07 英国应该对所有食品征收糖税以解决肥胖问题

古鲁穆尔蒂：从给食品包装贴营养标签，到设立挑战奖刺激创新，这些务实措施既能拯救生命，也有助于阻止不断膨胀的医疗支出。

全文共630个词, By Ravi Gurumurthy

When the soft drinks levy was announced in 2016, industry claimed it would be more effective as a stealth tax than a public health policy. Coca-Cola’s then general manager in the UK, Leendert den Hollander, warned that “the facts don’t suggest that a sugar tax works to change behaviour”.

2016年英国政府宣布将对软饮料征税时，行业宣称，此举作为一种隐形税，将比一项公共卫生政策更有效。时任可口可乐（Coca-Cola）英国总经理的伦德特·登霍兰德（Leendert den Hollander）警告称，“事实并未表明糖税能改变人们的行为”。

He may have been right about consumers but he was wrong about the behaviour of his own company. By the time the tax was introduced two years later, most drinks sold by Coca Cola — except chancellor Rishi Sunak’s beloved classic coke — had been reformulated to duck under the tax threshold, set at 5g of sugar per 100ml. As a result, industry sales and profits were maintained but sugar consumption in all soft drinks fell 30 per cent.

他对消费者行为的看法或许是正确的，但他却料错了自己公司的行为。两年后糖税实施的时候，可口可乐销售的多数饮料——除了财政大臣里希·苏纳克（Rishi Sunak）钟爱的经典可乐——都重新调整了配方，以避开征税门槛（每 100毫升饮料含糖量达到5克就要缴纳糖税）。结果是，行业销售和利润得以维持，而所有软饮料中的含糖量下降了30%。

This is a lesson in how to tackle obesity. It is possible for companies to reformulate many products without people even noticing. While most consumers may have ignored the tax increase, industry assumed that enough would be tempted by cheaper products, so altered their recipes.

这是如何应对肥胖问题的一条经验。企业可以在人们毫无察觉的情况下调整许多产品的配方。虽然大多数消费者可能未留意到这项增税，但行业认为足够多的人会被更便宜的产品所吸引，因此改变了配方。

These small changes add up. On average, people in the UK consume only 195 excess calories — roughly the equivalent of one packet of crisps — every day. If half those currently overweight reduced their intake by 250 calories, they would move down a weight category and 10m people would enjoy two more years of healthy life.

这些小的变化具有意义。平均起来，英国人每天只过量摄入了195大卡——大约相当于一包薯片的热量。如果目前的超重人群有半数每天能减少250大卡的摄入，他们的体重就能降一个档次，1000万人就能多享受两年的健康生活。

The government is moving in the right direction. It has recently announced plans to ban junk food advertising on television before 9pm. Later this week, Henry Dimbleby, co founder of the Leon restaurant chain, will publish the second part of the National Food Strategy. But more radical steps are needed if we are meaningfully to reduce obesity in the UK.

英国政府正朝着正确的方向行动。英国政府最近已宣布，将禁止晚上9点前在电视上播放垃圾食品广告。本周晚些时候，Leon连锁餐厅联合创始人亨利·丁布尔比（Henry Dimbleby）将发布“国家食品战略”（National Food Strategy）的第二部分。但如果我们要切实降低英国的肥胖症发生率，需要采取更为激进的措施。

First, a sugar tax should be extended to all big food items sold in shops and restaurants —or at least the most critical products. This can begin at a low level but ramp up over time,providing industry with a clear signal and incentive to reformulate and resize.

首先，糖税征收范围应该扩大到商店和餐馆出售的所有食品大类——或者至少针对最重要的产品。可以从较低水平开始征收，但随着时间推移逐步提高，为行业提供一个明确的信号和动机来重新调整食品配方和大小。

Second, government should mandate front-of-pack labelling, with a simple, traffic-light style heuristic such as NutriScore, which has shown evidence of shifting some consumer behaviour. As with the sugar tax, most people may not change their behaviour but the most health-conscious will and that is enough to incentivise industry. What appears to be a nudge to consumers is actually a shove to producers.

其次，政府应该强制要求在食品包装正面贴上标签，用一种简单的、交通信号灯式的启发法，例如在改变某些消费者行为方面已经显示出证据的NutriScore营养标签。拿糖税来说，大多数人可能不会改变自己的行为，但最具健康意识的人将会改变，这足以激励行业。看似是轻轻推了一下消费者，实际上是猛然推动了生产者。

Third, although there are many foods where reformulation may not be immediately viable,a range of large challenge prizes could stimulate innovation. Just as “Advance Market Commitments” spurred vaccine development, the public sector could stage a competition to develop healthier, cheaper school meals — with those meeting targets winning high volume public contracts.

第三，虽然有许多食品可能无法立即重新调整配方，但一系列大型挑战奖可以刺激创新。正如“预先市场承诺”（AMC）刺激了疫苗研发，公共部门可以发起一场竞赛，以开发更健康、更低成本的校餐——那些达到标准的企业将赢得大量公共合同。

The required policy response to tackle obesity is increasingly clear, but the public are not on the same page. New research from Nesta, the innovation foundation, and the Behavioural Insights Team shows that most people still believe that the most effective policy is to encourage individuals to change their diet and exercise. To prepare the ground for reformulation, we need credible messengers to build the case that obesity demands state and industry action. We also need to demonstrate that the transition will be fair to those on low incomes. The revenue from the sugar tax, for example, could be ringfenced for a Marcus Rashford-approved increase in spending on free school meals, or for child benefit.

解决肥胖问题所需的政策回应正变得越来越清晰，但公众的看法却不一样。创新基金会Nesta和行为洞察团队（Behavioural Insights Team）的最新研究显示，大多数人仍然认为，最有效的政策是鼓励个人改变饮食习惯和进行锻炼。为了给重新调整配方寻找理由，我们需要可信的先驱来证明解决肥胖问题需要国家和行业采取行动。我们还需要证明，这种转变对低收入者是公平的。例如，糖税带来的收入，可以专门用于加大马库斯·拉希福德（Marcus Rashford）所认同的免费校餐的支出，或增加儿童福利。

These measures may sit uncomfortably with a government keen to reassert personal freedoms. But with Sunak facing ballooning health expenditure and weak public finances,measures that save lives, protect the NHS and legitimise tax increases may induce pragmatism. With people in the lowest income decile dying almost a decade earlier than those in the highest, a muscular, societal approach to slimming down might also be the best route to levelling up.

这些措施可能与一个推崇个人自由的政府格格不入。但在苏纳克面临着不断膨胀的医疗支出和疲软的公共财政之际，能够挽救生命、保护英国国家医疗服务体系（NHS）以及使增税合法化的措施或许会催生实用主义。由于收入最低的十分之一人群比收入最高的人群预期寿命短了近10年，通过一种强有力的社会化的方法来实现瘦身，可能也是缩小差距的最佳途径。