Michael Pollan’s New York Times article makes several important points, one being that without changes in American rates of obesity, reforming the insurance system will be a partial change at best. What’s truly needed, he says, is to find ways to significantly decrease rates of preventable chronic diseases, chief among them diabetes, heart disease, obesity and cancer.
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.
Tellingly, according to Pollan, a key economic role of the food industry is to provide tens of millions of chronically ill people to the medical treatment industry. Economic growth, which does not distinguish between positive and negative health outcomes related to such growth, is perversely helped by the presence of these sick people, who fuel what has often been called the “disease care” system.
Private insurance companies, who until now have been incentivized to reject such extremely sick people from coverage (this is the famous ‘pre-existing condition’ problem), will, if health reform passes, no longer have the legal right to do so. Pollan asserts that this will lead insurers to prioritize prevention.
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.
This is just one of the potentially positive effects of the health reform plans working their way through Congress.
