2009-03-26 06:07:33 - President Obama's press conference claim that the "best way" to cut the deficit is "to reduce health care costs" by using "health information technologies," providing more "preventive care," and producing "good quality outcomes" overlooks the most obvious approach -- to prevent diseases in the first place rather than just get somewhat more efficient curing them, says public interest law professor John Banzhaf, who has been leading the legal attack against two major killers for forty years.

"Heart attacks, strokes, and cancer are very expensive diseases to treat no matter how efficiently you keep health records, spend money on healthy living campaigns, and improve treatment procedures, so the best way to reduce the deficit is not to improve the health care system at the margins,but rather to directly attack the major preventable causes of these and other deadly and costly medical conditions -- smoking and obesity -- by invoking personal responsibility.

Smoking and obesity together cost the American economy hundreds of billions of dollars a year in totally unnecessary health care and other expenses, much of which is paid directly or indirectly by taxpayers who don't smoke and aren't obese, because we don't require those whose habits are

driving the deficit up to take personal responsibility. The most efficient way to reduce those costs is not better management and treatment, but by taking proven steps to reduce these twin scourges.

Incredibly, this can be done at virtually no cost, which is fortunate since it now appears that the President will not get most of the tax money he is counting on for health care reform. Fortunately, the country can easily do the following without any cost to taxpayers, but with the largest possible deficit reduction:

* Ban smoking in virtually all public places, and around children in homes and cars. Banning smoking causes major declines in smoking rates by making it more difficult to remain a smoker, and by making the habit even less socially acceptable.

* Increase the tax on cigarettes on a par with the cigarette tax rates in most Western countries so that smokers will be forced to pay more of the share of health care and other costs they impose on other Americans. Far from costing money, this would provide tens of billions of dollars for further health care reform.

* Insure that smokers pay more than nonsmokers for health insurance under both private and government programs, just as they pay more for life insurance, and just as drivers with bad habits are usually forced to pay more for liability than drivers with good driving habits. This would provide a very powerful and immediate incentive to help the 80%-90% of existing smokers who already want to quit to do so.

* Consistent with a recent federal ruling, require the obese to pay more for their health insurance. This is fairer to the majority of Americans who are not obese, and provides a major new incentive for people to eat healthier. Ironically, the need for this is greatest during a recession for a variety of reasons.

* Require major restaurant chains to provide clear and conspicuous disclosure of the approximate amount of calories and fat in each offering, with fast food outlets required to provide this information on menu boards where people look when ordering. Only then can patrons exercise "personal responsibility" for their choices.

* Mandate that fast food outlets provide health warnings (or advisories) consistent with what torts law now requires for other consumer products; an important step for many Americans who do not appreciate many of the risks, especially as they are drowned out by ubiquitous advertising for fattening food items.

* Crack down of deceptive food advertising, especially that aimed at young children and teens, to avoid outright misstatements, misrepresentation by failure to disclose, etc. This would help prevent deception, and also help everyone to exercise more personal responsibility for what they eat.

* Modify government food subsidies so that there is greater support for healthier foods and less (if any) support for unhealthy foods -- just the reverse of what happens now. Let's subsidize good health, and not unhealthy eating habits, and save billions of additional tax dollars.

* No longer exempt especially fattening foods -- those containing mostly "empty calories" -- from sales taxes imposed on most other purchases. We may not want to tax those trying to buy potatoes, beans, or fruit for their families, but why exempt Coke, Ding Dongs, Ho Hos and similar foods from a tax.

Professor John Banzhaf is the man behind the ban on cigarette commercials and the banning of smoking in public places, both here and abroad. He also helped start the movement to bring fat law suits aimed at obesity -- ten of which have already been successful.

PROFESSOR JOHN F. BANZHAF III
Professor of Public Interest Law
George Washington University Law School
FAMRI Dr. William Cahan Distinguished Professor
FELLOW, World Technology Network
2013 H Street, NW, Washington, DC 20006, USA
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