Eating Up Health Care

One of the biggest recent developments in health-care reform is that Senator Max Baucus, chairman of the Senate Finance Committee, announced revisions to his still-fresh outline for what a bill should look like. After widespread criticism that the subsidies offered in his original proposal wouldn’t be enough to make health insurance affordable for the middle class, Baucus greatly increased the amount of money budgeted for subsidies.


But the past couple of weeks have also seen greater discussion of an often-overlooked factor in health-care costs: what we eat. In an op-ed piece in The New York Times, Michael Pollan, a journalist and frequent critic of the food industry, notes that having to cover all Americans could give the insurance industry a greater incentive to encourage healthy habits. But in the meantime, overweight and obesity play a large role in our health-care costs — accounting for about one-tenth of them, according to a study Pollan cites. Another study he cites concludes that much of the difference in health-care spending between the United States and Europe can be explained by chronic diseases, including Type 2 diabetes, that are linked to obesity. And as we covered in a recent blog entry, an overwhelming number of people with Type 2 diabetes exceed dietary recommendations for calories from fat, saturated fat, and sodium in their diet.

Taken together, these stories lead to a logical question: Should the government introduce widespread health-care subsidies without addressing a major factor in the rise of costs? The government already subsidizes health care, of course, through Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP). Yet as a matter of principle, many Americans seem to believe that the government — which has a unique ability to influence dietary habits — should not try to control what they eat. Many do, however, accept a government role in reducing smoking through both taxation and public smoking bans — which, a recent study concluded, reduce heart attacks by about a third in areas in which they are implemented.

What do you think — is there an important difference between governmental efforts to reduce smoking and those intended to improve eating habits? Should the government introduce health-motivated regulations on the food industry, or subsidies for healthy food, along with its potential health-care subsidies? Regardless of the role of government, should health insurance plans be allowed to discriminate based on eating habits, as many currently do based on smoking? Is it fair to charge the same insurance premiums to people who follow healthy diets and those who do not? If it were possible, would you allow your diet to be tracked in exchange for a potentially lower insurance premium? Leave a comment below!

Learn more about the health and medical experts who who provide you with the cutting-edge resources, tools, news, and more on Diabetes Self-Management.
About Our Experts >>

  • Sally Smart

    Why tax the people? Tax the makers who put out tempting sugar loaded stuff that is seen as a bad food. Put some kind of standard on bread makers that there should be more good quality ingredients in their products. Make these companies tell us what is really in the food they make and stop using chemicals. If they cant figure out how to make it so it lasts on the shelf long enough to sell it then it probably does not need to be sold to us. Health food costs an arm and a leg and that is why people chose the other stuff. Give benifits to factories or stores who put out the best foods so it happens more and the costs could possibly come down for the buyer,,, That is encouragement!!!. Over 4 bucks for a loaf of healthy bread versus $1.99 or less for a crappy loaf,,, you tell me which one most will buy.
    Our government spent a lot of years helping the farmers by giving them money when times were bad and promoting their flour products, how about giving us a bonus by subsidizing the cost of those veggies to us so he will sell more and we will all benifit. Even the Canadian food guide use to promote bread as high on the daily list and look at what it has caused. Put more money on teams who will clinically look at and judge food for what is really safe and what should not be eaten. If you told my customers I was selling a bad food it would be off my shelves in a hurry and something better would be there soon.
    The government wants to look good by setting costs against us,,, who governs the chemicals in cigarette tobacco? and what harm do these chemicals add to the product? The governemnt needs to look at their regulations and see if that needs to be fixed then decide where we are going wrong. Pricing things for the lining of government pockets is not always the answer. I have heard it said before that if everyone quit smoking in one day the government would fall to it’s knees and so would the government regulated drug companies that supposedly make us better when we are sick, so if that is true then why would the government want us to quit? That is probably why they do these little price hykes so they LOOK as if they are doing a good job to encourage us to quit so why not hit the food system and target us again??? Seems the little people always pay the price for what we cannot control and let the big guys pocket a little more, whats next? Why not charge us double for our grave sites so that when we die from eating bad stuff we can take a kick in the butt one last time.

  • Sally Smart

    Diabetes is our biggest issue with bad food, it is taking over our health systems money. If you put a team in to rate foods on a diabetic scale of one to ten, good to bad for consumption, and put it on the front of the pscksge, people would look at those markings and buy the best one. It is hard for someone who is not trained to look at lables and decide no matter how we may try because of the chemical names and even the different fat levels and carb counts (good carb, bad carb). Why not put money there and see if this does not help the medical system in a few short years? But who am I to say what would work? It is all about money and no one seems to know where to start so they charge the little guy every time because there are lots more of us who will take it. It is a penalty for not being the bread maker himself thank you very much.

  • Kim

    I think that the food industry should be forced to be more responsible for its marketing and advertising of unhealthy food choices. I am appalled at the advertising for fast food, soft drinks and other junk food. It is shameless that food companies like Coca Cola are making tons of $ on their soda when we, the people are paying for the health care costs related to obesity! I do feel it is similar to the tobacco industries irresponsible acts around the health issues of smoking. The difference between smoking and eating habits, is that eating is essential, smoking is not and those that can not afford healthier foods may be adversely affected by any tax on food that they can afford. It would be interesting to look at subsidizing healthy food. IF done thoughtfully and carefully may be helpful. However, education will be also very important. People need to see the value in eating well for the long term.

  • Julie

    Fascinating! I PERsonally think it sounds like a GREAT idea!
    Since the FDA requires all the nutritional labeling of foods (which I think is important), I believe, that although it would be a monumental task, it just might work…or at least get the wheels turning. Incentives for consumers who follow healthy eating (and exercise) habits and/or attend nutritional counseling could help as well. Guidelines that would require them to be approved for redemption of some kind of a rebate on a health care premium. Even things like personal chefs (for those who can afford it), and fixing the public school lunch systems!, and what aBOUT a tax on junk food? There would have to be very strict guidelines and monitoring of a lot of different things, but I think it is most DEFinitely something to look at. Thanks! J

  • Don Kovac

    I read the article about diet as part of health care reform. While I agree that diet helps in all ares of health, it is not the sole cause of diabetes.Also, do we really need big brother intruding into our lives more than today?
    I realize we hear “obesity” is the cause of more diabetes today than in the past.
    Maybe all of the “don’t eat this, don’t eat that” foods that studies have found may really be the cause of the problem.
    Add to that lifestyle modification due to parents utilizing the TV as a babysitter (this includes the games), resulting in a sedentary lifestyle may contribute far more to the problem than what we eat. Remember, the eating habits are coupled with lousong lifestyle choices, that is really the problem.
    I encourage people to fight back on some of these “studies” by truly researching the facts. The results can be real eye openers.

  • Harry…………………….

    There are also medications that precipitate type 2 diabetes as a side effect of the drugs used as prescribed.

  • Beverly

    I would like to see food choices influenced by implementing taxes on junk foods and sugar-sweetened sodas and juices. I would also like to see prices for fat, sodium and sugar laden foods sold in fast food (ie McDonalds, Burger King) and mid-range restaurants (ie Applebees and Red Lobster) increased through some form of taxation. Health choices would be, of course, exempt from these taxes. Very often the poor, in particular, and many of the rest of us, in general, gravitate toward poor food choices because it is cheap. If healthy foods were readily available and less expensive than poor food choices, economics would begin to influence what we eat. In this way the government would be directing us to eat better and help to finance universal health care.

  • Mary Kellogg

    It seems it would be fair if smokers have to pay the price, then maybe we should look at over indulging in food the same way. (There may be some circumstances that would need special considerations.) It might be good if we are all held accountable to a sensible goal, and not expect everyone else to fix the problem, when we just might be the problem for ourselves. If people won’t be accountable for themselves….
    I don’t believe the government should be in control, but the insurance companies could come up with some great incentive plans.

  • Cindy

    What we need is less stress less government and more personal responsibility. There are a meriad of reasons that people get Diabetes. Most of us are frustrated enough about the disease with out having to be made feel like it’s totally our fault and we are a burden to society. I know people that have diabetes who are thin…I think we deserve better. I for one will be requesting that I be removed from this mailing list.

  • Helen Afana

    I think the public is becoming more aware of good nutrition and healthy food choices. There are more healthy options at the grocery store and in restaurants. People making healthy choices are more admired these days instead of being thought of as weird or health fanatics. I hope this trend continues.

    I appreciate lower insurance premiums for not smoking. Taxes on cigarettes and alcoholic beverages are fine with me because I don’t use either because they are unhealthy habits. I am thankful for all the health problems I DO NOT have because I don’t use them. Continually studying good nutrition, finding the self control to implement what I know and exercising have all boosted my health. Keeping a food diary has been a valuable tool. A financial incentive to eat better would be a good thing. The ounce of prevention is always better than the pound of cure.

  • Bev

    If we want healthier people we need to EDUCATE them! Get the government to start advertising on the “babysitter” TV what is a healthy diet. Get the restaurants (both fast food and sit-down) to buy in. Not just healthy food but portion size will help decrease obesity! I’m a Type 1, can’t do anything about it but live a healthy lifestyle), but MANY of the Type 2’s and the Pre-Diabetics can eat healty and exercise (saving a ton of insurance money!!) and remove themselves from the diagnosis of being a diabetic.

    I don’t think we need the government to “dictate” what we eat, but EDUCATE the people as to what is healthy. Get the message out! I know I inform others, we already have 23.6 million Americans diagnosed with Diabetes, that’s 8% of our pop. (only 5% are Type 1), we have reached an epedemic but because “you can live with it” it isn’t a concern like Cancer, Heart Disease, Stokes, and Breast Cancer is. All very serious diseases, but how many people know that there are over 5 million that are still undiagnosed, 57 million have pre-diabetes, how many know that Diabetes is the FIFTH-DEADLIEST DIAEASE IN THE US? This is wnat needs to be stopped!

  • Angela

    It seems to me that everyone wants to blame someone or something for bad personal choices. All of these ideas have merit, but personal responsibility is number one. If you eat a McDonald’s hamburger, don’t do the fries or soft drink and eat just one. I bet you would not become obese if you only ate one hamburger. You are not going to starve to death on eating just one hamburger. If you are poor, you can still be responsible and quit blaming your choices on everyone else. Most people prefer fattening foods. I know I do, but I can’t blame someone else if I make a bad decision. You don’t need to tax colas or sweets if you just don’t eat that stuff.

    I do get tired of hearing that diabetes is tied to obesity. It may be, but I was very thin all my life and still ended up with diabetes. Family history sometimes plays more of a part than anything else. I just do the best I can with the situation I was dealt.

  • Douglas T. Hawes

    If I remember correctly, if you apply for a large life insurance policy the company will want to know your health (medical exam required), whether you smoke, drink or do drugs, preexisting conditions, age, sex, and maybe more. And the cost to you of this insurance policy is based upon the answers to these questions. So why shouldn’t eating habits and your life style, excercise, etc. be part of what the cost of your medical insurance is based on?

  • Vonnie De Rico

    I am thin and I have diabetes. Don’t jump on just Coca-Cola. Drink diet soda – cuts down on your appetite and make sure to limit potatoes and bread and you will have it under control.

  • Beverly S.

    I think taxing junk foods would be a fine idea. They are truly empty calories, and they benefit no one except the food manufacturers and food retailers. The beverage industry (read Coca Cola and Pepsi) is already wild with fear that this could happen to help pay for some of the changes in health care reform. Again I think this would be a fine idea. If this would cause people to cut back on soda purchases — wonderful!
    Yes, we all need to be personally responsible in what we eat and listen to our food advisors. However, many people just go ahead and eat whatever they want, gain weight and become sicker. Then they go to the doctor and have their medication increased to treat their disease(s) — high cholestero, diabetes, high blood pressure. In these cases we have yet another winner — the drug companies who have created medications to treat these chronic ailments.
    I know my tastes were formed when I was young and junk food was just a part of life. It was readily available, it tasted good and it was cheap. It has taken a tremendous effort on my part to wean myself away from junk and fast foods. I also am fortunate to be able to spend more on good food, so that I’m not tempted so much by the junk/fast foods that offer so little nourishment in return for the calories they provide. Yes, taxing junk foods would hurt, but if people were confronted with this pain, perhaps they would react by drinking water instead of soda and going home to have a sandwich instead of having a Big Mac. We could change the formation of tastes in the next generation and encourage this one to find alternative foods.