 An interesting article in the International Herald Tribune recently prompted some serious thought about the extent of government involvement in individuals’ lives for the sake of public health care.
In the article, “Japan, seeking trimmer citizens, decides to measure millions of waistlines”, reporter Norimitsu Onishi writes that under “a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines or about 44 percent of the entire population”.
This effort is directed at shrinking the overweight population by 10% over the next four years and 25 percent over the next seven years. Financial penalties will be imposed on companies and local governments that fail to meet specific targets. NEC, a large Japanese computer manufacturer could face as much as $19 million US in penalties if it fails to meet its targets.
Under the new law companies will have to measure not only the waistlines of their employees but also those of their families and retirees. The fear of mounting costs of obesity and related metabolic syndrome has resulted in company and city campaigns that have people dancing in gyms to the words of an anti-metabolic syndrome theme song. Translated, it goes something like this:
Goodbye, metabolic. Let’s get our checkups together. Go! Go! Go!
Goodbye, metabolic. Don’t wait till you get sick. No! No! No!
One company nurse says “nobody will want to be singled out as metabo” - a shortened, catchier name for obesity which some think sounds more inclusive. However, this brings peer pressure to a new level. The mayor of one town formed a weight-loss group called “The Seven Metabo Samurai” but the campaign ended badly when a 47 year old member with a 39 inch waistline died of a heart attack while jogging, reports Onishi.
Some experts believe that the targets will be impossible to achieve and some companies have started measuring the waistlines of all of its under-30 year old employees in hopes of avoiding having to play catch-up with obesity when patients are older.
With the government-approved waist line of 33.5 inches for men and 35.4 for women, some patients are refusing to be measured. Just what should be done with them is another conundrum.
No doubt this law will have repercussions for employees who do not meet the necessary waistline criteria and could indeed result in employees hired for their slender physique with obvious advantages for the company.
Japan’s population is aging ahead of Canada’s and we may want to consider the events unfolding in Japan warily. How far would Canadian governments be willing to go in terms of legislation that has as its intent to create a healthier population and save costs to the public health care system? How far should legislation go in this regard?
When diabetes continues to rise will overweight patients in Canada be targeted for additional peer pressure because of their cost to our health care system? When patients’ waistlines bulge for a variety of complex reasons will they want to be identified and want intervention while other patients with equally serious diseases but less obvious signs are not treated with the same kind of public scrutiny and judgement?
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