Fat People, Healthcare, and Tax Dollars

Launch week for the Weight and Healthcare newsletter continues with a daily post! Today I’m writing about how to counter the classic argument that fat shaming is justified, or that fat people’s bodies are their business because of their tax dollars. If you like what you are reading, please consider subscribing and/or sharing!

“But fat people’s bodies are my business because my tax dollars pay for their healthcare”

Anyone who attempts to address weight stigma will run into this argument, typically sooner rather than later.

In individual conversations when someone brings this up, I often ask to see their “Tax Yes and No” list. When they look at me quizzically, I explain that I want to see their list of things their tax dollars pay for, broken down into those they want to pay for and those they don’t, and the interventions in which they are participating for each of the things they don’t want to pay for. Nobody has ever produced such a list – because this really doesn’t have anything to do with their tax dollars, it’s simply a convenient way to couch their weight bigotry.

This argument is based on shaky claims that fat people are unhealthy and cost more money than thin people in healthcare. Today I’ll look at this in two ways. First the reality, and then as if those assumptions were true:

Reality:

Independent research has shown that the cost claims about fat people’s healthcare are seriously overblown (with studies doing things like assuming every health issue a fat person has is due to their body size, where as those same health issues in thin people are due to…something else… etc.) The truth is, you cannot tell how healthy a person is by looking at them, you can only tell what size they are.

There are people of all sizes at every point along the health spectrum, so being thin can neither be a sure preventative, nor a sure cure for health issues. And if fat people do experience health issues more often, instead of blaming their body size and calling it a day we have to look at what else might be causing that. Research suggests that health issues among fat people are driven by weight stigma (like the kind we experience from these “but my tax dollar” claims,) weight cycling, and healthcare inequalities.

Fat people are easy targets for this treatment because we are identifiable by sight, and it’s never a good idea to take a group of people who can be identified by sight and suggest that they should be eradicated to make things cheaper for everyone else. And even if it weren’t a blatant violation of human rights and basic decency, nobody making this argument can show a single method of weight loss that has been shown to work for more than a tiny fraction of people over the long term.

But let’s pretend that the assumption is true. In that case: fat people have higher healthcare costs, but…

Fat people pay taxes too, and our taxes go to pay for the deeply misguided and harmful “war on ob*sity.” We are actually funding a war waged against us by our government for the purpose of our eradication, that research suggests is harming our physical and mental health.

If we’re talking about “healthy behaviors” (and we shouldn’t be since there is no health or “healthy behavior” requirement to basic human rights) then we should be clear that there are people of the same weight with vastly different behaviors and people with the same behaviors and vastly different weights.

Fat people who look both ways before they cross the street still see their tax dollars go to pay for people who get run over after failing to do so.

Fat people who don’t mountain climb have their tax dollars pay for the healthcare costs of people whose attempts to do so are dramatically unsuccessful.

The estimated cost of contact sports injuries in high school and college alone is estimated to be between $6 and $20 billion dollars annually, but the people arguing that they should be allowed to stigmatize and control fat people because of tax dollars seem to be fine covering unnecessary injuries from sports that nobody needs to play.

And they should, because that’s how decent societies behave. I would rather my tax dollars pay for antibiotics to cure bronchitis than pay for an ER visit and hospitalization for pneumonia. And I’d rather my tax dollars pay for an ER visit and hospitalization for pneumonia than pay for a public burial because someone didn’t have access to healthcare. A society where everyone has access to healthcare is better for society from every possible angle (including overall cost, though that’s beyond the scope of this post and not even close to the most important argument.) I’m interested in removing barriers to healthcare, not justifying them with a weak-sauce argument about tax dollars.

Even if health was entirely within our control (and it’s very much not,) I’d rather my tax dollars go to the healthcare of people who make different choices than I do, than live in a world where there is someone who gets to tell us all how we should live. And I think that the people making the “fat people and my tax dollars” argument would agree. I’ve noticed that people who want to police my body and “health” are never that excited to have other people police theirs.

Should those who choose a raw foods vegan diet because they think it’s the healthiest option only have to pay for the healthcare of other raw foods vegans? If so, then do those who don’t think a raw foods vegan diet is the healthiest get to opt out of paying for their healthcare? Should people not be allowed to play sports because it results in billions of dollars worth of healthcare that wouldn’t be necessary if they weren’t playing sports? Should people who don’t pay sports get to withhold their tax dollars from those who have sports injuries? Can I opt out of having my tax dollars pay for the healthcare of fatphobes?

Other people live their lives in ways with which we disagree, we live our lives in ways with which other people disagree. We all deserve healthcare. All this “won’t somebody think of my tax dollars” hand-wringing is nothing but thinly veiled fat bigotry.

Bottom line:

Even if they could prove that being fat makes people unhealthy (they can’t)… And even if there was a method that was scientifically proven to lead to successful long term weight loss (there isn’t)… And even if there was proof that losing weight would make us healthier (there’s not)... And even if people were complaining that their tax dollars shouldn’t pay for injuries people get while exercising (which they aren’t,) this slope is still too slippery. And that doesn’t take into account the reality that the premise of this “fat people and my tax dollars argument” is completely flawed, the assumptions are faulty, and the method of shaming people is utterly ineffective since they can’t make us hate ourselves healthy or thin.

This is a bad faith argument created to reinforce harmful weight stigma and we should give it all the respect it is due – which is exactly none.

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More research:

https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings: Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrisons Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.