The battle over the bulges
Debate rages over government’s role in healthcare

By Sarah Wolberg
Colorado Public News

As the number of Americans tipping the obesity scale grows, another battle over the bulges has emerged: How much should public policy control the collective diet?
Suggestions include:

• Requiring government employees to meet certain health standards.
• Taxing sugar-laden drinks.
• Requiring healthier school lunches and physical education to curb childhood obesity.

Some say the government has a duty to protect citizens from unhealthy foods. Others argue for a free-market approach, waiting for consumers to demand healthier foods. Yet others call for collaboration.

The camps came together for a lively debate during the annual Colorado Health Symposium in Keystone late last month. Similar discussions are happening across the state and the nation.

“I do think we can begin to turn [the obesity crisis] around, but I think it’s going to be a coordinated effort between the private sector, government and nonprofit groups,” said Dr. James O. Hill, founding executive director of the Anschutz Health and Wellness Center in Aurora. “Somehow, we have to develop strategies that allow each sector to play a role.”

Hill, also a professor at the University of Colorado School of Medicine, supports the idea of health standards for government employees. The practice, which is also increasingly being used by private employers, may include programs that reward employees for being healthy – including giving them salary bonuses and lower insurance premiums.

“If you’re a government employee and you’re required to take care of yourself to work for the government, then part of doing that is going out into the community and seeking healthier options because being healthy is then important to your job,” he said.

Some in the private sector have gone further, adding penalties. Walmart now charges employees more for health insurance if they smoke.

Hill also suggested that government buildings could serve as testing grounds, where only healthy foods could be sold, including in vending machines.

“Rather than just implementing regulations, the government should test [possible solutions] to see if they will be effective,” he said.

Another major area that Hill promotes for government intervention is promoting schools as the first defense against obesity.

“Schools should teach kids healthy-eating skills that they’ll use throughout their lives, rather than just telling them what to do,” Hill said. That concept, he said, is effectively the result of strong government regulation.

Hank Cardello, the director of the policy research organization Obesity Solutions Initiative at the Hudson Institute in Washington, argued that such government regulation is misguided. The food industry, Cardello insisted, should play the largest part in encouraging healthy eating.

Cardello said that if consumers demand healthier foods by voting with their dollars – like buying health foods and leaving the potato chips on store shelves – companies will supply healthy products. Similarly, if companies supply healthier foods to the masses, consumers will support these companies and improve their health at the same time.

Cardello, a former executive at companies including Coca-Cola and Nabisco, said companies consider their bottom line, rather than worrying about any adverse health effects of the foods they sell. Consumer demands for healthier foods would encourage the food industry to produce healthier foods, he said.

“Not that anyone’s immoral here, but when [food industry executives] go into the office in the morning, [they don’t hear], ‘You got 37 attaboys for doing the right thing yesterday,’ ” Cardello said. “They hear, ‘Your brand sold less [products] than last year. Get to work.’

“That’s their report card. Their report card is not on addressing obesity.”

Cardello said that individuals must take the initiative in their own healthy eating without government policies.

“It’s not necessarily the food product [causing the obesity crisis],” he said. “We’re weapons of mass consumption. I have yet to meet the consumer who can say no.”

Lisa Katic, a registered dietician who works with the Food and Drug Administration in Washington on food policy, maintains a middle ground. The government, she says, should have a role in healthy eating and wellness – but not be too heavy-handed.

She cited Michelle Obama’s “Clear on Calories” campaign as an example of what she considers an effective approach. The campaign teamed the First Lady up with the beverage industry to put vital nutrition information on the front of drink packaging. The campaign is a part of her larger “Let’s Move” campaign designed to bring both government and the private sector together to combat childhood obesity.

“I don’t think the government should have no role in the issue; I just don’t think the government should be too heavy-handed,” Katic said. “What the First Lady is doing right now to raise awareness [about healthy eating] is great. She’s bringing all the right parties to the table.”

Katic, president of Washington-based K Consulting, said that other initiatives should also include the private sector. Government officials, she said, should work more with medical professionals – including dietitians like herself – when formulating health care policy.

“Registered dietitians are woefully underutilized in the obesity discussion,” she said. “R.D.s are trained to make the link between nutrition and disease, and they are important in preventative care.”

The debate over government’s role has taken on greater importance as health care costs continue to skyrocket. Also, Colorado’s status as the leanest state in the nation took a hit last year, as its population joined the other 49 states with an obesity rate over 20 percent. Currently, 55 percent of Colorado adults are overweight or obese.

Cara DeGette contributed to this report.


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