A few days ago San Francisco Mayor Gavin Newsom proposed adding a surcharge on soft drinks with high-fructose corn syrup as part of a campaign to combat obesity.
Newsom’s “soda tax” is just the latest development in a series of metropolitan initiatives aimed at promoting healthier living. New York, which pioneered smoking and trans fat bans, has been the most gung-ho city and similar bans now have been passed, or are being considered, by cities across the nation—and the world.
Efforts like the soda tax are often derided as unnecessary big government intrusions, especially for something like corn syrup (or trans fat) that doesn’t hurt bystanders the way second-hand smoke does. Those who eat or drink poorly only hurt themselves; and the right to self-destruct is a right the government should respect (or at least this is what some say).
But here’s the problem: the cumulative effect of saying that obesity isn’t my problem is to make it everyone’s problem. Newsom’s spokesman, Nathan Ballard told the New York Times that “there’s a well-established nexus between obesity, which is caused by high-fructose corn syrup, and the increased health care costs for the city.” According to a 2004 study in the Annual Review of Public Health, obesity is responsible for between 5 percent and 7 percent of total annual medical expenditures in the United States. Every year excess weight costs our health care system more than $90 billion. Even employers shoulder the burden of obesity: overweight workers require as much a $2,500 extra in health care costs, adding up to almost $300,000 in medical expenses for a 1,000 person firm.
The reason why obesity costs so much is obvious. Individuals who are carrying too much weight are at an increased risk of hypertension, osteoarthritis, high cholesterol, type 2 diabetes, heart disease, stroke, gallbladder disease, respiratory problems, and cancer. And it’s only getting worse. A RAND study from earlier this year found that from 2000 to 2005 the obesity rate in the U.S. (, i.e. the number of people with a body mass index of 30 or above,) increased by 24 percent. Meanwhile the number of people with a BMI over 40 grew by 50 percent, and the number of people with a BMI over 50 grew 75 percent.
To be fair, Ballard overstates the direct causality between corn syrup
and obesity. Dr. Walter Willett, the chairman of the nutrition
department of the Harvard School of Public Health, told the New York Times
in 2006 that “there’s no substantial evidence to support the idea that
high-fructose corn syrup is somehow responsible for obesity. If there
was no high-fructose corn syrup, I don’t think we would see a change in
anything important. I think there’s this overreaction." In other words,
we’re not 100 percent certain that corn syrup is what’s making America
But this isn’t an excuse for inaction. We know that sodas are low in
nutrients and high in calories—in fact, they’re the number one
contributor to Americans’ ultra-caloric diets. Whether or not
eliminating corn syrup is the silver bullet, we have a lot to gain by
cutting down on soda consumption.
Even if there is no proof that corn syrup is the leading cause of
obesity, citing uncertainty is a cop out. In risk assessment
science there’s something called the precautionary principle.
It states that if you understand the scope of a danger but aren’t 100
percent certain that a given solution will totally fix it—but you know
that this solution isn’t too costly and won’t make things worse—you
have to give it a try.
We in fact have a pretty good sense of what a soda tax can do for our health care system. The Commonwealth Fund estimates
that a national soda tax of one cent per 12-ounce drink would save our
health care system $283 billion over the next decade. If the surcharge
actually helped reverse obesity, the savings would be a whopping $1.1
trillion. Revenues from the soda tax could be reinvested in block
grants to states for obesity prevention programs, something that Newsom
is proposing at the city level. States would be eligible for such
grants only if they met minimum obesity control requirements, such as
banning trans fats, displaying nutritional information, banning soda in
schools, and enforcing existing regulations on nutritional value.
Tying these requirements to the soda tax helps us move past the
uncertainty as to whether corn syrup is the real bogey man, because the
soda surcharge would be part of a comprehensive set of anti-obesity
requirements. We would be casting the net wider.
The Commonwealth proposal is well worth considering. We know the health
risks of obesity. We know that, whether or not high-fructose corn syrup
is the cause of obesity, it’s not helping things. We know that a soda
surcharge wouldn’t make obesity worse and that we can package it with
other policies. We know the health care costs that we’ll incur if we
don’t try to do something about obesity in America.
Granted, there are some rebuttals. One is the fact that a soda tax,
like all sales taxes, is going to be regressive: poor people spend a
greater share of their income on sodas, so if you tax spending you end
up taxing more of what they make. And soda consumption does tend to
increase as income level decreases—poor people drink more soda than
But strangely, you want this tax to be regressive, because you want the
people drinking the most soda (low-income households) to be dissuaded
from doing so by higher prices. In that sense, the soda tax does become
a game of numbers. Your average teenage girl drinks
500 cans of soda a year; boys drink about 700. That means a family will
be shelling out an extra $50 or $70 per year for each soda-guzzling
kid. Will that be enough to change consumption patterns? I don’t know.
Finding the sweet spot is going to take some time.
Another objection is the standard slippery slope argument that
accompanies any attempts at government sponsored behavior modification:
taxing soda is just the beginning, and soon the government will be
telling us how to live our lives. This is a scary possibility, to be
sure; but it’s not scarier than the reality before us now. We already
live with quantifiable, not just hypothetical, health risks and health
care costs from obesity. They’ll get worse if we do nothing. And, as
per the precautionary principle, we don’t have to know that the soda
tax is a cure-all. We just need to know it won’t make things worse—and
so long as the only argument that it will is based on ideological
posturing, I’m not convinced.
So let’s give the soda surcharge a shot. We have too much to lose if we do nothing.