The Nanny State and Obesity

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“Nanny state” is a pejorative term used in criticizing government actions the attacker asserts are overprotective of fellow citizens, unjustifiably authoritarian, and which interfere too much with personal choice and freedom. Governor Romney’s remarks about the 47% of Americans who are “dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them” underlines that this election is about defining the powers, and the responsibilities, that voters should entrust to our federal government.

Treating the results of obesity is a troublesome “nanny state” issue. The Trust for America’s Health has analyzed current trends and foresees a 2030 America in which 13 states will have adult obesity rates above 60 percent, with every state weighing in at least 44 percent obesity among adults. The health care costs of obesity-related diseases are projected in the hundreds of billions of dollars, with even higher losses in economic productivity. Obesity, and the preventable diseases related to obesity, happens when individuals consume more calories than their bodies expend over a long period of time. A century ago, really fat adults were rare and the diseases associated with obesity – type 2 diabetes, coronary disease and stroke, hypertension, arthritis – were less common. Collectively we’ve made choices to become fatter and to stay that way. We’ve exercised our personal choices and our freedom, and one question is who should pay for the consequences.

No nanny state existed a century ago, and people needed to take care of their health problems with little government help. I understand Governor Romney’s argument; for example, why should the federal government spend billions treating people who “did it to themselves” by eating too much, or by smoking tobacco too much? There is natural resentment when taxpayers pay large medical bills to fix problems for adults who didn’t care enough to act responsibly, like the “organ donor” motorcyclist who refused to wear his helmet, but then expects the public to furnish expensive, long-term medical and other support after a careless wreck damages his brain.

Drawing lines, as the lawyers say, is a challenge. If you believe that government should offer help except when a citizen’s quasi-suicidal behavior caused his problems, what are the limits? For instance, some obese people have chronic, even genetic, issues that hinder losing weight and others are paying for the sins of parents who fed them unhealthy, obesity-producing diets. Allocating responsibility might be unfair. Further, once a pattern exists, breaking it can be very tough. The body becomes chemically dependent on regular nicotine fixes or on too-high-calorie food intake; the addiction then fights back against change. The trend since 1932 has been towards more government services, even for folks who unjustifiably failed to care for themselves, and setting limits is difficult. Is the public ready to leave people who hurt themselves at the hospital door?

November is an important election, and it may tell us whether Americans want more “nanny state” laws like New York City’s limits on over-sized, sugar-packed drinks, laws designed to protect the consumer from making herself sick, and to protect government from picking up the pieces.

Image by © 2010 by Tomasz Sienicki [user: tsca, mail: tomasz.sienicki at gmail.com] (Photograph by Tomasz Sienicki (Own work)) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons