Oxthink

Both as a society and as individuals, it seems we are extremely, and often rather, irrationally tolerant of others. Why, when I observe people, do I not recognise the fact that in some cases their condition or lifestyle will involve a financial cost to me?

Take, for example, the overweight. We know the risks. We are warned about the dangers of being overweight; we know there is a strong possibility that it will damage our health. And yet many people continue to ignore this advice.

Over sixty per cent of the UK population is deemed to be obese or overweight. Many will suffer from a variety of medical conditions, including heart disease and strokes, high blood pressure, Type two diabetes and joint problems. After smoking, it is the second biggest cause of premature death.

Conditions caused by being obese or overweight will, during their progression, make substantive demands on our medical services. They will cost our health service a vast sum of money.

These people are or will be a cost to society. And yet we continue to allow them to pursue their particular lifestyle. How can that be acceptable? Why do we tolerate it? It’s costing us money; it’s costing me money. Indirectly, through my taxes, I will be paying for their weight.

Perhaps we don’t recognise the costs involved. Not only are there wider economic costs in terms of reduced productivity and increased absence, but NHS England reports that over £16 billion is spent each year on the direct medical costs of diabetes and other conditions related to obesity or overweight. If we assumed that all this funding came from Income tax, then, with a tax-paying population of forty million, that works out to each of us paying, on average, £400 per year just to look after this single group of patients.

And that is an average figure. Some people will be paying substantially more than this. Nobody likes paying taxes; nobody likes paying for things they don’t have to; nobody likes wasting money. You would therefore think that we would be more challenging of those who cause us expense.

Would I let my teenage children have the house heating on full while also leaving the windows wide open? No. I would certainly say something to them; I would certainly try to change their behaviour. If it’s costing me money, if I’m not getting value for my money, then it is unacceptable. It can’t be allowed to continue.

The same argument questioning our excessive tolerance towards others could also be used about tobacco users, but they have one redeeming characteristic – they pay substantially for their habit. In 2016 £12 billion was raised through excise duties on tobacco. This more than covers the cost of looking after them as their health fails due to their smoking.

It may be that we are so tolerant because we don’t make the link between paying our taxes and how the money is used? Perhaps we just don’t perceive obesity as a cost to us. Obesity is an individual matter; it has nothing to do with me – or so we think.

Even more frustrating is that there are great demands made for medical support in other areas of the health service. The money spent on looking after patients with weight-related conditions could be used elsewhere. We recognise that there are never enough resources in the health service. We complain about long waiting lists for operations, the difficulty of seeing a GP, the shortage of hospital beds, and the fact that medical professionals are overworked.

And yet many of these complaints are the direct result of our need to look after people with ailments caused by their self-determined lifestyle.

Some hospitals will now refuse to do certain operations on patients who are vastly overweight. But this barely touches the surface of the obesity cost. The other remedial route often touted is introducing a sugar tax to discourage excessive consumption of sugary products.

But, in doing so, there is a danger that we might be unfairly punishing certain people. Some will always explain their weight issues as being out of their control, physically, mentally or emotionally. In such circumstances, should they have to pay for their condition?

The fact that our physical size does not come within the remit of the law, that, like smoking or alcohol consumption, being overweight is not illegal, may be the reason why we so readily tolerate it. By accepting its legality, we are also implicitly asserting that we are prepared to pay the costs of repairing the damage it does.

Perhaps we do not object to the health care of the overweight because we recognise that we all have vices, so we should not be so judgmental. Today we might challenge obesity; tomorrow it might be something that we choose or like to do – the consumption of alcohol, a physical sport…. If we can’t accept the overweight, who else might in the future become persona non grata?

As a society, we have to be careful not to stigmatise or marginalise sections of the population. If we see the obese as a burden, we will resent them, we will become prejudiced against them, and we will become antagonistic to them. That divides and weakens society.

And so we continue to foot the bill, paying for something we get no benefit from. We continue to let the overweight and obese take advantage of our generosity. It seems we are a very tolerant society.