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Print“Offering a personal tax deduction for adults/families having a body mass index (BMI) equal to or less than 25 will create a sustained incentive that is fully aligned with our national health priorities.”
Democratic Senators Max Baucus and Tom Harkin are drafting legislation to use tax incentives for businesses to develop a healthier workforce through employer-sponsored wellness programs. “Prevention and wellness should be a centerpiece of healthcare reform,” said Harkin, who regularly climbs the stairs to his seventh-floor office on Capitol Hill.
It certainly seems like a common sense approach, as employees with elevated cholesterol and blood pressure, poor blood glucose control, and excess weight are more likely to get sick, develop chronic disease, experience absence and disability, and over-utilize their fair share of expensive healthcare resources. Such health problems make U.S. firms less competitive and using tax incentives to address it may seem like a compelling way to address the problem. But there’s a more efficient and practical alternative without enacting yet another undue burden on business: personal tax incentives to adults and their dependents for achieving and maintaining healthy body weight. Here’s why.
Firstly, it’s important to understand that the high proportion of Americans with unhealthy personal lifestyles is the single largest factor driving the nation’s runaway healthcare spending. Obesity is the single largest contributor to chronic disease and to the increasing cost of medical care in America.
Compared to normal weight individuals, obese patients consume a disproportionately higher amount of healthcare spending. Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications. Obesity is directly associated with the leading causes of morbidity and mortality. Obesity and inactivity increase the risks for the top three causes of premature death in adults: heart disease, cancer, and strokes. Obesity and a sedentary lifestyle also strongly increase the risk of diabetes, the sixth leading cause of death.
Economically, the total national cost of overweight and obesity is $117 billion, with a direct cost of $61 billion and an indirect cost of $56 billion. In fact, even modest reductions in the proportion of overweight and obese Americans would slow healthcare spending enough to fund a significant proportion of President Obama’s healthcare reform proposal.
Why would personal tax incentives be superior to business tax incentives?
We are a nation of individuals, not employees.
The economic strength of our nation depends upon the health of our citizens. Personal health is patriotic.
Employer programs primarily target adult employees and not the epidemic of obesity among children and adolescents.
Employee turnover mutes the financial benefits of employer programs.
The economic climate is not conducive to incremental employer investments that do not pay out in the short term.
Corporate tax incentives could create work environments that stigmatize certain employees, creating fertile ground for expensive and wide-ranging legal disputes.
Individuals and families with higher obesity risk often over-index for under-employment and unemployment.
Why would personal tax incentives be superior to business tax incentives?
We are a nation of individuals, not employees.
The economic strength of our nation depends upon the health of our citizens. Personal health is patriotic.
Employer programs primarily target adult employees and not the epidemic of obesity among children and adolescents.
Employee turnover mutes the financial benefits of employer programs.
The economic climate is not conducive to incremental employer investments that do not pay out in the short term.
Corporate tax incentives could create work environments that stigmatize certain employees, creating fertile ground for expensive and wide-ranging legal disputes.
Individuals and families with higher obesity risk often over-index for under-employment and unemployment.
Offering a personal tax deduction for adults/families having a body mass index (BMI) equal to or less than 25 will create a sustained incentive that is fully aligned with our national health priorities. A person with a BMI of 25 or more is considered overweight and a person with a BMI of 30 or more is considered obeses. Citizens owing no federal tax would receive cash or cash credits for earning a qualifying BMI status. Such earnings could be redeemable for health, nutrition and wellness related expenses and disbursed through debit cards and managed via retail outlets such as Wal-Mart.
Tax deduction claims would require a BMI certification available from any licensed healthcare professional including pharmacists, nurses and physicians. This personal tax incentive initiative could also quickly kick-start President Obama’s electronic medical record system, with health professionals certifying BMI status via HIPPA compliant e-stamps or vouchers. To facilitate public participation, a grass-roots social marketing campaign should be undertaken. One of President Obama’s eight principles for health legislation is that it must “invest in prevention and wellness.” Yes we can.
Peter J. Pitts is President of the Center for Medicine in the Public Interest, Partner/Director of Global Health at Porter Novelli and a former FDA Associate Commissioner. Rob Dhoble is President, Diverified Agency Services Healthcare, Omnicom Group.
