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The State of Play on Obesity Policy

Campaign super-reporter Marc Ambinder has been working on a big article about obesity, and his blog, somewhat unexpectedly, has featured a lot of great stuff from the conferences he's been attending and the research he's been reading. Today's post, however, is about the best summation of thinking in obesity policy that I've seen. I'm a bit annoyed, because I wish I had written it. But you should definitely read it.

By Ezra Klein  |  July 31, 2009; 12:28 PM ET
Categories:  Health  
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Comments

it seems a clear case can be made that another aspect of health reform would be to stop subsidizing the sugar industry. It's hypocritical and stupid to talk about a tax, on products containing high fructose corn syrup after the government subsidy.

Posted by: goadri | July 31, 2009 4:20 PM | Report abuse

New Yorker had an interesting review of several books on obesity. One of the most interesting points was to note that in our society, eating, especially eating "fun" foods that are high in fats, salt, and sugar, is one of the cheapest (at least in immediate costs) forms of recreation. They referred to it as "eatertainment."

For large numbers of people in low and lower middle income groups, eatertainment is one of the few pleasures that are easily available. Camping in front of the the TV watching "free" network sports or entertainment while eating chips and drinking beer or soda is cheap, especially compared to the much higher costs of many other activities. For people who don't have the money for trips to the Bahamas, attending live sports or music events, ski trips, bars and clubs with $9 mojito's, or $1000 bikes, this is a good buy.

It is this eating for fun that is one of the most important factors in obesity.

Another interesting point in the article was that the US is no longer number one in the obesity sweepstakes. Finland, Germany, Czech Republic, Greece, and several Eastern European countries have passed us up. Other Western European countries are gaining fast, so to speak.

Posted by: PatS2 | July 31, 2009 7:20 PM | Report abuse

obesity is a major expense and when those that espouse the ranking of 37 or whatever it is of the WHO report where America stands they conveniently leave out this reason that Americans are grossly more obese than any other country in the world.

To that end why can't we in some way treat obese people like we do in many states including my own of NJ how we treat mental illness. Several years back the law was it would cover outpatient visits for all mental illness usually to a limit of 30 visits per year (this is the small group 2-50 market of employers). Then the law was passed to seperate biologically based mental illness from non biologically based mental illness and the argument was that biologically should be treated as any other illness and have no limitations (increased cost, but oh well they're going up anyway) because those that are biologically based had the genetic disposition to it. Doctors had to mention that in their diagnoses. Why can't we base the same premises on obesity and cover more for those with the genetic disposition to it and less for those that don't have that. Again this assumes that doctors can seperate the two oh and that they won't adjust their diagnoses (which i've seen done in my state) to make sure you get more coverage.

Geez, there's that fraud and abuse thing again.

Posted by: visionbrkr | August 1, 2009 9:22 AM | Report abuse

The Washington Post's Nation Digest section (28 July) had a short piece detailing the health costs of America's obesity crisis--147 billion dollars a year and rising. Obesity related diseases such as diabetes, heart disease and other illness account for 9.1 percent of medical spending. Yet as bad as this problem is, I have yet to see it mentioned by our political leaders in the debate over the costs of health care reform. So let me propose an idea to chew on; how about enacting a 15 percent tax on all fast food (defined as food bought over a counter top) as a down payment for national health care? Such a tax would raise enormous sums of money to help pay for health care. This tax would be fair--the very people who are eating themselves into ill health would also be contributing in an affordable way the very tax monies which ultimately will pay for their future obesity related health care costs--and the tax is entirely voluntary. You only pay it if you choose to eat fast food! If (unlikely but we can always hope) people actually reduce the amount of fast food they consume because of the 15 percent surcharge, so much the better because that would lessen the over all national intake of fast food, thus reducing our national obesity levels! Please don't bring up the 'regressive tax' argument; if you can afford to eat a Big Mac, you can afford to pack a better and more healthy lunch. One thing that Americans must know; for national health care coverage--just like fast food--there is no free lunch.

Posted by: edggg | August 1, 2009 11:00 AM | Report abuse

edggg,

while i agree that fast food is the cause of many of these problems taxing it will not help. many lower income individuals would be too negatively affected by it. the issue would be to somehow get fast food to be healthier. somehow convince those that eat fast food to say go to Subway as opposed to McDonald's. Saladworks as opposed to Popeye's Fried Chicken. unfortunately we can't force them to do that and if people are "handed" healthcare what incentive is there for them to eat healthier?

Also very little talk about the lack of primary care docs (i know ezra has talked about this some) but if we give everyone a public plan and docs are at their breaking point of patients now how will they see those that are coming there instead of the ER? also what FORCES them to even go there. I'd expect a large segment even when they're handed healthcare for free or relatively free still won't do anything with it.

I just doubt with all that we're spending we're doing much good. We can't force people to care about themselves and their wellbeing.

also do they really think that the majority of americans will understand options within a national health exchange? I've talked to attorneys who can't understand a health insurance contract much less your average american. i'm afraid we're spending ourselves into oblivion for nothing.

At best we'll move from 9% increases per year to 7%. still far outpacing GDP growth which we'll continue to stunt with this administration's policies.

Posted by: visionbrkr | August 1, 2009 1:39 PM | Report abuse

We should tax the obese, the smokers, the alcoholics and the drug users...wait, those are the people we'll be subsidizing...what was I thinking ??

Posted by: billbrann | August 4, 2009 10:46 PM | Report abuse

I think that there needs to be a significant tax credit for things such as Gym memberships, purchases of bicycles, kayaks, and other exercise equipment. I think that in theory things such as taxing fast food sounds good, but wouldn't work. For example, taxing of cigarettes hasn't derailed smokers. If punishing the offenders doesn't work atleast reward those who are doing things to stay healthy. After all they are the ones who will be around to pay for the rest of us overweight people.

I know one guy who lost 30+ pounds so that he could save money on his life insurance. If he lost the specified weight he would be in a lower risk pool and his premium would be significantly less. He made his deadline and still continues the exercise program.

I must admit that I really enjoy my trips to Sonic (and other fast food places) at the end of my 20+ mile bicycle rides. Tax or no-tax, I will be getting a Cherry Limeade at the end of that ride.

So Color Me Obese and Tax On!!!

Posted by: angelinacanterbury | August 7, 2009 12:46 AM | Report abuse

Maybe the government just needs to give every citizen a bicycle or a pair of skates.

Posted by: angelinacanterbury | August 7, 2009 12:52 AM | Report abuse

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