Penalties For Smokers, Obese People Debated As America Asks, ‘Who Will Pay For That?’

Penalties for smokers and the overweight and obese as a public health issue is not an entirely new subject. Punitive taxes costing smokers more than $10 a pack exist here in New York, and New York City Mayor Mike Bloomberg last summer announced a ban on large soft drinks to curb residents’ sugar drinking habits.

(While not a tax per se, Bloomberg’s move will cost thirsty folks a bit more at city concessions.)

Penalties for smokers have long ranged from the fiscally heavy (in the form of tax) to other sorts, like higher premiums and general societal ostracization as a nicotine habit becomes less socially acceptable.

But now that the legislation commonly known as Obamacare looms, the subject is being revisited as we all prepare for a slightly more egalitarian system, and Americans are wondering: Who exactly should pay for lifestyle choices and unhealthy habits?

While penalties for smokers never quite draw the same outcry, sanctioning the overweight is also being discussed. A paper last week written by a bioethicist, Daniel Callahan, argued for measures (which he admitted were “paternalistic”) to essentially “shame” people into eating more healthily and thus, he suggests, reducing weight-related conditions like type 2 diabetes and heart disease in the aggregate.

But the line between penalties for smokers and measures to motivate the overweight continue to have a bright, dividing line in implementation — the you versus me issue. S. Jay Olshansky, a professor at the University of Illinois-Chicago’s School of Public Health, tells MSN:

“When you ban smoking in public places, you’re protecting everyone’s health, including and especially the nonsmoker … When you eat yourself to death, you’re pretty much just harming yourself.”

Not necessarily so, says John Cawley, health economist at Cornell University. Cawley says that, while secondhand smoke hits us in the lungs, poor eating habits hit us in the wallet, hard:

“If I’m obese, the health care costs are not totally borne by me. They’re borne by other people in my health insurance plan and – when I’m older – by Medicare.”

As of now, no major penalties for smokers are on the table, save for higher premiums being allowable for those purchasing insurance. As for penalties for the obese, it remains to be seen if America can untie its love for state fair food from its love for not paying for the choices of others.