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By Max Greenberg

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About this blog: The day my doctor "congratulated" me upon entering the obese category for my height was the day I decided not to wait for my first heart attack to change how I was conducting my life. That was over two years and 40 lbs ago when I ...  (More)

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How to Encourage Healthy Food Choices & Reduce Health Care Costs

Uploaded: Jun 25, 2014
You know how folks who receive food stamps cannot buy certain supermarket items such as cigarettes, alcohol, candy (I think that's on the list) with them? Here's a modest proposal for encouraging folks to eat healthy foods which will lead to better health and reduce the need to access the health care system: Give EVERYONE a "Healthy Food Stamp Card" which allows us to purchase only "real" foods. It comes with a list of foods which are not permitted: processed foods; foods containing hi-fructose corn syrup; foods containing sugar or artificial sweeteners; foods with artificial coloring and GMOs; vast majority of foods sold at Safeway. Encouraging fesh fruits and veggies, and organic foods. The cost would come out of the massive savings the health insurance industry will reap by not having to treat and spend money and resources caring for previously ill people who for the most part were consuming so-called foods that harm them. In addition to paying for the Healthy Food Stamp Card, insurance premiums for the card users would go down as well, paid for out of those savings. It's a win-win for everyone, except for those purveyours of fake food (ie. supermarket chains), at least until they get with the program and phase out their fake food selection and replace it with the healthy food choices. Good nutrition = better health, less need for medical services. Typical American diet = non-optimal health, more sickness and disease. I'm sure vegetarians would want to exclude meat, fowl and fish from the list of Healthy Food Stamp Card items. Perhaps that could happen in phase 2.

Comments

Posted by A, a resident of Another Palo Alto neighborhood,
on Jun 30, 2014 at 9:24 am

Who would be giving out and paying for such a card, Comrade Max?

In all seriousness, congratulations on what you did for your health, and I applaud you wanting to share it. But forcing other people's choices in something as fundamental as eating rarely produces the desired outcome in the long run. There's a great book called Switch: How to Change Things When Change is Hard. The point is, you don't want to force everyone's choices, you want to make a path to the better choices. It's the difference between making it hard for people to drive when there really isn't any better alternative for most people (and being surprised that traffic problems and emissions go up not down, and people's time is monumentally wasted), and making it easier for transportation innovation to take place, or simply making a more attractive option the easier path.

"The cost would come out of the massive savings the health insurance industry will reap by not having to treat "

With all due respect, this misunderstanding is why healthcare costs so much and why Obamacare will, like the Massachusetts plan upon which it was based, cover everyone but not really reduce costs. (I voted for Obama, this is not a party ideological argument.)

Insurance companies aren't really driven by a desire to save money for the system. They profit as a percentage of the healthcare economy, so their incentive is to have as much CONTROL as possible within as LARGE a healthcare economy as the rest of us can possibly bear. Not surprisingly, it always is as large as we can bear, now around 20% of the national economy and crippling our competitiveness. The denials everyone hates have to do with that control, to save money within that context, not to save all of us, those paying for the system, money. So, for example, insurers love consolidation. They will happily pay for drugs instead of physical therapy, even if the physical therapy has better outcomes (in fact, they may even end up influencing what we all think is the better outcome, depending), because dealing with a handful of entities through big pharma is way preferable to dealing with thousands of little entities and therapists across the country.

Not surprisingly, one of the early-day occurrences of Obamacare was that drug costs went stratospheric. Not because of Obamacare per se, but insurance companies' incentives were to allow those costs to go as high as they could because it gave insurers a buffer for the future, because it's one of the areas they have most control over. Insurers hate change, because their control flows from predictability. That means they also really wouldn't be happy if suddenly tomorrow, we all needed half the care.

Every other advanced nation on the planet has implemented some kind if universal healthcare system, whether it's entirely through government as in England, or entirely private as in Germany and Switzerland, or some hybrid. Every other advanced nation is now paying far less per capita on care, covering everyone, and in some cases, offering better perks and outcomes. Even though these systems are all very different, they have one important thing in common. They all have nonprofit insurance. As TR Reid points out in his book The Healing of America, there is an irreconcilable difference between paying for people's healthcare and paying investors. We remain the only advanced nation with for-profit health insurance.

That is not to say that nonprofit insurance isn't part of a healthy market-based system. Everyone still works for a salary, doctors, labs, even drug companies still profit. But insurance companies no longer pay investors. Our own system worked better when nonprofits dominated our own system. In Switzerland, their for-profit insurers run healthcare, they just don't profit in the healthcare sector, and use their performance as advertising for how they would do with their other casualty products. There, insurers have an incentive to save money AND do a better job for you than another insurer you could choose.

Don't get me wrong, everyone has complaints about their systems. But ours is objectively costing twice as much per capita to not cover everyone, as the next system, in Switzerland, where a good policy will send you to a resort to recover from surgery.

How much is making that one investment vehicle available costing our nation? Not just in dollars (though a half trillion in paperwork annually saved when that control is no longer necessary is huge), but also in productivity and excellence. When doctors, care, manufacturing, all go offshore, so, too, does innovation, a reverse brain drain. If we were caring for everyone to the best of our abilities, not just with for-profit insurers pulling the strings, we'd also be innovating more in that sector.

So, I applaud your intentions, but as there's that saying about the road to hell for good reason.... Get that book about how to change things, I'd love to hear what you think might be a way to help create better paths to healthier eating for everyone. But that's really a different issue than our dysfunctional healthcare system.


Posted by RW, a resident of another community,
on Jun 30, 2014 at 1:54 pm

I'm not sure it's fair to say that supermarkets chains are "purveyors of fake food". All of the supermarkets I go to (yes, even Grocery Outlet) have an adequate selection of produce, meat, bread, cheese and other "real" foods. Also, I pet peeve on the term "real food". Just like if someone asks me if my ring is "real". Can you see it? Touch it? Then yes, it's real.

What's difficult for me is making the choice to choose less processed over more processed, more healthy over less healthy, less sodium over more sodium. If there were a card available for me to buy those healthier choices for less money, I'd certainly use it. But, that wouldn't stop me from choosing less healthy options as well.

As an aside, I belong to a great CSA where everything I get from them is real.


Posted by Max (the blog author), a resident of Midtown,
on Jul 14, 2014 at 3:04 pm

A: You obviously have given this subject a lot of thought and I appreciate your sharing your ideas with me (and the readers.) You make some excellent points. I think that (except for the processed food makers and fake-food purveyors) everyone would agree that if we all ate a healthy diet we would lead a healthier, happier, longer and more productive life, and the demands on our health care system would be substantially reduced. The question is, how to best create the change and get folks on board. We need to explain the WIIFM (what's in it for me.) In this case its what I stated above, plus the added bonus of having much of your healthy food paid for, and also avoiding the pain of higher health care premiums(another part of my plan which I didn't mention.) This cannot be framed as a "freedom of choice" debate, because folks are free to choose to continue with their toxic diets. They will just have to pay more for health care, similar to how dental insurance works now: take care of your teeth and don't exceed the yearly maximum. Maybe it's all a pipe dream of mine - but if it became a national initiative it could grow some legs.


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