Responding to Comment on “Should People Who Don’t Take Care of Themselves Pay More?”

Bradley—Thanks for your comment. I’m inclined to agree with you about smoking. Because so many people do quit, it’s clear that it is possible for most people who are addicted to tobacco to give it up. So a financial incentive (or penalty) might have some results. And there is no question but what smoking adds to our national health bill.

When it comes to weight loss, however, I’m convinced by the research that only a small percentage of the truly obese can take the weight off and keep it off. As for adults who are carrying an extra 10 to 20 pounds, this doesn’t seem to me a major health problem. Ideally everyone would be at their perfect weight, but if we begin charging people who are 10 pounds overweight an extra premium I’m afraid we would be feeding our culture’s obsession with being thin.