Who Opposed Obamacare - The Most Obesity States

The Supreme Court upheld the Affordable Care Act of 2010, otherwise known as Obamacare.  Judging from the polls, American public opinion appears to be very sharply divided over the legislation.  Some view it as socialism, others as the first success in a half-century of efforts to achieve a sensible national policy on health care.

Those who have the most to gain from President Obama’s health care legislation are those who have a pre-existing condition or are pre-disposed to illness, and that obviously applies to overweight and obesity Americans.  They are more likely to need medical care in the future, but can be charged higher rates if they try to buy private insurance, by virtue of their condition.  Or without a change in policy they can be excluded completely.  Each obese American currently incurs medical costs 42% higher than those of normal weight, that insurers can have been able to avoid that risk.

One of the interesting things about opposition to the ACA, was that some of the most obesity states voted against their own best interest. The chart below shows how Congressmen from each state voted on the Affordable Care Act on the vertical axis of Figure 1, with the state rates of obesity on the horizontal axis.   There is a statistically significant relationship.  But the relationship goes the other way:    states where more people are overweight, such as Mississippi, Alabama, South Carolina and Texas, are more likely to oppose Obamacare.   In those parts of the country where people are slimmer, such as New England, New York and Colorado, there is strong support for health care reform.  For every one percentage point increase in obesity, support for Obamacare declines by an estimated four percentage points on average.

      Figure 1:  States with higher obesity rates tend to oppose the Affordable Care Act 
   

Exercise and eating habits obviously relate to be overweight or obesity.  The states where residents get the most physical exercise are Minnesota, Utah, Oregon, Washington and Vermont; the states that get the least are Mississippi,  Tennessee,  Kentucky,  Lousiana and Alabama. And which states do data  data sources indicate has bad eating habits:  the five worst-ranking are Mississippi, Alabama, Missouri, Kansas and Oklahoma.

In addition to obesity, what the data reveal about how states rank on the overall health index.  The states that rank the best on an overall health index are Vermont, New Hampshire, Massachusetts, Minnesota, and Maine and Iowa.  The states where people are the least healthy overall are Louisiana, Mississippi, New Mexico, Nevada, Oklahoma and Texas.  The weight of the evidence is fairly clear: the states where people are most in need of help getting private insurance (and obesity related illness) are the states opposing the legislation that helps them do that.
 
It seems that the economists’ view of the world is wrong.  People are not voting in their self interest.
  
 Most people don’t know what Obama’s bill does.  Broadcast media has contribute to the view that it reduces personal responsibility for health care.  But the truth is the opposite.  In our current system, hospitals are required to treat patients who show up at the emergency entrance with a heart attack - even if their condition is partly their fault, due to habits of overeating and under-exercising.  This uncompensated care is passes on as a cost to insurers and other payors, and the rest of us end up footing the bill.   The universal mandate is designed to fix that, by making everyone pay for the health care they get (and perhaps even encouraging them to see a doctor who will advise them to adopt a healthy life style).  Establishing personal responsibility, not socialized medicine, is the reason why conservative think tanks proposed the idea of the universal mandate in the first place, and why Mitt Romney enacted it in Massachusettts.   But most people seem still unaware of this. 

Obesity Now Accounts for 21% of Healthcare Costs: Study

Obesity now accounts for almost 21 percent of U.S. healthcare costs — more than twice some previous estimates, reports a new Cornell University study.

An obese person incurs medical costs that are $2,741 higher (in 2005 dollars) than if they were not obese, according to the newest study. Nationwide, that translates into $190.2 billion per year, or 20.6 percent of national health expenditures.

The Cornell study is reported in the January issue of the Journal of Health Economics.

Previous estimates used by the government had pegged the cost of obesity at $85.7 billion, or 9.1 percent of national health expenditures.

However, the latest study is in line with a 2010 report by the same authors that found nearly 17 percent of U.S. medical costs could be blamed on obesity.

“Historically we’ve been underestimating the benefit of preventing and reducing obesity,” said lead author John Cawley, Cornell professor of policy analysis and management and of economics.

“Obesity raises the risk of cancer, stroke, heart attack and diabetes. For any type of surgery, there are complications with anesthesia, with healing [for the obese]. … Obesity raises the costs of treating almost any medical condition. It adds up very quickly.”

The new study, conducted with Chad Meyerhoefer of Lehigh University, estimates the effect of obesity on medical expenses by treating the heritable component of weight as a natural experiment. Previous research simply reported the difference between the medical expenses of heavier and lighter people, which the authors say is a misleading estimate of the causal effect because obese and non-obese individuals differ in so many ways.

“For example, I could have injured my back at work, and that may have led me to gain weight. The injury could have led to a lot of health care costs that are due to my back, not my obesity,” Cawley said.

Workers’ compensation carriers are among those concerned about this trend. Claims involving obesity have higher indemnity and medical costs, according to the insurers’ organization, the National Council on Compensation Insurance (NCCI).

Cawley believes the research provides evidence for policymakers to use in deciding whether and how much to fund obesity prevention programs. Since previous studies have underestimated the medical costs of obesity, the economic rationale for governments to intervene and reduce obesity has been under-appreciated, he said.

McDonald’s Shareholders Vote Against Childhood Obesity Report

By - Briana Rognlin

McDonald‘s has long been critiqued for contributing to obesity and chronic health problems, but this year the company’s shareholders themselves are battling over whether the company should publicly ‘fess up to their impact–specifically on child obesity. Shareholders voted on a resolution for better transparency with regards to the company’s health impact during their annual meeting, held yesterday in Oakbrook, Illinois. It’s the second year in a row that the resolution was voted down, but on the plus side: at least some are pushing for better corporate responsibility.

The resolution would have required the company to assess “the company’s policy responses to growing evidence of linkages between fast food and childhood obesity, diet-related diseases and other impacts on children’s health,” within reasonable cost and excluding proprietary information.

It’s easy to see why the proposal was shot down, but from a long-term perspective, many feel that such a report could actually do more to help the company than hurt it. As consumers continue to hold McDonald's in lower esteem–at least in part because of its lack of healthy options–it could end up boosting the brand’s image and sales to get a head start on addressing how their menu could be improved for the sake of customers’ health.

As Dr. Andrew Bremer, a pediatric endocrinologist and professor of pediatrics at Vanderbilt University, said in a statement on behalf of shareholder John Harrington:

McDonald’s can no longer ignore the spiraling costs of its business practices on our children’s health and on our health-care system.

And in an appeal to business-minded shareholders, he explained that refusing to adjust their menu and marketing, shareholders are exposing themselves to further risk; more likely to hurt the brand than boost it.

The proposal was shot down, with only 6.4% voting in its favor–but the proposal still sets a groundbreaking example for other companies.

Outgoing CEO Jim Skinner said that McDonald’s advertises responsibly to kids, and that he believes McDonald’s has done more than anyone else in fast food to offer healthy food options. We hope that his replacement has a more progressive attitude.

You can reach this post's author, Briana Rognlin, on twitter or via e-mail at briana@blisstree.com.

An objective food rating system that rates food based on nutrient density having an impact with manufacturers

Food Manufacturers Take Positive Steps Toward Improving the Nutritional Profile of Packaged Food Products

April 19th, 2012 | Press Release from Guiding Star 

Consumer Demand for Healthier Options, More Transparent Labeling, and Objective Rating Systems Encourage Both Branded and Private Label Manufacturers to Cut Back on Sodium, Added Sugars and Saturated Fat

New data from the patented nutrition guidance program Guiding Stars® suggests food manufacturers are responding to consumer demand for healthier choices by making positive changes to the nutrient content of packaged food products.  As a result, supermarkets are now able to offer a broader selection of products lower in saturated fat, sodium and added sugars and containing more fiber, whole grains, vitamins and minerals.

The formulation improvements come as good news for busy American families who often find it difficult to put healthier, more nutritious food on the table with the ease and convenience that pre-packaged foods can provide.

“Both the national brand manufacturers and private label companies are beginning to move in a positive direction, improving the nutritional profile of their products to meet consumer demand,” said Leslie Fischer, PhD, Research Assistant Professor of Nutrition at the University of North Carolina at Chapel Hill, and a member of the Guiding Stars scientific advisory board.  ”As consumers become more aware of the health benefits of reducing sodium, saturated fat and added sugar intake—and just how prevalent these ingredients are in many packaged foods—it is great to see manufacturers and retailers respond by providing more products that are aligned with current dietary recommendations.”

Fischer says the changes are the result of several factors.  More transparent labeling regulations now require manufacturers to accurately disclose ingredients and nutritional content, as well as substantiate claims such as “whole grain,” “low fat” and others with nutritional data.  Efforts by organizations such as the American Heart Association and others have also raised awareness among consumers and encouraged manufacturers to reduce sodium and cut back on other unhealthy ingredients in their recipes.

Meanwhile, nutrient profiling systems like the Guiding Stars program make it easier for consumers to make better food choices by clearly identifying more nutritious foods at a glance, mitigating the need to read and compare every label.  Guiding Stars rates more than 100,000 edible items, ranging from fresh produce to packaged foods, prepared deli items, and dairy products using a patented algorithm based on the USDA Dietary Guidelines for Americans and other national evidence-based nutrition policy.  Each food is clearly marked with a shelf tag, label, or other grocery store signage that indicates its nutritional value: one Guiding Star is good, two Guiding Stars is better and three Guiding Stars is best.  Foods that receive no stars do not meet the program’s rigorous criteria.

Since the program’s 2006 launch in Hannaford Supermarkets, more than 1,700 stores in North America have implemented the program and witnessed significant improvement in the nutritional profile of the foods they offer.  During the first year for the Guiding Stars program at Hannaford, only 17 percent of that retailer’s private label products earned at least one Guiding Star.  Five years later, after working closely with its private label manufacturers, Hannaford saw the proportion of its private label foods earning one or more Guiding Stars increase to 28 percent.  This compares favorably with the 25 percent of overall packaged foods carried by Hannaford—including national brands—earning one or more Guiding Stars.

Across the Guiding Stars database of more than 100,000 national and store brand foods, roughly one-third of all products now earn at least one Guiding Star, compared to only one-fourth just five years ago. A number of manufacturers have made significant improvements in the nutritional profile of their products, earning more Guiding Stars for their efforts, including:

• Dole Pineapple Chunks in 100% Fruit Juice, which went from 0 Guiding Stars to 2 Guiding Stars after changing from “packed in light syrup” to “packed in 100% juice,”
• DelMonte Fresh Cut Sweet Peas increased from 0 to 1 star after reducing both sodium, and added sugars,
• Thomas’ Light Multi-Grain Hearty Muffins went from 2 to 3 stars after removing the added sugars, and increasing calcium,
• Kelloggs Raisin Bran Crunch Cereal changed from 0 to 1 star by reducing the amount of added sugars,
• Hunts Crushed Basil Tomatoes now earns 2 stars instead of 0 since reducing sodium content,
• Ore-Ida Golden Fries French Fried Potatoes changed from 0 to 1 star after reducing the saturated fat content.

While these are just a few examples of what many manufacturers have done to improve the nutritional quality of their food products, Fischer says they represent an overall trend that ultimately benefits both manufacturers and consumers.

“As consumers become more aware of how nutrients in foods are linked to health and desire to make more informed food choices accordingly, manufacturers are developing more nutritious products to match this demand,” Fischer said.  ”It’s a win-win for both food producers and consumers that has the potential to positively impact our nation’s overall health and help reduce the prevalence of diet-related diseases such as obesity, diabetes, heart disease, and high blood pressure.”