By David Anderson
In the decades since we lost the Marlboro Man and Yul Brynner to lung cancer, governments like Australia’s have done their utmost to reduce the incidence of this disease. Plain cigarette packaging, packaging with scenes akin to a horror movie as well as heavy taxes, represent a concerted effort by government to dissuade Australians from smoking. And for the most part, the community would agree that this was just.
Now, with an expanding body of information linking the intake of sugar with obesity-increasing a persons risk of type2 diabetes, heart disease and cancer- there is growing support from health practitioners and researchers for the government to impose a tax upon foods and drinks with a high concentration of the sweet stuff.
When you follow the example of government control of smoking and even alcohol , state intervention in this area seems like the logical solution. But what of the regressive nature of such a tax? A flat levy on these items would seem to adversely affect people that could least afford it, possibly entrenching the cycle of poverty and ill-health. Questions also remain whether a top-down health initiative would directly conflict with the type of community health projects that One Health Organisation passionately supports. Which leads us to ask, would a sugar tax be the all-encompassing panacea for lifestyle diseases we crave?
Why a Tax?
Put simply, the state has a right to regain its costs.
It’s all well and good to be free to choose whether you treat your body like a temple or an amusement park, but when the government foots the bill for your choices it seems fair that it might want to recoup some of this money.
The Grattan institute estimates that obesity generated $2.6 billion in extra healthcare spending by governments in 2014/15. Along with researchers from Melbourne University, they argue that some form of taxation is justified as education programs to reduce obesity up to this point have failed. By implementing a tax, ‘the government places responsibility on producers and consumers to pay for the negative consequences of their production and consumption.’
Seriously, why a tax?
Of course, the proposal of any new tax in the modern political environment will always be met with some level of resistance.
In this instance, a ‘top down’ approach to attacking obesity appears to be at odds with the cutting edge of grassroots health improvement programs. One Health Organisation prides itself with empowering community projects to self determine their health solutions. And we can look no further than the recent success of our project partners Hope for Health to demonstrate this.
Bernard Keane, in his article titled “Getting a sugar rush from controlling the poor”, supports this notion when he states
‘The low-income earners who make up the majority of the people targeted by proposed public health measures have little or no voice, are not consulted and are seen as unable to understand their own best interests; instead, middle-class bureaucrats and academics must make decisions for them’ 
Further to this, it could be argued that the regressive nature of blanket increases in costs of certain food and drinks will adversely affect the very people most likely to be obese-the poor.
If the poor have less money, they are less likely to be able to improve their health.
As One Health CEO Jimi Wollumbin points out, ‘unhealthy socio-economic conditions give rise to unhealthy lifestyle choices. Empty pockets also don’t allow pilates classes and gym memberships. Simply put: poverty breeds chronic illness, and chronic illness is expensive’
While Dr Stephen Duckett of the Grattan Institute does concede that a tax would be ‘slightly regressive’ , he also notes that, ‘Importantly, a tax is avoidable if people change their consumption patterns.’
Which is precisely the point of a tax in this area, but the key question is;
Is it enough to convince people to consider healthier alternatives?
It would appear the big stick should be accompanied by a carrot, and maybe some other nutritious, subsidised, vegetables.
This is precisely what researchers at Melbourne University have recently advocated. They deliberately set about to find a combination of taxes and subsidies that would be “fiscally neutral” for consumers. As a result, the cost of say, a kilogram of apples, would fall by a quarter and their modelling concludes that ‘taxing foods that are high in sugar, salt and saturated fats — as well as subsidising fruit and vegetables — would also save $3.4 billion in healthcare costs.”
Even if only motivated by budget bottom lines, any attempt by government to reduce health costs through preventative measures should be applauded if a healthier society is the by-product.
But as Jimi Wollumbin points out,
‘a sugar tax alone is not enough to end the disease-poverty cycle whilst structural drivers of inequality remain untouched and too often unspoken. A comprehensive approach to the global chronic disease and obesity epidemic therefore needs to tackle symptoms like high caloric diets, at the same time as addressing the underlying social determinants.’
This reinforces the importance of grassroots health projects that address community- specific, upstream drivers of poor health through education and other initiatives.
Rather than conflict, the top down/bottom up approaches to health improvement each have a role to play in curbing behaviours that lead to obesity.
Any tax should be implemented within a raft of measures including subsidies and community support structures.
David Anderson is the Project Communications Officer for One Health Organisation.
 Ibid, p22.