Lately, President Obama has begun calling his plan to reinvent America's health care system "insurance reform." Yet the version of the plan moving through the Senate also includes restaurant menu reform (a mandate requiring the conspicuous posting of calorie counts) as well as grocery reform, transportation reform and recreation reform (money to build farmers markets, bike paths, sidewalks and jungle gyms).
These provisions are all aimed at making Americans thinner, on the theory that doing so will reduce medical spending. It won't. Even if it did, we should be wary of a political theory that says taxpayer-funded health care makes everyone's personal habits everyone else's business.
There are reasons to be skeptical that the anti-obesity provisions in the Affordable Health Choices Act will have a noticeable impact on Americans' waistlines. The same research that nutritional nags cite in support of menu mandates indicates that even in restaurants like Subway, where the clientele is unusually diet-conscious, most consumers prefer to avoid calorie counts, enjoying their food in blissful ignorance.
To justify government funding for farmers markets, which would be supported by a $10-billion-a-year Prevention and Public Health Investment Fund, the Trust for America's Health cites a survey in which 90 percent of visitors to two inner-city farmers markets in Michigan said they "wanted additional markets and had learned from the experience." But the fact that people who go to farmers markets like farmers markets does not mean subsidizing them will change what Americans eat.
Still, let's say the various anti-fat measures in the Senate bill work exactly as intended, improving diets, increasing exercise and reducing obesity rates. Surely that will save taxpayers money. After all, the U.S. Centers for Disease Control and Prevention says obesity-related health care costs something like $147 billion a year, accounting for about 9 percent of Medicare spending and 12 percent of Medicaid spending.
"The connection between rising rates of obesity and rising medical spending is undeniable," the authors of the Health Affairs study cited by the CDC conclude. "Without a strong and sustained reduction in obesity prevalence, obesity will continue to impose major costs on the health system for the foreseeable future."