Paying people to lose weight? We should be taxing them if they don’t

Why is the NHS paying obese people to lose weight?
Why is the NHS paying obese people to lose weight?

The NHS is chronically short of money because a callous, tight-fisted Tory government won’t pay it what it needs. In fact, it is so short of money that, as we found out this morning, it can only afford to pay a mere £400 each to obese men in order to persuade them to lose weight (although in a trial they only succeeded in losing enough money to bag an average of £128 each of the possible prize money). The NHS considers this good value because it spends an average of £979 to £1375 per year caring for severely overweight people, compared with £638 a year looking after someone of ordinary size.

Shame the government is trying to get rid of all those NHS equality and diversity officers, because I smell a bit of discrimination. Why do only obese men qualify for the money? I’m not fat, so why can’t I have £400 too? While we are at it, I don’t smoke either. Can I have another £400 for that, too? And a further £400 for not taking illegal drugs? Talk about perverse incentives; why do I have to get fat first before the NHS will pay me to lose weight?

Once you start redefining the NHS as a lifestyle management service, doling out financial incentives to do the right thing, there is really no limit to how much money it could start to gobble up. Before we know it we will have a National Food Service doling out the right kind of food. In fact we already do have one of sorts, through the food prescribed for people with allergies and intolerances.

There is also an NHS programme called Everyone’s Active, which pays for gym membership – but only if you have been in the habit of exercising less than twice a week for the past three months. Again, just look at that perverse incentive: if you want to join a gym for free, stop exercising, and then go along to your GP and get to join a gym for nothing. 

Obviously, preventative medicine is the best form of medicine. If we stayed slim, exercised regularly, stopped smoking and drank only in moderation we would be a lot healthier as a nation. But is bribing people really the best way to achieve that? It might work for a while, but what happens when the bribes come to a halt? Once you have created the expectation that healthy habits will be rewarded financially people will always expect them. Stop paying them and it wouldn’t surprise me if they start piling on the pounds again in protest.

We should want people to adopt healthy habits because they’ll feel better for it, improving their chances of living long enough to see their grandchildren grow up, not in return for some grubby financial reward. Give people information about healthy lifestyles, and what effect unhealthy ones are having on their bodies – and let people exercise their own judgement and personal responsibility. But please don’t fritter our money on bungs for fatties to lose a few pounds. The NHS has enough demands on its budget already without spending millions treating us like children.