Congress Fights Obesity With Healthcare Bills

Kent Garber

Both the House and Senate bills mandate calorie counts at fast-food restaurants

More than half the adults in Oklahoma, Mississippi, Kentucky, Maryland, Ohio, and South Dakota could be obese. That's just one of many alarming projections in a study released last week by Kenneth Thorpe, chair of Emory University's Department of Health Policy and Management, and it comes, appropriately, as Congress is grappling with how to best reform a healthcare system that is becoming wildly and unsustainably expensive.

By Thorpe's calculations, within a decade, nearly 1 of every 5 dollars spent on healthcare in the United States will be attributable to obesity-related conditions, including diabetes and high blood pressure.

"It's certainly a wake-up call," Thorpe says. "To see you've got six states within 10 years of the majority of the adult population being considered obese--that's a pretty remarkable statistic."

He added, "I think there is a growing recognition that a key driver of rising healthcare costs is the explosion of chronic diseases linked to rising rates of obesity." According to his study, if obesity rates were kept constant, the country could save $200 billion a year by 2018.

But how much attention is Congress paying to obesity's cost in the health bills it is debating? "I think they are moving in the right direction," Thorpe says. "The question is, Is it aggressive and fast enough?"

For the most part, the Democrats' healthcare reform legislation focuses on insurance coverage and insurance reforms. But experts say there are proposals on the table that at least begin to address the obesity problem. In one of the more far-reaching approaches, both the House bill, which passed earlier this month, and Senate Majority Leader Harry Reid's bill, released last week, would require fast-food chains and many restaurants to put calorie labels on their menus and displays.

It's a concept that's been tried out on a smaller scale with some success, most notably in New York City. According to a study released last month by the city's health department, customers who saw the labels at places like McDonald's and Starbucks consumed 106 fewer calories than people who didn't see the signs.

The menu labels are "an important first step toward educating the public on calories," says Joe Thompson, the surgeon general of Arkansas and director of the Robert Wood Johnson Foundation's Center to Prevent Childhood Obesity. "Most people don't know how many calories they are consuming when they order something off a menu."

Reid's bill also sets aside $25 million for projects aimed at curbing childhood obesity, while the House plan has a pilot program that would award grants to communities for public-health campaigns. And both would give incentives to doctors to spend more time helping patients make healthy lifestyle choices. But many of these programs are still small or poorly funded.

One place where Democrats clearly took a pass was a proposal to impose a federal tax on sodas and sugary drinks. About a dozen states have adopted such taxes, and in poll after poll this summer, voters ranked the soda tax as one of their favorite options for financing healthcare reform. But the tax was vigorously opposed by the powerful beverage lobby, which said that it would adversely affect poor people and would not change consumer behavior. And so it disappeared.

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