This week Davis became the first community, with a very modest proposal, to start taking a stand against sugary beverages for children. Those who argue that this doesn’t solve the problem of childhood obesity or diabetes are correct – it does not and it is not intended to.
Instead, it is a very low cost, low level change that does one very simple thing – it changes the default status of drinks on the children’s menu at restaurants to make healthier choices the default. If a parent wants to order their child a soda, this does nothing to stop them. But at least it makes them specifically request it.
The reaction by the local paper’s editor was very disappointing and demonstrated that the paper’s editor, Debbie Davis, does not understand the ordinance and did not take time to talk to anyone about its implications.
She wrote in the Friday column: “JEERS to the city’s new soda rules, mandating water or milk as the ‘default’ option on kids’ meals. We’re sure the City Council means well, but this is the sort of pointless micromanaging that gives the nanny state a bad name. And what restaurant has a ‘default’ drink? Don’t they usually ask the customer first? And if you’re so afraid to say ‘no soda’ to your kid that you need local government to step in, you have bigger problems.”
What do you mean what restaurant has a default beverage? The city identified 20 restaurants that have on their kids’ meal a default beverage of soda. Interestingly enough, if you go to McDonald’s and order a Happy Meal, you have to request soda, but soda is not one of the listed items on a Happy Meal. Has it really been that long since your kids were little that you didn’t realize that? That’s just sloppy.
Happy Meal’s default beverage is apple juice, orange juice or chocolate milk. You can ask for a soda and they’ll give you one, but it’s not the default.
But the more offensive comment is, “And if you’re so afraid to say ‘no soda’ to your kid that you need local government to step in, you have bigger problems.” This assumes that the only people who are ordering these things are well-educated on nutrition. Part of the problem that this attempts to address is that for many low-income children, their parents are not educated on nutrition. For many low-income families, fast food is a staple.
And the statistics are frankly alarming. The number of children in this community who are overweight and facing diabetes and pre-diabetes should cause us all shame. But, of course, the Davis Enterprise is not interested in discussing all of that.
Bob Dunning, who has a large family with many young children, should be leading the way on this issue. Instead, he writes, “Again, it’s not a ban … instead, it’s a simple publicity stunt to land Davis on the front page of newspapers near and far … in that regard, mission accomplished … we are, as it turns out, the first city in the nation to pass a soda pop ordinance that bans absolutely nothing … as the kids like to say, all bark and no bite …”
I juxtapose these uninformed comments against those by Dr. Harold Goldstein, executive director of the California Center for Public Health Advocacy, based in Davis.
“I want to applaud this council for considering this ordinance,” Dr. Goldstein stated. “We are in the midst of a skyrocketing diabetes epidemic. Diabetes rates in the United States have quintupled five-fold in the last fifty years.”
One-quarter of teenagers have either diabetes or pre-diabetes, the doctor told the council. One-third of all kids and half of kids of color will have diabetes at some time in their lives.
“It is true there are a lot of contributing factors to both the childhood obesity and the diabetes epidemic,” he said. “But without question, sugary beverages are the leading contributor. One twenty ounce soda has 16 teaspoons of sugar. Imagine eating 16 teaspoons of sugar.”
These beverages “deliver their sugar in liquid form. These beverages are nothing other than a sugar delivery device. Because it’s delivered in liquid form, it’s absorbed into the body in as little as 30 minutes. That sugar then, over time, overwhelms the pancreas, wears out the pancreas and is converted in the liver into fat. Now we have kids who have fatty liver disease as if they’re alcoholics. They’re not drinking alcohol, they’re drinking sugar and the sugar gets converted into fat in the liver.”
He said, “There is no reason that kids should be given a sugary beverage when they go to a restaurant – without their parents asking for it.”
He called this policy as libertarian as it gets, as “parents still get to have a complete choice. But the default will be the healthy choice.”
That’s really the key point here – no one is having their right to give their children sugar infringed upon, but we need to start sending the message that sugar kills. It’s slow but, as someone who suffers from diabetes, the reality is painful.
Frankly, I consider myself fairly educated on nutrition, especially in the last seven years of suffering from diabetes, but the idea that a 20 oz. soda, which is a standard size sold in plastic bottles, has 16 teaspoons of sugar is mindboggling. We expect parents to make good choices – but how can they when we are not given the full facts at our easy disposal?
One of our readers I think hit the opposition’s nail on the head: “Glad we finally took care of that. The people of Davis can feel so much better now as they drive home hitting potholes from McDonald’s with their kid’s meal and milk.”
So fixing potholes is now somehow more important than combating a health epidemic? Moreover, the cost of this ordinance is negligible. The opportunity cost is nil. It is not that we cannot fix our roads – because we had staffers who will never touch the roads spend a half hour on Tuesday night discussing another important issue.
Amazingly enough, during the same meeting that social services staff were discussing health beverages, public works director Bob Clarke was laying out his plan for spending $15 million on roads construction starting this summer.
So all that opponents of this ordinance are left with is the notion that this will not solve the problem. I agree. But why not implement a no-cost ordinance that at least can address the low-hanging fruit?
As Dr. Goldstein put it, there are many contributing factors to childhood obesity and the diabetes epidemic but, “sugary beverages are the leading contributor.” So why not at least get us to think about it before we purchase that next soda and, for low-income kids, maybe this can start the education process.
If that’s not enough, then by all means let’s do more. But at least that conversation is started now. And the roads will amazingly still get fixed.
—David M. Greenwald reporting
What are you saying here? Are you saying that low income people are stupid? Does income determine one’s IQ on nutrition? Do you consider a parent as being stupid to let their child have an occasional soda?
Newspapers and radio stations had a field day clowning Davis over this do nothing feel good soda ordinance. A few of the tidbits mentioned were the People’s Republic of Davis is at it again, liberals telling others how to live because they know what’s best for you, now we have a city telling a restaurant what they have to offer on their menu, typical Davis……..
Progressive paternalism, now that’s innovation, the Davis way.
;>)/
I’m saying that we have a health crisis and many parents are not well-educated when it comes to nutrition and the dangers of sugar and that those tend to be clustered in low income families. It’s not a matter of “IQ” or “stupidity” it’s a matter of being educated on good healthy eating practices – and quite frankly many well-educated people in other areas need help in this area too. But there is a strong correlation between education level, income, and obesity and diabetes.
Don’t take my word on it: http://frac.org/initiatives/hunger-and-obesity/why-are-low-income-and-food-insecure-people-vulnerable-to-obesity/
We now have to educate America and Mexico. The second is more difficult as many have minimal or no education.
Maybe it’s time to scrub photography or other elective classes and re-institute home economics / health, and ramp up physical education classes. John Kennedy’s worst fears came true.
https://www.youtube.com/watch?v=fISgKl8dB3M
The literacy rate in Mexico is about 93%.
Source? I also saw one Wikipedia source that said that the US literacy rate is 99%, had to believe. Politics seem to be at play, especially when upwards of 50% of some communities drop out of high school. Those numbers don’t add up.
I am not familiar with this website, but their claims seem to make more sense.
“…In 2013, however, according to the National Institute for Literacy, an astounding 42 million Americans cannot read, write or perform simple math. Another 50 million cannot read past the 4th grade level. It costs taxpaying Americans $240 billion annually in lost industrial productivity, uncollected tax revenues, welfare, crime, poverty and food stamps.
“As to lowered health standards, over 150 million Americans battle health issues such as obesity because they cannot read food labels, prescription directions or think critically enough to eat healthfully.
“As reported by NBC anchor Brian Williams, cities like Los Angeles, Chicago and Houston suffer 50 to 60 percent dropout/flunkout rates. Heading up those cities, in a study completed in 2009, Detroit, Michigan high schools suffered a 76 percent flunkout rate.”
http://www.newswithviews.com/Wooldridge/frosty848.htm
Educators I have spoken with say many illegal immigrants aren’t even fluent in their own language (typically Spanish).
“And if you’re so afraid to say “no soda” to your kid that you need local government to step in, you have bigger problems.””
Ms. Davis is technically correct. Many of these families who are frequenting fast food restaurants do have bigger problems. But accuracy does not hide the lack of compassion and thoughtless hubris behind these comments.
1) Illiteracy is a huge problem. Many are not literate regardless of their primary language. It was estimated a few years back that 14% of the primary English speakers that utilize the health care services where I work do not read above a junior high level.The percentage will obviously be much higher for those who are not primary English speakers. How likely do you think it is that these folks are going to be doing comparisons or understanding the fine points of the sugar content of apple juice, orange juice, chocolate milk vs soda or even why that is important. My mother was one of these. She didn’t “fear” us, and she wasn’t a bad mother, she just didn’t know when she was pouring our daily cokes.
2) Many of these folks cannot afford more healthful food either in money or in time to prepare the more healthful meals they could be making at home. My guess is that neither Ms. Davis, Mr. Dunning and only a tiny minority of those of us who post here have ever had to work two to three jobs to keep our families out of a shelter or a car. I doubt that many of us have been so exhausted at the end of a day at a factory or in the fields to even think beyond pulling into the closest fast food restaurant to get dinner.
What Ms. Davis and others are missing is that this is not about “fearing” one’s children. For me it is about a manufacturer and restaurant getting together to tell parents what they will get unless they take that added step of refusing it. Personally, I see no need to provide any default beverage at all. Why not just treat the beverage like any other menu on the item? I suspect, but cannot prove the answer. If a soda manufacturer is able to train the youngest drinkers that having a soda with meals is the norm, and not potentially a rare treat, think how much their sales and therefore profits will increase in the future. This is not conspiracy, this is good marketing. This is why we have marketing of children’s cereal’s, children’s toys, and virtually every other commodity for children with “cute cartoon characters”. The manufacturer’s aren’t stupid. They know that little children aren’t going out and buying these toys, so they play on two factors, the parents desire to make their children happy and the children becoming habituated to having a product as part of their daily lives. Do we honestly prefer being manipulated by giant companies to having a no cost, no burden, no ban, solution suggested by our government ?
I think that some of us still do, because after all, if a private company does it, it must be fine regardless of the future harm created. My hat is off to Alan Miller for thinking this one through rather than joining the “antigovernment chant” that so often surrounds these issues.
I am honored that a hat has been taken off in my direction. I do my best to take each issue on its own merit.
However, I have not left the “antigovernment chant” camp, which I clarify as: this isn’t the sort of issue I believe should be tackled by local government. I declared support precisely because this was so innocuous a measure that it really didn’t infringe much on business or personal rights. Despite the Davis mocking, it did get a some education out there without much harm.
However, I remain opposed to the idea of this being a local government matter, and am concerned that the next measure may not be so innocuous.
Alan
Two questions
Is there a level of government for which you do find fighting an epidemic appropriate ?
If you do indeed consider each measure as it comes, why would you be concerned about some hypothetical future measure ? Why not just consider it on its individual merits when and if it does occur ?
There is a difference between a epidemic that can be fought with education and one that spreads on its. The first is the parental responsibility, and whatever level education of parents occurs at, it sure isn’t city/county through the singular actions of council/b.o.s..
How about non-hypothetical past measures?
Yes, but I sure don’t like encouraging this being done through the singular actions of council/b.o.s.
Tia assumes a lot about Ms. Davis, Mr. Dunning, and others, while gladly handing out victim status. My understanding was that Mr. Dunning used to work both writing his daily column, and covering college athletics for UC Davis. This may have included long trips to the northern reaches of the state, and if I recall, games end at night, and there were likely late-night deadlines to meet.
America is changing drastically. We’re losing midwesterners, we’re losing those that went through the Depression, and we’re addicted to iPhones and electronic media. Many individuals in my family had a modest education (high school), but they knew the basics about healthy eating. We grew vegetables in flower beds. McDonalds was once a week, not once a day.
Maybe part of this is also the fact that we removed home economics from our classrooms. Children walked to school. Children had chores. Mothers told the children to “go outside until I call you for dinner”. Children had paper routes. Children cut yards, painted fences, helped with home repair, and helped clean house. I see little of that today.
I don’t believe the fallacy of healthy food costing substantially more than a McDonalds meal. Vegetable seeds are cheap, so is focused watering. A can of tuna at Walmart is $1.00 or .80 cents, terrific protein. There are probably 5 or 10 servings in one head of lettuce.
We are losing the two-parent household, and we have allowed in tens of millions of illegal immigrants who are largely uneducated with horrible eating habits. Can we change the eating habits of America and Mexico? These issues are far more impactful than soda laws.
I agree we should stop subsidizing high-fructose corn syrup!
I also find it hypocritical when I go into public schools, and there are soda machines at hand for the easy disbursement of these dreaded drinks. Did we get this from the principal who makes $120,000 a year, or the Superintendent who makes $220,000?
I don’t know if we’ve completely removed it, but home ec was mandatory for young women when I was in school. I think it should certainly still be taught in the schools. I’ve been hiring young adults for decades now, and most have not known even the basics about how to cook or how to eat in a healthy manner. Parents can do that. Schools can do that. The question is, what do we do to reduce obesity among populations that aren’t getting the message? Again: the industry spends around a billion dollars to promote consumption of these beverages. How do we counter that?
There are some steps we can take that are less heavy handed.
1. Re-introduce home economics / health for everyone.
2. Ban soda machines on campus.
3. Reintroduce John F Kennedy’s physical education program / goals.
4. Require that a rising amount of food stamp purchases go towards vegetables and fruit and less processed foods.
5. Develop special outreach programs for Latinos.
6. Close the border.
7. Quit subsidizing high-fructose corn syrup and such.
8. Ban toys with happy meals. This may be heavy handed to some, but it might alleviate some of the desire and pressure off of parents and children to slow an early adoption of a fast food lifestyle.
You have an interesting definition of “less heavy-handed.”
TBD, sometimes I wonder how your brain works. We’re losing Midwesterners? The US Census reports that in the period between 2010 and 2014 the population of the Midwestern States rose 1.2% from 66,927,001 to 67,745,108. The only parts of the US that we are “losing” are West Virginia and Puerto Rico. The Midwest had the #1 fastest growing state and the #9 fastest growing state.
TBD
“There are some steps we can take that are less heavy handed.”
I am amazed that you would consider some of the items on your list as “less heavy handed”.
1. Reintroduce home economics. I suppose you know that our schools do offer health classes. So do you consider it not heavy handed to put into place cooking classes as a mandatory ? Would you recommend that for both men and women or only for women.
2. Ban soda machines on camps ( I thoroughly agree) however, I don’t see how you can claim that an absolute ban is less heavy handed than a change in default beverage.
3. Physical education program – last time I looked, we had one. Maybe not as vigorous as you would like, but none the less there.
4. Tell food stamp users what they must eat. Yeah, that is certainly not heavy handed.
5. Develop outreach programs for Latinos. Already in existence in our county.
6. Close the border. Move along citizen, nothing heavy handed occurring here.
7. Now on subsidization of high fructose corn syrup and all similar products, we are in complete agreement.
Once again, I am amazed at how many posters here were adamantly insistent that government on all levels should be protecting us from the manufactured local fear of Ebola, and are yet so opposed to government attempts no matter how unheavy handed, balanced, and reasonable they may be to fight the epidemic that is upon us now, namely obesity.
Midwesterners: White people with big green front lawns.
These middling half-measures like not having soda as a default choice is just inconsequential, superficial tokenism. Are we serious, or do we just want to pad the paychecks of the political class that helped bring us to this abyss?
We are passing Trillions upon Trillions in debt to our grandchildren, infrastructure falling apart, social programs exploding, debt at ungodly levels both on (and off) the books, and on top of this we expect an unhealthy, morbidly obese population to protect and serve us and continue our society? Did you watch the JFK video with super fit youth from the 1960s?
[1. Reintroduce home economics. I suppose you know that our schools do offer health classes. So do you consider it not heavy handed to put into place cooking classes as a mandatory ? Would you recommend that for both men and women or only for women.]
I call it common sense. Yes, classes for Dick & Consuelo.
[2. Ban soda machines on camps ( I thoroughly agree) however, I don’t see how you can claim that an absolute ban is less heavy handed than a change in default beverage.]
So you agree, but still want to quibble? I offered practical solutions.
[3. Physical education program – last time I looked, we had one. Maybe not as vigorous as you would like, but none the less there.]
I hear too many stories of kids dodging them. I know one student who had 2 years.
[4. Tell food stamp users what they must eat. Yeah, that is certainly not heavy handed.]
So then you prefer the hope and wish that they’ll lay off the fried foods on their own? The converse is that we pay for the fried / ready made food, and the health costs on the flip side. Sorry, I don’t want to pay for both.
[6. Close the border. Move along citizen, nothing heavy handed occurring here.]
So you propose that we re-educate America and Mexico?
8. No comment on banning toys with Happy meals?
I see a gradual movement of food stamp dollars to fresh fruit and produce as common sense.
What is your list of solutions?
BP
“Are you saying that low income people are stupid?”
Stupidity and ignorance are not the same thing. I would be willing to bet that you do not know how to do a hysterectomy. That doesn’t make you stupid. It means that you have not learned that particular skill set and are therefore ignorant of it. There are many people, of whom my mother was one, who played completely by the rules of her day ( born in 1917) who never learned to read above grade school level because she was needed at home and no one felt she would ever need to read since she was going to grow up, get married, and raise a family. She was not stupid. She did all that was expected of her. But mastery of reading at a level where she could have understood nutritional facts was beyond what had been expected.
“now we have a city telling a restaurant what they have to offer on their menu”
Now it is you who are demonstrating willful ignorance. If you had read this proposal, you would know that it does not tell any restaurant what they “have to offer”, all choices will still be there.
LOL, it’s a far far cry from calling someone ignorant because they don’t know how to do a hysterectomy to knowing that things like sugar in soda or smoking a cigarette isn’t good for you.
No Tia Will, it’s you that’s demonstrating willful ignorance. The law dictates to the restaurant that they now have to offer water or milk in their children’s meal menu. Yes people can ask for something different, but they are being forced to offer what the city dictates. Not hard to grasp.
In your view was it the right thing for the public health community along with the government on a smoking education/ anti-smoking campaign over the last fifty years that has reduced smoking and thus saved millions of lives?
Very big difference between a local program that has a ‘sugary-drink’ education/anti-obesity campaign aimed at those 12 and under, and the anti-smoking campaign aimed at children, teens, AND adults since its inception. By your logic, the Davis ordinance, at a minimum, should be amended to include ALL meals, served to ALL ages, where a drink is part of the “package”. I’d not oppose that.
Perhaps stickers should be placed on all drink cups (and/or all menus)saying “The City of Davis is convinced that over-consumption of sugary drinks may contribute to obesity and other adverse health effects”.
Or are you saying over-consumption of sugary drinks after you turn 18 is fine?
If we’re going to “go it alone”, let’s at least do it RIGHT. I’d support that.
The reason I asked the question was not to compare the two, but rather to assess where the lines are drawn on these kinds of issues.
As to your specific comments, the way I saw the ordinance was low cost, easy to implement and then build from there. I do believe that sugar is a much bigger health crisis than most of us want to admit. What I don’t know is eventually where I want to go with it, because while I’m on the left on a lot of issues, I have a strong libertarian streak and get nervous about the government curtailing personal behavior. Education is different and I see this measure as being as much about education as it really is about behavior.
Finally, I don’t think we’re going this alone. I think a lot of community and health officials are wrestling with the same issue and the same balancing of principles.
Yes, now you’re talking. Quick, let’s get a movement going where if you order a coffee with cream and sugar Starbuck’s has to go to an automatic default of non-fat milk and Splenda.
The opportunities are endless.
BP, “cream” is a specific product that is different from “non-fat milk”. If a customer orders that specific product, why would you make your proposed substitution?
Starbucks/Peets/Mishkas may choose its default whitener from a long list of specific dairy and non-dairy products, but a customer’s order is still a customer’s order.
El wrongo, BP… if you order a coffee with CREAM and SUGAR, that’s what you’d, get, just as under the ordinance, if you ordered a children’s meal with SODA (or, sugary drink), that’s what you’d get.
Or, in New York, you’d just say “regular.”
Okay, then when you order a coffee sweet with milk, the default shall be non-fat milk and Splenda unless you specifically ask for whole milk and sugar. Is that better?
But in Davis “regular” could someday end up being non-fat milk and Splenda if our over-reaching council wants it that way.
Why does all this bother you so much? I saw Facebook comments where people were getting all worked up about it. You can order whatever you want. Nobody is banning anything. I seriously don’t get why people care so much and so negatively about this.
Because we don’t need a city council dictating these sorts of things.
Who should dictate them?
Don, you do know that Davis is the first city to do this? So no other city councils felt they needed to dictate to restaurants what should come in a kid’s meal. Why the over-reach in Davis?
So what? Nobody is “dictating” (hyperbole alert!) what “should come in a kid’s meal.” It is a simple thing that could help improve public health and reduce health care costs. Simple, easy to implement. Why are you so upset about it?
BP, to the best of my knowledge they have not “dictated to restaurants what should come in a kid’s meal.” What they have done is establish what the default beverage should be absent any specific customer instructions otherwise. This is no different than establishing that the default at restaurants should be no glass of water absent any specific customer request for a glass of water.
I’m not upset about it. I’m going to speak up though when I feel something is wrong. Is that okay with you?
Why is it wrong?
If your concern is that the city is telling restaurants what to do, perhaps instead Davis could follow the example of New York and pay to run advertisements, put up billboards, and otherwise educate people about the health impacts of sugary beverages. Here’s a sample ad running in New York City: https://www.youtube.com/watch?v=SGCCguRI2sU
I’m sure a small tax would cover the costs.
BP
“it’s a far far cry from calling someone ignorant because they don’t know how to do a hysterectomy to knowing that things like sugar in soda or smoking a cigarette isn’t good for you.”
Different in degree, same in principle. And it was not your use of the word “ignorant” I objected to. It was your use of the word “stupid” as though the two were synonymous.
Maybe we should bring back home economics, victory gardens, and ban soda machines from public schools.
hpierce
“Or are you saying over-consumption of sugary drinks after you turn 18 is fine?”I
I agree that it would be best to directly provide information against the regular use of sugary drinks for everyone. However, I do not think that we can discount the effect of disparate impact on different age groups. Using the smoking cessation campaigns as a model, according to data from the National Lung Association:
“Ninety percent of adults who smoke started by the age of 21, and half of them became regular smokers by their 18th birthday.”
It is clear that the younger a person starts smoking, the more likely they are to become addicted. Also being in a society in which smoking, or in the current case, the consumption of sugary drinks is ubiquitous, normalizes this behavior for children at a time when they are developing their tastes and food preferences. Therefore the impact of targeting this population to promote healthier behaviors is likely to have a greater impact in the short term for the individual, but perhaps across generations as well as today’s children do not pass on this deleterious behavior to their children.
Also worth pointing out that information and choices are guided by advertising, and the industry spends just under a billion dollars a year advertising soft drinks. They direct that advertising to teens and websites visited by youth and children. They wouldn’t be spending that money if it didn’t get results.
Maybe we should ban childrens toys with meals and close fast food places at 9 PM.
There is a stark difference in US obesity rates by race.
Blacks = 47.8%
Latinos = 42.5%
Whites = 32.6%
For children it is:
Blacks = 20.2%
Latinos = 22.4%
Whites = 14.3%
Asians as a group have a lower rate of obesity than the average population.
Interesting that the adult percentage of obesity by race tracks along with the ratio for SNAP benefits.
People having received SNAP benefits in their life:
Blacks = 31%
Latinos = 22%
Whites = 15%
Also, 10% of Republicans and 22% of Democrats have received SNAP benefits during their life.
A possible conclusion here is that Democrats liberal social policies are making minorities and their children obese. And now those same liberals want to ban soda. If liberals want to stop seeing so many obese people and/or people with diabetes, maybe liberals should stop blocking economic development while cutting back on SNAP and welfare.
Possible, but given all the other factors at work, highly unlikely.
So a possible conclusion is that soft-drink manufacturers are carefully targeting lower-income and minority communities because they find their advertising pays off. And those same corporations always oppose restrictions on soft drink sales or unit sizes, and deny any correlation between soft-drink consumption and obesity.
So maybe soft drink manufacturers should stop advertising to people who are being harmed by their products.
But of course, correlation does not equal causation.
The correlation is poverty, read the link I posted above.
Poverty without SNAP and welfare, or with?
Can you wrap your head around the hundreds of billions spent to fight the war on poverty so you and other liberals and social justice champions can continue to blame it for everything wrong?
Do you think that abolishing SNAP and welfare would somehow reduce obesity? Or are you just trying to score partisan points?
What causes poverty in this country?
Lack of money causes poverty. This article is about obesity. Do you think that abolishing SNAP and welfare would somehow reduce obesity?
I do think that SNAP should have a nutritional component to it.
What causes lack of money that causes poverty that apparently causes obesity? Not a lack of SNAP benefits and welfare… since it does not appear to help prevent poverty and obesity.
Nope, there is another answer.
Lack of money can be caused by wage stagnation, single-family households, lack of employment mobility, cost of health care, and other factors.
The single most effective anti-poverty program ever implemented in the United States was Social Security. Poverty among the elderly dropped steadily with the creation and steady increase in benefits of Social Security; taxing everyone to provide cash to the elderly directly reduced poverty. No question about it. Providing cash to poor people would reduce poverty.
SNAP benefits and welfare do, in fact, help to reduce poverty and SNAP directly reduces hunger.
So “there is another answer” is probably incorrect. More likely, we are about to get your ideological solution. There are solutions to poverty that you don’t like: make health care free. Provide free contraception. Give people money. There are obviously unintended and somewhat undesirable consequences from just giving things to people, so means-testing and work requirements have been implemented and could probably be expanded. But the conservative mantra that anti-poverty programs “don’t work” is simplistic and often wrong.
Calorie for calorie, it can actually be cheaper for poor people to buy fast food than it is to make a meal at home. The impact of advertising should not be underestimated. Focusing on poverty as a root cause of obesity is actually a deflection, and it appears to be a deflection of both liberals and conservatives. Obesity can be reduced by means of education, better application of government resources and funds, and sometimes by simple regulations. The publicity value of legislation that limits the size of soft drinks or simply mandates a healthier option for kids meals should also not be underestimated. The fact that people are talking about what Davis did can be surprisingly powerful just by getting people talking. Just as Mayor Bloomberg got people talking when he sought to ban super sized beverages.
I am reminded of the process we went through to get cigarette smoke out of our lives, and the hue and cry about freedom of choice and individual rights back then. Just as we had then, there are powerful lobby groups that deny the linkage to health issues and fight every regulation — no matter how innocuous.
I know that, once again, you’re going to try to make partisan points about an issue that really doesn’t need that. Somehow this is all going to be the fault of liberals and big government. That’s just baloney.
Poverty is an especially loaded term in America, where we don’t even count the numerous transfer payments (i.e., welfare) as reducing the poverty level. For example, someone can make $20,000 a year and receive $30,000 a year in transfer payments, but that $30,000 isn’t counted (which would reduce who we consider poor). I’ve also been told we have a poverty inflation adjustment that is above the inflation rate (I haven’t checked this yet).
America is one of the few places where one can be obese while being considered “poor”.
I believe single-parent status is a top driver of poverty. Being a high school dropout also ranks high (and no GED).
There are many other closely related issues, the breakdown of the family, the breakdown of religion, lack of discipline, NAFTA, and an open border which allows unlimited cheap labor to flow across our border. (Even Cesar Chavez was against illegal immigration as he knew it hurt the working man and woman already here.)
This has manifested itself in a dramatic contrast on both ends of the socioeconomic system. On the one end, we have the “super educated” marrying the “super educated”. A doctor marries a doctor (not the secretary), a consultant marries the hedge-fund trader (see Chelsea Clinton). On the other end, we have the new “multi-partner fertility” where minimally educated adults are having multiple children with different partners outside of marriage. (Out of wedlock.)
Almost by definition, a one-person household with a child is in poverty. In Yolo County, that person would have to earn >$23/hour to have a ‘living’ wage. So provide free contraception.
But none of that negates the fact that increased consumption of sugary beverages — due to advertising, serving size, and poor education about diet — is a cause of obesity and illness. Again this is all a deflection. The problem is what people are eating. Poverty is caused by lack of money. Obesity is caused by what you eat and how much. Keep it simple. Unless, of course, you don’t really want to look for solutions that have any chance of being implemented, and just want to have an ideological debate instead of actually getting something done.
Yes, Don, just give poor people money and all of our troubles would float away. If only it were that simple. We’ve spent what, $20 Trillion in the War on Poverty, and the inner cities in many places are far worse than they were in 1960. BTW, Social Security is theoretically a retirement system; but it’s not funded, and its tens of trillions in debt, leading some to refer to it as a Ponzi Scheme.
We spend a huge amount of money maintaining a government bureaucracy as many don’t like the idea of giving people cash, so there are the workers and the political patronage jobs, and there is the desire to dictate where people spend our money (most don’t want it to go to drugs or booze).
Don, who would pay for this free health care you propose? Barack Obama just created this gargantuan federal program, he lied to us, and he hasn’t covered that many new individuals. Our costs went up (not down), ER visits haven’t declined (so we haven’t saved money), and young people haven’t signed up in the numbers needed.
Where are the work requirements for the record amount of social spending we do today? Obama gutted Clinton’s welfare reform. Are you suggesting we open up federal work camps like during the Great Depression, and pay workers peanuts?
Some argue that the Left is now importing more poor people from south of the border so that they can run the political table for 50 years or more. Import more poor, who depend upon government programs to survive, thereby maintaining their grip on political power. Essentially, Democrats need more poor people.
False. Social Security is fully funded. It just faces a long-term demographic issue, which could easily be solved simply by raising the SS taxes by as little as 2 – 3% and increasing the retirement age.
The answers to your other questions and assertions are: taxes fund health care one way or another, Obamacare is a success, reinstate the work requirements if that would work, and loose immigration is a very inefficient way to increase the number of voters.
Now back to obesity.
Don, both Tia and myself have listed solutions. It is not just sugary drinks. Take McDonalds. Thirty years ago the standard burger was their now current small, and there were just the (tiny) fries packet – no large or supersize portions. Portion sizes have exploded, and we went along with it. Children also get little exercise, parents are frightened by TV news, keeping children inside, and electronics rule the roost. It is not just one thing.
Of course it’s not “just” sugary drinks. I mentioned serving sizes. But I doubt you’d support any regulation of those, either.
I marvel at the fact that nobody seems to think advertising makes any difference.
Ummmm, NO!
Happy to see that my question led to the REAL discussion.
I can distill this down to the a chicken and egg analogy.
What comes first, the people making chronic bad life-choices that we in-turn try to help with costly liberal policies (the egg)… or the costly liberal policies influencing people to make chronic bad life choices because it trains them to a lower level of personal responsibility (the chicken)?
Evidence of the chicken is plentiful.
– Spending trillions on the war on poverty with constant demands that we need to spend more.
– Generations of the same families stuck on social payments.
– People getting the social payments the most highly over-represented in most of the negative individual and social statistics like obesity and crime.
From my perspective it is the 80-20 rule. 20% will make chronic bad life choices no matter what options or opportunities we provide them. But liberal and other misguided do-gooders have exploited the problems of this 20% (and also exploited periods of economic downturns when the number of real needy has jumped) to demand costly social programs and policies have created a codependent sub-culture within the standard American culture of independence, self-sufficiency, self-determination and personal responsibility. The effect of this is to populate the sub-culture with another 80% that could otherwise be lead to join what used to be the productive mainstream.
It is a virtual plantation where people cannot escape and more are added daily.
Certainly there are problems with the US food culture that contribute to obesity. However, the same market forces that put so much unhealthy food choices into brains and stores, are changing drastically. The food industry is responding to what consumers want, and more and more consumers are demanding fresher and healthier choices. The organic food market is expected to increase 20% from 2013 – 2020. The trajectory is expected to continue. It is being done because of consumerism and semi-free markets, not because of top-down rules to live by pushed on all of us by a few busy-body liberals.
The rate of obesity in this country is primarily a symptom of the larger problem of lack of personal responsibility for self.
Said another way, liberal social policies make more people obese. The solution is to move more people out of the codependent subculture and into the culture of self-sufficiency and personal responsibility.
How we do that is where we should be focusing the debate… not if we should just add more of what we can clearly see failing us.
You give no evidence for this whatsoever. It’s just dogma.
Something that could clearly reduce obesity would be full expansion of Medicaid through the ACA to all those red states where obesity is highest. Among the many preventive care coverages mandated by the ACA are routine office visits and specific screening for obesity, all at no co-pay. Catching obesity earlier would reduce health problems later in life, and reduce costs to society overall.
The people who need this most, in the states that need it most, aren’t getting what they need.
http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html
The liberals had decades to design ObamaCare / ACA, and it has failed to ensure the “uninsured”. It’s costly, and it hasn’t achieved it’s stated goals.
False. It is achieving its stated goals. It is also not what “liberals” wanted. Liberals wanted single-payer.
I agree with Don 100%. It has achieved its stated goals. However, it was/is/and-always-will-be a political compromise that guaranteed (because of its compromises) that it was flawed, and would create some ancillary problems. Those problems would all evaporate if the actuarial risk pool covered all the insureds in all 50 states. That would mean that the fiscal risk of a very rare, and very expensive to treat, illness/condition would be spread over the maximum possible number of lives. As the current system works, each and every insurance company has to actuarially account for 100% of that risk in computing their rates … or make a decision not to cover that illness/condition at all. The result is either artificially inflated premium rates or incomplete coverage. Both are sub optimal.
So count me in the list of people who saw what was passed as sub optimal and not what I wanted.
as much as this is off-topic, it is remarkable to me that conservatives flat out do not get that liberals did not want the aca, they wanted universal, single payer. we’ll settle for it as its far better than what we had, but it’s not my ideal.
Achieving its stated goals… absolutely not. It is insuring far fewer than the Democrats claimed it would.
And it is doing so at a far greater individual and economic cost than in claimed it would.
At least acknowledge these things if you don’t want to be seen as riding on the Obama lie train.
It is insuring millions of people who could not get health insurance before. It has expanded health care to millions in those states that accepted the Medicaid expansion.
I’ll wait for you to acknowledge that before returning your insults.
Specifically,
And, just to keep this on topic and to repeat my previous point, the ACA could reduce obesity thanks to the mandated minimum coverage requirements and the expansion of Medicaid.
This is simply not true.
By the time we add and subtract the people that would have been added to Medicare, the people that got dropped by their employer and the people that would have purchased individual policies regardless of Obamacare, and when we count the drop-offs… those that stop paying premiums after they enroll… the actual number is estimated to be more like 5 – 6 million… a paltry percentage of the 50 million uninsured claimed by Democrats to push this partisan junk legislation… that we had to pass to see what’s in it… through and extremely costly per covered when factoring the extra tax levied on people paying for their own insurance through contributions or compensation discounts from their employer.
There were much more affordable approaches this the problems of heath care access and affordability.
There are still tens of millions without, and you are ready to applaud it at any cost.
Partisan if ever.
No, my friend. There were NEVER any “more affordable approaches” on the table, ever. No proposal ever came close to the coverage expansion of Obamacare. Ever.
There are tens of millions who have health care and health insurance now that did not have it before.
Your statement that “the actual number is estimated to be more like 5 – 6 million…” is false.
The number covered through the ACA is expanding. It would have expanded by millions more — many millions more — if the states had all allowed the Medicaid expansion. Republicans have blocked the success of the ACA in providing coverage to the poor whenever and however they can. That is one of the primary reasons “there are still tens of millions without,” yet you have the chutzpah to claim that I am the partisan one?
For those of us who could not get insurance before, it is clearly a success.
For myself and most of my employees, it is a success.
For millions of Americans, it is a success.
It would be a success for millions more if Republicans did not obstruct it in many states.
If the lawsuit prevails before the Supreme Court, those millions will lose coverage or be unable to afford it.
And yet, it would help prevent obesity, and reduce mortality from any number of diseases.
Happy that you got coverage Don. Happy that others did too. But the cost is way too high. The number of underemployed and discouraged workers is a big part of that cost.
You calculator on this is purely partisan and self-serving.
My quick glance at your second link made it clear that this group is not an unbiased source of information. As to this….
Self-serving? Sure. Have you ever been rejected for health insurance? Or had your rate go up 15%, then 20% two years in a row? Don’t talk to me about “self-serving.”
David,
Dunning and Davis were right this new ordinance in reality does nothing. It only applies to 18 or 20 restaurants that have kids meals, not kids menus. Shallow Dan is already claiming victory on his Facebook page because all he cares about is a short sound bite that he can use the next time he runs for higher office. I am surprised that Rob and Bret didn’t call bul***it on him. [moderator: edited to remove personal attack] This was truly a waste of city resources when there are bigger issues to address. Now that the city council has solved childhood obesity (really they haven’t even made a difference) they can move forward with roads, budgets, water, … .
If they really wanted to have an impact ban the sale of sodas in vending machines. Ban the sale of soda to minors in the city unless the parent purchases it. Make the ban like the sale of tobacco to minors and enforce it the same way as a crime along with a fine on the store owner. Treat is like children going to an R rated movie. Get the school district to ban soda machines on campus and as any kind of option on any of the campuses. There were a number of really meaningful options that were not used.
In my humble opinion the obesity is not from the sale of sugary drinks to children in happy meals. It is from poor nutrition that parents or schools provide to children in their meals. Many low income families cannot afford the fresh fruit and vegetables and instead feed the children low cost starches. Mac and cheese can feed a child much less expensively than meat and vegetables. This is a problem that the military has identified in the families of the lowest ranking soldiers who have the most limited income.
If parents want to provide soda as the default family beverage that is their (bad) choice. This kind of stupid legislation ranks right up there with the Toad tunnel, police station made of straw, and reducing the lighting on the bike paths to eliminate light pollution.
We should be thanking the enterprise for calling the hollow ordinance what it was. A whole lot of politicians patting themselves on the back for doing nothing.
I will be happy to put down my list of suggestions.
1. Rigorous health and education and physical education in our schools. ( By the way, children have always ducked classes that they do not want to go to or see the value of, at least dating back to when I was in school )
2. No soft drinks on any campuses or any public recreational venues.
3. No advertising soft drinks, candy bars, and other non foods to kids at all ( much as was done for cigarettes). No advertising on billboards, buildings, trucks, buses, or in movie theaters.
4. Placement of soft drinks in all stores above the reach of young children.
5. Stop subsidizes to all food “industries”. If we are going to pick winners, lets at least pick healthy winners.
6. Offer incentives for the kind of home gardens or fruits that you are suggesting. I earned my school clothes and helped my mom financially with the money from such a side yard venture, until of course we could no longer afford to live in our country home and had to live in a single apartment with nothing but concrete surrounding. Kind of hard to grow anything there.
7. Incentivize people who are using the equivalent of food stamps to make better choices by charging them less for rice, beans and fresh produce rather than telling them what they can and cannot purchase.
I think if we combine much of your and my list, our country would make real progress.
Problem is with lobbyists giving big money to Congress, many of these will never see the light of day. But we are creating our own cyclical nightmare as it is our young people who will pay our Social Security benefits! I think you pointed out a huge gift the Mars Company made to our campus.
TBD
I agree that doing many of the items off both your list and mine would be beneficial.
“Problem is with lobbyists giving big money to Congress, many of these will never see the light of day”
I also agree with this statement and feel that this is a very good reason for acting small, and acting locally. Just because Davis is the first city to implement such a proposal does not make the proposal a bad idea. Every good idea had a source of origin regardless of whether or not the idea spread. I see this proposal as essentially a very small educational step. Many have suggested that education is the most important factor. I would tend to agree. But “education” comes in many forms. It is not just what we learn in school. It is what we see happening all around us as we grow up. If we go to a theater and the only drinks available are sodas, that will become our norm. If we go to a restaurant and the default beverage is a soda, children will come to see that as the norm. There is nothing radical or liberal about this idea. This is how we absorb our culture and learn how to be in the world. We as the adults have the responsibility to teach the young better and healthier ways to be in the world.
One poster said that this is the responsibility of the parents. I happen to believe that it is the responsibility of all adults. And I suspect that said poster does too, where we differ is degree. If a small child in our neighborhood ran into the street, I am fairly sure that either my libertarian neighbor or I would pull the child out of harms way if able to. True, it is the responsibility of the parent to keep the child out of the street, but failing that for whatever reason, is it not our responsibility to save the child if we can ? Different degree, same principle.
So here we have an epidemic that we are all paying for….ER visits for diabetic ketoacidosis, loss to the economy from renal failure, blindness, amputations, premature infants with their astronomic Neonatal Intensive Care Unit stays…. and we are really going to leave this entirely to individual parents many of whom were raised on “happy ads” for Coke and Pepsi. And we seem to be more in favor of paying these costs than we are to even consider simple, non intrusive, non expensive measures not to serve as panaceas, but as small educational steps aimed at de-normalizing the soda as the drink of choice.
“I think you pointed out a huge gift the Mars Company made to our campus.”
I have indeed pointed this out on several occasions. I have not spoken more strongly because I do not know the details of the “gift” and what projects it will go towards. But since the mission statement of the Mars company is to promote the sale of “food products” which usually translates into non foods ( candy bars as a Mars staple) it is hard for me to imagine that this will be primarily geared towards healthful foods which are certainly not synonymous with food products.
Frankly
“The food industry is responding to what consumers want, and more and more consumers are demanding fresher and healthier choices. The organic food market is expected to increase 20% from 2013 – 2020. The trajectory is expected to continue. It is being done because of consumerism and semi-free markets, not because of top-down rules to live by pushed on all of us by a few busy-body liberals.”
The change in consumer preferences has not occurred in a vacuum. Just as the alliance of health professionals, private, and public efforts were needed to address the problem of smoking, the same forces are starting to come together to combat the problem of obesity. This is largely due to educationally driven awareness of the problem. Why should the county which is charged with public health matters not be working in conjunction with the local communities to help with these educational efforts concerning what is probably the most serious global health threat to our society at the present time ?
The population did not know that smoking included high doses of carcinogens. I would argue that obesity has been known to be unhealthy about the same time people started getting fat.
I am fine with education. I am fine with food label requirements. I am fine with spending some government money to put some advertisements out there to combat those from private companies marketing food products that are unhealthy.
It is simple to understand our differences on this and many other things. You come at the problem as an elite that knows better and the masses are seething crowds of ignorant, confused and addicted folk that cannot seem to make good decisions. So you will advocate for rules and forcing scarcity of things that are bad for them in their poor decision-making so you can “SAVE” them from themselves. That is your addiction (and part of your profession)… to save people from themselves.
I, on the other hand, think better of most people. I think they can and should make their own choices in life and reap the rewords and suffer the consequences of those choices on their own merits. But to HELP them I support copious education services.
But I do not support this bonehead liberal approach to make zillions of unnecessary rules to live by, and eliminate services and choice from everyone just because there is a percentage of the population that cannot control themselves and make healthy choices.
But would you agree that we don’t have to subsidize ingredients (i.e., sugar) that are killing us and our children? And we don’t have to put soda machines on campus (One little segment in the movie I mention below says that lab rats addicted to cocaine were given a choice between cocaine and sugary water; 40 of 44 rates chose sugary water.)
Can’t we treat some of these things like cigarettes? Help children to grow up healthy while their brains develop, and then if they want to live on candy bars when they are 19, fine. But should we allow children to be hypnotized by these life-altering ingredients?
Frankly
“You come at the problem as an elite that knows better and the masses are seething crowds of ignorant, confused and addicted folk that cannot seem to make good decisions.”
You are also coming at this as an elite…. one who likes to pretend that because you know a fact, then everyone does, or at least should so that they could be as successful as you are. We cannot help but come at this from our own elite statuses because that is what we are through a combination of hard work and private and public support ( please don’t deny this if you ever attended a public school). However unlike you, I know that there are many financially unsuccessful people who are not less worthy as human beings because of their ignorance of nutrition or finance. My own mother was one.
And yes, my profession does involve “saving people”. I am proud, not ashamed of that fact. I don’t know when saving people by educating them to stay well instead of only getting involved once they are ill became so unfashionable amongst our libertarian element. I would think that everyone could spot the bargain of stopping a disease before its starts for our health care system. This leads me to conclude that you really don’t care about either the health of the country, or the increased financial output needed to treat rather than prevent. What you seem to care about is your ideologic stance and looking down on others while pretending not to.
You give yourself away when you say “eliminate services and choice from everyone ” regarding a proposal which does neither for anyone.
Tonight I watched 90% of a documentary on our obesity / health crisis in America on Netflix. It’s late, I’ll post the name tomorrow. It’s a very good movie, and while I can quibble with some minor points, the major findings are alarming.
The movie claims that when there have been multiple attempts to make a major stand, major businesses come in and co-opt the message. They change the message from “over-consumption of food is bad” to “it’s about a balance between exercise and eating”… “strike a balance, and we really need to exercise.” Then you see the calories in one can of sugary soda, or one slice of pizza, and it takes 45 minutes to burn that off.
The film definitely has a viewpoint it wants to get across. It seems to give parents a pass, and I can’t help but think of all the stay-at-home Moms in the 50s, 60s, and 70s who made healthy meals, who repeatedly told their children to “go outside and play”, Moms who provided a well-balanced meal most of the time and required children to eat fruits and vegetables … or how about the school administrators who chose to stop make meals on site, and went for the frozen poor-quality food for lunch? School leaders who allow soda machines on campus.
The movie is “Fed Up”, an “advocacy documentary”. I’d love to hear Tia’s feedback on it. I did find myself doubting some of their allegations, and they had too many sources who were politicians and journalists. I’d have preferred more nutritionists and doctors. But there was still some very good information and insights.
FWIW, San Francisco is now considering new regulations on soda advertising, etc.
“Happy that you got coverage Don. Happy that others did too. But the cost is way too high.”
That is purely a matter of perspective. If you are the one of those whose life or health is saved by early intervention, the cost was not too high at all. If you are the fetus who was saved from preterm delivery at 25 weeks because of maternal related diabetic disease with its attendant risks of life long disability for which we will all pay, who now with a term delivery goes on to be a fully contributing member of our society, then the cost was not too high. If you were saved from bankruptcy by having some of your medical costs picked up by insurance provided on the exchanges, the cost is not too high.
I suspect that the only people who feel that the “cost is way too high” are those who already had good insurance…..and those that they have duped into thinking that they are being robbed.
My situation and that of my employees is reflective of the situation millions of Americans found themselves in prior to the ACA. Frankly doesn’t get that. He doesn’t understand that our health insurance system was broken beyond repair for tens of millions of Americans.
Don
I know. And what makes this really difficult is that on some issues I know that I am not as informed as Frankly and would benefit by education in his economics. What is so very frustrating to me is the unawareness ( possibly willful, possibly not) of what I see in my office every day. Women who are coming in for care of neglected breast cancers, uterine cancer, cervical dysplasia ( precursors to cancer), diabetes, high blood pressure and its complications. Women that tearfully say to me, “Yes, I knew there was a problem” but I didn’t have insurance. They come for highly reliable birth control now that they are able precisely because they are acting responsibly.
Frankly states that he believes that people should be responsible for the consequences of their own bad choices. It seems to me that he thinks that they should also “be responsible” for those things over which they have no control. The implication of his position is that if you cannot pay for both housing, food, clothing and medical care…… too bad. Guess you should have made better choices. Regardless of whether your initial illness was caused by an addiction started at age 13 when you tried your first cigarette, or by the food that your mother prepared as the norm at home which was pop tarts in the morning, a snackable at lunch, and frozen pizza and soda for dinner, or whether your disease had nothing do with any behavioral factor of which we are aware. This completely ignores that fact that we would all pay far less if we all had access to preventive services.
I’ve also heard some claim that this “preventable services savings” is a canard.
The choice is not ACA or nothing. I have auto insurance, but I don’t call AAA when I need my oil changed or new wipers. I go to an auto store, or Speedee Lube. But we’ve evolved to this place where we have this super complex medical system, and the ACA appears to have solved little, and it covered just a few million people for an enormous cost. (There were millions who signed up for Medicaid, and millions who were kicked off of their existing plans, and forced to join the ACA.)
We need more free market, not less. And yes, this could include covering those with pre-existing conditions.
These few changes would have a huge impact:
1. Double the graduates from medical schools. (Increase Supply, lower costs.)
2. Publish pricing!
3.
Not sure why my changes to the list were kicked out.
These few changes would have a huge impact:
1. Double the graduates from medical schools. (Increase Supply, lower costs.)
2. Publish pricing!
3. Allow bare-bones coverage.
4. Allow / promote cross-state competition with health care choices.
5. Allow / promote giving to another health savings plan (HSP) from my HSP. For example, someone from my church or group gets cancer, I’ve been healthy; let me transfer $1,000 from my HSP to their HSP. Win-win-win.
Frankly, what do you think of these ideas?
Tia, while we agree with much per sugar, the ACA is another matter where we disagree. I believe that facts, lies, and common sense all have a place.
1. President Obama lied when he said the average family would save $2,500 per year; the average family had costs go up $2,500 per year.
2. President Obama lied to us repeatedly when he told us we could keep our doctor.
3. Common sense dictates that the majority of Congress has to agree on legislation for it to survive. See Social Security and Medicare. Obama failed here.
4. You provide a false choice when you say it is the ACA, or nothing.
5. Emergency rooms visits were supposed to decrease, helping to reduce overall costs. Fail.
6. Dr. Tom Coburn from Congress aid he covered for a colleague for six weeks in his practice. He said the two nurses spent 90% of their time on paperwork. Apparently, the ACA didn’t fix that problem.
7. Oregon and Hawaii both spent upwards of $200 Million on their heath care enrollee websites, which failed, an astronomical cost of $20,000 or more per new health care covered individual. They scrapped their systems, and will use a federal system. $400 Million down the drain that could have been used wisely.
For this massively expensive system (ACA), we still have only covered a minimal amount of people; most new enrollees actually signed up for Medicaid, an existing program, or were kicked off of plans they preferred.
You seem unencumbered by overall costs, and who will pay for such. I’d argue that being efficient is important, and getting the best bang for our buck. The free market is vastly, vastly better than Big Government in this regard.
The ACA did eliminate services when it declared existing healthy care services invalid or inadequate. I know of some very healthy people in their 50s and 60s who preferred to have a minimal basic care coverage as they were healthy and self insured. These choices were eliminated.
TBD
“You provide a false choice when you say it is the ACA, or nothing.”
And you are falsely attributing a number of statements and beliefs to me. I have never said “the ACA or nothing” The ACA is not what I wanted. I wanted and continue to want and promote single party payer. There are many aspects of the ACA that did not work out as intended ( you call them lies, I see them as inadequacies…. but since neither of us is in President Obama’s head I don’t suppose we will ever know who is right).
What I do know is that many ( in the thousands just regionally and just within our health care system) are able to access care who were not able to so previously. I know this for fact since these are my new patients. I will take the direct evidence in my own office over horror stories of someone not being able to see their own doctor ( as if that did not happen on a regular basis anyway when someone switched jobs, or lost their job). At least they could see a doctor, which is more than millions could say before the ACA.
Yes, President Barack Obama lied.
We now have the documents that prove such. He knew Americans would not be able to keep their doctor, or often their health care plan, or both, but he repeatedly told them they would be able to keep both. He repeated this lie over 60 times.
TBD
The number I quoted was for world wide deaths, not just the US.
The following is information from the CDC on smoking:
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/
If anything, it looks like I underestimated the number of deaths significantly by not checking the date on the information that I quoted initially which was from 2009 so probably compiled a few years earlier.
I wish I knew where the AMA is on a large number of issues. Let’s just say that I consider the AMA a subsidiary of a medical industry of which I want no part. I am not a member, have never been and will never be a member of that organization. However, that does not mean that there are not many, many doctors who take up the health issues that are most prevalent in our own communities and work hard to make improvements, usually on the local and county level.
“ObamaCare also has had a devastating effect on new drugs and medical procedures with it’s high cost and taxes on new medical devices. It has had a chilling effect for investors.”
I know that this is an argument that is made repeatedly. I have a very different perspective. The same drug manufacturers that sell hepatitis C medication in here in the United States for $1000 a pill are quite willing to negotiate with European countries to sell that same drug for a fraction of that amount. So either, they are financially able to do so, or you are accepting the premise that the US should subsidize the cost of this and many other medications for the rest of the world to spur the egregious salaries not of the scientists actually providing the knowledge and hours but of the CEOs and investors…… hmmmm…
This also does not explain why anything with the name “medical” attached to it will cost 10-50 times more than the same item for a non “medical use”. There is no research involved in the manufacture of the lump of plastic with smaller imbedded lumps that we use to educate women about the various manifestations of breast cancer. Such a lump of plastic would cost about $5.00 at a novelty store. About two years ago I wanted to order a few for my Breast Screening Clinic. The least expensive model of any value was $50.00 at that time. I bought one and we carry it from room to room. This is ubiquitous in medicine. So much for your well spent “research dollars”.
And then, there is the issue of transparency in charges. Let’s say that you have the misfortune to be hospitalized. If your stay is covered in its entirety, how lucky for you. If not, good luck figuring out whether or not you are being charged the correct amount, or even for items actually used. Never mind that you can’t bring your own Tylenol in, but if they give you one, you will be charged many times the cost you paid for your own. All of that is before we even get to the charge master. The charge master for those who do not know is the list of items and services provided while in the hospital some of which may benefit you, some not so much so. Let’s suppose your nurse accidentally contaminates your IV line during insertion. Does the hospital pay for the error. Of course not, you do, although you do not know it. You will pay for the second IV solution with any medications that were in it as well as the bag and any attached tubing. How many of you remember the exact number of IVs you had during a particular hospital stay ? I’m a doctor and I don’t know how many IVs I received on my last stay.
And, as your doctor, I can’t tell you how much your hospital stay is likely to cost in advance. Why not ? Because I can’t get this information either. Those who are in charge of the “charge master” aren’t handing out their secrets, even to front line docs. Now member services can often give some very broad guidelines, and what percentage of the bill your particular insurance is likely to cover….. but will that be an accurate reflection ? Only if you are lucky.
Now bear in mind, we are talking about procedures that are necessary for health and sometimes for life. This would be the equivalent of our automobile industry doing business under a model where they did not have to tell you the price of a car before you signed the purchase agreement. And we are not talking about the difference between electively choosing to buy a cheap 4 door sedan vs a Mazerati, we are talking about procedures in which an individuals health and sometimes life is at stake and they are held hostage to the hospital affiliated with the insurance that their employer has chosen. It isn’t like you can just get up and go out comparison shopping.
If you doubt any of this, I would recommend this article which lays out how this works in terms even a numerically challenged obstetrician can understand.
http://economix.blogs.nytimes.com/2009/01/23/how-do-hospitals-get-paid-a-primer/?_r=0
Per my original point: “ObamaCare also has had a devastating effect on new drugs and medical procedures with it’s high cost and taxes on new medical devices. It has had a chilling effect for investors.”
[Tia wrote: “I know that this is an argument that is made repeatedly. I have a very different perspective. The same drug manufacturers that sell hepatitis C medication in here in the United States for $1000 a pill are quite willing to negotiate with European countries to sell that same drug for a fraction of that amount. So either, they are financially able to do so, or …”]
Actually, I know one or two doctors. I am aware of one who has a new technology, we have discussed it. He has patents, much of the legwork is done. It would be a new choice, less invasive, and less costly. But he explained to me the ramifications of the new Obamacare taxes, and how they stifle innovation. How most new drugs and medical inventions are developed in America. The immense legal costs, the costs to go to clinical trials, etc. And then the requirements of investors. How many years it takes to gain approval for clinical trials, and then to go to market. His analysis is that the new Obamacare taxes have had a chilling effect on medical innovation.
[Tia: …”All of that is before we even get to the charge master. The charge master for those who do not know is the list of items and services provided while in the hospital some of which may benefit you, some not so much so. Let’s suppose your nurse accidentally contaminates your IV line during insertion. Does the hospital pay for the error. Of course not, you do, although you do not know it….”]
Ouch. Well, I’ll pay for a sterile IV, too bad a carpenter who cuts a piece of wood incorrectly, or the marble cutter, can’t charge for his / her errors. Doctor privilege?
[Tia: “I can’t tell you how much your hospital stay is likely to cost in advance. Why not ? Because I can’t get this information either….”]
One of my suggestions was published pricing. Obama didn’t do that, did he? Pretty easy to start on basic procedures, add 100 a year to the required list.
TBD
“Can’t we treat some of these things like cigarettes?”
Yes TBD, we could and we certainly should. However, we lack the will to do so. It took decades of push back from the lying tobacco industry chiefs who at every turn tried to convince Congress and the public that the science behind the addictive properties and carcinogenic properties of cigarettes were in doubt. This was far past the point where the data was present and known to them, but all they have to do is to cast the slightest doubt, which combined with their overwhelming financial resources was enough to slow any reform efforts.
Look how much controversy has been generated from even this very simple, very non intrusive, no ban on anything ordinance. This tiny, tiny step in the right direction nutritionally speaking has brought down almost as much howling from the “you can’t tell me what to do ” set ( all of whom seem oblivious to the fact that no one is telling anyone what to do or not do) as though a constitutional right had been abridged.
It has been a ridiculous swing here between “this is a useless, feel good measure which will do nothing” and its opposing ” this measure is “so heavy handed as to be unacceptable.”
I would put forward the very straightforward idea that we don’t know whether or not the measure will be useful. It has never been done in this country before so we have no idea. What we do know is that addiction and habituation occur early while our basic tastes in food and drink are still being formed. We do know that manufacturers of sweets, whether sodas, or candy bars, or other non foods play to the tastes of children deliberately by advertising with cartoons and celebrities. But let’s do take that trip back to the 50’s. Would any of you been ok with your child’s “Happy Meal” being accompanied by a cigarette that they could enjoy after the meal along with mom and dad ? Would any of you have been ok with a candy cigarette? Remember those ? Early training for the next group of smokers ! Highly effective, highly lucrative.
So here is a key rub that I see. Those of us on the political left of the spectrum want the government to serve as a tool for strengthening our country. What those on the right choose to ignore is that no regulation would be necessary if private businesses always did the right thing. They want us to turn a blind eye to the death causing chicanery of those in private business because profit is their highest value. The heads of tobacco companies knew that their product was addictive and lethal, and yet continued ( and in more subtle forms today) continue to promote smoking pretending that they do not target children and teens. If a shadowy cabal were threatening to kill 4 million people around the world in one year, we have a word for that. The word is terrorist conspiracy. This is what the executives of tobacco companies are engaging in when they continue to sell these lethal products. They know it, and we know it. But we are complicit since for many of us the right to make millions while causing the deaths of others is no problem.
We are now seeing exactly the same strategies used to defend purveyors of non nutritional edible commodities which are habituating, are known to be so, and are marketed to children directly. Where is the outrage against this practice. If private business wants to be left alone by the government, why are they not leaning on their own private business colleagues to clean up their acts ? Where is the self policing function in the private business sector ? It took us many,many years in medicine to even start addressing rather than hiding the failings of our own systems. In my view it is time for our private business owners to do the same. Where is the article from Ms. Davis or Mr. Dunninng calling publicly for the restaurants to stop promoting sodas by automatic distribution unless declined ? Where is the outreach from our business community providing leadership on this issue ?
I guarantee you, that if private businesses would step up and do the right thing ( as admitted by nearly everyone here) then you would not hear me advocating for government intervention. It’s easy. Do the right thing as indicated by the evidence and there would be no need for government intervention.
You make some good points, but I don’t think you need to exaggerate numbers. I’ve heard that 400,000 people a year die from smoking. Am I wrong?
Where also is the AMA when we have quack remedies and medical claims that we allow to buy commercial space on TV and in newspaper ads? Yet we sit on new wonder drugs that get bogged down in an antiquated approval system?
ObamaCare also has had a devastating effect on new drugs and medical procedures with it’s high cost and taxes on new medical devices. It has had a chilling effect for investors.
Tia, are you forgetting the ongoing travesty at the VA?
Or how about the fraud rates with Medical and Medicare?