query: An individual's BMI is no longer a purely personal matter  The obesity epidemic is taking an enormous toll on global medical costs. In the US alone the health care costs attributable to either direct or indirect consequences of obesity have been estimated at $147bn. [1] Put into context, this amounts to roughly 9% of the health spending in the US. [2]  The figure might seem excessive, but we need to remember that obesity is linked to Type 2 Diabetes, several kinds of cancer, coronary artery disease, stroke, congestive heart failure, asthma, chronic back pain and hypertension, to name just a few.  We also need to realize that many of the diseases on this list are chronic in nature, requiring lifelong pharmacological therapy, which often follows complex and expensive diagnostic procedures, frequent medical specialist consultations, and not infrequent emergency interventions. [3]  Adding to the list is the value of income lost due to decreased productivity, restricted activity, and absenteeism, not to mention the value of future income lost by premature death.  Thus it becomes increasingly clear that due to the substantial cost obesity presents to the society, individual choices that might lead to excessive weight gain, can no longer be considered as solely individual in nature. [4]  Therefore the government is legitimate in its action to introduce a form of a fat tax in order to try to dissuade the population from becoming obese and cover the increasing societal costs the already obese individuals are responsible for.  [1] CDC, Obesity: Economic Consequences, published 3/28/2011,  , accessed 9/12/2011  [2] RTI international, Obesity Costs U.S. About $147 Billion Annually, Study Finds, published 7/27/2009,  , accessed 9/14/2011  [3] The Council of State Governments, Costs of Chronic Diseases: What Are States Facing?, published in 2006,  , accessed, 9/14/2011  [4] Los Angeles Times, Should there be a 'fat tax'?, published 4/11/2011,  , accessed 9/12/2011

positive: tax health health general healthcare weight house would implement fat tax An important source of extravagant medical spending around the world, especially in the US, can be traced to inherent inefficiencies of current medical care systems. [1] And the current trends show the situation to be worsening.  It is thus impossible for anyone to really say whether the rising cost of the medical care system can really be attributed to obesity related diseases, especially since those are some of the most common ailments of the modern age.  It is also unfair to single out obesity as the single cause that should get such intense scrutiny and attention. What about the connection between consumption of meat and colorectal cancer? [2] Should we introduce an additional levy in that case as well?  [1] Connolly, C., U.S. ‘Not Getting What We Pay For’, published 11/30/2008,  , accessed 9/12/2011  [2] The HMS Family health guide, Red meat and colon cancer, published in March 2008,  , accessed 9/12/2011

negative: tax health health general healthcare weight house would implement fat tax A fat tax levels out the playing field for healthier food  An important reason why people continuously turn to unhealthy, fat, sugar and salt laden food, is the simple fact that it’s often cheaper than a more wholesome meal comprised at least in part of fresh produce.  A study done at the University of Washington found that “when they compared the prices of 370 foods… junk foods not only cost less… but junk food prices are also less likely to rise as a result of inflation.” [1]  A similar conclusion was reached by a group of Australian researchers, who found that the prices of healthy food have risen 20 per cent above inflation, while the harmful counterpart have actually dropped below inflation – as much as 20 per cent below. [2]  Noting that obesity is more prevalent in groups of lower socioeconomic status, we find that the price of food is a substantial incentive for consumption.  Thus it is only reasonable to levy a tax against unhealthy, fatty food in order to give healthy food a fighting chance.  [1] Parker-Pope, T., A High Price for Healthy Food, published 12/5/2007,  , accessed 9/12/2011  [2] Burns, C., The rising cost of healthy foods, published 10/16/2008,  , accessed 9/12/2011

negative: Creating a mentality of illness  Advertising to patients promotes a ‘pill for every ill’ mentality as the drug industry seeks to ‘create’ new markets for its drugs by convincing patients that a pill can solve their problems.  This leads both to greater hypochondria and to self-diagnosis of normal conditions as medical ones. For instance in October 2001, GSK ran advertisements for Paxil in the New York Times, claiming the drug would solve chronic anxiety. These advertisements came at a time when the events of 9/11—rather than a medical condition—were probably to blame for New Yorkers’ stress. The FDA declared in a 1999 study that fewer than one in four new drugs has any therapeutic value and the medical community now accepts that prevention through lifestyle choices is often the best way to tackle disease (for instance, rather than seeking a weight-loss or diabetes wonder-pill, childhood obesity should be tackled through exercise and healthy eating).  Pill-popping seems easier and so is more attractive to many patients but in practice it is worse for the long-term health of society. By allowing the prescription drugs to be advertised we are making more people believe they are ill and need pills for them, rather than explaining to them that their back pain and high blood pressure are problems caused by their lifestyle choices. [1]  [1] Health Information Action, Direct-to-Consumer Prescription Drug Advertising The European Commission’s Proposals for Legislative Change, September 2011,  , accessed 08/07/2011

negative: Banning alcohol would lead to healthier individuals.  A ban of alcohol would have a great impact on the health of every individual.  Alcohol and especially alcohol abuse are very common problems in today’s society. Long lasting abuse of substances leads to many chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders. [1]  With a ban of alcohol we would very much lower the rates of consumption, as already current drug laws show. Even though drugs have a similar effect as alcohol, because of the risk of consequences when using those substances.  Therefore in general the number of alcohol addiction would sink and cause also less of a financial health burden. According to the US alone, the economic cost of alcohol abuse in 1998 was 184.6 billion dollars. [2] This is a burden which many state budgets have to bear.  Therefore if this cost can be prevented, the lives of people improved (by not getting the chronic diseases) we should do so.  [1] Center for Disease Control and Prevention, Alcohol and Public Health,  , accessed 08/17/2011  [2] Harwood, H.; The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. Report prepared for the  National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism,  , accessed 08/17/2011

negative: health general weight house would ban junk food schools Media sensationalism is a poor justification for any state intervention of any kind. What histrionic television documentaries usually provide nothing more than a warning that our kids are in danger, along with a list of all the diseases obesity might cause. But there is absolutely nothing that would explain how exactly something as drastic as a ban would do anything to begin solving this problem.  These observations highlight a distressing truth about contemporary western society – we are unable to accept that the state is unable to solve problems without the assistance and support of civil society. We have a hard time accepting the fact that responsibility will have to fall on the shoulders of parents to enforce (or, more likely, to adopt in the first place) a healthy and active lifestyle in their families.  Advice provided by the Mayo Clinic explains that just talking isn’t effective. Kids and parents should go together for a brisk walk, ride on the bike or any other activity. It is important for a healthy lifestyle that parents present exercise as an opportunity to take care for the body, rather than a punishment or chore [1] .  Finally, there is absolutely nothing stopping schools from offering healthier options alongside existing ones. In fact, many schools are choosing a healthier path already, without being forced by governments or regulatory bodies.  [1] MayoClinic.com, 'Fitness for kids: Getting children off the couch',  , accessed 09/10/2011

negative: tax health health general healthcare weight house would implement fat tax A tax is not an effective instrument to fight obesity  There are very legitimate concerns whether artificially increasing the cost of fatty food by specifically targeting it with a tax would have a significant effect on the obesity trend.  In fact, research shows that a fat tax would produce only a marginal change in consumption – not the dramatic shift in public awareness the proponents of the fat tax are hoping for. The reason, LSE researchers believe, is simple: “those on the very poorest diets will continue to eat badly.” [1]  Other than the economic reasons for such behavior, it could be argued that is also a thing of habit and culture: fast fatty food is quick, accessible and tasty. [2] Thus while a tax might be useful in reducing things such as the use of cigarettes – which are at heart an unnecessary “luxury” and thus more easily affected by the price – eating food, whether junk or not, is necessary. It also seems that the fast fatty kind of food is fulfilling a specific need, a need for a quick, tasty and filling meal, something people consider worth paying good money for.  The fight against obesity ought to be multifaceted, complex and well thought out – and a fat tax is none of those things. We should approach the issue with more cunning and introduce other programs: such as increasing the availability of healthy food by introducing healthy vending machines; [3] increasing the amount of physics exercise by requiring it in school, improving possibilities for recreation and access to public transportation thus encouraging people to burn more calories [4] and, most importantly, proper education on the topic if we want to create lasting change. [5]  [1] Tiffin, R., Salois, M., A fat tax is a double whammy for the poor – it will do little to prevent obesity in those on lower incomes, and will hurt them financially, published 9/2/2011,  , accessed 9/12/2011  [2] Hitti, M., Top 11 Reasons For Fast Food's Popularity, published 12/3/2008,  , accessed 9/14/2011  [3] Yara, S., Best And Worst Vending Machine Snacks, published 10/6/2005,  , accessed 9/14/2011  [4] CDC, Recommended Community Strategies and Measurements to Prevent Obesity in the United States, published 7/24/2009,  , accessed 9/14/2011  [5] Bunce, L., ‘Fat tax’ solutions ignore wider social factors driving junk food habits, published 8/16/2010,  , accessed 9/12/2011

negative: Universal healthcare is not affordable  No policy is created, debated or implemented in a vacuum. The backdrop of implementing universal health coverage now is, unfortunately, the greatest economic downturn of the last 80 years. Although the National Bureau of Economic Research declared the recession to be over, we are not out of the woods yet. [1] Is it really the time to be considering a costly investment?  With estimates that the cost of this investment might reach 1.5 trillion dollars in the next decade, the answer is a resounding no. Even the Center on Budget and Policy Priorities – a left leaning think tank – opined that the Congress could not come up with the necessary funding to go ahead with the health reform without introducing some very unpopular policies. [2]  Does this mean universal health care should be introduced at one time in the future? Not likely. Given that there are no realistic policies in place to substantially reduce the “riot inducing” US public debt [3] and the trend of always increasing health care costs [4] the time when introducing universal health care affordably and responsibly will seem ever further away.  [1] New York Times, Recession, published 9/20/2010,  , accessed 9/18/2011  [2] New York Times, Paying for Universal Health Coverage, published 6/6/2009,  , accessed 9/18/2011  [3] Taylor, K., Bloomberg, on Radio, Raises Specter of Riots by Jobless, published 9/16/2011,  , accessed 9/18/2011  [4] Gawande, A., The cost conondrum, published 6/1/2009,  , accessed 9/18/2011

negative: tax health health general healthcare weight house would implement fat tax Though one might be inclined to agree with the statement, that a fat tax on its own would be insufficient to solve the problem of rising obesity, it is also simply not the case.  There are numerous educational campaigns underway, from celebrity chef Jamie Oliver’s school dinners to the first ladies ‘Let’s move’ that are effectively targeting that aspect of the fight against obesity.  What is needed to balance these is tangible action by the government that is able to underwrite and solidify what these campaigns are saying. In short, to help our society practice what we preach.

negative: Inventing the idea of fat  There's a lot to be said for eating well and being generally healthy. It's not just a matter of weight but the effect that bad nutrition has in contributing to heart conditions, blood pressure, energy levels and other health indicators. [1] None of these things are helped by trying to drop three stone in a couple of months by filling your body with one thing regardless of what it needs at the time as many of these diets do  Our physical appearance should be an indicator of our lifestyle not an accessory to it.  The diet industry has poured considerable time and effort, with help from Holywood and the publishing industry, in to promoting the idea that thin and emaciated are the same thing.  Fad diets are, for many, less healthy than being a little overweight.  [1] BMJ, ‘Obesity – how to lose weight’, 31 October 2012, p.3,

negative: Aging means we will be spending more on the old, not less  There is simply no room to be increasing spending on young people as an Ageing population means that western nations are going to have to focus more resources on the elderly. A larger elderly population will mean less tax take for the government as there will be less people working, at the same time there will many unavoidable costs. The average cost of retires households to health services is £5200, compares to just £2800 for those who are not retired. [1] The expansion and progress of medical science has been amazing, we can treat many conditions that were incurable. But this means many more are living longer with medical support, which is costly. A US study estimates total healthcare expenditures “increase substantially with longevity, from $36,000 for persons who die at the age of 65 to more than $230,000 for those who die at the age of 90”. [2] Clearly the government cannot both increase spending on youth and pay more on healthcare for the elderly at the same time. With healthcare a matter of life and death it seems clear which should be prioritised.  [1] ‘The ageing population’, parliament.uk,   [2] Alemayehu, Berhanu, and Warner, Kenneth E., ‘The Lifetime Distribution of Health Care Costs’, Health Services Researech, vol.39, no.3, June 2004, pp.627-642,  (does not show pages but near the end)

negative: While the idea that better access to preventative medicine will quickly and drastically lower general medical care costs is an incredible notion, it sadly is just that – a notion.  As an aside, the same argument – lowered costs – could be made for simply improving the existing tactics of preventative medicine without the need to invest into universal coverage.  Returning to this proposition though, while it might be realistic to expect some reduction in costs from improved prevention, those would very unlikely ever amount to a significant amount – and certainly not an amount that would make introducing universal health coverage a feasible strategy. [1]  Universal health care will cause people to use the health care system more. If they are covered, they will go to the doctor when they do not really need to, and will become heavy users of the system. We can see in other countries that this heavier use leads to delays in treatment and constant demands for more resources. As a result care is rationed and taxes keep going up.  [1] Leonhardt, D., Free Lunch on Health? Think Again, published 8/8/2007,  , accessed 9/18/2011

negative: health general weight house would ban junk food schools Schools need to practice what they preach  Under the pressure of increasing media coverage and civil society initiatives, schools are being called upon to “take up arms” against childhood obesity, both by introducing more nutritional and physical education classes, as well as transforming the meals they are offering in their cafeterias. [1]  Never before has school been so central to a child’s personal and social education. According to a study conducted by the University of Michigan, American children and teenagers spend in school about 32.5 hours per week homework a week – 7.5 hours more, than 20 years ago [2] . School curricula now cover topics such as personal finance, sex and relationships and citizenship. A precedent for teaching pupils about living well and living responsibly has already been established. Some schools, under national health programs, have given out free milk and fruit to try and make sure that children get enough calcium and vitamins, in case they are not getting enough at home [3] .  While we are seeing various nutritional and health food curricula cropping up [4] , revamping the school lunch is proving to be a more challenging task. “Limited resources and budget cuts hamper schools from offering both healthful, good-tasting alternatives and physical education programs,“ says Sanchez-Vaznaugh, a San Francisco State University researcher. [5]  With expert groups such as the Obesity Society urging policy makers to take into account the complex nature of the obesity epidemic [6] , especially the interplay of biological and social factors that lead to individuals developing the disease, it has become time for governments to urge schools to put their education into practice and give students an environment that allows them to make the healthy choices they learn about in class.  [1] Stolberg, S. G., 'Michelle Obama Leads Campaign Against Obesity', New York Times, 9 February 2010,  , accessed 9/11/2011  [2] University of Michigan, 'U.S. children and teens spend more time on academics', 17 November 2004,  , accessed 09/08/2011  [3] Kent County Council, Nutritional Standards, published September 2007  , accessed 09/08/2011  [4] Veggiecation, 'The Veggiecation Program Announced as First Educational Partner of New York Coalition for Healthy School Food',18 May 2011,  , accessed 9/11/2011  [5] ScienceDaily, 'Eliminating Junk Foods at Schools May Help Prevent Childhood Obesity', 7 March 2010,  , accessed 9/11/2011  [6] Kushner, R. F., et al., 'SOLUTIONS: Eradicating America’s obesity epidemic', Washington Times, 16 August 2009,  , accessed 9/11/2011

negative: Food labeling is an important form of consumer protection  It is a basic right for us as consumers to know what it is we eat.  Today more and more foods that we buy are processed [1] , they include many harmful additives, causing conditions such as hyperactivity in children [2] , or are advertised as health food, but are in reality loaded with sugar or salt [3] .  It is therefore necessary for consumers to be made aware of all their food contains in order to make safe and healthy choices for themselves and their families.  [1] Parvez, S., Processed food exports rise 41pc, published 3/26/2009,  , accessed 9/15/2011  [2] Rosenthal, E., Some Food Additives Raise Hyperactivity, Study Finds, published 9/6/2007,  , accessed 9/15/2011  [3] Smellie, A., That 'healthy' bowl of granola has more sugar than coke... and more fat than fries: Busting the diet food myths, published 5/21/2011,  , accessed 9/15/2011

negative: There is precedent of paternalistic government policies in NYC.  The principle of paternalism, that the state may interfere with another person, against their will, with the motivation of protecting that person from harm, [1] underlines a wide range of policies and laws across the United States, and there is already a precedent for such paternalistic laws particularly within New York City. New York City, under the leadership of Mayor Bloomberg, has enacted regulations on smoking, restaurants’ use of salt and trans fats. Laws prohibiting marijuana, cocaine, and other potentially harmful drugs are made with the goal to protect citizens. Seatbelt laws and the prohibition of cell phone use while driving all infringe upon a person’s freedom of choice but have been accepted for their inherent positive causation meaning there will be less deaths and injuries in accidents. Paternalistic policies are made to maintain the public’s safety and well-being with the assumption that the government “knows best.” Mayor Bloomberg’s proposed ban on soda sold in containers larger than 16 ounces targets the growing problem of obesity in New York City. Although obesity has been a popular topic of discussion in the City, there has been negligible advancement in weight-loss. This growing problem shows that education is not enough to incentivize people to control themselves. Dr. Donald Klein writes, “A fleeting, short-term self that enjoys chocolate, nicotine, or heroin is working his will on an enduring self that pays the cost. Although we may fancy ourself a fully integrated and consistent being, it might make more sense to describe ourself as a bundle of multiple selves, selves that overlap, intermingle, and sometimes conflict”. [2] That more than 50% of New Yorkers are overweight shows the people do not recognize their own long term interests. [3] Mayor Bloomberg’s goal is to limit soda consumption of the population. He has the wellbeing of New Yorkers in mind and he is following a precedent that people need guidance in personal choices.  [1] Dworkin, Gerald, ‘Paternalism’, in Edward N. Zalta e., The Stanford Encyclopedia of Philosophy, Summer 2010.  [2] Klein, Daniel B., ‘The Moral Consequences of Paternalism’, Ideas on Liberty, May 1994.  [3] Hu, Winnie, ‘Obesity Ills That Won’t Budge Fuel Soda Battle by Bloomberg’, The New York Times, 11 June 2012.

negative: Health care would substantially reduce overall costs  With universal health care, people are able to seek preventive treatment. This means having tests and check-ups before they feel ill, so that conditions can be picked up in their early stages when they are easy to treat. For example in a recent study 70% of women with health insurance knew their cholesterol level, while only 50% of uninsured women did. In the end, people who do not get preventive health care will get treatment only when their disease is more advanced. As a result their care will cost more and the outcomes are likely to be much worse. Preventative care, made more accessible, can function the same way, reducing the costs further. [1]  In addition, a single-payer system reduces the administrative costs. A different way of charging for the care, not by individual services but by outcomes, as proposed by Obama’s bill, also changes incentives from as many tests and procedures as possible to as many patients treated and healed as possible. [2]  We thus see that not only does universal health coverage inherently decrease costs because of preventative care, much of the cost can be avoided if implemented wisely and incentivized properly.  [1] Cutler, D. M., Health System Modernization Will Reduce the Deficit, published 5/11/2009,  , accessed 9/17/2011  [2] Wirzibicki, A., With health costs rising, Vermont moves toward a single-payer system, published 4/7/2011,  , accessed 9/17/2011

negative: Food labeling helps people make better choices regarding their food  Given that there is a global trend of increasing numbers of overweight and obese people, [1] food that is fattening and therefore contributes to this problem needs to be clearly labeled so people can avoid them.  Research shows that having this nutritional information helps people make better choices. Up to 30% of consumers reconsider buying a food item after reading the food label and finding out what’s inside [2] .  Another study points out that there were “significant differences in mean nutrient intake of total calories, total fat, saturated fat, cholesterol, sodium, dietary fiber, and sugars” when people could go ahead and use the information about the food they were considering buying. [3]  It is therefore clear that making more information about food available, especially in the form of readily available food labels, helps people make choices that will help the fight against obesity.  [1] Elseth, M., Obesity numbers rise in 28 states, published 6/29/2010,  , accessed 9/15/2011  [2] Arsenault, J. E., Can Nutrition Labeling Affect Obesity?, published in 2010,  , accessed 9/15/2011  [3] diabetesincontrol.com, Nutritional Labeling and Point-of-Purchase Signs Work to Make Better Choices, published 8/10/2010,  , accessed 9/15/2011

negative: Healthcare has been recognised as a right  The two crucial dimensions of the topic of introducing universal health care are morality and the affordability.  Paragraph 1 of Article 25 of the Universal Declaration of Human Rights states the following: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” [1]  Analyzing the text, we see that medical care, in so far, as it provides adequate health and well-being is considered a human right by the international community. In addition, it also states, that this right extends also to periods of unemployment, sickness, disability, and so forth.  Despite this, why should we consider health care a human right? Because health is an essential prerequisite for a functional individual – one that is capable of free expression for instance – and a functional society – one capable of holding elections, not hampered by communicable diseases, to point to just one example.  Universal health care provided by the state to all its citizens is the only form of health care that can provide what is outlined in the Declaration.  In the US the only conditions truly universally covered are medical emergencies. [2] But life without the immediate danger of death hardly constitutes an adequate standard of health and well-being. Additionally, programs such as Medicaid and Medicare do the same, yet again, only for certain parts of the population, not really providing the necessary care for the entire society.  Further, the current system of health care actively removes health insurance from the unemployed, since most (61%) of Americans are insured through their employers – thus not respecting the provision that demands care also in the case of unemployment. [3]  But does insurance equal health care? In a word: yes. Given the incredible cost of modern and sophisticated medical care – a colonoscopy can cost more than 3000 dollars – in practice, those who are not insured are also not treated. [4]  [1] UN General Assembly, Universal Declaration of Human Rights, published 12/10/1948,  , accessed 9/17/2011  [2] Barrett, M., The US Universal Health Care System-Emergency Rooms, published 3/2/2009,  , accessed 9/17/2011  [3] Smith, D., U.S. healthcare law seen aiding employer coverage, published 6/21/2011,  , accessed 9/17/2011  [4] Mantone, J., Even With Insurance, Hospital Stay Can Cost a Million, published 11/29/2007,  , accessed 9/17/2011

negative: addiction healthcare international africa house believes ghanas ban smoking public Lower healthcare costs  Smoking caused disease causes large expenses for healthcare systems, something which is particularly burdensome in countries without the rich well developed healthcare systems of the developed world. In the UK lung cancer, one of the diseases caused by smoking, costs £90 per person or £9071 per patient. 1 Even the cost per head of population is higher than Ghana’s entire healthcare budget of $83.4 (about £50) per person. 2  The reduction in smoking, which would be triggered by the ban, would lead to a drop in smoking related illness. A study in the US state of Arizona showed that hospital admissions for smoking related diseases dropped after a ban on smoking in public places 3 .  This would allow resources to be focused on the big killers other than tobacco – including HIV AIDS.  1 The National Cancer Research Institute, ‘Lung cancer UK price tag eclipses the cost of any other cancer’, Cancer Research UK, 7 November 2012,   2 Assuming Ghanaian health spending of 5.2% of GDP which is $40.71 billion split between a population of 25.37 million from World Bank Databank    3 Herman, Patricia M., and Walsh, Michele E. “Hospital Admissions for Acute Myocardial Infarction, Angina, Stroke, and Asthma After Implementation of Arizona’s Comprehensive Statewide Smoking Ban”, American Journal of Public Health, March 2011,

negative: health general weight house would ban junk food schools Better nutrition leads to better students.  There is a growing body of evidence linking a healthy lifestyle, comprising of both adequate nutrition and physical exercise, with improved memory, concentration and general academic performance. [1] A study has shown that when primary school students consume three or more junk food meals a week literacy and numeracy scores dropped by up to 16% compared to the average. [2]  This is a clear incentive for governments to push forward for healthier meals in schools for two reasons. The first obvious benefit is to the student, whose better grades award her improved upward mobility – especially important for ethnic groups stuck worst by the obesity epidemic and a lower average socioeconomic status.  The second benefit is to the schools, who benefit on standardized testing scores and reduced absenteeism, as well as reduced staff time and attention devoted to students with low academic performance or behavior problems and other hidden costs of low concentration and performance of students. [3]  [1] CDC, 'Student Health and Academic Achievement', 19 October 2010,  , accessed 9/11/2011  [2] Paton, Graeme, ‘Too much fast food ‘harms children’s test scores’’, The Telegraph, 22 May 2009,  accessed 20 September 2011  [3] Society for the Advancement of Education, 'Overweight students cost schools plenty', December 2004,  , 9/11/2011

negative: Universal healthcare systems are inefficient  One of the countries lauded for its universal health care is France. So what has the introduction of universal coverage brought the French? Costs and waiting lists.  France’s system of single-payer health coverage goes like this: the taxpayers fund a state insurer called Assurance Maladie, so that even patients who cannot afford treatment can get it. Now although, at face value, France spends less on healthcare and achieves better public health metrics (such as infant mortality), it has a big problem. The state insurer has been deep in debt since 1989, which has now reached 15 billion euros. [1]  Another major problem with universal health care efficiency is waiting lists. In 2006 in Britain it was reported that almost a million Britons were waiting for admission to hospitals for procedures. In Sweden the lists for heart surgery are 25 weeks long and hip replacements take a year. Very telling is a ruling by the Canadian Supreme Court, another champion of universal health care: “access to a waiting list is not access to health care”. [2]  Universal health coverage does sound nice in theory, but the dual cancers of costs and waiting lists make it a subpar option when looking for a solution to offer Americans efficient, affordable and accessible health care.  [1] Gauthier-Villars, D., France Fights Universal Care's High Cost, published 8/7/2009,  , accessed 9/17/2011  [2] Tanner, M., Cannon, M., Universal healthcare's dirty little secrets, published 4/5/2007,  , accessed 9/18/2011

negative: addiction healthcare international africa house believes ghanas ban smoking public The argument that states will save money due to less people smoking based upon healthcare costs from treating smoking related diseases is over-simplistic. While smoking does cause medical costs, taxation can counterbalance this – in 2009, the South African government gained 9 billion Rand (€620 million) from excise duties on tobacco 1 . Paradoxically, less people smoking could lead to less money for other projects. Indeed, some countries in Europe raise the amount of health expenditure it causes from tobacco taxation 2 .  1 American Cancer Society, “Tobacco tax success story: South Africa”, tobaccofreekids.org, October 2012,   2 BBC News, “Smoking disease costs NHS £5Bn”, BBC News, 2009,

negative: health general weight house would ban junk food schools Targeting schools will be an ineffective strategy.  Schools may seem like a perfect place to effect behavioral change in youth, since 95% of young people are enrolled in schools. [1]  But what researchers find is that changing the choices we have available does not necessarily lead to any behavioral change. Penny Gordon-Larsen, one of the researchers, wrote: "Our findings suggest that no single approach, such as just having access to fresh fruits and veggies, might be effective in changing the way people eat. We really need to look at numerous ways of changing diet behaviors. There are likely more effective ways to influence what people eat.” [2]  In the case of school children is this point seems particularly salient. Given that high school students in the US average only 6 hours in school [3] and the widespread availability of fast and other forms of “junk food”, we can hardly expect that impacting this single environment of the school will lead to any lasting behavioral changes. Realistically, what we can expect is for school children to go outside the school to find their favorite snacks and dishes.  Even if, by some miracle, the ban would change the behavior of children in schools, there is still the matter of 10 hours (the ATUS suggests kids sleep an average of 8 hours per day) they will spend outside schools, where their meal choices will not be as tailored and limited.  [1] Wechsler, H., et al., 'The Role of Schools in Preventing Childhood Obesity', National Association of State Boards of Education, December 2004,  , accessed 9/11/2011  [2] Nordqvist, C., 'No Single Approach Will Solve America's Obesity Epidemic', Medical News Today, 11 June 2011,  , accessed 9/11/2011  [3] Bureau of Labor Statistics, 'American Time Use Survey', 22 May 2011,  , accessed 9/11/2011

negative: Compulsory vaccines are a financial relief on the health system  Commonly-used vaccines are a cost-effective and preventive way of promoting health, compared to the treatment of acute or chronic disease. In the U.S. during the year 2001, routine childhood immunizations against seven diseases were estimated to save over $40 billion per birth-year cohort in overall social costs including $10 billion in direct health costs, and the societal benefit-cost ratio for these vaccinations was estimated to be 16.5 billion. [1]  Another aspect is also, that productivity rates remain high and less money is earmarked for social and health transfers because people are healthier. This is also supported by a WHO study, that claims: “We calculate that the average percentage increase in income for the children whose immunization coverage increases through will rise from 0.78 per cent in 2005 to 2.39 per cent by 2020. This equates to an increase in annual earnings per child of $14 by 2020. The total increase in income per year once the vaccinated cohort of children start earning will rise from $410 million in 2005 to $1.34 billion by 2020 (at a cost of $638 million in 2005 and $748 million in 2020).” [2] This study based on economic and health indicators is part of the world immunization program GAVI.  [1] Wikipedia. Vaccine Controversy.   [2] David Bloom, David Canning and Mark Weston, The value of immunization, World Economics, July – September 2005  , accessed 05/28/2011

negative: Adverts generate profit. Profit funds research into improved drugs  We should not attack drugs companies for making profits from their products, nor for encouraging patients to use them. Each new drug costs an average of $500m to produce and very small percentage of the drugs that are researched ever make it to the market. [1] The more profitable the industry, the more new drugs it can afford to research and develop and thus the more patients who can receive appropriate treatment. Many of the complex cures being developed for diseases like cancer, HIV/AIDs, SARS and Avian Flu will take decades to research. In the meantime, drug companies require funding streams from other drugs to continue research.  Drugs have become increasingly expensive and advertisement helps to cover those costs. From 1980 and 2004, from about $6 billion (in 2005 dollars) to $39 billion. There has been a real growth rate of about 8 percent a year, on average.  By comparison, drug firms’ gross margins—sales revenue minus costs and income taxes—have been increasing more slowly, by about 4 percent annually. [2]  So, with more personalized medicine and greater costs in drug development, the industry needs a greater source of revenue in order to research therapeutics further. Advertising would provide this revenue.  [1] Hollis A., Me-too drugs: is there a problem ?, University of Calgary, published December 2004,  , accessed 08/08/2011  [2] Congres of United States, Research and Development in the Pharmaceutical Industry, October 2006,  , accessed 08/01/2011

negative: The costs and effects of advertising will place an additional burden on the healthcare system  Allowing advertising places an additional burden on the health care system.  As a result of advertising, if it were allowed, many patients would request the more expensive brand drugs and so place an additional burden on the public health care system. The offered generic drugs have the same effect; they are simply cheaper because they do not spend several millions on advertising.  Drug costs are increasing at a faster rate in the United States than anywhere else in the world (roughly by 25% year on year since the mid-1990s). This growth has been mainly driven by patients demanding advertised drugs (they accounted for half the 2002-2003 increase, for instance). Advertised drugs are always more expensive than generic rivals because of the branding and advertising costs, as well as the increased price that manufacturers can demand for a snappily named product. In private health care systems, this drives up insurance premiums, thereby pricing large numbers of people out of health care coverage (44 million Americans have no coverage, despite the United States spending more per capita on health care than any other country). Alternatively, it forces many people to select insurance packages with lower levels of coverage (the solution introduced in 2005 by the Bush administration). The EU has estimated that its member states with public healthcare systems would be crippled if they spent as much on drugs as the United States [1] .  Actually estimates in the United Kingdom state that, by buying generic drugs, the public health care system could save more than £300m a year. General practioners could make more use of cheaper, non-brand versions of the drugs, without harming care. An example of the NHS overpricing drugs: one treatment for gastric problems, Omeprazole, can be bought from wholesalers for between £2.50 and £3.40, yet the NHS pays £10.85 every time it is prescribed. To make the matter worse, doctors often over-prescribe; at least £100m could be saved if they were more careful in this matter. [2]  Therefore, because it would create a substantial financial burden to the current public health care system, allowing advertising would be a bad idea.  [1] Heath Care in the United States.   [2] BBC News, Drug profiteering claims denied, published 03/14/2004,  , accessed 07/30/2011

negative: Universal healthcare stifles innovation  Profits drive innovation. That’s the long and short of it. Medical care is not exception, albeit the situation is a bit more complicated in this case.  The US’s current system has a marketplace of different private insurers capable of making individual and often different decisions on how and which procedures they’ll choose to cover. Their decisions are something that helps shape and drive new and different practices in hospitals. A simple example is one of virtual colonoscopies. Without getting into the nitty gritty, they often require follow up procedures, yet are very popular with patients. Some insurers value the first, some the other, but none have the power to force the health care providers to choose one or the other. They’re free to decide for themselves, innovate with guidelines, even new procedures. Those are then communicated back to insurers, influencing them in turn and completing the cycle.  What introducing a single-payer universal health coverage would do is introduce a single overwhelming player into this field – the government. Since we have seen how the insurer can often shape the care, what such a monopoly does is opens up the possibility of top-down mandates as to what this care should be. With talk of “comparative effectiveness research”, tasked with finding optimal cost-effective methods of treatment, the process has already begun. [1]  [1] Wall Street Journal, How Washington Rations, published 5/19/2009,  , accessed 9/18/2011

negative: There are several reasons why health care should not be considered a universal human right.  The first issue is one of definition – how do we define the services that need to be rendered in order for them to qualify as adequate health care? Where do we draw the line? Emergency surgery, sure, but how about cosmetic surgery?  The second is that all human rights have a clear addressee, an entity that needs to protect this right. But who is targeted here? The government? What if we opt for a private yet universal health coverage – is this any less moral? Let’s forget the institutions for a second, should this moral duty of health care fall solely on the doctors perhaps? [1]  In essence, viewing health care as a right robs us of another, much more essential one – that of the right to one’s own life and one’s livelihood. If it is not considered a service to be rendered, than how could a doctor charge for it? She couldn’t! If it were a right, than each of us would own it, it would have to be inseparable from us. Yet, we don’t and we can’t. [2]  We can see that considering health care as a basic human right has profound philosophical problems, not the least of them the fact that it infringes on the rights of others.  [1] Barlow, P., Health care is not a human right, published 7/31/1999,  , accessed 9/18/2011  [2] Sade, R., The Political Fallacy that Medical Care is a Right, published 12/2/1971,  , accessed 9/18/2011

negative: There is no doubt that weight is not purely a medical issue but that a positive appearance helps self-confidence and opens lifestyle opportunities. Different people approach losing a few pounds in different ways, some have the time for the meticulous dietary exercise and training regime Prop is suggesting but most don't. Promotion of other option is simply meeting that need.

negative: This reduces the incentive for pharmaceutical companies to complete the testing process  Testing new drugs is a very expensive process, in 2000 the average cost was estimated at around 86 million for the large scale phase III tests1 however this is contested and it could be much higher it represents 40% of pharmaceutical companies R&D expenditures, which since a recent estimated the development cost of a drug can be up to $5.8billion (due to including failures) the cost of trials would in some cases then be $2billion,2 which is currently funded by pharmaceutical companies. They fund these tests because it is either impossible, very difficult or very risky to access large markets before testing has been completed (e.g. in the USA companies are only allowed to sell new drugs “off-study”, i.e. during trials, at cost3)  If you allow all terminally ill patients access to experimental drugs, you reduce the incentive for companies to continue testing their products: they will have access to a large market prior to the completion of testing, and will therefore have no incentive to complete trials, which are expensive and risk finding the product ineffective.  1 DiMasi, Joseph A. et al., ‘The price of innovation: new estimates of drug development costs’, Journal of Health Economics, Vol.22, 2003, pp.151-185, p.162   2 Roy, Avik S. A., ‘Stifling New Cures: The True Cost of Lengthy Clinical Drug Trials’, Project FDA Report, No. 5, April 2012,   3 Schüklenk, Udo, and Lowry, Christopher, ‘Terminal illness and access to Phase 1 experimental agents, surgeries and devices: reviewing the ethical arguments’, British Medical Bulletin, Vol.89, 2009, pp.7-22,

negative: Trans fats are not uniquely unhealthy  The issue with trans-fat is that there is no better substitute. The fact is that the substitutes are also as bad, if not worse, than trans-fat itself. By banning trans-fat, restaurants will have to adopt these substitute substances, thus undermining the work of the government. This process is a waste of our resources as the government will have to spend huge amount of money to bring about a ban on trans-fat without getting any positive outcome.  The trans-fat ban would only have clear benefits if it were to cause a general reduction in the overconsumption of high-fat foods, but a restaurant ban on one ingredient will not achieve this. This will mean that money will be wasted as increased costs will be passed on to the consumer while there is no benefit.(8) Trans fats are not uniquely and excessively unhealthy. Sugar is unhealthy. Salt is unhealthy. Runny eggs, rare meat, processed flour, nearly anything consumed too frequently or excessively is potentially dangerous. We would not ban these foods because they are unhealthy so the same should apply to trans fats.  The current obesity crisis within the US is not the result of regulatory failure and will not be solved by a ban on trans fats. Better choices, better parenting, exercise and personal restraint are the keys. None of these behavioural traits can be mandated by government.(9) Even if trans fats were eliminated from food products, overall a ban would do nothing to help individuals develop healthy lifestyles. While the ban would curtail consumption of onion rings (if they were cooked in trans fats), for example, it would remain perfectly legal to gorge oneself on Häagen-Dazs or chocolate, both unhealthy foods that contain no trans-fat.(10)  The main alternatives to trans-fat is not even that much healthier. In most cases, food makers will move to saturated fat, which carries all of the same health risks, for example it has been linked to diabetes and cancer.(9) The ban is therefore unlikely to have a perceptible effect on public health.  Trans-fats actually serve two useful purposes. Firstly, trans fats serve an important function of extending the shelf life of products.(1) This is necessary for both producers and consumers as it makes producing these foods cheaper and reduces waste. It also means that consumers are less likely to consume spoiled food and become sick as a result. Secondly, trans fats are tasty and offer enjoyment to consumers. Trans fats keep foods from turning rancid on store shelves; give croissants their flakiness, keep muffins moist and satisfy the sweet tooth. The enjoyment of such tasty foods has a qualitative value to one's emotions and happiness.(3) Therefore trans fats are not uniquely unhealthy and a ban would not improve general public health -it would simply remove a useful and tasty substance from the market. Thus a ban is unjustified.

negative: Liberal societies have a duty to minimise avoidable suffering that might affect their members  Some of the genetic diseases tested include great suffering for the individual, one of them is the Tay Sachs syndrome. Where nerve cells become fatty from reoccurring infections.(1) This is a disease, where even with the best of care; a child dies at the age of 4.  Another is also Down Syndrome, where half of the sufferers have heart defects, increased risks of types of leukemia and high risks of dementia. Physical and mental limitations are also a feature of such a defect which causes many children to die early. (2).  So it is the duty of any society to prevent such sufferings for both child and parents at any cost or method. A similar view is shared among the Jewish community, who has problems with a high prevalence of Tay Sachs syndrome. They believe that due to the psychological and physical repercussions of the birth of a child with the genetic disorder it is better to screen and choose a healthy embryo (or abort the present pregnancy). (3)  So because such diseases cause great distress for the involved parties and we could prevent it, it is morally right for society to engage in genetic screening.  1. National institute for Neurological Disorders and Stroke,  , accessed 05/24/2011  2.Medline Plus 10/18/2010,  , accessed 05/24/2011  3. Daniel Eisenberg, A Jewish perspective on issues related to screening Tay-Sachs disease,  , accessed 05/24/2011

negative: animals environment general health health general weight philosophy ethics Vegetarianism is healthier  There are significant health benefits to 'going veggie'; a vegetarian diet contains high quantities of fibre, vitamins, and minerals, and is low in fat. (A vegan diet is even better since eggs and dairy products are high in cholesterol.) The risk of contracting many forms of cancer is increased by eating meat: in 1996 the American Cancer Society recommended that red meat should be excluded from the diet entirely. Eating meat also increases the risk of heart disease - vegetables contain no cholesterol, which can build up to cause blocked arteries in meat-eaters. An American study found out that: “that men in the highest quintile of red-meat consumption — those who ate about 5 oz. of red meat a day, roughly the equivalent of a small steak had a 31% higher risk of death over a 10-year period than men in the lowest-consumption quintile, who ate less than 1 oz. of red meat per day, or approximately three slices of corned beef.” [1] A vegetarian diet reduces the risk for chronic degenerative diseases such as obesity, high blood pressure, diabetes and types of cancer including colon, breast, stomach, and lung cancer because of it's low fat/cholesterol content. There are plenty of vegetarian sources of protein, such as beans and bean curd; and spinach is one of the best sources of iron.  [1] Tiffany Sharples, ‘The Growing Case Against Red Meat’, Time, 23rd March 2009

negative: Profits do drive innovation. But there is nothing out there that would make us believes that the profits stemming from the health care industry are going to taper off or even decrease in a universal coverage system. In short in a single-payer system, it’s just the government that’ll be picking up the tab and not the private companies. But the money will still be there.  An expert on the issue from the Brigham and Women’s Hospital opined that this lack of innovation crops up every time there is talk of a health care reform, usually from the pharmaceutical industry, and usually for reasons completely unrelated to the policy proposed. [1]  Whereas the opposition fears new research into efficiency of medical practice and procedures, we, on the other hand, feel that’s exactly what the doctor ordered – and doctors do too. [2]  [1] Klein, E., Will Health-Care Reform Save Medical Innovation?, published 8/3/2009,  , accessed 9/18/2011  [2] Brown, D., ‘Comparative effectiveness research’ tackles medicine’s unanswered questions, published 8/15/2011,  , accessed 9/18/2011