What are we to make of Nancy Pelosi's home town's measure to ban Happy Meals? Shall we say that the San Francisco board of supervisors got a little carried away in their zeal to prevent childhood obesity? Or is it about time someone staged an intervention to shake Americans out of their sickening (literally) eating habits?
Well, maybe, but not this way. When liberals unleash their coercive urges as the supervisors in San Francisco have done, even some Democrats -- notably the mayor -- are forced to protest. Would we like it if McDonalds changed its menus in response to social pressure and consumer demand? Yes. And by the way, that is happening. Customers at McDonalds can now choose salads, fruits, and quite tasty coffee in addition to the usual fatty fare. But that clearly didn't satisfy the food cops.
So imagine a parent in San Francisco who has made the following deal with her child: Eat five servings a day of fruits and vegetables, and three servings of milk or yogurt, and on the weekend, you can have a Happy Meal. Not anymore.
While banning Happy Meals (the law actually just banned meals with toys that failed to meet certain nutritional guidelines -- but the shorthand is accurate) will probably have no effect on the health of San Franciscans, there are ways in which the law could be changed to reward healthy behavior. Unfortunately, the Democrats failed utterly to consider them when revamping our health care system.
The Obama Democrats took a system that was groaning under the weight of exploding Medicare and Medicaid costs and made it worse by adding another entitlement. They took a system that encourages voracious consumption of health care services (because a third party is paying) and expanded it. They took a system that already inhibited choice (by, for example, imposing costly mandates on insurance carriers) and restricted competition still further.
President Obama claims that his is a (cough, cough) non-ideological administration. He has promised many times to invest only in "what works." But the Massachusetts health reform (aka Romneycare) adopted very similar reforms to those in the Obamacare law. It's been a failure. The Massachusetts experiment has failed to reduce costs (they are the highest in the nation), and has reduced quality as physicians flee the state, leading to longer wait times for appointments. This information was available in March.
In the midst of the health care debate, the CEO of Safeway Inc., described the kind of reform that has a track record of success. Steven Burd began by noting that 70 percent of health care costs are the direct result of behavior, and that 74 percent of health care dollars go to just four conditions -- cardiovascular disease, cancer, diabetes, and obesity. Eighty percent of cardiovascular disease and diabetes is preventable, as are 60 percent of cancers and more than 90 percent of obesity. His company, which self-insures and thus makes its own rules, offers employees tests for those four conditions, which include questions about tobacco use, weight, blood pressure, and cholesterol levels. Safeway then provides discounts for those who achieve good scores. If, a year after receiving a bad test result, the employee is able to reverse it through good habits, the company offers a refund equal to the premium difference.
The results, as Burd described it in the Wall Street Journal, were arresting. Between 2005 and 2009, Safeway's per capita health spending remained flat while health spending in the rest of the economy increased by 38 percent. A survey of employees found that 76 percent wanted more incentives for healthy behaviors, and 78 percent rated the program as good, very good, or excellent.
Whole Foods, another supermarket player, adopted its own form of health savings accounts that allow employees to keep and roll over any unused portion from year to year.
Each of these companies adopted programs that rewarded individual responsibility. There was no coercion, but rather incentives for healthy choices and careful consumption of health care. Not only did Obamacare fail to take account of these excellent models, it will very likely force these companies to abandon them.
Another sad report: As of Nov. 1, 111 labor unions and politically well-connected businesses had secured waivers from the Secretary of HHS from complying with the onerous taxes, fees, and requirements of Obamacare. This cronyism is brought to you by the same kind of people who banned Happy Meals. "What works" is completely irrelevant to them. The important thing is that government decides.
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