I'd be in favor of a ban on marketing to children if I had some confidence in it being able to be enforced, but that is difficult (it's difficult to prove it was marketed to children?). Besides, most of the problem is that *adults* made bad decisions, including decisions on behalf of their children.

Restricting certain markets from doing business would be even more difficult, since it would be hard to get a consensus on which activities are bad and how bad. We're bordering on social engineering here.

So, yes, we could do all that. Or, we could just have people pay the full cost of the decisions they make, and let people decide for themselves. To me, that options seems easier to implement and more reliable. If the government is not in the business of subsidizing health care in the first place, there would be no problem with how to pay for it. (please see my first comment for details on my proposal in which people pay based on the risk associated with the behaviors they choose–and the risk is determined by private insurance companies).

among other things we could:
implement laws that severely restrict marketing to children period.
restrict marketing in certain areas the same way that cigs/alcohol have restrictions on marketing
and/or
We could out-market the companies who are currently encouraging bad lifestyle choices
also
Local planning councils could permit/encourage/demand walking neighborhoods with neighborhood shops/parks/cafes/etc., rather than clumping the shops/etc into strip malls that have to be driven to and from.
To me the local councils are a key player – and whoever licenses shops. That's where small businesses get stymied.

It's a complex issue isn't it?

Personally we got rid of the TV about 3 years ago – life's too short and I don't like the influence on the small children…

How do you recommend we implement your strategy? Do we pass laws forbidding companies that make unhealthy choices to advertise?

Step 1. We kill Over the air broadcast TV.
Step 2. We Kill Cable TV.
Step 3. We create a market in which people can buy TV programming by the show.

Easy Problem solved.

How do you recommend we implement your strategy? Do we pass laws forbidding companies that make unhealthy choices to advertise? I don't see that as any better than Ned's proposal, and it means an endless political debate about which choices and bad and how bad. The result would be a mish-mash of over-simplified policies that won't get it right even most of the time.

As a side note, your comment reminded me of a TV documentary I once watched where they put a banana and a cupcake in front of a child and allowed them to choose. Of course they always chose the cupcake. Until they plastered stickers of cartoon characters all over the banana. Then they chose the banana. Since then I've always wondered by health food companies don't do more to market their foods to kids. If you look at any produce section, or any health food packaging, it's always extremely boring to kids. But I don't think this is a question of government policy, just marketing strategy of private companies.

We could market healthy choices instead. No nasty tax disincentives to administrate
We could encourage local neighborhood businesses like fruit and veg shops, butchers, bakers, SMALL grocery stores with some raw ingredients and not so much processed/packaged foods (Trans fats anyone?). Shops that are close enough to walk to (exercise). Instead of marketing/selling pepsi and coke we could sell the idea of kitchen gardens and small farms and living and eating locally. This might also encourage people to slow down and to stop multi-processing (good for mental health as well). While we're at it how about some local cafe's as well? With real chefs cooking real food and *not* brought in from some food industrial complex in handy portion controlled packaging to be warmed up by the staff… This would also provide useful employment and business ownership and people that have a vested interest in the people and the community.

The possibilities are endless (and healthy)!

We shouldn't penalize people for being swayed by the marketing machines that assault us everyday that encourage unhealthy choices and lifestyles.

We could even re-employ the marketing people that currently work for Coca-cola/Pepsi/McDonalds/Heinz/etc since they've done such a good job with their current employers.

The only exception would be baby food for those under three years old. Babies need calories. Adults do not like baby food, so I doubt this will create a calorie abuse problem.

Really? What about pregnant women and nursing mothers? They don't need calories? For that matter, what about children over three? Children over three don't need calories? Diet Coke is no healthier than regular Coke. It contributes to osteoporosis in older women. Not that that's going to stop me drinking it; I'm addicted to the stuff. But I'd rather make that decision myself than have the government tell me it doesn't matter if my bones snap. And what about orange juice? Great for you, loaded with Vitamin C… Terrible for you, loaded with sugar.

I could go on. Your plan is impractical at best and extremely foolish at worst, for lots of reasons. In general, I'm opposed to the school of thought that believes punishing people for the choices they make is better than addressing the varied and complicated reasons people make the choices they do.

However, I do think your general point is correct. The fairest way to pay for our healthcare system is to make those who make poor health choices pay more. In an ideal world, when a person makes a choice that increases their likelihood of needing more healthcare, they should pay more proportional to the extra risk they are taking on. This is one of the main problems I have with universal health care in which everyone pays the same amount, since it means no one is financially responsible for their own poor health decisions. However, I'm usually the first to point out that many health problems are not predictable or preventable. That's why I advocate this approach:

Currently, our health care system punishes those who are sick, whether they are sick because of poor choices, or whether they are just unlucky. This is a failure of the free market system (how well the free market works in any particular case is proportional to how strong the relationship between choices and results is). However, we can fix this by keeping the free market system, but regulating it such that it punishes people for the *choices* they make, not their health status. So I don't entirely disagree with you that we need to find a way to create an incentive for making good healthcare choices. This is very difficult for the government to do, since pretty much the only tools they can use are taxes or banning certain choices. We'd likely get a system that is either too simplistic, such as a tax on calories, or else a mish-mash of compromises that is unproductive, since it would be very difficult to get the government to agree on what choices are good and bad, and how good and bad they are.

Ironically, it is the free market that is best equipped to create such an incentive system. They are already in the business of judging someone's risk of needing health care based on their current condition and lifestyle. The only change would be that health insurance providers would need to be regulated such that they would only be able to use peoples *choices* to determine what to charge for insurance, and not current health condition. For example, a smoker with lung cancer would get charged the same amount as a smoker without lung cancer. The health insurance companies would be allowed to ask only behavior questions, such as “do you ride a motorcycle?” Of course you could have people lying, but if someone gets in a motorcycle accident who had told the company they would never ride a motorcyle, the company would be off the hook, and the patient would be responsible for his health care costs, so there is no incentive to lie.

But alas, the premise of your post is that we have a government-run health care system, so my solution is probably off topic.

Sin tax, such as tobacco tax is already in place and rising.

To jwest's predictably cold comment, get used to it, buddy. Every generation lives about 50% longer than they think they will. It's not a matter of us doing something to make this happen. It will happen anyway, so better we plan for it than pretend health nuts or 'end of life' procedures are causing it. Had to laugh at your 'rich people' are thinner line. Your party has presided over a 30 year stagnation of income for middle income and lower Americans, while the already rich got richer.

Brilliant Ned, just brilliant.

Do you have any idea of how much money it would cost society to have people healthier than today? I realize you’re trying to save money, but that’s not what this plan does.

The biggest problem with healthcare spending is end-of-life extraordinary measures being performed when the remaining quality of life doesn’t justify the cost. Living longer also places a burden on the Social Security system, which is going broke as it is.

Rich people tend to be thinner, healthier and of course have access to the best healthcare. They also have the means to support their lifestyle and add to the overall economy while aging. The poor are more prone to be obese, which reduces lifespan, generates relatively sudden deaths and eases the monetary burden on the segment of society that is not a net consumer (rather than contributor) of social services (public money).

If you force people to be healthier overall, the minor savings you will achieve in short term medical costs will be more than offset by the higher expenditures on these same people later in life, along with other costs (Social Security, etc.) that would not have been paid out if the person had died early.

Everyone dies Ned. It just makes sense that those who cost society more die sooner than those who contribute. This may sound a bit harsh, but it’s reality.

You are right infants and toddlers generally should not be calorie restricted, but since most babies are eating mostly table foods by one year your baby food exemption would not be adequate to ensure they will get adequate calories.

Moderate alcohol intake is at least neutral and possibly beneficial to overall health.

Many other groups should not be calorie-restricted, including many elderly, people on chemo, people with severe emphysema, people who are malnourished for various reasons, etc, etc.

The concept of taxing food will hit the poor disproportionately and will be a very tough sell.