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Vocapedia > Media > USA > NYT > Illustrations >
2008-2009
Eric Hanson
Letters
Putting America
on a Healthier Diet
September 12, 2009
The New York Times
To the Editor:
Re “Big Food vs. Big Insurance,” by
Michael Pollan (Op-Ed, Sept. 10):
Mr. Pollan rightly contends that health care reform will be ineffective unless
the country’s increasing obesity problem is addressed. But because the food
industry is only part of the problem, reforming it is only part of the solution.
The other part of the problem is the American consumer. While food producers
provide an array of unhealthy fare, how, what and when we eat are personal
choices.
Mr. Pollan praises attempts to tax sugary sodas because these products add empty
calories to our diets, particularly for our youth. Yet sugar-free sodas have
been available and widely consumed for 40 years. The choice is the consumer’s.
If we are to make headway on this issue, we must have comprehensive physical
education and health education in our schools and incentives supporting healthy,
active lifestyles and nutritional food choices for all citizens.
Like all industries, the food producers are driven by their bottom line. Only
when consumers begin to demand healthier food will the industry change.
Anne-Marie Hislop
Davenport, Iowa, Sept. 10, 2009
•
To the Editor:
I applaud Michael Pollan’s recognition that obesity is the “elephant in the
room” in the health care debate, but dissent on his solutions.
Taxing specific products such as soft drinks or creating yet another educational
program will not get the job done. Multiple studies have demonstrated that “fat”
taxes will not appreciably lower obesity rates, while attempts to change
consumer eating behavior have historically come up short.
The real enemy is the number of excess calories available for consumption,
regardless of the source. The only way to slim down this beast is to engage the
food industry.
Rather than alienate or overregulate the industry, my recommendation is to put
into effect tax incentives that would entice food companies to sell fewer
calories. If they cut their calories, they would be rewarded. If they continued
to spew excess calories on the public, they would risk losing favorable tax
treatments.
This approach is well worth discussing. Our nation’s health depends on it.
Henry J. Cardello
Chapel Hill, N.C., Sept. 10, 2009
The writer is a former food industry executive and author of “Stuffed: An
Insider’s Look at Who’s (Really) Making America Fat.”
•
To the Editor:
Eating well and exercising are important, but not necessarily a panacea against
disease.
I am a 55-year-old woman who is slim, eats a healthy organic diet, takes ballet
classes and practices yoga on a weekly basis.
I had breast cancer in 2003 and learned I had Stage 4 tonsil cancer in 2008. My
out-of-the-pocket costs for my recent treatment for tonsil cancer totaled
$15,000.
As part of my follow-up care, I need thousands of dollars of dental work, plus
expensive magnetic resonance imaging every six months for the next three years.
My monthly health insurance premium, for me alone, has gone up to $662.
Michael Pollan is correct in targeting agribusiness for contributing to obesity,
but he does a grave disservice to me, and Americans in general, when he links
the dire consequences of not having strong and meaningful health care reform
with the honorable, but separate, issue of food industry reform.
Francesca Pastine
San Francisco, Sept. 10, 2009
•
To the Editor:
As a big fan of Michael Pollan, I was delighted to read “Big Food vs. Big
Insurance.”
I am 65, look 50, and weigh 10 pounds more than when I graduated from high
school, where I lettered in two sports. I work out three or four times a week,
recently added two weekly yoga classes, take stairs whenever possible and have
no major health issues.
My “diet” is to eat as much as I need, and no more. If my weight is up a little
any morning, I just eat less that day.
My wife and I usually split the massive entrees at restaurants, we eat very
little meat, and our snacks are fruits and nuts. And yes, I indulge — with a
little delicious dark chocolate and low-fat ice cream every day.
I don’t eat junk food or buy the soft drinks and other reconstituted muck that
American agribusiness currently substitutes for real food.
When Americans demand that restaurants and agribusiness put our health first, I
will no longer be unusual.
James G. Goodale
Houston, Sept. 10, 2009
•
To the Editor:
Michael Pollan’s essay on the role of the food industry in contributing to
obesity and associated chronic diseases may have some merit, but only because
too many consumers make poor dietary choices, meal after meal, day after day.
Are we really going to blame the food industry for providing foods we enjoy but
overindulge in? When did personal responsibility go out the window?
Most of us like a good hamburger with all the “fixings,” maybe even fries and a
shake with it. But is the provider to blame when we consume them day after day,
and couple this with other food choices that are high in calories and fat, with
little or no exercise to offset these poor dietary choices?
The old saying that there are no good foods or bad foods, only good or bad
diets, is still relevant.
Rather than play the blame game, we should direct our efforts at better
educating consumers on the importance of balancing caloric intake with energy
output.
Taxing or blaming the food industry may add more money to the government
coffers, and make some feel better, but it has no public benefit.
James Stanley
Jasper, Ga., Sept. 10, 2009
Putting America on a
Healthier Diet, NYT, 12.9.2009,
http://www.nytimes.com/2009/09/12/opinion/l12pollan.html
Op-Ed Contributor
Big Food vs. Big
Insurance
September 10, 2009
The New York Times
By MICHAEL POLLAN
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.
According to the Centers for Disease Control and Prevention, three-quarters of
health care spending now goes to treat “preventable chronic diseases.” Not all
of these diseases are linked to diet — there’s smoking, for instance — but many,
if not most, of them are.
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.
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.
That’s why it’s easy to imagine the industry throwing its weight behind a soda
tax. School lunch reform would become its cause, too, and in time the industry
would come to see that the development of regional food systems, which make
fresh produce more available and reduce dependence on heavily processed food
from far away, could help prevent chronic disease and reduce their costs.
Recently a team of designers from M.I.T. and Columbia was asked by the
foundation of the insurer UnitedHealthcare to develop an innovative systems
approach to tackling childhood obesity in America. Their conclusion surprised
the designers as much as their sponsor: they determined that promoting the
concept of a “foodshed” — a diversified, regional food economy — could be the
key to improving the American diet.
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.”
Big Food vs. Big
Insurance, NYT, 10.9.2009,
http://www.nytimes.com/2009/09/10/opinion/10pollan.html
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