There's more money in sugar-addicted fat people. Even in the US, drug and food policy is coordinated (see FDA drug approval board https://academic.oup.com/jnci/article/100/5/296/938813/Membe...). It's a big industry where profitable addictive foods also support a lucrative obesity healthcare industry ($190bn in the US, https://www.hsph.harvard.edu/obesity-prevention-source/obesi...).

> It's a big industry where profitable addictive foods also support a lucrative obesity healthcare industry

And that's the crux of the problem, isn't it?

If the U.S. had a single-payer healthcare system, you can bet it would care a lot more about issues like obesity, pollution, and all the things that make people sick and would make the government pay more for healthcare. It would have an incentive to reduce those issues.

Instead, the U.S. has a system where it's "profitable" to have sick people, so the stuff that makes people sick is kept in place. It's the same kind of the same perverse incentives we see with the private prison industry.

Your argument is based on the incorrect assumption that the obese and smokers cost more over their lifespan for healthcare relative to a health individual. The reality is the opposite.

For the population at large, MOST health care costs are accumulated at 60+, see this graph[0]. In fact ages 1-50, on average, cost almost as much as 65-75. And worse still from retirement people pay a lot less tax.

Why is this relevant? Smokers and the Obese often die after their working (and taxpaying) life but before their expensive retirement. This means that while their last few years might be more expensive, their costs over the course of their life may be half that of someone that lived until 85.

The ironic thing is that obesity/smoking might save social security from insolvency and be a massive saving for Medicare (as the Obese/Smokers won't ever enter Medicare, but will pay tons into it). Single payer would likely include the current Medicare ages, thus it would still remain cheaper to cover an Obese/Smoker who dies at 60 than a completely healthy person that dies at 80.

The reality is that people hate the Obese/Smokers due to biases, not costs. Or because they think it is immoral/a character flaw to allow oneself to die early. There's no actual economic argument to be made that Obesity/Smoking is bad for society, they're net contributors by every major metric (particularly healthcare, retirement contributions, and taxes).

There's been multiple studies drawing the same conclusion[1][2][3]. But most won't look at the data, and ignore the "long tail" of healthy individuals that is so expensive while talking about the "short tail" expense of the obese or smokers.

[0] http://blogs-images.forbes.com/danmunro/files/2014/04/hccost...

[1] http://journals.plos.org/plosmedicine/article?id=10.1371/jou...

[2] http://www.nejm.org/doi/full/10.1056/NEJM199710093371506#t=a...

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225433/

Does this imply that higher health insurance rates aimed at people with less healthy lifestyles is really just another insurance scam? Penalize them while we can, and easily get away with it because it is socially acceptable?

No because health insurance usually only last one year, and person with unhealthy lifestyle would statistically cost more than person with healthy lifestyle in one year at the same age.

Obese people spend thousands more per year on healthcare and an obese BMI of 30-35 results in only a 2-4 year lifespan reduction. The GP is massaging data to fit a fat acceptance narrative. Healthcare companies fight against obesity because of quality of life issues as well as cost savings. Its not a conspiracy.

The GP is presenting multiple studies in respectable journals. You'd have to show that the studies themselves are "massaging data" which you haven't attempted to do.

Forbes:

Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.”

Making the cost impact all the more troubling is the fact that, unlike smokers, obese people tend to live almost as long as those who keep their weight under control. "Smokers die early enough that they save Social Security, private pensions, and Medicare" trillions of dollars", said Duke's Eric Finkelstein. "But mortality isn't that much higher among the obese."

http://www.forbes.com/sites/rickungar/2012/04/30/obesity-now...

The Klim McPherson study you linked doesn't have any real conclusion and is focused on UK health, which might have different factors than US healthcare, which is privately run for the most outside of retirement. None of your other cites calculate anything have to do with obesity costs in healthcare. I'm sorry but you sound like a typical fat acceptance advocate trying to skirt the issue.

Forbes:

Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.”

Making the cost impact all the more troubling is the fact that, unlike smokers, obese people tend to live almost as long as those who keep their weight under control. "Smokers die early enough that they save Social Security, private pensions, and Medicare" trillions of dollars", said Duke's Eric Finkelstein. "But mortality isn't that much higher among the obese."

---

So in other words we're looking and year over year cost increases that are significant. A BMI of 30–35 kg/m2 reduces life expectancy by two to four years [wikipedia].

Two to four years is nothing especially when you have all these extra yearly costs to make up. Yes, the very obese can lose 6-10 years of life, but they're rare. 30-35 is the common range. Not to mention advances in stent technology and advances in heart drugs means that a obese person today is going to have a very good chance at a long lifespan. We may be able to eliminate that 2-4 shortage sooner than later.

> The Klim McPherson study you linked doesn't have any real conclusion and is focused on UK health, which might have different factors than US healthcare, which is privately run for the most outside of retirement.

Medicare is a public insurance scheme in the US, not private.

> None of your other cites calculate anything have to do with obesity costs in healthcare.

So you're dismissing one study ("Does Preventing Obesity Lead to Reduced Health-Care Costs?") because it uses data from the UK and ignoring the other completely ("Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure") why? Both are expressly about calculating costs in healthcare.

You aren't even arguing against their methodology or conclusions, just dismissing their mere existence.

> I'm sorry but you sound like a typical fat acceptance advocate trying to skirt the issue.

Bring up facts backed by studies is "skirting the issue?" What exactly does addressing the issue head on look like?

I am following the science where it leads. You can paint that as an ideology but I'd suggest dismissing studies you don't like the conclusion of is more ideological than presenting them as is. The key difference is that my views can be changed with more data, seems like your views have already been made up prior to today and you'll dismiss counter-evidence at a hand wave.

My article had actual facts. You had misleading factoids not directly related to obesity spending and obesity lifespans. There's a difference.

Not to mention the false claim you make compared obese people to smokers. Smokers do die young, obese do not. Again, a 2 year lifespace difference is not a cost savings when you're looking at several thousands per year extra healthcare spending for an obese person.

I'm sorry but your biased fat acceptance "facts" are false. I wish you would own up them, accept the data in the forbes article instead of attacking me in this passive aggressive fashion.

I appreciate the data in your post, but essentially calling the GP "a typical fat acceptance advocate" seems like a needless reductionist attack.

I'm in Australia and we have a fairly effective public health system.

We seem to have much the same problems as the US WRT regulation of harmful recreational foods.

> Are you familiar with 4th generation war theories? If you're interested drop me a line at gmail and I'll direct you to some fascinating reading.

Would you mind sharing a bit here?

Maybe start with this blog. and the Wikipedia article which is shallow but a good overview. I don't want to politicize the thread. http://globalguerrillas.typepad.com/

Personally, I'd really prefer to not pay inflated costs for soda, should I choose to consume it.

I am however completely and 100% fine with paying a higher i.e. health insurance premium due to my soda drinking habit (or any other habit that causes my health risk to be higher).

I'm just not a big fan of 'sin taxes' -- though I could be persuaded if they were actually put to use in the same way that the health insurance/risk concept would be; I'm just not convinced that's actually what would happen in the long or short term.

I agree with the idea that sin taxation is stupid in the sense that there's a moral component involved. The tax in this case is essentially an indulgence. That said, I see a benefit in taxing soda and cigarettes in particular because they impose a substantial externalized cost on society that isn't reflected in their price. With smoking its lost productivity for smoking, sickness, secondhand smoke, etc. With soda its increased diabetes, weight, secondary issues (joints, etc.).

I do love me some regular Dr. Pepper, but it's so bad for me I rarely drink it any more. (Admission: I still drink diet soda. I had to acquire the taste.)

Please pardon me nitpicking on one phrase from your comment - it's not directed at you but at the discourse that often ensues when selective taxation is discussed. There was a soda tax on the ballot where I live last election season and I got more junk mail opposing it than all the other political mailers put together - completely wasted as it passed anyway :)

I absolutely reject the notion that tax on soda or other potentially-addictive substances are a punishment of the consumer for poor moral choices. Making sugar expensive is simply an effective strategy to lower consumption by shifting the equilibrium point for consumer purchases.

We have a family friend that's disabled, she's an adult but only able to read around a 4th grade level. She's seen her grandmother die of diabetes, her mom has it too and the friend herself is fat. But notwithstanding the healthy food we give her when she visits or stays with us, and no matter how many times we remind her about how to choose between different kinds of food, if she goes into a store on her own and has money she's more likely than not to buy 2 quart bottles of soda and drink one of them immediately.

It's really hard for some people, especially kids, to resist getting jacked up on sugar. The younger they do so the more likely they are to develop lifelong eating habits that are going to give them painful and expensive medical problems and send them into an early grave. There's no moral component involved at the consumption end for me because many people are just not smart enough to carry around the idea of healthy eating and to choose it over the marketing signals that surround them. The younger they get exposed to an addictive substance, the more difficulty they're likely to have resisting the temptation to consume it.

I am utterly indifferent to the economic situation of shareholders in the crap food industry. They don't have a right to make money out of people; it's usually the suppliers who make the moral argument about consumers needing to make healthy choices and tax being a horrible punishment. That's just an attempt to shift the entire burden of responsibility onto consumers at the same time that the suppliers are spending a fortune on marketing to kids. Frankly most of the drug dealers I've met in my life had more of a moral center than the professional lobbying and marketing people I've known.

While that is pretty sad, it is also an extreme case and it sounds like she either needs a caretaker or she needs a better caretaker; I would say the same thing about children: they are the parents responsibility.

And whether you reject the notion the fact of the matter is that it is still going to punish every responsible person with a new tax that will go into the general government coffers.

It's not an extreme case; it only seems so because this person is disabled and it's surprising to discover that this superficially adult person has the mind of a 9-year old. I'm using that to draw attention to the fact that kids often make terrible decisions, and there are a lot of 9-year olds buying a lot of soda whose future negative health outcomes are easy to overlook because marketing has trained people to associate soda with healthy people having fun.

I would say the same thing about children: they are the parents responsibility.

I know you would, and I think your reasoning is foolish. Many parents are clearly not responsible, either from indifference or ignorance. I am fine with government acting in loco parentis in a very narrow way (even for adults) because the negative health outcomes and their associated costs are predictable and lowering those costs has demonstrable overall utility. Available information shows this policy to function better than waiting for people to get a responsibility transplant and just shrugging our shoulders about kids who end up suffering because of their parents' poor guardianship.

How are you being 'punished' if your soda costs $0.50 more? When I smoked cigarettes I didn't feel punished by their continually-rising cost. I'd rather pay for something with a large negative externality at the point of purchase than in the form of income tax, since it's likely to be more efficient. The Coase theorem tells us that aside from transactional friction, it is no more expensive to pay up front than later, and in its role of insurer of last resort the public interest is best served by minimizing the predictable scope of the problem.

The fact that revenue ends up in the general fund is irrelevant; the objective is to reduce consumption, and soda taxes have been demonstrated to be effective in that goal. In case you're not familiar with the geography, Berkeley and San Francisco are only about 20 minutes apart by subway and travel between them for work or leisure is very common.

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.3...

> It's really hard for some people, especially kids, to resist getting jacked up on sugar.

Somehow that reminds me of this:

https://en.wikipedia.org/wiki/Stanford_marshmallow_experimen...

oh come on, get off that high horse. if she's impaired she should be in custodial care. if she's not disabled then she's entitled to do what gives her pleasure. if she's as disabled as you say she is, who's to say that's not the best part of her day when she pops open that soda? she's entitled to make that choice regardless of what the hard left such as yourself think about it.

She is in custodial care but she's functional enough to visit people, take a dog for a walk, play videogames and paint pictures. When she's at our place we try to behave like responsible parents. Maybe it is the best part of her day to guzzle a quart of soda in one go, but as someone invested in looking after her I don't want her to suffer from diabetes later.

Also, have you noticed that many kids like soda but have poorly-developed reasoning skills because they're not finished growing? I object to people exploiting that to make money while avoiding the taxes to pay for the predictable social costs.

So those taxes on cigarettes are passed to employers for the lost productivity? And the taxes on sugar will be passed to insurance companies?

The answer is of course no to both... so people are being taxed because others are being infringed, but the taxes don't serve those infringed.

Also, diet soda has its' own issues... and more fat people are drinking diet soda than regular.

--

edit: Also, we don't need to tax soda, just stop subsidizing farming...

You don't need to pass the tax on to those effected for it to work. As long as people pay something like the costs they impose, they'll only do it when it's worth that cost. After that, it doesn't matter if the money goes to those effected, or the local schools, or road maintenance, or whatever.

I agree that not subsidizing sugar production would be a much better step to take here.

Wait..are you suggesting tax something because reason A in order to raise money for thing B where A has absolutely no relation to B? This is why people hate liberals. Why do we need to arbitrarily tax things? Let me guess these are things you don't like or use so you have no problem with increasing taxes on them.

No, I'm suggesting that if activity A imposes some external cost on B, you can discourage A by the "proper" amount by taxing it even if the money doesn't go to B.

Would you mind cutting out that "this is why people hate liberals" nonsense? It's incredibly obnoxious.

Lost productivity isn't a valid reason to tax something, unless you would also tax working less than full time, taking a year of to travel or fishing trips.

Just because you ingest something doesn't mean you will ever get sick. Maybe there are some people that can drink a lot of soda, but would never use the insurance.

I agree with the 'sin tax' because it places it closer to the source. There are many, many external variables that will affect the individual before it affects health insurance.

If "soda" is "bad", then tax soda. Don't attempt to figure out the cost once it is so far removed from the situation (i.e. don't attempt to measure the flapping of butterfly wings in a hurricane)

I think an issue with all of this is that the entire field send unreliable. Until recently a fat tax could have been conceivable. Right now a carb tax seems not unjustified. Since we don't fully understand what's causing it, maybe we should tax non-disease caused obesity? As far as I'm considered nutrition is a hot mess.

I like your idea, but it seems like then the government (or somebody) would have to have a guaranteed way to detect whether or not you're drinking soda, smoking, etc. Seems invasive.

If the only argument for a soda tax is the externalised costs of obesity healthcare, why not just charge people for obesity healthcare?

After all, someone who drinks soda and does a lot of exercise or hard work might not impose any cost on the health system - and someone who eats a lot of bacon or home-baked cakes might get obese without drinking any soda.

Obesity isn't strictly a lifestyle choice for everyone afflicted with it.

If you pay with a bank card or use a loyalty card that exists already.

As for the tax, it doesn't need to be applied at the point of sale, but can be further back in the chain.

Lots of people don't like diet soda and would stop drinking soda rather than switching to diet. The realistic outcome of heavy tax on sugary soda is a reduction in the amount of soda consumed. (Which I'd probably call a win, though obviously not a win-win.)

There will almost certainly be some reduction (unless soda becomes a Veblen good, which seems unlikely but not impossible) the question is how much the price elasticity is. I found a scientific paper[1] that suggest that under some ideal conditions I am not sure apply to reality a 10% tax means 10% less less consumption.

However what do they then consume? A switch from diet cola to juice would be bad from a sugar perspective and a switch to milk would be bad from a caloric perspective. Sparkling water is better from both perspectives but it is worse for your teeth than regular water [2] plain tea seems mixed [3] but realistically would you expect most people to switch to plain tea or tea with tons of sugar?

[1]: http://www.sciencedirect.com/science/article/pii/S1570677X15... [2]: http://www.today.com/health/sparkling-water-bad-your-teeth-d... [3]: https://en.wikipedia.org/wiki/Health_effects_of_tea

Why not just drink water? Why does your drink need flavors? And anyway, the sparkling water will still be better for teeth than the soda. Don't let perfect get in the way of good.

Because it tastes better that way? Anyway the relevant question isn't why my drink needs flavour, but what the majority of those who choose to consume less soda with this proposed sugar tax will switch to. And remember they are doing it for economic reasons, not for health.

Sure, as long as you ignore all the costs of people cutting their soda consumption (e.g. costs to soda drinkers that have a healthy lifestyle, loss of utility from switching to a lower-valued activity, redirection of resources to substitutes).

But if you're going to make that assumption, just ban soda, since you no longer recognize any upsides to it.

My city attempted a large tax on sugary beverages only, but they ended up compromising with the opponents of the bill and implemented half the beverage tax on diet as well as sugary drinks. It seems like once the regulation for soft drinks is on the table, it's only a matter of time before diet sodas are included

Is diet soda really any better with regard to health? I was under the impression that the sweet taste without the calories causes problems with insulin or satiety or something (can't recall details).

There's some evidence that artificial sweeteners have a negative effect on the human gut[1].

https://www.scientificamerican.com/article/artificial-sweete...

That is compared to water, not sugary drinks. People aren't drinking diet drinks as a replacement to water, they are drinking them as a replacement for sugary drinks.

That seems a weird compromise. Who is against a soda tax, but pro a tax on diet soda?

I would have thought most big soda manufacturers sell both, and even if you only sold non-diet soda, you think it would be easier to pivot to diet soda than push for legislation to raise it's price.

1. It's not as addictive as sugar 2. Significant number of people don't like diet sodas

3. Can cause gastrointestinal pain 4. Promotes overeating

5. Aftertaste reminiscent of something that would warrant a call to poison control

I have that reaction to all USian soda (am UKian) because of HFCS rather than straight up sugar. Honestly, to me, the diet stuff actually tastes slightly less awful.

Weirdly, diet Tropical Tango tastes better to me than the sugared version, possibly because its flavourings are so artificial already that the artificial sweetener fits better ... or possibly just because I'm weird.

Real-sugar soda variants in the US (we do have them! And not just imported Mexican coke!) usually come in glass which makes it harder to do a useful side-by-side tasting. I do prefer them, but I'm not sure how much of that's the glass. Meanwhile, I can tell instantly when I've accidentally tasted something with artificial sweetener in it. I've even picked it out from products that have real sugar but are supplemented with a bit of something artificial, waaaaay down the ingredient list, having no idea in advance that it'd be there.

[EDIT] I should add that I'd be surprised if the sugared variants typically have no difference to the HFCS sort other than subbing out the sweetener, so that's another wrinkle to attempting straight comparisons of sugar vs. HFCS

Any food can cause gastrointestinal pain. If you eat a lot of it :) Also any food that tastes good can be reasonable claimed to "promote overeating".

Doesn't regular soda fall into these categories, too?

There are numerous studies that link artificial sugar to overeating even when you account for the self-selection bias. I'm not going to pretend to be an expert, so you should evaluate their quality for yourself but the story goes something like this.

Your body uses some pretty basic heuristics in order to determine one, that you're full, and two that you're getting a sufficient caloric intake. Introducing high-volume, low-calorie foods into your diet isn't necessarily a problem, but your body will quickly determine that you need more volume to reach its caloric needs. Especially if you use diet soda / lite snacks to satisfy hunger. So when you mix 'diet' foodstuffs with normal food you will more than likely overeat on the high calorie foods leading to more weight gain.

This is where philosophy for the other dieting extreme comes from. If you normally eat extremely high-calorie/low-volume foods to satisfy hunger and put up with a grumbly stomach for a while you will adjust the other direction and under-eat on normal calorie foods, ideally leading to weight loss.

> There are numerous studies that link artificial sugar to overeating even when you account for the self-selection bias. I'm not going to pretend to be an expert, so you should evaluate their quality for yourself but the story goes something like this.

Sources? This is something I spent a bit of time looking into and the consensus at the time was there was no strong consensus.

Coke zero is actually quite nice.

I'm not a big fan of the metallic aspartame aftertaste.

The vast majority of people can't tell the difference in double blind taste tests, especially at the cold temperatures it's served at.

I reckon with properly blinded tests many people couldn't tell the difference between 7up and coke if you served it cold enough.

After drinking a lot of diet Coke & Dew because soda is free in my office and I don't want to be a fat ass, I actually prefer it to the regular stuff. The regular is too sticky and sickly.

That's what i also realized. it's still bad, but maybe a bit better than the sugary one.

> The soda industry has poured over $67 million into defeating state and local efforts to regulate soft drink sales in the United States since 2009, according to the Center for Science in the Public Interest.

That seems like a very tiny amount compared to the profits we are looking at. I mean Let us say if you are focusing on 10 major US cities + DC then it is merely $6M per city. Isn't that too tiny an amount to get anything done ?

Political lobbying has some of the highest RoI a business can hope for. At a municipal level, a few hundred dollars can be sufficient to turn a councilor, get access to edit legislature as it is written, or just get your proposed legislature accepted as verbatim.

If the local media doesn't make a stink of it, you'll get away with it, too.

> get access to edit legislature as it is written

In the US most legislation is already written by the lobbyists themselves.

... Because they have access. Through lobbying. It's not a state of nature.

They are probably aware of the pending shift in attitudes with diet sodas, ie more people becoming aware of [1] that they realize that regulation of sodas will lead to regulations of diet sodas a few short years later.

[1] http://www.forbes.com/sites/quora/2016/09/08/the-awful-truth...

1. the soda industry poured over...

2. I was just listening to a Stuff you should know on artificial sweeteners, and it seems that there's some downsides to diet sodas as well. One example was that the non-calorie sweetener reduced the body/brain's relation between sweetness and calories. This causes the body not to recognize other sweet things (full sugar drinks/candy, carbs, etc) as caloric.

$67M is probably a drop in the bucket for them.

It's definitely a drop in the bucket.. The combined revenue for PepsiCo and CocaCola is over $100 billion per year.

$10 million/year fighting against soda taxes represents 0.01% of their revenue. I'd be surprised if they were only spending $10m/year.

1) The relevant metric is net income not revenue (that's what at stake for them)

2) Those figures are worldwide, not just for Mexico.

That said, I wouldn't be surprised it's not Coke and Pepsi directly behind the spying, but FEMSA and other bottlers. After all, why would Coke risk its huge brand when the bottlers, who have as much as stake, are Mexican, and are thus better to "influence things over there"

These taxes often include taxes on sugar-free versions too.

They do both.