One good thing about mandatory coverage through Insurers . . .

[abumbyanyothername]

http://www.nytimes.com/2009/09/10/opinion/10pollan.html?pagewanted=1&_r=1&emc=eta1

<snip>

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.

AGRIBUSINESS dominates the agriculture committees of Congress, and has swatted away most efforts at reform. But what happens when the health insurance industry realizes that our system of farm subsidies makes junk food cheap, and fresh produce dear, and thus contributes to obesity and Type 2 diabetes? It will promptly get involved in the fight over the farm bill — which is to say, the industry will begin buying seats on those agriculture committees and demanding that the next bill be written with the interests of the public health more firmly in mind.

In the same way much of the health insurance industry threw its weight behind the campaign against smoking, we can expect it to support, and perhaps even help pay for, public education efforts like New York City’s bold new ad campaign against drinking soda. At the moment, a federal campaign to discourage the consumption of sweetened soft drinks is a political nonstarter, but few things could do more to slow the rise of Type 2 diabetes among adolescents than to reduce their soda consumption, which represents 15 percent of their caloric intake.

<snip>

I especially wanted to include the two paragraphs following this from page 2 of this editorial, but I abide by DU's rules.

[Ninga]

1. Great point. I agree. I will read the entire article. Thanks. n/t

[customerserviceguy]

2. This seems like wishful thinking to me, sorry

Public health campaigns really don't reduce the incidence of smoking (I certainly wish they would), but most people are able to tune out a nanny's voice. The only things I've ever seen that have worked with smoking are either:

1) Substantial breakthroughs in treatment methods, such as the patch. I had hoped that Chantix would be one of them, but I sat around a table with a bunch of (still) smokers last weekend who told me about the awful psychological side effects it had.

2) Further reducing the number of places that people can smoke. I noticed a sizable dropoff in the rate of co-worker smokers when it was no longer allowed inside office buildings, and another one when it was no longer allowed in bars.

3) Dramatic increases in the price of cigarettes, especialy when onerous new taxes are first imposed. People do get used to them, so you have to step it up every few years.

Now, when you apply those methods to food, there are problems. #1 would be ideal, but until we get to the genetic level, I believe that every method of dealing with overeating medically has been tried. I remember my mother's diet pills, they were speed! Since then, other methods have proved to be either ineffective, or to have significant side effects.

Perhaps insurance companies would be willing to pay for gastric bypass or lap-band surgeries, but I don't think we've had enough people having had them for a long enough time to really evaluate the long term effects.

There's no way to do #2, even if you banned fast-food places (good luck!) you'd still have ways of cooking high-calorie, low-nutrition foods at home. If I've got a hankering for a cheeseburger, I don't need Mickey D to be my "pusher".

Number 3 is a possible option, if we figured out what to tax excessively to discourage, and people were not able to substitute other things, that might work. Perhaps a 200% tax on ground beef to subsidize organic produce might work, but again, if you've got that hankering...

In any case, healthier living just postpones the inevitable, and I don't really think insurance companies are really going to be wild about seeing the average age of their oldest group of insureds going from 65 to 75, that decade has a lot of non-fatal expenses that are as costly to treat over a decade as a person's final illness.

[Oregone]

3. "Public health campaigns really don't reduce the incidence of smoking"

No, but an alternative thought here....about the "free" market

Well, those bastard shareholders who inherited their wealth from the great granddaddies who owned slaves and ran sweat shops, and do nothing to earn profit off sick people....

They are also invested in some of these other businesses making shit food. Maybe if they realize suppressing the profits of part of their portfolio boosts the profits of their insurance portfolio, they will take actions that will lead to a healthier America.

On the other-hand, they could also be invested in health care delivery (pills, hospitals, etc) and have an incentive to keep Americans sick. So maybe absorbing some diminished dividends in insurance is worth the junk food/health delivery boost.

[Igel]

5. It's not really all that hard to not eat a diet consisting

primarily of "shit food". Looking to government to provide will power is probably not a good thing.

Moreover, when the cheap, high-calorie foods are off the market, don't look for the more expensive, nutrition-dense foods to be any cheaper. While taxes could make the two equally expensive, it's just another way of making sure that people do what "we" want them to do. More "engineering of the human soul".

[abumbyanyothername]

7. All the author is asking for is

diversion of farm subsidies from subsidizing corn and corn-fed beef to subsidizing fruits and vegetables.

I think he would settle for an end to farm subsidies period, but that might be the one issue that Tom Harkin and Chuck Grassly could agree to oppose.

[abumbyanyothername]

4. My parents both quit smoking

because of a public health campaign. The first surgeon general's warning on cigarette packs.

My ex-wife quit when the kids told her that she either quit or they were going to live with their father (thank God she didn't call that bluff!).

I think public health campaigns work. They may not work amongst your friends so you can share anecdotal evidence. But the campaign may have helped set the stage for the restrictions that you credit with working.

I am, however, concerned that insurers might see their business as "cost plus"; i.e., the collect premiums, pay claims and retain a profit margin on all the funds passing through their hands. In that case they might have incentives to see costs (and premiums and margins) increase.

[customerserviceguy]

6. I'll admit, my father did, too

about that time, or at least when it was starting to become the law that it would happen. But as the warnings got stronger and stronger, I really didn't see any drop-off in the smoking rate.

I remember about forty years ago, the idealists thought that taking cigarette ads off of radio and TV would lead to a cessation of smoking among the younger generation. After all, my brother and sister and I could all spout off the jingles for cigarettes! But even with that influence, none of us ever smoked, and the banning of ads has zero effect on the youth smoking rate.

I still see legions of teens and twenties sucking them down. Even in the computer chip factory where I worked, and you had to pass multiple intelligence tests to even get an interview, there was a sizable minority of regular smokers. You cannot 'educate' people out of bad behavior, at least not as much as you'd want to.

I really don't see where insurers see their business as "cost plus", if it were so, why would they deny so many treatments?

[Edweird]

8. Or they can deny care or drag their feet till you drop dead and make even more money.

Like they are doing right now.