above two statements; (i) it is not your fault, (ii) Medicaid pays ... $21,369, reflect the problem as it is posed. No responsibility and not understanding who really pays.

The irony is that in Mankiw's blog today he refers to his Pigou tax as as a way of saving lives with regard to drinking and driving. Yet a year ago he rejected the same out of hand regarding a carb type tax. Mankiw highlights:

A conservative estimate is that the federal tax reduced injury deaths by 4.7%, or almost 7,000, in 1991.

When the above highlights $6 B  in costs due to an ever increasing tax burden. One could argue about the analysis referred by Mankiw as possibly flawed, it regresses on the amount of alcohol consumed but there clearly are multiple other factors as well, but with obesity the number are clear. 

Obesity is the driving factor in health care costs. Stories as the above clearly demonstrate that we would rather pay exorbitant costs to solve it afterwards than prevent it. Here is a clear and direct case of a Pigou tax, one of the few I can believe in. Ironically the proponents of such taxes place them more freely on gasoline and alcohol,  ones where it in my opinion are much more specious.

Finally the success of this surgery is highly erratic. Oftentimes the patient regresses back to the original state, after all they were told it was not their fault and there is no disincentive to reduce caloric consumption.