• Another public health disaster

    The Burger King Bacon Sundae.

    Fun facts:

    • Denny’s and Jack in the Box beat BK to this market, as they already offer bacon + ice cream products
    • 510 calories, 18 grams of fat and 61 grams of sugar
    • BK tested this product in Nashville first (loosen the buckle on the Bible Belt). Based on the sales there, BK is now “rolling it out” nationwide.
    • Time for a Pigovian tax on fast food?


    • 1. If you want to get less of something, tax it directly. If the goal is to reduce obesity – then a “tax” on the obese via higher premiums will be much more effective than a general tax on high calorie food – irrespective of whether it’s being eaten by a morbidly obese diabetic or an Olympic decathelete.

      This is easy to do by allowing health insurers to price the extra health risks associated with obesity into policies in the same way that they do for smokers. An incapacity to regulate one’s consumption of cigarettes is no more or less an indelible character of birth than one’s incapacity to regulate one’s consumption of food – so our collective decision to allow insurers to charge higher premium for smokers but not the obese is entirely arbitrary.

      2. Once you eliminate the mechanism by which the obese impose their excess health costs onto the public by allowing insurers to charge rates that reflect the health risks of obesity – obesity is no longer any more of a “public health risk” than the excess mortality and morbidity associated with, say, hang-gliding is a public health risk.

      3. Forcing the public to shoulder the costs associated with every private behavior that has potentially adverse health consequences is a great mechanism for endowing a broad class of rent seekers with the power, authority, and political resources required to intervene in decisions that should be the exclusive domain of private citizens. It’s far less clear that doing so does much of anything to help the folks that all of this fretting, wonking, and legislating is ostensibly supposed to benefit.

      • @JayB gives a libertarian defense of an expansive view of personal responsibility, and therefore a narrow view of public health. Richard Epstein and others have made similar claims, seeking to limit public health to cases with clear negative externalities, such as infectious diseases.

        The dominant view is that public health is population health, focusing on health outcomes for the population rather than treatment of the individual. Externalities matter, but are not determinative.

        Finally, these approaches don’t have to be mutually exclusive. Given the complexities of human behavior, why not evaluate all available approaches against obesity?

    • Kevin – I think that the tension between these perspectives arises at the boundary between the collective and the individual. In a liberal society we place constraints upon the government’s ability to deprive individuals of essential rights and freedoms even in those cases where it appears as though the collective would benefit from doing so.

      Anyhow – for the sake of argument let’s accept the proposition (or rather, I’ll accept the reality) that taxes on particular kinds of food are within the scope of the policy options that government can consider in order to reduce the prevalence and severity of obesity.

      Is there any evidence that such a tax has or will work to do so? Is it even theoretically plausible based on what we know about obesity? If the first two conditions are or were satisfied – is it possible that there’s more effective tax? How might these compare to simply pricing the risk of obesity into insurance premiums?

    • I know that you are at least partly jesting but I want to get this in:
      Yesterday, I heard on the radio a discussion featuring the authors of the book “Zoobiquity” (http://zoobiquity.com/book). They made a strong case that it is simply abundance that makes us obese. They pointed out that our pets have gotten fat along with us and that animals in the wild get fat in times of abundance.

      So, I do not think that particular foods and drinks are the problem but simply the abundance of food.

      • Addendum:
        The above also implies that if you are to have an effective tax it would have to be a calorie tax, that taxes all consumable calories equally.

        • That’s an interesting conjecture – and I think that the results would hold for animal populations where food consumption is completely predetermined by biological programming.

          Having said that – aside from BF Skinner I don’t think that there are too many people that believe that food consumption or any other human behavior is completely impervious to conscious influences ranging from culture to personal convictions.

          It’s also worth noting that the above model would predict a relatively uniform distribution of obesity across the income scale once food was sufficiently cheap that income posed no barrier to consumption at any income level. What we’ve seen in practice is that the poorer a population is, on average, the fatter they are.

          It’s an interesting idea – but not one that can be extrapolated directly from animals to humans IMO.