In KineSophy’s thirteen years, I’ve written extensively about the many benefits of exercise, interviewed leaders in the growing belief that physical activity is a form of medicine, and shared the latest research on how exercise benefits a host of health conditions. Most Americans understand that physical activity is beneficial. Yet this country suffers from an epidemic of inactivity and obesity-driven health issues. Given the divide between knowledge and action, I think it’s reasonable to ask: should there be a law requiring physical activity? In this article, I explain why physical activity could be more beneficial than existing laws that compel individuals to protect their well-being. In the end, I argue for a similar voluntary program that would save people money and improve their health.
Exercise Policy in America
Last summer, United States Senator Roger Wicker introduced the Promoting Physical Activity for Americans Act. If passed, the bill would require the US Secretary of Health and Human Services to “publish a report that provides physical activity recommendations for the people of the United States” every ten years, beginning in 2029. The motivation behind such a report is obvious. According to a 2018 report by the aforementioned Secretary, “lack of physical activity is linked to approximately $117 billion in annual health care costs and about 10 percent of premature mortality.” In theory, specific physical activity recommendations could save money and lives.
In a 2024 interview with Harvard evolutionary biologist Daniel Lieberman, journalist Derek Thompson took Senator Wicker’s idea one step farther. After Lieberman described the many health benefits of exercise, Thompson opined:
“It seems maybe a little bit strange and probably big brothery to have something like an exercise policy for a country. But I feel like if you take the effects of exercise seriously, it’s almost strange to not have a policy. Like the stranger thing in a way is to look at a country where 80% of Americans get below the minimum level of exercise and say, this is something that government should not care about or respond to with any kind of policy. … It is interesting that some of these issues that seem like the most important ideas in the country, whether it’s the decline of socializing or the decline of exercise, we don’t really think of them as policy problems. We think of them as problems that policy can’t make contact with. And that’s just kind of strange.”
Exercise, Seatbelts and Tobacco
Legislation and government policy to save people from themselves are not totally foreign concepts. Laws requiring automobile passengers to wear seatbelts have been around for forty years. The minimum age to purchase tobacco increased from eighteen to twenty-one in 2019. So why not have a law mandating physical activity minimums for all Americans?
The math paints a stark picture. In 2022, there were 261,211,607 adults in the US, and the premature death rate was 309 deaths per 100,000 adults. Those numbers equate to just over 807,143 premature deaths. Using the Health and Human Services Department’s ten percent figure, 80,714 premature deaths were linked to lack of physical activity. By comparison, the National Highway Traffic Safety Administration estimated that, in 2016, 2,500 deaths would have been averted had the deceased worn seatbelts. And a 2024 review found that the law increasing the tobacco purchase age could prevent up to 526,000 premature deaths by 2100—an average of 6,575 deaths per year. Each year, physical activity would save 32 times as many lives as wearing a seatbelt and 12 times as many lives as banning under-twenty-one tobacco purchases.
Pros and Cons of Requiring Physical Activity
Positive and Negative Duties
Moral philosophers distinguish between positive and negative duties. A positive duty is a legal or moral obligation requiring people to perform a specific action. A negative duty is a legal or moral obligation requiring people to refrain from a specific action. The seatbelt law codifies a positive duty, and the under-twenty-one tobacco ban codifies a negative duty. Positive duties are generally considered more onerous than negative ones. All things being equal, it takes more effort to perform an action than to not perform an action.
A law requiring a certain amount of physical activity would introduce a massive positive duty. Current physical activity guidelines for American adults suggest at least 150 minutes a week of moderate-intensity, or seventy-five minutes a week of vigorous-intensity, aerobic activity, plus muscle-strengthening activities of moderate or greater intensity on two or more days a week. Requiring Americans to exercise would introduce a significant time commitment into their daily lives. And that’s on top of the potential monetary cost of running shoes, exercise equipment, gym memberships and travel to and from wherever one plans to exercise.
Plus, there are the twin issues of privacy and enforcement. Ensuring that every American adult met the required exercise guidelines would likely require everyone to wear activity monitors which transmitted their data to the government agency responsible for enforcement. And that sounds a lot like a scene from 1984.
Personal Wellness Laws
So there is one very good reason for requiring physical activity (saving many more lives than other laws directed at isolated individual behavior) and many persuasive arguments against such a requirement (time burden, cost, privacy). But the reason in favor of requiring physical activity depends on one accepting that laws requiring seatbelts and restricting tobacco purchases are themselves good laws. Personally, I’m not convinced anyone should be legally mandated to look after their personal health and safety. If some people want to forgo the safety of a seatbelt or smoke cigarettes, fine with me. I draw the line when an individual’s decisions affect others. If dad decides not to buckle up, he still better make sure his kids do so. And if you want to give yourself lung cancer, knock yourself out. Just don’t make me breathe your secondhand smoke.
Positive Duties While Driving
One might argue hear that people already accept all kinds of time-consuming positive duty laws. Among other requirements, drivers must maintain a valid license, wear a seatbelt, signal when turning or changing lanes, keep vehicle lights and signals in working order, perform regular emissions testing, etc. Americans average an hour a day in their cars. That’s sixty minutes-worth of positive duties a day—less time than would be required by an exercise mandate. Physical activity proponents would suggest that Americans have long since accepted driving as a necessary part of life. A similar acceptance of physical activity might not happen all at once, but it would be better for everyone’s physical and mental wellbeing and the health of the planet that an hour a day behind the wheel.
Of course, not all driving time is spent actively performing positive duties. Wearing a seatbelt is a mostly passive activity once you take the five seconds to buckle it. And not all people drive. The analogy between exercising and driving is not universal. Furthermore, most people who drive do so for an essential purpose (e.g. to get to and from the job that keeps them and their families fed and sheltered). Driving is not leisure time or an opportunity for self-improvement. It is often a means to a very important end. And while health is also an important outcome, exchanging thirty minutes of driving time for thirty minutes of exercise at the drop of a hat is simply not feasible for many Americans.
Solving the Cheap Rider Problem
Perhaps a different approach is necessary. As I have argued previously, government-mediated healthcare like Medicare has a “cheap rider” problem. Every American has to pay taxes to fund Medicare, but physically inactive people rely more on Medicare-funded healthcare than their active counterparts. Physically inactive Americans are cheap riders in that they benefit by paying the same and taking more.
If the stick model of exercise policy remains a non-starter, the carrot approach has some promise. What if the government offered a Medicare discount to anyone who met recommended physical activity guidelines? A similar discount could be extended to health care plans in the Affordable Care Act Health Insurance Marketplace. I have no intention of weighing the pros and cons of government-subsidized healthcare in this space. But given that these programs exist in the US, I believe they provide an opportunity to ameliorate the cheap rider problem while saving participants money and improving their health.
A Voluntary Compromise
Those interested in taking advantage of the tax break would have to provide proof of their physical activity—perhaps by sharing fitness tracker data or gym check-ins. That might sound invasive to many people. But the idea is not novel. Many car insurance companies currently offer a safe driving discount that pulls driving data from a mobile app.
Like a safe driving app and unlike a law mandating physical activity, claiming this health insurance discount would be voluntary. Don’t want to share your data with Big Brother? No problem. Continue with business as usual. But such an incentive could encourage many people to become more physically active while reducing their tax and healthcare burdens.
Obviously, an incentive-based program would lack the reach of a strict mandate. But it would encourage some Americans to voluntarily change their habits. If those who take advantage of the program extol its benefits, adoption might become more widespread. And if just a fraction of the American population becomes more active, it would lead to a meaningful reduction in premature deaths and economic costs.
Benefits Without the Cost
In the United States, physical inactivity is a significant driver of poor health and increased mortality. Achieving recommended physical activity levels has the potential to save far more lives than self-protecting laws like seatbelt mandates and tobacco age limits. But the costs of this positive duty outstrip the costs of those existing laws. Offering physical activity discounts on Medicare payments and government-subsidized healthcare plans would address both these issues. These voluntary discount programs could save enrollees money and improve their health without imposing unwanted costs.