Skip to main content
Log in

The public finance of healthy behavior

  • Published:
Public Choice Aims and scope Submit manuscript

Abstract

Lifestyle can often affect the likelihood an individual will have a future illness. Subsidies often mitigate the consequences of poor lifestyle choices. In this paper we explore tax-subsidy policies that lower the consequences of incurring ill health. We find that a funding mechanism consistent with current US policy lowers the investment in healthy lifestyles by both the wealthy, who pay taxes, and the poor, who receive subsidies. We also explore alternative policy interventions such as investing in research to lessen the impact or probability of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Becker, G., & Murphy, K. (1988). The theory of rational addiction. Journal of Political Economy, 96, 675–700.

    Article  Google Scholar 

  • Bednarek, H., & Pecchenino, R. (2002). A macroeconomic analysis of publicly funded health care. Journal of Public Economic Theory, 4, 243–270.

    Article  Google Scholar 

  • Bednarek, H., Jeitschlo, T., & Pecchinino, R. (2006). Gluttony and sloth v. bliss? A theory of choice in the presence of behavioral adjustment costs. B.E. Journal Contributions to Economic Analysis and Policy 5, article 6.

  • Bednarek, H., Pecchenino, R., & Stearns, S. (2008). Do your neighbors influence your health? Journal of Public Economic Theory, 10, 301–315.

    Article  Google Scholar 

  • Bhattacharya, J., Bundorf, K., Pace, N., & Sood, N. (2009). Does health insurance make you fat? Working Paper 15163, National Bureau of Economic Research, Cambridge, MA.

  • CDC (2006). State-specific prevalence of obesity among adults—United States, 2005. Morbidity and Mortality Weekly Report (MMWR), 55, 985–988.

    Google Scholar 

  • CDC (2010). Chronic Diseases and health promotion. http://www.cdc.gov/chronicdisease/overview/index.htm. Last accessed February 2, 2010.

  • Chang, F. (1996). Uncertainty and investment in health. Journal of Health Economics, 15, 369–376.

    Article  Google Scholar 

  • Courbage, C., & Coulon, A. (2004). Prevention and private health insurance in the U.K. The Geneva Papers on Risk and Insurance, 29, 719–727.

    Article  Google Scholar 

  • Cropper, M. L. (1977). Health, investment in health and occupational choices. Journal of Political Economy, 85, 1273–1294.

    Article  Google Scholar 

  • Cutler, D. (2008). Are we finally winning the war on cancer? Journal of Economic Perspectives, 22(4), 3–26.

    Article  Google Scholar 

  • Dubay, L., & Kenney, G. (1997). Did Medicaid expansions for pregnant women crowd out private coverage? Health Affairs, 16, 185–206.

    Article  Google Scholar 

  • Ehrlich, I., & Becker, G. (1972). Market insurance and self-protection. Journal of Political Economy, 40, 623–648.

    Article  Google Scholar 

  • Feldstein, M. (1999). Prefunding Medicare. American Economic Review, 89, 222–227.

    Article  Google Scholar 

  • Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80, 223–255.

    Article  Google Scholar 

  • Harrison, G. W., Lau, M. I., & Williams, M. B. (2002). Estimating individual discount rates in Denmark: a field experiment. American Economic Review, 92(5), 1606–1617.

    Article  Google Scholar 

  • Hubbard, R., Skinner, J., & Zeldes, S. (1995). Precautionary savings and social insurance. Journal of Political Economy, 103, 360–399.

    Article  Google Scholar 

  • Internal Revenue Service (2009). Individual income and tax data, by state and size of adjusted gross income for 2007. http://www.irs.gov/taxstats/article/0,,id=171535,00.html. Last accessed February 2, 2010.

  • Komlos, J., Smith, P., & Bogin, B. (2004). Obesity and the rate of time preference: is there a connection?. Journal of Biosocial Science, 36, 209–219.

    Article  Google Scholar 

  • Lawrence, E. C. (1991). Poverty and the rate of time preference: evidence from panel data. The Journal of Political Economy, 99(1), 54–77.

    Article  Google Scholar 

  • Lee, J., McClellan, M., & Skinner, J. (1999). Distributional effects of Medicare. In J. Poterba (Ed.), Tax policy and the economy (Vol. 13). Cambridge: MIT Press.

    Google Scholar 

  • Levy, A. (2002). Rational eating: can it lead to overweightness or underweightness? Journal of Health Economics, 21, 887–899.

    Article  Google Scholar 

  • Liljas, B. (1998). The demand for health with uncertainty and insurance. Journal of Health Economics, 17, 153–170.

    Article  Google Scholar 

  • Manson, J., & Bassuk, S. (2003). Obesity in the United States: a fresh look at its high toll. Journal of the American Medical Association, 289, 229–230.

    Article  Google Scholar 

  • McClellan, M., & Skinner, J. (1997). The incidence of Medicare. NBER Working Paper #6013.

  • Must, A., Spadano, J., Coakley, E., Field, A., Colditz, G., & Dietz, W. (1999). The disease burden associated with overweight and obesity. Journal of the American Medical Association, 282, 1523–1529.

    Article  Google Scholar 

  • NIH (2005). Replacing some carbohydrates with protein and unsaturated fat may enhance heart health benefits. http://www.nhlbi.nih.gov/new/press/05-11-15a.htm. Last accessed February 2, 2010.

  • NIH (2010). Dietary supplement fact sheet: vitamin D. http://www.ods.od.nih.gov/factsheets/vitamind.asp. Last accessed February 2, 2010.

  • Pauly, M. V. (1968). The economics of moral hazard. American Economic Review, 58(3), 531–537.

    Google Scholar 

  • Phelps, C. E. (2003). Health economics (3rd edn.). New York: Addison-Wesley.

    Google Scholar 

  • Picone, G., Wilson, M., & Uribe, M. (1998). The effect of uncertainty on the demand for medical care, health capital and wealth. Journal of Health Economics, 17, 171–185.

    Article  Google Scholar 

  • Pope, S., Shue, V., & Beck, C. (2003). Will a healthy lifestyle help prevent Alzheimer’s disease? Annual Review of Public Health, 24, 111–131.

    Article  Google Scholar 

  • Preston, S., & Ho, J. (2009). Low life expectancy in the United States: is the health care system at fault? Working Paper 15213, National Bureau of Economic Research: Cambridge, MA.

  • Smith, T., & Tasnadi, A. (2007). A theory of natural addiction. Games and Economic Behavior, 59, 316–344.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert Rosenman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosenman, R. The public finance of healthy behavior. Public Choice 147, 173–188 (2011). https://doi.org/10.1007/s11127-010-9611-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11127-010-9611-z

Keywords

JEL Classification

Navigation