3 c) Should the user of the system bear the cost? It should be obvious that our spending on health education is not working, but why? I really believe that the effort to educate the public has been effective, so why is the obesity rate not declining. Some like to blame the fast food Industry, others the primary food manufacturers. While I agree that these are factors they are not, in my opinion the major issue. The vast majority of American’s know what they should do, but they do not. Until we place financial incentives in place I doubt we will make any significant head way. Instead of throwing tax payer money at the problem, I suggest that we ask people that are causing the problem to pay their fair share of the costs. Remember that in addition to the wasted Billions spent on Health Education, obesity is costing our health care system, incrementally, hundreds of Billions of additional dollars each year. Smokers also create a cost burden on the system. I suggest that both smokers and obese persons should pay their fair share of these costs rather than their costs being subsidized by the remainder. The following does a good job of quantifying the issue: Obesity & Smoking Source: Mayo Clinic

• Which Costs More…Obesity or Smoking?

‎Obese Workers Have Even Higher Health Costs than Smokers, Study Finds Chicago IL — Obesity adds more to health care costs than smoking does, reports a study in the March Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM). James P. Moriarty, MSc, and colleagues of the Mayo Clinic, Rochester, Minn., analyzed the incremental (additional) costs of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007. Both obesity and smoking were associated with excess costs for health care. Compared to nonsmokers, average health costs were $1,275 higher for smokers. The incremental costs associated with obesity were even higher: $1,850 more than for normal-weight individuals. For those with morbid obesity, the excess costs were up to $5,500 per year. The additional costs associated with obesity appeared lower after adjustment for other accompanying health problems (comorbidity). “This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions,” Moriarty and colleagues write. Smoking and obesity place a growing strain on an already stretched healthcare system. Employers are evaluating wellness programs — such as quit-smoking and fitness programs — in an attempt to lower costs by reducing health risk factors.