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 over-weight. We know the risks. We are warned of the dangers of being over-weight; we know that there is a strong possibility that it will damage our health. And yet many people continue to ignore this advice.
Over sixty percent of the UK population are deemed to be obese or over-weight. 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 the fact that they are over-weight.
Perhaps we don’t recognise the costs involved. Not only is there the wider economic cost in terms of reduced productivity and increased absence, but NHS England report that over £16 billion is annually spent on dealing directly with the medical costs of diabetes and other conditions related to being obese or over-weight. If we assumed that all this funding came from Income tax, then – with a tax paying population of forty million – that works out at 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 that they don’t have to; nobody likes to waste money. You would therefore think that we would be more challenging of those that cause us expense.
Would I let my teenage children have the house heating on full but let them also leave 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 what the money is used for? 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 to look 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 difficulties of getting to see a GP, the shortage of hospital beds, the fact that medical professionals are over-worked.
And yet many of these complaints are the direct result of our need to look after people who have ailments that have been caused by their self-determined lifestyle.
Some hospitals will now refuse to do certain operations on patients who are vastly over-weight. But this barely touches the surface of the obesity cost. The other remedial route that is often touted may be that of introducing a sugar tax to discourage the 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 over-weight 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 over-weight because we recognise that we all have vices, so we should not be so judgemental. 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 over-weight 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 prejudicial against them, we will become antagonistic to them. That divides and weakens society.
And so we continue to foot the bill, paying for something that we get no benefit or value from. We continue to let the over-weight and obese take advantage of our generosity. We are it seems a very tolerant society.
© Steve Oxley, 2019