Amy Goodman recently interviewed David Kessler, who used to be Commissioner of the FDA under Bush I and Bill Clinton. He has really turned up the heat on the unhealthy food industry, and it is a huge industry. It’s repeat clients also frequent hospitals in droves, as reported by DemocracyNow:
[A] new report from the Centers for Disease Control and Prevention warns that the direct medical costs of obesity total about $147 billion a year. That amounts to nine percent of all US medical costs. It’s also over $50 billion more than the annual spending on cancer.
The problem is that we have these innate and insatiable cravings for salt and sugar and fat.
Fat and sugar, fat and salt, fat, sugar, and salt stimulate us to eat more and more. Does the food industry understand the inputs? Absolutely. They understand that fat, sugar and salt stimulate us, and they understand the outputs. They understand we keep on coming back for more and more, as Kessler explains:
Have they understood the neuroscience? Have they understood how fat and sugar work? I don’t think so. But we now have that science. But what’s important is the fact that they have figured out—they’ve learned it experientially—what works, and they construct food to stimulate us to eat more . . .
What has the food industry done? They’ve taken fat, sugar and salt, they’ve put it on every corner. They’ve made it available 24/7. They’ve made it socially acceptable to eat at any time. They’ve added the emotional gloss of advertising. Look at an ad; you’ll love it, you’ll want it. They’ve made food into entertainment. We’re living, in fact, in a food carnival.
But how much fat, sugar and salt can you possibly pump into food? More than you can imagine. Kessler explains the formula:
So, take an appetizer in a modern American restaurant. Take buffalo wings. What are they? You take the fatty part of the chicken, fried usually in the manufacturing plant first. That loads about 30, 40 percent fat. Fry it again in the kitchen of the restaurant. That loads more fat. That red spicy sauce? What is it? Fat and sugar. That white creamy sauce on the side? Fat and salt. What are we eating? Fat on fat on fat on fat on sugar on fat and salt.
But aren’t the obese people the real problem? Why blame the terribly unhealthy food industry (Did you like this framing of the question)? Yes, people need to get disciplined about the way they eat. No doubt. But when 2/3 of American adults are overweight, it’s time to assume that the artery-clogging food manufacturers of American are immorally creating an environment ubiquitously filled with toxic supersized portions. In short, I fully support new Congressional legislation would provide up to $10 billion a year for a prevention and public health investment fund that would include a focus on curbing obesity.
See this related post on the effect of growing portion sizes.
I have heard that tobacco use is the largest contributor to health care costs in the US. More than obesity.
Give me ONE reason I should pay to subsidize health care for obese tobacco users. Why should their foolish lifestyle choices cost ME money?
TMOL: What do you think about people who get hurt engaging in risky sports like bungee jumping, Xtreme bicycle racing? Should they pay more in health insurance? People with head injuries who rode bikes or motorcycles without helmets? Using dangerous street drugs? Having risky sex? Failing to wear seat belts?
I'm not suggesting that I know the answer for these cases. I don't want to subsidize their health care for their risky choices, but I don't know whether there is any reasonable way to administer a health care plan to discourage these risky behaviors. If you cut these people out of insurance, either the government picks up the bill or they live potentially short lives as beggars on the streets. No happy solutions.
"If you cut these people out of insurance, either the government picks up the bill or they live potentially short lives as beggars on the streets."
I don't suggest cutting them out of insurance. If they can afford it, they can try to buy high risk insurance for whatever it costs, without government subsidy. If they cannot afford insurance or self-pay for health care, it is their choice to smoke, be obese, and beg on the streets. Supposedly "it's a free country" and thus people should have a right to choose their lifestyle, but not at MY expense.
I still ask someone to give me just ONE reason why I should subsidize health care or health insurance for a person who chooses to be obese and to smoke.
TMOL: Again, I'm not yet taking a position on this thorny issue, but consider this:
"If people stopped smoking, there would be a savings in health care costs, but only in the short term. Eventually, smoking cessation would lead to increased health care costs."
This is not written by a crackpot. It was in the New England Journal of Medicine. A similar case can be made for obesity: Being obese can take ten years off a person's life.
Therefore, from a purely economic standpoint, one could think it preferable that others smoke and be obese. What do you say now, TMOL?
What do you say now, TMOL?
if there is a heaven and i get there, can i eat whatever i want, and if you are there will you quit arguing with me?
In heaven, I'll be asking you to please pass the manna.
tmol
people who smoke already pay more taxes than you (due to taxes on tobacco). For countries like the UK, where single payor is the rule, that directly supports their additional healthcare needs (likewise, the obese eat more and pay more taxes on the food they purchase, versus you).
For the US, this means only that these people pay more taxes. Where they are 'personnaly insured' they do pay significantly higher premiums, but there is no mechanism to capture and penalize based on risk. And rightly so.
I have a colleague (same age, essentially the same 'health profile' as me) who is congenitally pre-disposed to heart disease. He takes as much care as he can, but he is still at greater risk than me. Should he pay more in his health premiums that I do? Should I pay less?
Where would that stop?
Someone may smoke (or be obese) and therefore 'increase their risk' but that increased risk may still be less than that for someone with a congenital issue.
Insurance is amortization. You accept people with different risk factors, assuming that the low risk 'compensate' for the high risk. As soon as you start 'cherry picking' you create a situation where risk is unacceptably penalized, to the point that people cannot get any insurance (at an 'affordable' cost).
What would you consider appropriate exclusions. Today it's smoking and obesity. What about alcohol use? Driving. Riding a bicycle. playing sports. not playing sports.
As soon as you start the behavior of 'appropriate exclusion' you set the stage for further exclusions.
You are treading a very fine line between 'sense' and 'libertarianism' in your commentary. next thing you'll be suggesting eugenics.
People are quite fretful about a health care shift robbing them of control- the ability to choose a doctor, choose a plan, and pick a course of treatment is held quite dear. In some cases, though, control is already being robbed from people by the companies that insure them. The Cleveland Clinic and other companies have previously instituted non-smoking, non-obesity policies for their employees, firing or refusing to hire applicants who fall into either risk group. I have a lot of qualms with the health care reforms that are currently on the table- but I also hate the current tie that health insurance has to employment. Our current paradigm takes the power out of consumers' hands, too- just as health care reforms are feared to.
Erich asked, "What do you say now, TMOL?"
The NEJM article is provocative, but seems to not account for the possibility that the relative cost of old age care versus the cost of treating the chronic diseases associated with smoking might be very different in the future compared to today. In particular, money currently being spent to find cures for the chronic diseases associated with smoking could be redirected to try to find cures for the medical costs of a population that lives longer, thus potentially lowering the costs. If so, then there could potentially be very significant medical cost savings from smoking cessation.
Erika
Insurance companies have always been extremely controlling (in -v- out of network). In recent years the variance in benefits has gotten much greater (in the 90's — 80% out of network vs 100% in network was common; now 60% out of network and 90% in network is common)
The networks have also shrunk significantly (as medical practitioners focus on single networks to reduce their workload while maximising their return — sustin via the primary local 'network' and higher 'non network co pay' for out of network patients)
I am thinking of forming a new company – actually, a new industry – and am hoping all of you readers will pay a monthly premium to be my customers. inasmuch as everyone needs to eat (just like everyone needs health care) my new company will provide food insurance. you will pay a fixed monthly premium and my company will pay all of your grocery bills.
everybody will pay the same monthly premium.
oh, i forgot to ask, would you prefer that i include or exclude obese people from the group with which you will be participating, and upon whose grocery bills your monthly premium will be calculated?
please let me have your thoughts on whether we should allow obese people into our plan.
tmol;
I personally know slender people and eat much more that people who are obese. A former coworker of mine brought his lunch in two shopping bags, and he never weighed more than 130 lbs. A current coworker of mine weighs 120 lbs and eats continually.
Many of the most obese people have really tight grocery budgets, but the problem in part is that the cheaper foor items in the grocery stores are the high carb foods. These high carb foods cause carb loading, resulting in elevated blood glucose levels even in non-diabetics which in turn causes them to feel tired and draggy and less inclined to get the excersize needed to burn off the carbs they consume.
Many food additives, such as caffeine, have been shown to cause insulin resistence, which not only increases blood glucose levels, but at the same time increases the hunger sensation as the cells are not getting the full benefit of the elevated sugar levels.
You cannot always count on products labeled as health foods to be healthy either. Granola bars are loaded with sugar.
We are hardwired to crave sugars starches and fats becasu those are the fuel our bodies run on. We need salt as well, because it is used to regulate many bodily functions, and additionally is used to produce the stomach acid needed for digestion.
The answer is not just food reform, but finding ways to encourage aerobic activity. Our current social setting discourages activity, and it is killing us.
I won't buy into TMOL's company.
I agree, however, with his general point that Americans absolutely need to start taking better care of their bodies. They need to eat better and exercise every day. They need more sleep more and they need to wean themselves of their consumerist frenzies, whereby they usurp their energies to wasteful displays requiring LONG hours at work, instead of spending their time and money on things that they themselves claim to be important. It's gotten so incredibly bad that, in my opinion, we should announce an National Emergency.
When they fail in these regards, they are crapping up their own lives, many of them condemning themselves to extremely limited, painful and often demeaning existences. Many serious medical issues result, including heart attacks, orthopedic issues, strokes and cancers. Further, they are utilizing far more of the health care system than necessary.
I know several very large people who stay home–rarely go anywhere–because it's too uncomfortable. Difficult to fit in a car, much less an airplane.
I would like to see preventive medical care take the front of the stage with regard to any health care reform.
I hope this comment is taken in the spirit in which I am offering it. I am not ranting and pointing fingers. We have constructed a toxic world where it's all too easy to live unhealthy lives.
We can help these people to help themselves. It would be good for everyone, no exceptions.
A new study finds that children are more likely to have an intense sweet tooth if they have a family history of alcoholism, or if they've suffered from depression themselves.
http://www.aolnews.com/health/article/study-links…