Nanny State vs Daddy Market

(A shorter version of this piece appeared on Marketplace today)

Bigger isn’t always better. By 2030, half of Americans won’t just be overweight, but obese. By then, nearly a fifth of our healthcare dollars will be spent treating the diseases that come with being bigger. Our lifestyles, rich in fat, sugar and inactivity, are creating a debt that’ll become the planet’s most expensive public health issue.

So what to do? One battle centers on how to make us better eaters and, especially, drinkers. Half of the sugar in US diets comes from sweetened beverages. Advocates of what gets called a soda-tax look like they’ve a strong case. Tax the sugar in the drink and the consumption goes down, right? Well yes, but a study from Northwestern University recently found that overweight people prefer diet drinks. You can almost hear the soda industry snickering.

But this oughtn’t to make us give up on the idea of taxation in the name of public health. Think about tobacco. A dollar tax on a pack of cigarettes makes some people smoke less, but that’s not the only thing we’ve done to curb smoking. We have changed regulation to target not just cigarettes but anything containing tobacco. We limited marketing to children. We’ve confronted the companies who profit from tobacco with a coherent public health push, and made them pay for their ill-gotten profits.

So why can’t taxes together with other ideas work with sugar? One in three kids born in America today will develop some form of diabetes, one in two kids of color. A meaningful soda tax – say a penny per ounce on sugary drinks – is an important part of a bigger policy strategy. We can, for example, take back the billions we spend subsidizing commodity and processed food production, and gives it to those most harmed by these products.

The food industry has responded by trundling out its experts – most notably Derek Yach, formerly an anti-tobacco hero at the World Health Organization, now a pro-Pepsi pundit at Pepsi – but also running adverts castigating soda taxes as a toll on the poor. “I can choose what to buy without help from the government”, offers TVs hapless and put-upon mother. That obesity is the result exclusively of a personal failing is a perception widely shared. As I argued in Stuffed and Starved, if the perception were true, you’d have a hard time explaining why Mexican teens are more overweight the closer you get to the US border.

So let’s just say that the individual interpretation of obesity is only part of the story. Advocates of a comprehensive public health strategy around obesity have to answer another charge -that they’re mongers of class war. This looks harder to evade – taxing food is always going to affect the poor disproportionately because poor people spend a greater proportion of household budgets on food than the rich. With poverty, energy dense foods become a rational way to “provide daily calories at an affordable cost”. As one researcher argues, “obesity is the toxic consequence of economic insecurity and a failing economic environment.”

But if that’s true, a soda tax sounds like it’s blaming the victim, part of a culture war between the rich who can afford not to drink Coke, and the poor who can’t afford anything else. And, certainly, if the move to tax soft drinks were an end in itself, then I’d want nothing to do with it. There’s far too long a history of culture war around food, with everything from white bread to Coca-Cola conscripted into a great battle over class and identity.

That said, if a soda tax can work as part of a bigger programme to rein in food companies and provide real choices to everyone across the food system, I’m all for it. That a tax falls disproportionately on the poor is reason to worry, of course. But tobacco taxes are like that too. What’ll make the difference is whether the tax is part of a bigger project to make the food industry pay for the health costs that will fall disproportionately on poor people. Ultimately, what we need an end to is not soda, but poverty. That’s a conversation long overdue.

In the meantime, though, don’t hate the soda tax. Local and regional governments are already experimenting with it, and the sky has yet to fall. This isn’t the nanny state as much as it is a response to the wild excess of Daddy Market. It’s just leveling the playing field back away from big food, so we’ll have fewer big people.