Majority of US Healthcare Costs Are Caused by Bad Eating Habits

http://www.nytimes.com/2009/09/10/opinion/10pollan.html

by jyu • 17 years ago

48 59 17 years ago

vijayr• 17 years ago

Isn't it the same everywhere (assuming there is no war or natural calamity etc like situation)?

anigbrowl4• 17 years ago

Not necessarily. For example: http://library.thinkquest.org/16665/causes.htm <- leading causes of mortality in ~20 countries. Look at how big the variations between different countries can be even for coarsely-grained statistics.

RyanMcGreal2• 17 years ago

Are American eating habits really that significantly different from Canadian eating habits to explain the fact that the US spends twice as much per capita as Canada spends - notwithstanding the 50 million Americans without coverage?

ankeshk• 17 years ago

Comparing Canada vs USA obesity rates shows that YES indeed eating habits seem to be very different:

http://eaves.ca/2008/07/08/fatness-index-canada-vs-united-st...

hughprime5• 17 years ago

If you look at the comments below the post, though, the comparison doesn't seem to be valid, due to different measurement methodologies.

RyanMcGreal2• 17 years ago

WOW. That's just astonishing - thanks for the link! I think it's definitely worth studying how two very similar societies can have such radically different obesity indicators.

potatolicious2• 17 years ago

As a Canadian living in the USA I have to say, we don't eat that differently in Canada, the big difference is we eat less.

Canada is just as full of greasy, nutrtionless, processed-to-hell food as America is, but we simply do not consume as much of it, from my observations.

When I moved to the USA I immediately (over 4 months) gained a buttload of weight (both figuratively and literally...). This is due to my bad habit of finishing everything on my plate. I've since fixed this and my weight is rapidly decreasing. Yay. Serving sizes in the USA are simply ludicrous and completely out of step with reality.

Before talking about high-fiber, low-fat diets, Americans need to do one simple (but difficult) thing: eat less. Eat way less.

A friend and I (both Canadian) paid a visit to the Cheesecake Factory this last weekend - when our plates landed on our table our eyes bugged out. There was enough food to feed 4 people in a standard Canadian restaurant. I'm not even exaggerating :S The table next to ours polished their food single-handedly and then ordered dessert. We were shocked. How any single person can consume that much food in one sitting is unimaginable, and somewhat disgusting.

pchivers• 17 years ago

As a Canadian who visits the United States often, I can definitely say the portion sizes are a lot larger in the United States. Every time I go to the US I go into a state of shock when I see the portion sizes.

You would think that after 20-30 trips to US I would have learned to adjust my expectations by now, but it is still amazing to me to witness how much food Americans eat no matter how many times I see it.

tjr• 17 years ago

I once offered to pick up some "Chinese food" for some colleagues visiting the US from China. They didn't recognize anything on the menu, and ended up ordering the "house special", with grilled chicken, vegetables, and rice. Reasonably healthy, from the looks of it.

About an hour after getting our food, I remarked that they had not finished what they ordered.

"This is too much food for us; we can't eat it all!" they explained.

"It's too much for us too," I assured them, "but we eat it all anyway."

hughprime5• 17 years ago

The headline "Majority US Healthcare Costs Are Caused by Bad Eating Habits" is not the headline of the article, nor is this supposed fact stated anywhere in the article.

I very much doubt it's true, and I don't think it's well-defined enough to even be false.

anigbrowl4• 17 years ago

(...) the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

This is a key argument in the article and the headline seems like a reasonable paraphrase of that.

joe_the_user2• 17 years ago

At the minimum, a lack of physical activity has to be included as a factor in this along side diet.

ars2• 17 years ago

> ... the fact that the United States spends twice as much per person as most European countries ....

Is actually explained by the fact that we pay our doctors twice as much as they do.

We have the same number of doctors per person as they do. And unless our doctors are way more efficient, that means we get sick at about the same rate.

But we spend twice as much, because we pay twice as much. Not because we get sick twice as much.

And see this: http://news.ycombinator.com/item?id=816589 which was just posted.

jyu• 17 years ago

Yea, I couldn't think of a better way to describe this article. Surely I think it's an improvement over "Big Food vs. Big Insurance" which doesn't give you any idea of what the article is really about. Do you have a better suggestion?

thesecret• 17 years ago

I work in healthcare and this is my understanding from the responses of patients that I encounter - fast food is cheap. One of the families I work with, both parents are diabetic and the children are all overweight. I asked them about their eating habit and the answer was : McDonalds for breakfast, lunch, and dinner. Why? Because it's cheap to eat at McDonalds for a family of 4 than it is to buy vegetables at the market....for 3 bucks, you get a whole meal for one person. $3 at Safeway, you only get..a cabbage and some tomatoes?

They didn't understand that their eating habit is going to cost them much more in health expenses

dasil0034• 17 years ago

The big problem is farm subsidies for corn and soybeans. If they transferred those subsidies to produce we could make it significantly cheaper to eat healthy.

However, if you are smart it's possible to eat much cheaper than McDonalds and almost infinitely healthier. The secret is just eat like they do in poor countries. Start with bulk quantities of some basic staples. I'm Brazilian, so for me it's rice and beans. Then buy veggies and meat that are on sale. Of course if you want it to taste good you have to learn to season and cook it properly, which takes time.

I admit that corn syrup drinks, processed carbs and extremely fatty/salty/msg-y food tastes great and can be quite addictive. I sympathize with people who are stuck in that cycle. However I've found that how I feel from eating healthy and getting a reasonable amount of exercise is far more significant to me than something that tastes good for 5 mins while I eat it. I'm convinced if people were more in touch with their own bodies it wouldn't be hard to convince them to eat healthier. Unfortunately American culture itself is a huge impediment to this, which is why I'm so happy to see Michelle Obama planting a garden. Cultural change is what we need.

rglullis• 17 years ago

(OT, but your profile info does not have an email.)

From reading that, it seems that you are living in the US for quite some time. As a Brazilian living in Cambridge, MA, may I ask you where do you live now? There are lots of Brazilians in Mass, but I'm yet to find a fellow Brazilian hacker.

lionhearted• 17 years ago

I've heard this before, but it isn't true. I make one cup of Quaker oatmeal most mornings - cost is around 11 cents. I buy tea and coffee in bulk - another 11 to 25 cents or so. My entire breakfast costs less than 50 cents, and all it requires is boiling water or 3 minutes in the microwave. It's faster than a drivethrough.

Rice and beans are practically free they're so cheap. I buy turkey or chicken cold cuts, again very cheap. I buy "turkey dogs" (hot dogs, but made of turkey) when they're on sale for something like $2 per six. 3 of them is 210 calories, almost all protein, for about $1. I buy whatever fruit is on sale, fruit isn't so expensive either. I don't like bread, but wheat bread is cheap. My girlfriend sometimes cooks a huge pot of stew that sits on the stove for 3-4 days and serves 10+ meals for under $10.

I'm not sure how much eggs are per dozen - maybe a dollar or two?

It's possible to eat very quickly and inexpensively. The problem isn't cost, it's a mix of education and being willing to forsake convenience/delay gratification. Our culture is decent at the former, but quite bad at the latter.

coderdude• 17 years ago

I agree, I find that going to the grocery store and paying upfront for my meals to come is more cost effective than constantly buying fast food. Fast food is not very cheap at all actually. Unless you're buying from the dollar menu, in which case it's $3... for your kids. It's hard to get full on 99c fries and a mini burger.

eru2• 17 years ago

I agree. Though with your stew boiling for 3 days you should begin to factor in energy costs.

dejb• 17 years ago

You probably should add some more vegetables by the sounds of it.

kdw2• 17 years ago

Part of the problem is likely that some menu items are simply far worse for you than you'd guess, if you don't check the nutrition information.

As an example, I was on the road recently and I stopped by a Burger King drive-thru to get a quick lunch. I knew that a Spicy Chicken Sandwich is 450 calories, which isn't wholly unreasonable.

Sadly, they were out of those, but they asked if I'd like an "angry tendercrisp sandwich' instead. It sounded similar, so I said yes.

The angry tendercrisp sandwich: 1030 calories, 61g of fat, 15g of fat, and 2670mg of sodium.

But I'm sure there are some people who order them, thinking they're healthier than a burger.

drsnyder• 17 years ago

My suspicion is that their struggle is more about the perceived cost and time. My wife and I are able to eat most of our meals at $2-3 per person. We have found that to get the cost low, you need to seek out cheaper produce (usually not safeway) and cut way back on meat consumption. Making your own cereal also helps as well as only buying things on sale. You also need a little more time to prepare the raw ingredients.

hughprime5• 17 years ago

This seems to come up every couple of weeks, and is invariably followed with a whole bunch of recipes for rice and beans.

But the thing is that eating at McDonald's for three meals a day is both dumb and expensive. It isn't just expensive compared to rice and beans, it's expensive compared to regular-person food. A meal at McDonald's doesn't cost $3, it generally winds up more like $6... but even if you could find a way to eat at McDonald's for $9 per person per day, that's still a helluva lot of money compared to a sensible diet of breakfast cereal for breakfast, sandwiches for lunch, and meat + veges + rice/whatever for dinner.

christofd• 17 years ago

Don't agree! I've cracked down on eating out for a month and lived off pasta and vegetables. You can't get a meal for $3 at McD. but you can eat for $ 1 for the day making your own food. It's an interesting experiment!

This excludes meat and dairy products though.

wallflower2• 17 years ago

> both parents are diabetic and the children are all overweight

As an interesting factoid:

Pre-late 1800s per-capita Sugar consumption: 1 lb/person

Today: 150+ lb/person

The paradigm-busting, pivotal event in the late 1800s: the invention and introduction of Coca-Cola. Once Coca-Cola started putting sugar into American diets, the door was opened for sweeteners.

"According to health officials at this ancient pueblo, where the Zuni have hunted and farmed for perhaps 800 years, diabetes is now the single leading reason for Indians to seek hospital treatment."

http://www.nytimes.com/1986/02/18/us/surge-in-indians-diabet...

scrollinondubs• 17 years ago

exactly. The true costs of each burger are deferred from the McDonald's counter and amortized over a lifetime and a population in the form of Medicare deductions on your paycheck. This article is timely as I had written this blog post last week suggesting a fast food tax: http://www.scrollinondubs.com/2009/09/01/fast-food-tax/

It wasn't an optimal solution but it at least attempted to redirect the costs of poor eating choices to the people who make the bad decisions. The proposal from the NYT article is way simpler and more effective:

yank the "preexisting condition" defense from insurance companies and they become instantly incented to encourage healthy eating. Current advocates of proper eating habits gain a powerful ally at that point.

sean

awt• 17 years ago

Doesn't everyone die? If so, isn't the question what diseases take the longest time to cause death, and thus require the most medical expenditure? Wouldn't medical expenses be lower if everyone died of a heart attack at 55? That would certainly be cheaper than living till 70 and treating cancer, bone loss issues, bladder issues, and cholesterol issues over a period of several years.

dasil0034• 17 years ago

If so, isn't the question what diseases take the longest time to cause death, and thus require the most medical expenditure

Not exactly. You're missing two variables. The rate of infection in the population as a whole, and the rate of expenditure to treat the disease.

hughprime5• 17 years ago

How so? The argument is that eventually everybody dies of something, so avoiding one fatal disease only shifts your death to another disease at some point in the future.

I really think it's quite likely that fat people, on average, cost less in health care over their lives than thin people. I don't have any numbers to back this up, but every person who dies suddenly of a heart attack saves an awful lot of money by not dying of cancer, or worse still some degenerative disease.

anigbrowl4• 17 years ago

Well, when a lot of people are obese hospitals need to be able to accommodate them even before they die. Consider the cost of beds, wheelchairs, examination and operating tables, and so on. All that equipment has to be reliable for intensive long-term use; if patient's hospital bed collapses underneath them they would sue and almost certainly win.

Now, bearing in mind that this basic-but-necessary equipment is not cheap to start with, making sure that it can handle the weight of an obese person gets quite pricey.

edw519• 17 years ago

There’s lots of money to be made selling fast food and then treating the diseases that fast food causes.

All the more reason for each of us to take more personal responsibility for our food and our health. I wouldn't count on anyone else helping me much with either any time soon.

Retric• 17 years ago

Most health care spending in the US is caused by aging. Most heath care spending is paid for by the state, local, or federal government (50%+). Most heath care spending is caused by people living longer. Most heath care spending is caused by better and more expensive treatments that we did not have 100 years ago. Smokers have shorter lives and spend less on heath care over their lifetime. Smokers cause a huge short term spike in heath care costs.

PS: There are plenty of ways of slicing it, but excluding sudden death we are all going to spend a lot of money on heath care and we are all going to die.

nova• 17 years ago

Yes, but before advocating any diet please read Gary Taubes' "Good Calories, Bad Calories".

Please. The government already amplified a terrible mistake to colossal dimensions and could do it again.

wallflower2• 17 years ago

A retired gastroenterologist once told me his personal theory: Every human can consume a finite amount of sugar in his/her lifetime - once you exceed that limit, you die. The theory is a bit flimsy but it makes you think about cumulative nutritional choices.

bokonist• 17 years ago

* and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. *

Cancer and heart disease are fundamentally diseases of age. Everyone will die of one or the other eventually. The links to certain dietary elements are almost all a result of a data mining.

nradov• 17 years ago

We are digging our graves with our teeth.

Caring for diabetes and related conditions consumes about 1/7 of all US healthcare spending (could be a little more or less depending on how you count). http://www.diabetes.org/diabetes-statistics/cost-of-diabetes... The vast majority of type-2 diabetes cases could be prevented with better eating habits. If the incidence of preventable chronic diseases was greatly reduced, healthcare costs would be so low that we wouldn't be arguing over how to pay for it.

peregrine• 17 years ago

This is a poor headline. I'd say a better one would be. "Majority of US Healthcare Costs are Cause by Not Exercising enough to burn calories from Bad Eating Habits"

xsmasher• 17 years ago

Well, there is something slightly perverse about eating more food than you need, and then doing useless physical work to balance out the equation.

asciilifeform• 17 years ago

Why is there no mention of the artificially restricted supply of doctors? This fact plainly accounts for a large portion (if not the majority) of US health care costs.

Majority of US Healthcare Costs Are Caused by Bad Eating Habits

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