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How Government Will Control Our Diet

From the dieticians of the Op-Ed page at the New York Times:

Big Food vs. Big Insurance

By MICHAEL POLLAN

September 10, 2009

Berkeley, Calif. — To listen to President Obama’s speech on Wednesday night, or to just about anyone else in the health care debate, you would think that the biggest problem with health care in America is the system itself — perverse incentives, inefficiencies, unnecessary tests and procedures, lack of competition, and greed.

No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

That’s why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry

We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care.

The American way of eating has become the elephant in the room in the debate over health care. The president has made a few notable allusions to it, and, by planting her vegetable garden on the South Lawn, Michelle Obama has tried to focus our attention on it. Just last month, Mr. Obama talked about putting a farmers’ market in front of the White House, and building new distribution networks to connect local farmers to public schools so that student lunches might offer more fresh produce and fewer Tater Tots. He’s even floated the idea of taxing soda.

But so far, food system reform has not figured in the national conversation about health care reform. And so the government is poised to go on encouraging America’s fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.

Why the disconnect? Probably because reforming the food system is politically even more difficult than reforming the health care system. At least in the health care battle, the administration can count some powerful corporate interests on its side — like the large segment of the Fortune 500 that has concluded the current system is unsustainable.

That is hardly the case when it comes to challenging agribusiness. Cheap food is going to be popular as long as the social and environmental costs of that food are charged to the future. There’s lots of money to be made selling fast food and then treating the diseases that fast food causes. One of the leading products of the American food industry has become patients for the American health care industry.

The market for prescription drugs and medical devices to manage Type 2 diabetes, which the Centers for Disease Control estimates will afflict one in three Americans born after 2000, is one of the brighter spots in the American economy. As things stand, the health care industry finds it more profitable to treat chronic diseases than to prevent them. There’s more money in amputating the limbs of diabetics than in counseling them on diet and exercise.

As for the insurers, you would think preventing chronic diseases would be good business, but, at least under the current rules, it’s much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.

But these rules may well be about to change — and, when it comes to reforming the American diet and food system, that step alone could be a game changer. Even under the weaker versions of health care reform now on offer, health insurers would be required to take everyone at the same rates, provide a standard level of coverage and keep people on their rolls regardless of their health. Terms like “pre-existing conditions” and “underwriting” would vanish from the health insurance rulebook — and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change.

The moment these new rules take effect, health insurance companies will promptly discover they have a powerful interest in reducing rates of obesity and chronic diseases linked to diet. A patient with Type 2 diabetes incurs additional health care costs of more than $6,600 a year; over a lifetime, that can come to more than $400,000. Insurers will quickly figure out that every case of Type 2 diabetes they can prevent adds $400,000 to their bottom line. Suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.

When health insurers can no longer evade much of the cost of treating the collateral damage of the American diet, the movement to reform the food system — everything from farm policy to food marketing and school lunches — will acquire a powerful and wealthy ally, something it hasn’t really ever had before…

All of which suggests that passing a health care reform bill, no matter how ambitious, is only the first step in solving our health care crisis. To keep from bankrupting ourselves, we will then have to get to work on improving our health — which means going to work on the American way of eating.

But even if we get a health care bill that does little more than require insurers to cover everyone on the same basis, it could put us on that course.

For it will force the industry, and the government, to take a good hard look at the elephant in the room and galvanize a movement to slim it down.

Michael Pollan, a contributing writer for The Times Magazine and a professor of journalism at the University of California, Berkeley, is the author of “In Defense of Food: An Eater’s Manifesto.”

As Mr. Pollan suggests (and obviously hopes), government run healthcare will bust this can of worms wide open.

If worms will still be allowed to be canned in the brave new world of healthcare reform.

This article was posted by Steve Gilbert on Thursday, September 10th, 2009. Comments are currently closed.

3 Responses to “How Government Will Control Our Diet”

  1. wardmama4

    While I agree with some of the premise presented – I do not think it is now nor ever shall be ‘government’s’ – right to be the one doing the controlling.

    The AMA and FDA should have and could have put a stop to this decades ago – at one point 2/3 of the food additives (colors, flavorings and preservatives) weren’t tested – they’d gotten waivers to postpone the testing – and low and behold just never went back to it – and the FDA just never cared.

    Aspartame was denied as Aspartame in 1974 – but heck just repackage it, rename it, lie to the FDA (just in diet foods) and walla – it’s a keeper!

    Convenience foods are the problem – laden with chemicals, sugars and colorings – they are poisoning the human body – but then not many people know how to cook real food anymore anyway. Or even know what real food is.

    But I still don’t want Uncle Obama to tell me what I can and cannot eat – and that is why paying for your own – be it food, housing, insurance and medical care is the only fair and just way about it.

    Get an Education, Work Hard and Eat Healthy – guess what – your peripheral costs are probably going to be a lot less.

    Sit around griping about how unfair life is, getting up only to cash your check once a month and buying cheetos and beer with it – well then you pay for it – in more ways than one.

  2. wardmama4

    I really hate the NYTs – it is no wonder they are losing money. Mr. Pollen in his book says that the obesity is because of the government and it’s control of food. Exactly what I said (about the additives etc), which is the real cause of obesity. And of course the NYTs has to distort the message a bit – because it is the government who lays down all the controls and regulations and as I said – does not do the real vetting of the additives. Which are both what the problem is.

    I am just so sick of government having their fingers in ‘solutions’ that both control and in the end create even more problems with the result that government invades even more and further into our lives and bodies – and No one is stopping it and pointing out that the Elephant in the Room is Government and growing bigger every single minute.

  3. MinnesotaRush

    “How Government Will Control …” .. STOP right there! How gov’t will control ..

    What happened to “Public Service” .. “Public Servant”? What!?!? No funerals this week?!?!


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