I am sure that I heard Treasurer Joe Hockey say somewhere, perhaps in his Treasurer’s speech on the budget, that he — perhaps all Australians — expected that we would look after ourselves with respect to health. It is a view that I hold myself, and maybe I was projecting it on to him. But my reason for raising it now is that ethical discussions of the Government’s position have been hard to find in the subsequent clamour over the Budget. It is all about lies, broken promises and heartlessness.
I’ll be a boring Grumpy Old Man for a moment and say that I cannot remember more than one or two obese people in the towns I lived in when I was growing up. I’m sure there were more, and one of my my grandmothers was rather plump, but my memory is that we kids ate everything put in front of us, raced around outside, drank lots of milk, and had little money to spend on sweets. We walked or ride our bicycles to school, we played a lot of sport, and only a few families had cars.
We were all slim to skinny, the kids of my youth and adolescence. A few boys were bigger and taller, but they weren’t fat. Only one kid in my whole school experience had the nickname ‘Fatty’, and he wasn’t in any sense obese, just a bit plumper than the rest of us. By and large, my generation of high school students remain lean rather than overweight, and that is more than fifty years after we left school.
More recent generations seem to be rather heavier. The reasons are clear, and we all know most of them: Australia is a lot richer, food is cheap, we eat out a lot, we eat food for comfort, we eat a lot more sweet things, we don’t exercise much, we drive cars and watch the telly, and so on. Officialdom is out there warning us. We are the second most obese nation after the USA. There’s trouble ahead, with adult-onset diabetes, high blood-pressure, strokes, heart disease and so on facing the fat as they get older.
So far as I can see, the governments, state, territory and Federal, are the principal worriers, because obesity leads to ill-health, which leads to health care and hospitals, which leads to higher health costs. Again, as far as I can see, the general population takes little notice, though some individuals do try to sort themselves out. We are buying more bicycles, walking and exercising more, and all that is good, but still the obesity ‘epidemic’ is out there, infecting children now; it’s not hard to see a lot of overweight children.
Why is there resistance? Well, we like to do what we like, and eating, drinking and watching television are enjoyable. Giving them up can cause pain. ‘I’ll do what I want to do!’ is the current mantra, not just about food, but in general. We have ‘lifestyles’ and they are addictive.
In health-cost terms, the whole community bears the cost of obesity through taxation. Is that fair? If obesity is something we bring on ourselves, or on our children, and is preventable for the great majority through living a healthier life, shouldn’t we all go down the healthy path? Now I don’t think that Joe Hockey said anything about obesity, perhaps because he didn’t want to be termed a ‘fattist’. But it does seem to me to be an obvious example.
Obesity is generally measured through the use of the Body Mass Index (BMI), which relates your weight to your height, with three grades: Normal, Overweight and Obese. Some measurers simply run a tape measure around your waist, and tell you that 94 cm plus is a no-no. Either way, there is both commonsense and simplicity in the measurements, and they do tell you something.
Now smokers know that they are paying a hefty tax in order to enjoy cigarettes, and the tax is there in part because of the likely high medical costs that face smokers at the end of their (usually shorter) lives — and in part to discourage the practice itself. I can’t see a real equivalent in the case of the obese. You could have a varied Medicare rebate related to your BMI, so that the lean and hungry get a full rebate and the obese very little. But in practice that won’t work, I should think.
In my view the health system, like social welfare itself, is there to save us all from catastrophe. It is not a convenience. We should feel fortunate in going through life without needing it, and happy to pay our taxes so that it is there for the others who do suffer catastrophes. I am glad it is there, but I do feel that we should construct our lives so that we are both self-reliant and altruistic. Why should the lean support the overweight?
A friend to whom I was setting out all this remarked that he remembered a slogan pasted to the bottom of a mirror in a hospital bathroom that said: ‘The person you are looking at is the one who is responsible for your health and well-being’. I agree. I would also be interested in what readers think about this issue and other like it. Governments are trying to educate us, but is that enough?
On re-reading I perhaps should have remembered that Mr Hockey might have avoided using the example of obesity because while not obese himself, he is not really in the ‘lean and hungry’ category. I also thought his Treasurer’s speech was, as a speech, rather a good one.