After health care reform, will Big Insurance be the enemy of Big Food?

Source: eHow

Michael Pollan has a great editorial in today’s New York Times on Big Insurance and Big Food. Could health care reform motivate the insurance industry to lobby for healthier food? The argument goes like this.
According to the Centers for Disease Control and Prevention, three-quarters of health care dollars are spent on preventable chronic diseases. Smoking is an obvious culprit, but many (if not most) chronic diseases – diabetes, heart disease, cancer – have a connection to poor diet. We eat too few fruits and vegetables and too much sugar, salt, refined carbohydrates, and saturated fat.

The US spends $116 billion a year to treat diabetes. Another $147 billion is spent on obesity. Hundreds of billions more go towards heart disease and the many types of cancer associated with the contemporary Western diet.
In a money-driven medical system, poor health increases profits.

The market for prescription drugs and medical devices to manage Type 2 diabetes, which the Centers for Disease Control estimates will afflict one in three Americans born after 2000, is one of the brighter spots in the American economy. As things stand, the health care industry finds it more profitable to treat chronic diseases than to prevent them. There’s more money in amputating the limbs of diabetics than in counseling them on diet and exercise.

What’s true for the health care industry is also true for the health insurance industry. Under current regulations, there’s no motivation to encourage prevention . There are just too many ways to keep patients who are at risk of developing a chronic disease out of the insurance pool: Lifetime caps on coverage, excluding pre-existing conditions, or simply canceling the policies of those who become sick.

Before and after health care reform

What might happen if health care reform became a reality and insurance industry regulations changed to prohibit these practices?

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.

Once the insurance industry can no longer avoid customers with chronic diseases, they could conceivably confront the vested interests that have determined our diet.

Agribusiness dominates the agriculture committees of Congress, and has swatted away most efforts at reform. But what happens when the health insurance industry realizes that our system of farm subsidies makes junk food cheap, and fresh produce dear, and thus contributes to obesity and Type 2 diabetes? It will promptly get involved in the fight over the farm bill — which is to say, the industry will begin buying seats on those agriculture committees and demanding that the next bill be written with the interests of the public health more firmly in mind.

Cheap food is subsidized by the government for political reasons, ignoring the social and environmental costs. Today’s fast food produces the future patients of America’s health care system. Wouldn’t it be great if health care reform not only reduced the cost of health care, but actually made us healthier?
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