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>17% unvaxxed times the US population is 56,508,640 unvaxxed, give or take.

17% is the unvaxxed over-18 population, not the US' population, so 44.3M

As for the rest of it, great, and I do wish there was a subsidy for being healthy and beautiful or, as a proxy, being able to run a 10-minute mile and complete one pull-up, at the very least

And we need to throw McDs executives in jail, or take China's example and do something far worse

Then, we could stop deluding ourselves, accept that we affect each other in ways that go far beyond the cost-sharing of socialized medicine, and try to be less individualistic.

Contrary to libertarian fantasy, you have a responsibility towards everyone around you, which you can fulfill by being your healthiest, best self.

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I realized this error exactly two seconds after I hit the "post" button, but I don't think it fundamentally changes the results much.

I think you're strawmanning libertarian fantasy. Libertarians do have fantasies, but they're different fantasies. Libertarian fantasy is "government doesn't enforce responsibility, but everyone just does what's responsible anyway." In classic cultures, this utopian ideal was enforced by religious indoctrination instead of institutions and cops.

To translate that fantasy directly to this topic, 100% indoctrination into the "gluttony is a sin" meme would save everyone in the country around $700 a year.

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You're right, it doesn't change the calculation much.

I shouldn't have called it a libertarian fantasy, because it is not limited to libertarians; at the risk of sounding like a hippie, almost nobody in a modern culture has a clear sense of the degree to which we really do all affect each other, even in the face of a pandemic.

'Individualism' for humans makes about as much sense as it does for an ant in a colony, or for a cell of a mycelium, but evolution has never required that we understand this; in fact, the incorrect belief is adaptive (for men) in the ancestral environment but we are very, very far from that environment.

As for the calculation, the absolute cost of medical care is not the large part of the difference between a counterfactual healthy world and ours. The weight of fat people on the economy is surely orders of magnitude larger than $700/head.

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I love the term NPC for the herd that is just running scripts but I realized there is a corollary - NHC non human character - we are the outliers the ones not standing in line for a concert for hours like the herd for example. Most things people do I would never do - so I’m a proud NHC (independent vaguely libertarian thinker)

But the point is these remind me of the fantasy aspect - we are the crazy outliers.

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What seems to be missing from the analysis in this comparison is a question of how much obesity is a volunteer choice. I assume part of the idea of taxing the unvaccinated is to encourage vaccination (tax the things you want to discourage), because proponents happily pay the hospital bills of the vaccinated. The point is not to cover the total cost, just the percentage that is due to voluntary choice. We know that obesity is caused to some degree by genetics, compulsion or addiction (the counter-argument to what I'm saying here is that we already DO tax cigarettes). The second point to consider is how much of obesity is due to poverty. Healthier foods tend to be more expensive, whereas high-calorie foods (fast food, sodas, etc.) are more affordable. According to the CDC, obesity is more prevalent in lower-educated and/or lower-income women (though more prevalent towards the middle class in men). So, not apples to oranges, although it makes for a compelling discussion. Part of the impetus must be a tax on "immorality", so to what degree are overweight people morally culpable?

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I like the way you think sir, but I think juxtaposing the BMI of folks at the turn of the 20th Century against that of the folks at the turn of the 21st shows pretty clearly that (A) most if not all of this is lifestyle choice, and (B) objective poverty is not the root cause given the differential between objective poverty 120 years ago and 20 years ago.

https://voxeu.org/article/100-years-us-obesity

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To some degree it depends also on what you consider "choice". First of all, when you say most if not all "of this", I believe you are referring to the excess rates of obesity beyond what would be expected according to projections. We do know that there are genetic and other non-culpable components to obesity, so it opens the question to how such a tax should be designed: should there be exemptions based on personal circumstances? (the same could be said for a non-vaccination tax - there are conditions under which going unvaccinated is not a personal choice). A separate public health policy approach that has been followed in the past is to instead regulate to some degree food manufacturers, restaurants and so on. But at this point I am way beyond my area of expertise, and beyond the whole point of the analogy. Thanks for the thought exercise!

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I do not believe the genetic profile of the United States changed significantly in the last 100 years, so I don't think "it's genetics" is a reasonable response.

But if you want to drag genetics in, personality type is certainly genetic, and more independent personalities are more likely to not get vaccinated, so you're in the same bucket. Genetics either fails to explain obesity, or relatively equally explains non-vaccination.

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Right. Obesity increased. But wasn't unheard of, which means there's some baseline (and the CDC study I showed elsewhere shows a non-insignificant contribution of genetic composition to the problem). The increase is also due to widespread changes in lifestyle (it's not like obesity grew in specific pockets, like "get fat clubs") which are outside our immediate control - we are now born into a world in which the chance for obesity is greater, for many reasons. What's unknown is to what degree a tax would result in a decrease in obesity (it would be proportional to the degree it's a lifestyle choice, but would be regressive, so have a much higher impact on low-income people). As for non-vaccination, while I take your point, it begs the question of non-determinism. While I do, in fact, believe there is no such thing as free will, I do not believe we should abolish the penal code: it still works (to the extent that it does) as a deterrent. The bottom line is people make a very explicit decision (to the point of public declarations) that they will not get vaccinated. Only comedians, actors and pissed off people declare they intend to get obese.

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To be explicitly clear, the proposal had nothing to do with incentivizing behavior at all. The incentivization was never factored into the math. All that was factored into the math was getting people to pay for their own burdens.

But to be up front, I don't advocate a fat tax any more than I advocate a vax tax, and the gist of the article was to run A Modest Proposal rhetoric, but I think you probably get that.

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> it depends also on what you consider "choice".

If https://slatestarcodex.com/2017/04/26/anorexia-and-metabolic-set-point/ is correct, anorexia is a good example of this: it includes not just (sometimes not at all) a desire to eat less, but also less conscious elements such as an unusual lack of hunger, a propensity to fidget (and thus burn more calories), & an unreasonable feeling that one is fat or has eaten too much. These symptoms tend to make the person thinner, & while they can theoretically be consciously suppressed, this is in practice very difficult, so that for an anorexic person, choosing to eat a healthy amount doesn't exactly fit into a dichotomy of chosen vs. involuntary. I have seen some arguments (e.g. https://slatestarcodex.com/2017/04/25/book-review-the-hungry-brain/ & https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-part-i-mysteries/ ) that obesity is similar, but I don't know enough about the subject to say how plausible this is.

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really? the genetics argument again? is there some history of fat people remaining fat while on hunger strikes or placed on restricted calorie diets? but you are probably on the right track with suggestions on food manufacturer or taxes there. the American intake of sugar today is way above what it was 100 years ago due to the changes in what we eat. a sugar tax to discourage this might make some sense. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785287/

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You can't completely exclude genes from studies of body weight. https://www.cdc.gov/genomics/resources/diseases/obesity/obesedit.htm#:~:text=Rarely%2C%20obesity%20occurs%20in%20families,people%20in%20various%20ethnic%20groups. And there are other physical limitations, genetic or not: those limited to a wheelchair, people with a pacemaker that limits cardiovascular activity, and so on. But here's another external form of causation: "an “obesogenic” environment, which offers ready access to high-calorie foods but limits opportunities for physical activity" - do we tax people for living in a situation that limits opportunities for physical activity? Or do we tax employers that require their employees to work in a sedentary environment? Many more reasons why obesity is not a simple matter of choice, in contract to vaccination.

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Literally "taxing the fat" in my opinion is off the table, and off the table in such an egregious way that it should also explain why taxing the unvaxxed is off the table. I have long argued, however, that we could potentially implement "revenue neutral medicare for all, payed for entirely with a sugar tax that adjusts yearly," and get some great benefit as a country.

So I think there's very likely some actual overlap between our positions. I do think, though, that "tax the unvaccinated" and "tax the fat" are basically perfectly aligned positions.

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We do tax the smokers, so taxes to discourage bad health decisions aren't completely unheard of. Just to be clear, I haven't stated a position at any point in this discussion. I'm just discussing the various factors involved. I guess the only position that I've taken is that not getting vaccinated is a more conscientious choice than being obese.

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a sugar tax on processed and ultraprocessed food makes a lot of sense, which is probably the first reason it doesn't have a chance either.

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who said anything about "completely" excluding genetics? it's clearly harder for some people to lose weight than others just as it's clearly harder for some people to do math than others. people with handicaps are strawmen. there's nothing to stop those you mention from limiting caloric intake. same for the obesogenic environment; it compounds the individual problem of weight mangement but it isn't forcing food down anyone's throat or making him/her sit on the sofa for hours watching TV. figuring out a scheme as for how to tax employers would be difficult, but it might not be hard to develop a tax write off that rewarded them for getting employees moving. and vaccination, though a choice, is not a "simple" matter of choice unless you are someone who believes people should blindly do what governments tell them to do. if one is to make an informed choice to vaccinate some research is required and research can be hard because it often leads into the gray rather than the black or white.

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True, there's no doubt that an element of obesity is involuntary. But I suspect that if you ran the analysis and factored in things like poverty and genetics, you could easily make a case that +50% of it is voluntary. Thus, the obese person would still be 50% on the hook for that choice. Using the numbers in the article, that would be a hypothetical fat tax of $833 ($1666/2). That's still miles above the unvaxxed tax of $245.

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I think if you do a historical analysis you can show that all of the increase since the era when we were basically not-obese is due to choices.

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I think you're using a very broad definition of "choices" here. Would you say that the increase in average height over the last 100 years is due to choices?

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No that's clearly due to all the fat people.

I kid. If that's not clear. But I do think that it's possible the increases in height are due to over nourishment, which may mean they're related.

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Well, the goal (in the name of fairness) would be to fully tax those that are culpable, and not those that aren't. We would want to encourage people that are able to to lose weight, but not unnecessarily burden people that can't do anything about it. But my inexpert guess is that no doctor, and certainly no government, would be able to determine that with any accuracy. I'd be against a tax that doesn't make that discernation. Interestingly, insurance companies might "tax" someone that's overweight with higher premiums, independent of the cause, and I'm ok with that. But their motivation is pure profit. They would also happily deny people with pre-existing conditions insurance, something that the state should never do.

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I disagree with this take. Government does lots of stuff to people who aren't culpable when the things they do upset the ant hill. Some wokeists claim that pedophiles aren't culpable for their choices because of genetics. "They're just born that way" etc. It's possible some people are born more violent than others. Certainly this is true in dog breeds. We don't choose not to put down a dog who bites a kid purely because the dog's breed is more likely to attack kids.

So I don't think genetic culpability plays in, in either direction. Nobody is getting a no-vax-tax waiver for having a certain genetic personality profile.

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I don't support the idea of taxing obesity (or the unvaccinated), for so many reasons. I only meant that the argument could easily be made that, to a significant extent, obesity is a voluntary condition. Because assessing liability isn't a zero-sum game, whether in insurance (as you mentioned) or in law (where people often receive lesser sentences due to mitigating circumstances), if we start taxing the unvaccinated, people will naturally question how we can let obesity completely off the hook.

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“BuT ObEsiTy’s NOt cONtaGIoUs!” **spongebob meme**

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>If policy makers want to tax the unvaccinated, and they want to do it in an honest fashion

At the risk of being more heat than light here, they don't. Any talk of mandates post-omicron is no longer about public health (assuming they were in the first place), it is purely about getting the few remaining holdouts to submit to the authority of their betters.

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Quebec had the policy in place and only yanked it after three days of trucker protests. Greece unrolled the policy *today*. So it is not at all outside the realm of possibility.

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I looked at the tweet that video of the trucks at night comes from and people are saying it's actually from Germany in 2019.

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Ahh damn. You win ten internet points if you find me a better one to edit into the article. :)

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nevermind, pulled one from my feed

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I like this one better, even if internet points aren't involved:

https://twitter.com/bennyjohnson/status/1487962909426823170

Remember kids, your enemies must be always at the same time too strong and too weak.

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Perfectly logical. Unfortunatley logic is dead.

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I think you did your math wrong. The political calculus is:

Tax the obese = anger 44.9% of the electorate, probably increasing their voter enthusiasm by an outsized (pun intended) percentage

vs.

Tax the unvaxxed = anger 17% of voters, most of whom probably are on their way to being too demoralized to vote anyway, plus you probably give your tribe something to be enthusiastic about (at a time when they have little of that).

(I know you know this. Asking for anything that makes sense from the politicians who write out tax laws is asking too much these days.)

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Of course I know this. But the best way to show it is to not even bring it up, just put the math on the table and let people struggle with it.

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The Kaiser Foundation is not exactly trustworthy. It is part of the media and coastal elite and I am pretty sure the number of unvaccinated people is higher than 17%. I am curious if it would make more sense to have two different surveys and split the difference. Not sure how the math works out but reading this is just not convincing considering Kaiser has a working relationship with NYT and WaPo. They also work with a lot of the elite universities as well.

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You'd need to get this info from someone tapped heavily into insurance actuarial circles, though, and they're the most tapped AFAIK. If you can find a different source for the net costs, rerun the analysis and see what you get. It's a simple analysis.

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welp, getting a vaccine takes a little bit of time and effort versus going from obese to a healthy weight which takes a whole lot more. this even in the absence of genetic factors which may contribute.

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